Krach Linda E, Kriel Robert L, Gilmartin Richard C, Swift Dale M, Storrs Bruce B, Abbott Rick, Ward John D, Bloom Karen K, Brooks William H, Madsen Joseph R, McLaughlin John F, Nadell Joseph M
Pediatric Rehabilitation Medicine at Gillette Children's Specialty Healthcare, St Paul, MN, USA.
Pediatr Rehabil. 2005 Jul-Sep;8(3):207-13. doi: 10.1080/13638490400021479.
The purpose of this study was to assess whether there is an improvement in motor function in persons with cerebral palsy (CP) who have had a reduction of muscle tone by continuous intrathecal baclofen infusion. This was a prospective, open label, non-blinded case series without a control group, conducted at multiple centres. There were 31 subjects, aged 4-29 years. All had a pre-treatment mean lower extremity Ashworth scores of >or= 3 and a significant reduction in tone after a bolus injection of intrathecal baclofen (ITB) and received an implanted pump for continuous delivery of ITB. Motor function was assessed by the Gross Motor Function Measure (GMFM) prior to and 1 year following pump implantation. Significant improvement (p < 0.05) in mean GMFM scores was seen in subjects < 8 years (mean change 4.1) and in those from 8-18 years (mean change 3.7) and in subjects with CP Classes 2 and 5 (mean changes 6.2 and 2.9). There was a statistically significant decrease (p < 0.05) in Ashworth scores in CP classes 2-5. Subjects or their caregivers that completed a survey about perceived changes stated that motor control, positioning and endurance improved.
本研究的目的是评估通过持续鞘内注射巴氯芬降低肌张力的脑瘫(CP)患者的运动功能是否有所改善。这是一项在多个中心进行的前瞻性、开放标签、非盲法病例系列研究,无对照组。共有31名年龄在4至29岁之间的受试者。所有受试者治疗前下肢Ashworth评分均值≥3,鞘内注射巴氯芬(ITB)推注后肌张力显著降低,并接受了植入式泵以持续输注ITB。在植入泵之前和之后1年,通过粗大运动功能测量(GMFM)评估运动功能。年龄<8岁的受试者(平均变化4.1)、8至18岁的受试者(平均变化3.7)以及CP 2级和5级的受试者(平均变化6.2和2.9)的GMFM评分均值有显著改善(p<0.05)。CP 2至5级的Ashworth评分有统计学意义的下降(p<0.05)。完成关于感知变化调查的受试者或其护理人员表示,运动控制、体位和耐力有所改善。