Motta Francesco, Stignani Cecilia, Antonello Clara E
Department of Paediatric Orthopaedics, V Buzzi Children's Hospital, Milan, Italy.
J Pediatr Orthop. 2008 Jan-Feb;28(1):91-6. doi: 10.1097/BPO.0b013e31815b4dbc.
The literature shows that intrathecal baclofen (ITB) treatment in patients with cerebral palsy (CP) is able to reduce spasticity. The purpose of this work is to evaluate the motor function of the upper limbs in patients with CP treated with ITB.
A consecutive series of 20 patients with spastic CP (mean age at implant, 11.4 years) implanted with pumps in our center was studied. These patients were classified using the Gross Motor Function Classification System. The patients were followed up over a 12-month period for assessment of the upper limb function with the Melbourne Assessment of Unilateral Upper Limb Function scale.
The data show a reduction of upper limb spasticity in all 20 patients (P < 0.05). The Melbourne scale shows a statistically significant improvement of the total score (P < 0.05) and an improvement of the subskills of range of movement, target accuracy, and fluency. Twenty-five percent of patients showed a clinically significant improvement.
The subjects with CP of different degrees of severity had an improvement in the quality of the upper limb function and showed overall satisfaction with the results achieved. The study also shows the importance of evaluating the quality of upper limb function in children with CP treated with ITB therapy.
文献表明,鞘内注射巴氯芬(ITB)治疗脑瘫(CP)患者可降低痉挛程度。本研究旨在评估接受ITB治疗的CP患者上肢的运动功能。
对在本中心连续植入泵的20例痉挛型CP患者(植入时平均年龄11.4岁)进行研究。这些患者采用粗大运动功能分类系统进行分类。在12个月的随访期内,使用墨尔本单上肢功能评估量表对患者的上肢功能进行评估。
数据显示所有这20例患者的上肢痉挛均减轻(P<0.05)。墨尔本量表显示总分有统计学意义的改善(P<0.05),且运动范围、目标准确性和流畅性等子技能也有改善。25%的患者显示出临床上显著的改善。
不同严重程度的CP患者上肢功能质量得到改善,对所取得的结果总体满意。该研究还表明了评估接受ITB治疗的CP儿童上肢功能质量的重要性。