Dose-dependent Changes in Gait Pattern after Intrathecal Baclofen Bolus Injection in Adult Ambulatory Cerebral Palsy −A Case Report−
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Intrathecal baclofen (ITB) therapy has been proven to reduce severe spasticity in cerebral palsy (CP). However, few results reported the objective gait pattern change after ITB bolus injection in adult ambulatory CP. We therefore evaluated observational and kinematic gait patterns at different ITB bolus injection doses. We performed a test trial of 3-day ITB bolus injections at doses of 12.5 μg, 25 μg, and 50 μg in ambulatory CP. We evaluated modified Ashworth scale, visual analogue scale, observational gait scale, and kinematic gait analysis after ITB bolus injection. Intrathecal administration of low-dose baclofen 25 μg was successfully used not only for the treatment of spasticity but also for the treatment of gait disturbance, whereas the higher dose baclofen 50 μg induced foot drop and deteriorated gait pattern. We experienced dose-dependent changes in gait pattern confirmed by the observational and kinematic gait assessments after ITB bolus injection in adult ambulatory CP.
Abstract
Intrathecal baclofen (ITB) therapy has been proven to reduce severe spasticity in cerebral palsy (CP). However, few results reported the objective gait pattern change after ITB bolus injection in adult ambulatory CP. We therefore evaluated observational and kinematic gait patterns at different ITB bolus injection doses. We performed a test trial of 3-day ITB bolus injections at doses of 12.5 μg, 25 μg, and 50 μg in ambulatory CP. We evaluated modified Ashworth scale, visual analogue scale, observational gait scale, and kinematic gait analysis after ITB bolus injection. Intrathecal administration of low-dose baclofen 25 μg was successfully used not only for the treatment of spasticity but also for the treatment of gait disturbance, whereas the higher dose baclofen 50 μg induced foot drop and deteriorated gait pattern. We experienced dose-dependent changes in gait pattern confirmed by the observational and kinematic gait assessments after ITB bolus injection in adult ambulatory CP.
참고문헌 (10)
- Ross SA, "Relationships between spasticity, strength, gait, and the GMFM-66 in persons with spastic diplegia cerebral palsy", Arch Phys Med Rehabil, 88, pp.1114~1120 (2007)
- Lynn AK, "Surgical management of spasticity in persons with cerebral palsy", AAPM&R, 1, pp.834~838 (2009)
- Penn RD, "Continuous intrathecal baclofen for severe spasticity", Lancet, 326, pp.125~127 (1985)
- Walter M, "Intrathecal bacolfen therapy in children with severe spasticity: Outcome and complications", Dev Neurorehabil, 17(6), pp.368~374 (2014)
- Horn TS, "Effect of intrathecal baclofen bolus injection on lower extremity joint range of motion during gait in patients with acquired brain injury", Arch Phys Med Rehabil, 91, pp.30~34 (2010)
- Hoving MA, "Safety and one-year efficacy of intrathecal baclofen therapy in children with intractable spastic cerebral palsy", Eur J Paediatr Neurol, 13, pp.247~256 (2009)
- Boyd RN, "Objective measurement of clinical findings in the use of botulinum toxin type A for the management of children with cerebral palsy", Eur J Neurol, 6(supple 4), pp.S23~S35 (1999)
- Bleyenheuft C, "Experience with external pump trial prior to implantation for intrathecal baclofen in ambulatory patients with spastic cerebral palsy", Clin Neurophysiol, 37, pp.23~28 (2007)
- Pin TW, "Use of intrathecal baclofen therapy in ambulant children and adolescents with spasticity and dystonia of cerebral origin: A systematic review", Dev Med Child Neurol, 53, pp.885~895 (2001)
- Jasmin L, "Analgesia and hyperalgesia from GABA-mediated modulation of the cerebral cortex", Nature, 424, pp.316~320 (2003)
