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The effect of continuous intrathecal baclofen therapy on ambulatory children with cerebral palsy
Blazej Pruszczynski1, Julieanne Sees2, Robert Hulbert3
1Clinic of Orthopaedics and Paediatric Orthopaedics, Medical University of Lodz, Lodz, Poland.
Insights
Continuous intrathecal baclofen infusion (CITB) improved muscle tone and knee flexion in ambulatory children with cerebral palsy. However, CITB did not enhance gait speed or overall gross motor function.
Area of Science:
- Neurology
- Pediatrics
- Rehabilitation Medicine
Background:
- Cerebral palsy (CP) is a common neurodevelopmental disorder affecting motor function.
- Spastic CP, particularly at Gross Motor Function Classification System (GMFCS) level III, presents significant mobility challenges.
- Continuous intrathecal baclofen infusion (CITB) is a treatment option for severe spasticity.
Observation:
- This retrospective study analyzed 19 ambulatory children with CP undergoing CITB.
- The cohort had a mean age of 12.4 years at treatment initiation and a mean follow-up of 5.1 years.
- Gait analysis was performed with a mean follow-up of 2.8 years.
Findings:
- CITB significantly improved muscle tone and knee flexion at initial contact in children with CP (P<0.05).
- No significant improvements were observed in gait speed or gross motor function following CITB.
- The majority of participants (74%) had a spastic CP diagnosis, and most (58%) were GMFCS level III.
Implications:
- CITB effectively manages spasticity symptoms like muscle tone and knee flexion in ambulatory children with CP.
- Further research is needed to explore strategies for improving gait speed and gross motor function in conjunction with CITB.
- This study highlights the nuanced effects of CITB, emphasizing its role in symptom management rather than global functional recovery.
Abstract:
The effect of a continuous intrathecal infusion of baclofen (CITB) was retrospectively studied in 19 ambulatory children with cerebral palsy (aged 12.4±4.9 years at CITB initiation). The mean clinical follow-up was 5.1±2.4 years and the mean follow-up gait analysis was 2.8±1.9 years. Spastic cerebral palsy diagnosis [14 (74%)] was most frequent. Most patients [11 (58%)] were Gross Motor Function Classification System level III. CITB significantly improved muscle tone and knee flexion at initial contact (P<0.05), but it did not lead to improved gait speed or gross motor function.
