Attainment of personal goals in the first year of intrathecal baclofen treatment in dyskinetic cerebral palsy: a prospective cohort study. Issue 8 (10th April 2023)

• Record Type: Journal Article
• Authors: Bonouvrié, Laura A.; Haberfehlner, Helga; Becher, Jules G.; Vles, Johan S. H.; Vermeulen, R. Jeroen; Buizer, Annemieke I.
• Is Part Of: Disability and rehabilitation. Volume 45:Issue 8(2023)
• Page Start: 1315
• Page End: 1322
• Publication Date: 2023-04-10
• Subjects: Cerebral palsy -- dystonia -- dyskinesia -- injections intrathecal/spinal -- baclofen; People with disabilities -- Periodicals; Rehabilitation -- Periodicals; 617.03
• DOI: 10.1080/09638288.2022.2057600
• Languages: English
• ISSNs: 0963-8288

Abstract

Abstract: Purpose: To assess attainment of individual treatment goals one year after intrathecal baclofen (ITB) pump implantation in individuals with dyskinetic cerebral palsy (CP). Materials and methods: A multi-center prospective cohort study was conducted including 34 non-walking individuals with severe dyskinetic CP, classified as Gross Motor Function Classification System (GMFCS) IV/V, aged 4–24 years, 12 months after pump implantation. The main outcome measure was Goal Attainment Scaling (GAS). Predictors of GAS results were analyzed. Complications were registered systematically. Results: Seventy-one percent of individuals with dyskinetic CP fully achieved one or more treatment goals. One or more treatment goals were partially achieved in 97% of individuals. Two factors were found to be associated with attainment of goals: Dyskinesia Impairment Scale (DIS) score at baseline and the difference in pain score between baseline and follow-up. These two variables explain 30% of the variance in the outcome. Conclusions: Intrathecal baclofen is effective in achieving individual treatment goals in children and young adults with dyskinetic CP after nine to 12 months of ITB treatment. A positive outcome on treatment goals is, for a small part, associated with higher severity of dystonia at baseline and with improvement of pain during treatment. Clinical trial registration number: Dutch Trial Register, number NTR3642. Implications for rehabilitation: Intrathecal baclofen treatment is effective in attainment of personal treatment goals, one year after pump implantation in patients with dyskinetic cerebral palsy. A positive outcome on treatment goals is, for a small part, related to higher severity of dystonia at the start and on improvement of pain during treatment.