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Intrathecal baclofen therapy in children: an analysis of individualized goals

Peck Yee Liew1, Kirsty Stewart2, Debra Khan3

  • 1Eastern Health, Melbourne, Vic., Australia.

Developmental Medicine and Child Neurology
|January 20, 2018
PubMed

Insights

Intrathecal baclofen (ITB) therapy significantly improves performance and satisfaction in children with hypertonia. These gains in goal areas like dressing and transfers are evident within six months and sustained long-term.

Area of Science:

  • Pediatric Neurology
  • Rehabilitation Medicine
  • Biomedical Engineering

Background:

  • Intrathecal baclofen (ITB) therapy is used for managing severe hypertonia in children.
  • Patient-reported outcomes are crucial for evaluating treatment effectiveness in pediatric care.
  • Goal-oriented assessments provide personalized measures of functional improvement.

Purpose of the Study:

  • To evaluate the impact of ITB therapy on performance and satisfaction in parent-identified goal areas for pediatric patients.
  • To assess the efficacy of ITB in improving functional outcomes and quality of life in children with hypertonia.

Main Methods:

  • A multicentre national audit was conducted across six Australian pediatric ITB pump implant centers.
  • The Canadian Occupational Performance Measure (COPM) was used to assess performance and satisfaction at baseline, 6 months, and 12 months post-implant.
  • Paediatric patients receiving ITB therapy for the first time between December 2009 and December 2014 were included.

Main Results:

  • Twenty-five children (mean age 11 years 1 month) participated, with 19 diagnosed with cerebral palsy and 22 at GMFCS levels IV-V.
  • Significant improvements in goal performance (p<0.001) and performance satisfaction (p<0.001) were observed at 6 months compared to baseline.
  • These improvements were clinically significant and maintained at the 12-month follow-up.

Conclusions:

  • Intrathecal baclofen therapy leads to clinically significant improvements in performance and satisfaction for pediatric patients with hypertonia.
  • Improvements in functional goals, such as dressing and transfers, are most notable within the first six months of ITB therapy.
  • ITB therapy is an effective intervention for enhancing functional abilities and satisfaction in children with severe hypertonia.
Abstract

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