Optimizing Physical Assessment in Intrathecal Baclofen Screening Trials for High-Performing Patients With Spastic...

Area of Science:

• Neurology
• Rehabilitation Medicine
• Physical Therapy

Background:

• Intrathecal baclofen (ITB) therapy is a proven treatment for severe spasticity.
• Pre-implantation ITB trials assess efficacy, safety, and patient suitability.
• Standardized physical assessments for ITB trials are not fully established.

Purpose of the Study:

• To identify effective physical assessments for ITB trials in patients with spastic paraparesis.
• To evaluate the utility of various neurological, musculoskeletal, and mobility tests.

Main Methods:

• Included 22 patients with spastic paraplegia undergoing ITB trials.
• Assessed physical functions before and after ITB administration.
• Utilized Modified Ashworth Scale, reflexes, clonus, range of motion, muscle tests, Berg Balance Scale, Timed Up and Go Test (TUG), 10-Meter Walk Test, and step length.

Main Results:

• Modified Ashworth Scale, reflexes, clonus, hip abduction/ankle dorsiflexion ROM, TUG, and step length showed significant changes.
• Manual muscle test, most joint ROMs, and 10-Meter Walk Test did not show significant differences.
• Berg Balance Scale total score was not significant, but one item showed difference.

Conclusions:

• Modified Ashworth Scale, reflexes, TUG, and step length are useful for ITB screening in spastic paraparesis.
• Timed Up and Go Test (TUG) is a reliable, quantitative measure reflecting daily activities, making it suitable for assessing ITB effects.