FUNCTIONAL OUTCOME OF CONTINUOUS INTRATHECAL BACLOFEN PUMP INFUSION IN SPASTICITY
Background and goal of study:
Spasticity is one of the most frequent and incapacitating motor abnormalities present in many patients with neurological disorders. Spasticity assessment requires several scales that allow the identification of its intensity and its influence on functional performance.1,2 Baclofen is used to treat spasticity. When administered intrathecally –continuous intrathecal baclofen pump infusion (CIBPI) - allows a significant reduction of spasticity, with lower doses of the drug minimizing side effects of oral therapy.3 This study aims to assess functional consequences of CIBPI in the treatment of spasticity.
Material and Methods:
After approval by the Ethics Committee an observational retrospective study in patients under treatment in our Chronic Pain Unit with CIBPI took place. Patients with complete records regarding functional assessment of spasticity before and after CIBPI were included. 75 patients were included. Functional assessment of spasticity was performed by the functional scales Ashworth and Penn. Collected data were submitted to a descriptive analysis of the variables and non-parametric tests were performed (Wilcoxon) for comparisons.
Result and Discussion:
From 75 patients analyzed, 62.7% (n = 47) were male and the average age was 45.9 years (range 15 to 75 years). The most common cause of spasticity was stroke (18.8%, n = 14). Scores obtained for both scales were lower after placing the pump (p <0.001 both). Patients with stroke, also presented lower scores in both scales after pump placement (p = 0.001 for the Ashworth scale and p = 0.003 for Penn).
Conclusion:
In this study we conclude that the CIBPI has a positive impact in the treatment of spasticity with reduced frequency of muscle spasms and rigidity.
References:
1 Phys Med Rehabil Clin N Am 2001; 12:733-746. 2 Rev. Neurol 2005; 40:30-33. 3 Sinapse 2003; 2:34-39.

Functional outcome of continuous intrathecal baclofen pump infusion in spasticity