TY - JOUR
T1 - Prospective 12-month study of intrathecal baclofen therapy for poststroke spastic upper and lower extremity motor control and functional improvement
AU - Schiess, Mya C.
AU - Oh, Irene J.
AU - Stimming, Erin F.
AU - Lucke, Joseph
AU - Acosta, Fernando
AU - Fisher, Stanley
AU - Simpson, Richard K.
PY - 2011/1/1
Y1 - 2011/1/1
N2 - Objectives: To assess the effects of intrathecal baclofen (ITB) therapy for the treatment of poststroke spastic hemiparesis on quality of life, functional independence, and upper, lower extremity (UE, LE) motor functions. Materials and Methods: Prospective observational study of adult men and women with a minimum 6-month stroke-related spastic hemiparesis graded as ≥2 in UE and LE on Modified Ashworth Scale (MAS). Patients served as their own controls with measures compared pre-implant with 12 months post ITB including: MAS, manual muscle test (MMT), gait distance/velocity, Functional Independence Measures (FIM), stroke-specific quality of life scale (SSQL), and upper extremity manual activity log. Results: After 12-month ITB therapy, 26 patients (poststroke = 6.4 ± 9 years) demonstrated 1) reduced MAS/increased MMT for most LE muscle groups (pa≤ 0.0001); 2) reduced MAS/increased MMT most UE muscle groups (pa;circ 0.01); 3) FIM scores improved (pa≤ 0.05) except bed mobility and lower body dressing; 4) gait distance and velocity improved (pa;circ 0.05); 5) SSQL domains of family roles, mobility, personality, self-care, social roles, thinking, UE function, and work/productivity improved (pa≤ 0.05); 6) amount of use and quality of movement of the spastic UE in performing common activities of daily living increased (p < 0.0001). Conclusions: Regardless of duration of spastic hemiparesis, a reduction in tone with ITB therapy facilitates motor strength improvement and is associated with clinically significant improvements in functional independence and quality of life.
AB - Objectives: To assess the effects of intrathecal baclofen (ITB) therapy for the treatment of poststroke spastic hemiparesis on quality of life, functional independence, and upper, lower extremity (UE, LE) motor functions. Materials and Methods: Prospective observational study of adult men and women with a minimum 6-month stroke-related spastic hemiparesis graded as ≥2 in UE and LE on Modified Ashworth Scale (MAS). Patients served as their own controls with measures compared pre-implant with 12 months post ITB including: MAS, manual muscle test (MMT), gait distance/velocity, Functional Independence Measures (FIM), stroke-specific quality of life scale (SSQL), and upper extremity manual activity log. Results: After 12-month ITB therapy, 26 patients (poststroke = 6.4 ± 9 years) demonstrated 1) reduced MAS/increased MMT for most LE muscle groups (pa≤ 0.0001); 2) reduced MAS/increased MMT most UE muscle groups (pa;circ 0.01); 3) FIM scores improved (pa≤ 0.05) except bed mobility and lower body dressing; 4) gait distance and velocity improved (pa;circ 0.05); 5) SSQL domains of family roles, mobility, personality, self-care, social roles, thinking, UE function, and work/productivity improved (pa≤ 0.05); 6) amount of use and quality of movement of the spastic UE in performing common activities of daily living increased (p < 0.0001). Conclusions: Regardless of duration of spastic hemiparesis, a reduction in tone with ITB therapy facilitates motor strength improvement and is associated with clinically significant improvements in functional independence and quality of life.
KW - Baclofen
KW - functional independence
KW - hemiparesis
KW - intrathecal
KW - quality of life
KW - spasticity
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U2 - 10.1111/j.1525-1403.2010.00308.x
DO - 10.1111/j.1525-1403.2010.00308.x
M3 - Article
C2 - 21992161
AN - SCOPUS:79251553731
SN - 1094-7159
VL - 14
SP - 38
EP - 45
JO - Neuromodulation
JF - Neuromodulation
IS - 1
ER -