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Intrathecal Baclofen Therapy Helps Hemiplegic Stroke Patients With Mobility: Presented at NASM
By Lynn Haley
Special to DG News
SAN DIEGO, CA -- August 17, 2001 -- Stroke survivors with spastic hemiplegia show improvement in comfortable walking speed (CWS) following intrathecal baclofen therapy (ITB), according to a study by researchers at The Institute for Rehabilitation and Research at Baylor College of Medicine in Houston, Texas.
Their findings were presented at the 2001 North American Stroke Meeting held here August 15th-18th.
Researchers say that ITB therapy in stroke survivors can result in significant improvement in muscle tone while preserving muscle strength in the uninvolved lower limbs. For some patients, this tone reduction can result in improved ambulation.
Investigators studied four men (ages 42, 47, 48 and 69), and four females (ages 42, 50, 55 and 68). All were stroke survivors who had been treated with other pharmacologic and physical therapies which had failed to provide adequate control of their spasticity.
The patients underwent ITB pump implantation 14 to 55 months following their stroke.
The average time from stroke-onset to pump implantation was approximately 27.8 months. Prior to receiving ITB, all patients had been ambulatory. Patients were then asked to walk a distance of 50 feet in three trials, with CWS being the mean. All were asked to walk at a speed them deemed comfortable.
Results showed that at a mean 9.4 months following pump implantation, the average modified Ashworth Scale (MAS) lower limb muscle scores dropped from 2.22 to 0.54. Normal muscle strength (5/5) was preserved in the uninvolved lower limbs. Functional Independence Measure (FIM) mobility, which measures mobility in areas such as locomotion, sit-to-stand, stand-to-sit, stairs, and community ambulation, improved from an average of 17.8 to 22.5. As well, average timed ambulation for these patients over a distance of 50 feet showed improvement, dropping from 132 to 63.6 seconds.
Researchers concluded that ITB therapy improves CWS as well as certain FIM-mobility in stroke survivors with spastic hemiplegia.
The research was funded by Medtronic, Inc.
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