TY - JOUR
T1 - Intrathecal baclofen for severe spasticity
T2 - A meta-analysis
AU - Creedon, Steven D.
AU - Dijkers, Marcel P.J.M.
AU - Hinderer, Steven R.
N1 - Funding Information:
Preparation of the manuscript was possible in part with financial assistance from the National Institutes of Health, National Center for Medical Rehabilitation Research (Grant HD30355), the National Institute on Disability and Rehabilitation Research (Grant H133N50006), and the Del Harder Rehabilitation Fund. Parts of this paper were presented at the 1996 annual meeting of the American Spinal Injury Association, Seattle, Washington.
PY - 1997/7
Y1 - 1997/7
N2 - In order to evaluate the potential of intrathecal baclofen (IB) for treatment of severe spasticity, we meta-analyzed English-language literature and found that IB significantly reduces spasticity in most cases, reducing the mean Ashworth score from 3.9 to 1.6 (t-test: p ≤ .001) and the mean Penn spasm score from 3.2 to 0.6 (p < .001). No effectiveness differences by age or time since onset were evident; however, persons with cerebral palsy appear to experience less relief than do other diagnostic categories. Although 92% of all cases have a significant reduction in spasticity, a minority (8%) decide against implantation of a pump, and of those implanted, 8% discontinue treatment by one year, resulting in an overall 78% success rate. Dosage creep is about 15% per month, on average. Our conclusion is that lB is effective for treating spasticity but less so than previously, claimed. Quantitative data to evaluate its effect on pain, comfort, and function are largely lacking. Further research on longer term effects, and complications, is necessary.
AB - In order to evaluate the potential of intrathecal baclofen (IB) for treatment of severe spasticity, we meta-analyzed English-language literature and found that IB significantly reduces spasticity in most cases, reducing the mean Ashworth score from 3.9 to 1.6 (t-test: p ≤ .001) and the mean Penn spasm score from 3.2 to 0.6 (p < .001). No effectiveness differences by age or time since onset were evident; however, persons with cerebral palsy appear to experience less relief than do other diagnostic categories. Although 92% of all cases have a significant reduction in spasticity, a minority (8%) decide against implantation of a pump, and of those implanted, 8% discontinue treatment by one year, resulting in an overall 78% success rate. Dosage creep is about 15% per month, on average. Our conclusion is that lB is effective for treating spasticity but less so than previously, claimed. Quantitative data to evaluate its effect on pain, comfort, and function are largely lacking. Further research on longer term effects, and complications, is necessary.
KW - Baclofen
KW - Infusion pumps, implantable
KW - Injections, intrathecal
KW - Meta-analysis
KW - Muscle spasticity
UR - http://www.scopus.com/inward/record.url?scp=0031464578&partnerID=8YFLogxK
U2 - 10.1007/BF02766064
DO - 10.1007/BF02766064
M3 - Article
AN - SCOPUS:0031464578
SN - 1068-9591
VL - 3
SP - 171
EP - 185
JO - International Journal of Rehabilitation and Health
JF - International Journal of Rehabilitation and Health
IS - 3
ER -