The effect of intrathecal baclofen treatment on activities of daily life in children and young adults with cerebral palsy and progressive neurological disorders

Eur J Paediatr Neurol. 2016 Jul;20(4):538-44. doi: 10.1016/j.ejpn.2016.02.013. Epub 2016 Mar 3.

Abstract

Introduction: Intrathecal baclofen (ITB) treatment is applied in patients with spastic cerebral palsy (SCP), dystonic cerebral palsy (DCP) and progressive neurological disease (PND). Our aim was to investigate whether ITB treatment has a different effect on activities of daily life (ADL) in these groups.

Method: A retrospective and cross-sectional survey was conducted using a questionnaire to assess the qualitative effect of ITB (Likert scale) on different domains of functioning (mobility, personal care, communication, comfort) and satisfaction with the results. Groups were compared using non-parametric statistics.

Results: Questionnaires were completed for 68 patients (39 SCP, 13 DCP, 16 PND). Satisfaction scores were relatively high in all groups (7-8) and the positive effect on personal care and communication was similar in all groups. The PND group had the shortest follow-up and scored significantly less favourably for the effect on mobility and comfort.

Discussion: This is the first study to show that ITB treatment has similar effects on personal care and communication in stable and progressive neurological disease. The decrease in mobility in the PND group is likely due to the progressive nature of the disease. The different effect on comfort between groups is mainly due to the smaller effect on startles in the PND group.

Keywords: Baclofen; Cerebral palsy; Child; Dystonia; Muscle spasticity; Nervous system diseases.

MeSH terms

  • Activities of Daily Living*
  • Adolescent
  • Adult
  • Baclofen / administration & dosage
  • Baclofen / therapeutic use*
  • Cerebral Palsy / drug therapy*
  • Child
  • Cross-Sectional Studies
  • Female
  • Humans
  • Injections, Spinal
  • Male
  • Muscle Relaxants, Central / administration & dosage
  • Muscle Relaxants, Central / therapeutic use
  • Muscle Spasticity / drug therapy*
  • Nervous System Diseases / drug therapy*
  • Retrospective Studies
  • Young Adult

Substances

  • Muscle Relaxants, Central
  • Baclofen