Five-Year Retrospective Cohort Study of Changes in the International Classification of Functioning, Disability and
Anna Bruna Ronchetti1, Giulia Biasotti2, Angela Pistorio3
1From the Physical Medicine and Rehabilitation Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy.
Insights
Continuous intrathecal baclofen (cITB) therapy significantly improved spasticity, pain, and function in children with cerebral palsy over five years. This treatment offers long-term benefits for children with severe mobility impairments.
Area of Science:
- Neurology
- Pediatrics
- Rehabilitation Medicine
Background:
- Intractable spasticity in children with cerebral palsy (CP) significantly impacts function and quality of life.
- Conventional treatments often provide limited long-term relief for severe spasticity.
- The International Classification of Functioning, Disability and Health of Children and Youth (ICF-CY) provides a comprehensive framework for assessing treatment outcomes.
Purpose of the Study:
- To compare the 5-year outcomes of continuous intrathecal baclofen (cITB) therapy versus conventional treatment for intractable spasticity in children with CP.
- To evaluate the long-term efficacy of cITB using ICF-CY criteria.
Main Methods:
- A 5-year single-center retrospective cohort study analyzing ICF-CY data.
- 24 pediatric patients with CP (GMFCS levels IV-V) were included.
- 12 patients received cITB, while 12 received conventional treatment.
Main Results:
- The cITB group showed sustained improvements in spasticity, pain, and BMI z-scores over 12 months and 5 years.
- Continuous baclofen administration (max 140 μg/d at 2000 μg/mL) was effective.
- The cITB group demonstrated significant benefits in Structure and Function, Autonomy, and Participation compared to the control group.
Conclusions:
- cITB therapy offers significant short-term and long-term improvements in functioning and participation for children with severe CP.
- cITB is a highly effective treatment for intractable spasticity, particularly in patients with greater initial pain and hypertonia.
- Long-term ICF-CY data collection is crucial for personalized treatment and comparative research in pediatric CP management.
Objective:
This study aims to compare the long-term results of continuous intrathecal baclofen therapy rehabilitation against those of conventional treatment for intractable spasticity in children with cerebral palsy using the International Classification of Functioning, Disability and Health of Children and Youth.
Design:
This is a 5-yr single-center retrospective cohort study.
Results:
The International Classification of Functioning, Disability and Health of Children and Youth data from 24 patients with cerebral palsy of Gross Motor Function Classification System levels IV-V (aged between 8 and 18 yrs) were retrospectively analyzed for 5 yrs. The results show different trends between the 12 patients who received continuous intrathecal baclofen therapy and the 12 who were excluded because of contraindications.The continuous intrathecal baclofen therapy group improved spasticity, pain, and body mass index z-scores over 12 mos and during the 5-yr follow-up with a continuous simple Baclofen administration at a maximum of 140 μg/d at a concentration of 2000 μg/mL.
Conclusions:
Continuous intrathecal baclofen therapy improves structure and function, autonomy, and participation in both short and long term. Overall, the continuous intrathecal baclofen therapy group, with its characteristics of initially greater pain and hypertonia, benefited significantly from the efficacy of intrathecal Baclofen treatment compared with the control group, which continued to receive conventional treatment.The International Classification of Functioning, Disability and Health of Children and Youth outcome measures demonstrated an interrelationship between spasticity and weakness and disease progression over childhood to adolescence.Follow-up will be vital for effective personalized treatment, quality of life, and research.Long-term International Classification of Functioning, Disability and Health of Children and Youth data collection is key to comparing treatment outcomes.
More Related Videos
Related Concept Videos
02:20Longitudinal Research
01:21Cerebrospinal Fluid
CSF Production
CSF is produced mainly in the choroid plexus, a network of capillaries and ependymal cells located within the ventricular system of the brain.
01:26Longitudinal Studies