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Long-term therapy with intrathecal baclofen improves quality of life in children with severe spastic cerebral palsy.
Eur J Paediatr Neurol. 2017 May; 21(3):565-569.EJ

Abstract

INTRODUCTION

Children with severe spastic cerebral palsy (CP) are highly limited in daily life activities causing a reduced quality of life (QoL). This is partly due to an increased muscle tone causing pain and contractures. Continuous intrathecal infusion of baclofen (ITB) reduces the spasticity of affected patients. The hypothesis of the present study was that ITB leads to a significant improvement of QoL in non-ambulant children with CP.

PATIENTS AND METHODS

13 patients (10 male, 3 female, mean age 14 years) were included. Mean time between pump implantation and follow-up was 60 months (range, 12-100). QoL was assessed before and after baclofen pump implantation using standardized questionnaires (CP CHILD, KINDL). Spasticity was evaluated using the modified Ashworth Scale (MAS) at the two time points.

RESULTS

QoL evaluated with the CPCHILD questionnaire and the KINDL improved from pre - implantation to follow-up. MAS markedly decreased from 3.8 to 1.7. All interviewed participants indicated that their expectations had been met and that they would choose ITB treatment again.

CONCLUSION

Intrathecal treatment of baclofen is an excellent method for spasticity management in children with severe cerebral palsy. Quality of life sustainably improves, parents' satisfaction is high and the level of spasticity decreases. Therefore, baclofen treatment can be highly recommended in non-ambulant children with CP suffering from spasticity.

Authors+Show Affiliations

Division of Paediatric and Adolescent Orthopaedics, Medical University of Graz, Auenbruggerplatz 34, 8036 Graz, Austria. Electronic address: tanja.kraus@medunigraz.at.Division of Paediatric and Adolescent Orthopaedics, Medical University of Graz, Auenbruggerplatz 34, 8036 Graz, Austria.Division of Paediatric and Adolescent Orthopaedics, Medical University of Graz, Auenbruggerplatz 34, 8036 Graz, Austria.Division of Paediatric and Adolescent Orthopaedics, Medical University of Graz, Auenbruggerplatz 34, 8036 Graz, Austria.Division of Paediatric and Adolescent Orthopaedics, Medical University of Graz, Auenbruggerplatz 34, 8036 Graz, Austria.Department of Paediatric and Adolescent Surgery, Medical University of Graz, Graz, Austria.

Pub Type(s)

Clinical Trial
Journal Article

Language

eng

PubMed ID

28237420

Citation

Kraus, Tanja, et al. "Long-term Therapy With Intrathecal Baclofen Improves Quality of Life in Children With Severe Spastic Cerebral Palsy." European Journal of Paediatric Neurology : EJPN : Official Journal of the European Paediatric Neurology Society, vol. 21, no. 3, 2017, pp. 565-569.
Kraus T, Gegenleitner K, Svehlik M, et al. Long-term therapy with intrathecal baclofen improves quality of life in children with severe spastic cerebral palsy. Eur J Paediatr Neurol. 2017;21(3):565-569.
Kraus, T., Gegenleitner, K., Svehlik, M., Novak, M., Steinwender, G., & Singer, G. (2017). Long-term therapy with intrathecal baclofen improves quality of life in children with severe spastic cerebral palsy. European Journal of Paediatric Neurology : EJPN : Official Journal of the European Paediatric Neurology Society, 21(3), 565-569. https://doi.org/10.1016/j.ejpn.2017.01.016
Kraus T, et al. Long-term Therapy With Intrathecal Baclofen Improves Quality of Life in Children With Severe Spastic Cerebral Palsy. Eur J Paediatr Neurol. 2017;21(3):565-569. PubMed PMID: 28237420.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Long-term therapy with intrathecal baclofen improves quality of life in children with severe spastic cerebral palsy. AU - Kraus,Tanja, AU - Gegenleitner,Kathrin, AU - Svehlik,Martin, AU - Novak,Michael, AU - Steinwender,Gerhardt, AU - Singer,Georg, Y1 - 2017/02/11/ PY - 2016/08/18/received PY - 2017/01/28/revised PY - 2017/01/30/accepted PY - 2017/2/27/pubmed PY - 2017/12/22/medline PY - 2017/2/27/entrez KW - Cerebral palsy KW - Child KW - Intrathecal baclofen KW - Spasticity SP - 565 EP - 569 JF - European journal of paediatric neurology : EJPN : official journal of the European Paediatric Neurology Society JO - Eur. J. Paediatr. Neurol. VL - 21 IS - 3 N2 - INTRODUCTION: Children with severe spastic cerebral palsy (CP) are highly limited in daily life activities causing a reduced quality of life (QoL). This is partly due to an increased muscle tone causing pain and contractures. Continuous intrathecal infusion of baclofen (ITB) reduces the spasticity of affected patients. The hypothesis of the present study was that ITB leads to a significant improvement of QoL in non-ambulant children with CP. PATIENTS AND METHODS: 13 patients (10 male, 3 female, mean age 14 years) were included. Mean time between pump implantation and follow-up was 60 months (range, 12-100). QoL was assessed before and after baclofen pump implantation using standardized questionnaires (CP CHILD, KINDL). Spasticity was evaluated using the modified Ashworth Scale (MAS) at the two time points. RESULTS: QoL evaluated with the CPCHILD questionnaire and the KINDL improved from pre - implantation to follow-up. MAS markedly decreased from 3.8 to 1.7. All interviewed participants indicated that their expectations had been met and that they would choose ITB treatment again. CONCLUSION: Intrathecal treatment of baclofen is an excellent method for spasticity management in children with severe cerebral palsy. Quality of life sustainably improves, parents' satisfaction is high and the level of spasticity decreases. Therefore, baclofen treatment can be highly recommended in non-ambulant children with CP suffering from spasticity. SN - 1532-2130 UR - https://www.unboundmedicine.com/medline/citation/28237420/Long_term_therapy_with_intrathecal_baclofen_improves_quality_of_life_in_children_with_severe_spastic_cerebral_palsy_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1090-3798(17)30098-3 DB - PRIME DP - Unbound Medicine ER -