Eek Meta N, Olsson Kristina, Lindh Karin, Askljung Berit, Påhlman Magnus, Corneliusson Olle, Himmelmann Kate
Regional Rehabilitation Centre, Queen Silvia Children's Hospital, Gothenburg, Sweden.
Department of Neurosurgery, Sahlgrenska University Hospital, Gothenburg, Sweden.
Dev Med Child Neurol. 2018 Jan;60(1):94-99. doi: 10.1111/dmcn.13625. Epub 2017 Nov 17.
To investigate the effect of intrathecal baclofen (ITB) on function and activity in dyskinetic cerebral palsy (CP).
A retrospective cohort study of records from 25 children (15 males, 10 females; mean age 10y 11mo, SD 4y 9mo). Five were classified in Gross Motor Function Classification level IV and 20 in level V. Parents were interviewed about activities in daily life, sitting, communication, pain, sleep, and gross and fine motor function. Differences before and 1 year after ITB were graded as positive, no change, or negative. Assessments of dystonia (using the Barry-Albright Dystonia Scale) and muscle tone (Ashworth Scale) were made. Joint range of motion (ROM) was measured.
Both dystonia and increased muscle tone, present in all participants before ITB, decreased after (p<0.001). Passive ROM was restricted, with no difference after. Parents reported improvements in activities in daily life (p<0.001), sitting (p<0.001), communication (p<0.001), and fine motor function (p=0.013), but no change in gross motor function. Before ITB, pain and disturbed sleep were reported. There was a reduction in pain (p=0.002) and sleep improved (p=0.004) after ITB.
After ITB in individuals with dyskinetic CP, improvements were found in sitting, communication, and fine motor skills. There was a reduction in dystonia and muscle tone, and pain and sleep improved.
Intrathecal baclofen can affect specific aspects of functioning in dyskinetic cerebral palsy. Sitting, communication, and fine motor function improved. Dystonia and spasticity were reduced. Pain was reduced and sleep improved.
探讨鞘内注射巴氯芬（ITB）对运动障碍型脑性瘫痪（CP）功能及活动能力的影响。
对25例儿童（15例男性，10例女性；平均年龄10岁11个月，标准差4岁9个月）的记录进行回顾性队列研究。5例为粗大运动功能分级IV级，20例为V级。就日常生活活动、坐位、沟通、疼痛、睡眠以及粗大和精细运动功能对家长进行访谈。ITB治疗前和治疗1年后的差异分为阳性、无变化或阴性。对肌张力障碍（采用巴里 - 奥尔布赖特肌张力障碍量表）和肌张力（Ashworth量表）进行评估。测量关节活动范围（ROM）。
所有参与者在ITB治疗前均存在肌张力障碍和肌张力增高，治疗后降低（p<0.001）。被动ROM受限，治疗后无差异。家长报告日常生活活动（p<0.001）、坐位（p<0.001）、沟通（p<0.001）和精细运动功能（p=0.013）有所改善，但粗大运动功能无变化。ITB治疗前报告有疼痛和睡眠障碍。ITB治疗后疼痛减轻（p=0.002），睡眠改善（p=0.004）。
运动障碍型CP患者接受ITB治疗后，坐位、沟通和精细运动技能有所改善。肌张力障碍和肌张力降低，疼痛减轻，睡眠改善。
鞘内注射巴氯芬可影响运动障碍型脑性瘫痪功能的特定方面。坐位、沟通和精细运动功能改善。肌张力障碍和痉挛减轻。疼痛减轻，睡眠改善。
