Article

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.
CI - (c) 2017 Mac Keith Press.

Langue : ANGLAIS