Improvement in walking speed in poststroke spastic hemiplegia after intrathecal baclofen therapy: a preliminary study.

Abstract

OBJECTIVE:

To explore whether intrathecal baclofen (ITB) therapy improves ambulation in stroke survivors.

DESIGN:

Case series.

SETTING:

Tertiary care center.

PARTICIPANTS:

Ten adults with poststroke hemiparesis who were ambulatory at the time of pump implantation.

INTERVENTIONS:

Implantation of ITB pump after inadequate control of spasticity with other interventions. Time from stroke onset to implantation averaged 28.6 months (range, 9-55mo).

MAIN OUTCOME MEASURES:

Customary walking speed was measured from the time required to walk 50ft (15m) at a self-selected pace. Evaluators rated spastic hypertonia and functional mobility.

RESULTS:

Statistically significant improvements occurred in walking speed, functional mobility ratings, and spasticity (P<.05) at a follow-up interval that averaged 8.9 months. Mean walking speed over 50ft improved from 36.6 to 52cm/s. Mean Modified Ashworth Scale scores in the muscles of the affected lower limb improved from 2.0 to 0.4. Normal muscle strength (5/5) was preserved in the unaffected limbs.

CONCLUSIONS:

This preliminary study suggests that ITB therapy, in combination with physical therapy, may improve walking speed and functional mobility in ambulatory individuals with poststroke spastic hemiplegia.

• Authors: Gerard E Francisco, Corwin Boake
• Journal: Archives of physical medicine and rehabilitation (Arch Phys Med Rehabil) Vol. 84 Issue 8 Pg. 1194-9 (Aug 2003) ISSN: 0003-9993 [Print] United States
• PMID: 12917859 (Publication Type: Clinical Trial, Comparative Study, Journal Article)

Chemical References

• Muscle Relaxants, Central
• Baclofen

Topics

• Adult
• Aged
• Baclofen (administration & dosage, adverse effects)
• Female
• Hemiplegia (drug therapy, etiology, rehabilitation)
• Humans
• Infusion Pumps, Implantable
• Injections, Spinal (methods)
• Male
• Middle Aged
• Muscle Relaxants, Central (administration & dosage, adverse effects)
• Muscle Spasticity (drug therapy, etiology, rehabilitation)
• Severity of Illness Index
• Stroke (complications)
• Stroke Rehabilitation
• Treatment Outcome
• Walking (physiology)