Affiliations: Department of Orthopaedic Surgery, Wake Forest
University School of Medicine, Winston-Salem, NC, USA
Note: [] Address for correspondence: Jeffrey S. Shilt, Associate
Professor, Department of Orthopaedic Surgery, Wake Forest University School of
Medicine, Medical Center Blvd., Winston-Salem, NC 27157, USA. Tel.: +1 336 716
3949; Fax: +1 336 716 6286; E-mail: jshilt@aol.com
Abstract: The purpose of this study is to report the short-term outcome of
intrathecal baclofen therapy on the function of individuals with diplegic
cerebral palsy (CP) and the health-related quality of life (HRQL) of their
caregivers. Eight pediatric patients with spastic diplegia were treated with
ITB following failed oral spasticity management and were followed for a minimum
of 2 years. Physical and functional outcomes were assessed using Ashworth
Scores (AS), Physician Rating Scale (PRS), and a subset of the Functional
Independence Measure for children (WeeFIM). HRQL was assessed using SF-36,
CES-D short form, Impact on Family Scale, Life Orientation Test, Rand Social
Support Scale, and Social Desirability Scale. At final follow-up, AS was
significantly reduced (all p ⩽ 0.03). The PRS scale
showed statistically significant improvement in four out of six subscales:
median gait pattern (p = 0.05), median hind foot strike
(p = 0.03), median knee position (p = 0.03)
and median hind foot gait (p = 0.05). The WeeFIM score
improved significantly with a mean increase of 32% (p = 0.03). ITB therapy
significantly reduced spasticity and improved the function of these eight
children with diplegic CP. HRQL of the parents or the caregivers remained
stable despite the surgical intervention and follow-up visits required for pump
refills.
Keywords: Cerebral palsy, diplegia, intrathecal baclofen, health-related quality of life, function
