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Intrathecal baclofen in dyskinetic cerebral palsy: effects on function and activity.
Dev Med Child Neurol. 2018 01; 60(1):94-99.DM

Abstract

AIM

To investigate the effect of intrathecal baclofen (ITB) on function and activity in dyskinetic cerebral palsy (CP).

METHOD

A retrospective cohort study of records from 25 children (15 males, 10 females; mean age 10y 11mo, SD 4y 9mo). Five were classified in Gross Motor Function Classification level IV and 20 in level V. Parents were interviewed about activities in daily life, sitting, communication, pain, sleep, and gross and fine motor function. Differences before and 1 year after ITB were graded as positive, no change, or negative. Assessments of dystonia (using the Barry-Albright Dystonia Scale) and muscle tone (Ashworth Scale) were made. Joint range of motion (ROM) was measured.

RESULTS

Both dystonia and increased muscle tone, present in all participants before ITB, decreased after (p<0.001). Passive ROM was restricted, with no difference after. Parents reported improvements in activities in daily life (p<0.001), sitting (p<0.001), communication (p<0.001), and fine motor function (p=0.013), but no change in gross motor function. Before ITB, pain and disturbed sleep were reported. There was a reduction in pain (p=0.002) and sleep improved (p=0.004) after ITB.

INTERPRETATION

After ITB in individuals with dyskinetic CP, improvements were found in sitting, communication, and fine motor skills. There was a reduction in dystonia and muscle tone, and pain and sleep improved.

WHAT THIS PAPER ADDS

Intrathecal baclofen can affect specific aspects of functioning in dyskinetic cerebral palsy. Sitting, communication, and fine motor function improved. Dystonia and spasticity were reduced. Pain was reduced and sleep improved.

Authors+Show Affiliations

Regional Rehabilitation Centre, Queen Silvia Children's Hospital, Gothenburg, Sweden.Regional Rehabilitation Centre, Queen Silvia Children's Hospital, Gothenburg, Sweden.Regional Rehabilitation Centre, Queen Silvia Children's Hospital, Gothenburg, Sweden.Regional Rehabilitation Centre, Queen Silvia Children's Hospital, Gothenburg, Sweden.Regional Rehabilitation Centre, Queen Silvia Children's Hospital, Gothenburg, Sweden.Department of Neurosurgery, Sahlgrenska University Hospital, Gothenburg, Sweden.Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

29148568

Citation

Eek, Meta N., et al. "Intrathecal Baclofen in Dyskinetic Cerebral Palsy: Effects On Function and Activity." Developmental Medicine and Child Neurology, vol. 60, no. 1, 2018, pp. 94-99.
Eek MN, Olsson K, Lindh K, et al. Intrathecal baclofen in dyskinetic cerebral palsy: effects on function and activity. Dev Med Child Neurol. 2018;60(1):94-99.
Eek, M. N., Olsson, K., Lindh, K., Askljung, B., Påhlman, M., Corneliusson, O., & Himmelmann, K. (2018). Intrathecal baclofen in dyskinetic cerebral palsy: effects on function and activity. Developmental Medicine and Child Neurology, 60(1), 94-99. https://doi.org/10.1111/dmcn.13625
Eek MN, et al. Intrathecal Baclofen in Dyskinetic Cerebral Palsy: Effects On Function and Activity. Dev Med Child Neurol. 2018;60(1):94-99. PubMed PMID: 29148568.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Intrathecal baclofen in dyskinetic cerebral palsy: effects on function and activity. AU - Eek,Meta N, AU - Olsson,Kristina, AU - Lindh,Karin, AU - Askljung,Berit, AU - Påhlman,Magnus, AU - Corneliusson,Olle, AU - Himmelmann,Kate, Y1 - 2017/11/17/ PY - 2017/10/11/accepted PY - 2017/11/18/pubmed PY - 2017/12/28/medline PY - 2017/11/18/entrez SP - 94 EP - 99 JF - Developmental medicine and child neurology JO - Dev Med Child Neurol VL - 60 IS - 1 N2 - AIM: To investigate the effect of intrathecal baclofen (ITB) on function and activity in dyskinetic cerebral palsy (CP). METHOD: A retrospective cohort study of records from 25 children (15 males, 10 females; mean age 10y 11mo, SD 4y 9mo). Five were classified in Gross Motor Function Classification level IV and 20 in level V. Parents were interviewed about activities in daily life, sitting, communication, pain, sleep, and gross and fine motor function. Differences before and 1 year after ITB were graded as positive, no change, or negative. Assessments of dystonia (using the Barry-Albright Dystonia Scale) and muscle tone (Ashworth Scale) were made. Joint range of motion (ROM) was measured. RESULTS: Both dystonia and increased muscle tone, present in all participants before ITB, decreased after (p<0.001). Passive ROM was restricted, with no difference after. Parents reported improvements in activities in daily life (p<0.001), sitting (p<0.001), communication (p<0.001), and fine motor function (p=0.013), but no change in gross motor function. Before ITB, pain and disturbed sleep were reported. There was a reduction in pain (p=0.002) and sleep improved (p=0.004) after ITB. INTERPRETATION: After ITB in individuals with dyskinetic CP, improvements were found in sitting, communication, and fine motor skills. There was a reduction in dystonia and muscle tone, and pain and sleep improved. WHAT THIS PAPER ADDS: Intrathecal baclofen can affect specific aspects of functioning in dyskinetic cerebral palsy. Sitting, communication, and fine motor function improved. Dystonia and spasticity were reduced. Pain was reduced and sleep improved. SN - 1469-8749 UR - https://www.unboundmedicine.com/medline/citation/29148568/Intrathecal_baclofen_in_dyskinetic_cerebral_palsy:_effects_on_function_and_activity_ L2 - https://doi.org/10.1111/dmcn.13625 DB - PRIME DP - Unbound Medicine ER -