Article

OBJECTIVE: To report outcomes of intrathecal baclofen (ITB) therapy for
spasticity management in a cohort of patients who had received this treatment for
at least 10 years. DESIGN: A cross-sectional survey and retrospective chart
review. SETTING: An academic rehabilitation outpatient clinic. PARTICIPANTS:
Adult patients with spasticity treated with ITB for at least 10 years. MAIN
OUTCOME MEASUREMENTS: Surveys included the Brief Pain Inventory, Penn Spasm
Frequency Scale, Epworth Sleepiness Scale, Fatigue Severity Scale, Diener
Satisfaction with Life, Life Satisfaction Questionnaire, and Intrathecal Baclofen
Survey. RESULTS: Twenty-four subjects completed the surveys. The subjects had
been treated with ITB from 10.0-28.4 years, with a mean (standard deviation) of
14.7 +/- 4.2 years. The mean (standard deviation) dose of ITB was 627.9 +/- 306.7
mug/d, with only 6 subjects averaging daily dose changes of more than 10%
compared with 3 years earlier. The mean (standard deviation) scores on outcomes
surveys were the following: 2.6 +/- 2.3 for pain severity on the Brief Pain
Inventory, 1.4 +/- 0.7 for spasm severity on the Penn Spasm Frequency Scale, 7.9
+/- 5.4 on the Epworth Sleepiness Scale, 4.1 +/- 1.6 on the Fatigue Severity
Scale, 19.4 +/- 8.1 on the Diener Satisfaction with Life, 3.9 +/- 0.9 on the Life
Satisfaction Questionnaire, and 8.8 +/- 1.9 for overall satisfaction with ITB on
the Intrathecal Baclofen Survey. On the Brief Pain Inventory, the mean scores for
pain severity and interference of pain with life showed moderate inverse
correlations with ITB dose (r = -0.386, P = .115; and r = -0.447, P = .062,
respectively). On the Life Satisfaction Questionnaire, the mean scores for life
satisfaction showed statistically significant positive correlation with ITB dose
(r = 0.549, P = .021). CONCLUSIONS: The subjects reported low levels of pain,
moderate levels of life satisfaction, normal levels of sleepiness,
low-to-moderate levels of fatigue, infrequent spasms at mild-to-moderate
severity, and high levels of satisfaction. The efficacy and favorable adverse
effect profile of ITB therapy was sustained in this cohort of subjects with more
than a decade of treatment.
CI - Copyright (c) 2014 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS