Intrathecal Baclofen Management of Poststroke Spastic Hypertonia

Implications for Function and Quality of Life

Cindy B. Ivanhoe, Gerard E. Francisco, John R. McGuire, Thyagarajan Subramanian, Samuel P. Grissom

Research output: Contribution to journalArticle

50 Citations (Scopus)

Abstract

Ivanhoe CB, Francisco GE, McGuire JR, Subramanian T, Grissom SP. Intrathecal baclofen management of poststroke spastic hypertonia: implications for function and quality of life. Objectives: To evaluate the impact of intrathecal baclofen (ITB) on function and quality of life (QOL) and to obtain efficacy and safety data in poststroke spastic hypertonia. Design: Prospective open-label multicenter trial with follow-up at 3 and 12 months. Setting: Twenty-four stroke treatment centers in the United States. Participants: Ninety-four stroke participants (age range, 24-82y) with spastic hypertonia. Seventy-four participants underwent ITB pump implantation. Intervention: Participants were implanted with an ITB pump. Main Outcome Measures: FIM instrument and QOL (Sickness Impact Profile [SIP]) changes, spastic hypertonia (Ashworth Scale), and safety. Results: FIM scores improved overall in repeated-measures analysis of variance (ANOVA) (P=.005) and by 3.00±7.69 (P=.001) at 3 months and by 2.86±10.13 (P=.017) at 12 months. Significant improvements in SIP scores were noted overall (repeated-measures ANOVA, P<.001) and at 3 (P=.003) and 12 months (P<.001). The combined average Ashworth Scale score of the upper and lower limbs decreased by 1.27±0.76 (P<.001) at 3 months and by 1.39±0.73 (P<.001) at 12 months from baseline, which was significant overall (repeated-measures ANOVA, P<.001). Strength in the unaffected side did not change overall (repeated-measures ANOVA, P=.321) or at either 3 (P=.553) or 12 months (P=.462). Minimal adverse events and device complications were reported. Conclusions: There was significant improvement in function, QOL, and spastic hypertonia at 3 and 12 months after implant, without adversely affecting muscle strength of the unaffected limbs. Data suggest that ITB therapy is a safe and efficacious treatment for spastic hypertonia resulting from stroke.

Original languageEnglish (US)
Pages (from-to)1509-1515
Number of pages7
JournalArchives of Physical Medicine and Rehabilitation
Volume87
Issue number11
DOIs
StatePublished - Nov 1 2006

Fingerprint

Baclofen
Muscle Spasticity
Quality of Life
Analysis of Variance
Sickness Impact Profile
Stroke
Safety
Muscle Strength
Multicenter Studies
Lower Extremity
Extremities
Outcome Assessment (Health Care)
Equipment and Supplies

All Science Journal Classification (ASJC) codes

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation

Cite this

Ivanhoe, Cindy B. ; Francisco, Gerard E. ; McGuire, John R. ; Subramanian, Thyagarajan ; Grissom, Samuel P. / Intrathecal Baclofen Management of Poststroke Spastic Hypertonia : Implications for Function and Quality of Life. In: Archives of Physical Medicine and Rehabilitation. 2006 ; Vol. 87, No. 11. pp. 1509-1515.
@article{023554d4d0544fe0998b6ee90e970b70,
title = "Intrathecal Baclofen Management of Poststroke Spastic Hypertonia: Implications for Function and Quality of Life",
abstract = "Ivanhoe CB, Francisco GE, McGuire JR, Subramanian T, Grissom SP. Intrathecal baclofen management of poststroke spastic hypertonia: implications for function and quality of life. Objectives: To evaluate the impact of intrathecal baclofen (ITB) on function and quality of life (QOL) and to obtain efficacy and safety data in poststroke spastic hypertonia. Design: Prospective open-label multicenter trial with follow-up at 3 and 12 months. Setting: Twenty-four stroke treatment centers in the United States. Participants: Ninety-four stroke participants (age range, 24-82y) with spastic hypertonia. Seventy-four participants underwent ITB pump implantation. Intervention: Participants were implanted with an ITB pump. Main Outcome Measures: FIM instrument and QOL (Sickness Impact Profile [SIP]) changes, spastic hypertonia (Ashworth Scale), and safety. Results: FIM scores improved overall in repeated-measures analysis of variance (ANOVA) (P=.005) and by 3.00±7.69 (P=.001) at 3 months and by 2.86±10.13 (P=.017) at 12 months. Significant improvements in SIP scores were noted overall (repeated-measures ANOVA, P<.001) and at 3 (P=.003) and 12 months (P<.001). The combined average Ashworth Scale score of the upper and lower limbs decreased by 1.27±0.76 (P<.001) at 3 months and by 1.39±0.73 (P<.001) at 12 months from baseline, which was significant overall (repeated-measures ANOVA, P<.001). Strength in the unaffected side did not change overall (repeated-measures ANOVA, P=.321) or at either 3 (P=.553) or 12 months (P=.462). Minimal adverse events and device complications were reported. Conclusions: There was significant improvement in function, QOL, and spastic hypertonia at 3 and 12 months after implant, without adversely affecting muscle strength of the unaffected limbs. Data suggest that ITB therapy is a safe and efficacious treatment for spastic hypertonia resulting from stroke.",
author = "Ivanhoe, {Cindy B.} and Francisco, {Gerard E.} and McGuire, {John R.} and Thyagarajan Subramanian and Grissom, {Samuel P.}",
year = "2006",
month = "11",
day = "1",
doi = "10.1016/j.apmr.2006.08.323",
language = "English (US)",
volume = "87",
pages = "1509--1515",
journal = "Archives of Physical Medicine and Rehabilitation",
issn = "0003-9993",
publisher = "W.B. Saunders Ltd",
number = "11",

}

Intrathecal Baclofen Management of Poststroke Spastic Hypertonia : Implications for Function and Quality of Life. / Ivanhoe, Cindy B.; Francisco, Gerard E.; McGuire, John R.; Subramanian, Thyagarajan; Grissom, Samuel P.

In: Archives of Physical Medicine and Rehabilitation, Vol. 87, No. 11, 01.11.2006, p. 1509-1515.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Intrathecal Baclofen Management of Poststroke Spastic Hypertonia

T2 - Implications for Function and Quality of Life

AU - Ivanhoe, Cindy B.

AU - Francisco, Gerard E.

AU - McGuire, John R.

AU - Subramanian, Thyagarajan

AU - Grissom, Samuel P.

PY - 2006/11/1

Y1 - 2006/11/1

N2 - Ivanhoe CB, Francisco GE, McGuire JR, Subramanian T, Grissom SP. Intrathecal baclofen management of poststroke spastic hypertonia: implications for function and quality of life. Objectives: To evaluate the impact of intrathecal baclofen (ITB) on function and quality of life (QOL) and to obtain efficacy and safety data in poststroke spastic hypertonia. Design: Prospective open-label multicenter trial with follow-up at 3 and 12 months. Setting: Twenty-four stroke treatment centers in the United States. Participants: Ninety-four stroke participants (age range, 24-82y) with spastic hypertonia. Seventy-four participants underwent ITB pump implantation. Intervention: Participants were implanted with an ITB pump. Main Outcome Measures: FIM instrument and QOL (Sickness Impact Profile [SIP]) changes, spastic hypertonia (Ashworth Scale), and safety. Results: FIM scores improved overall in repeated-measures analysis of variance (ANOVA) (P=.005) and by 3.00±7.69 (P=.001) at 3 months and by 2.86±10.13 (P=.017) at 12 months. Significant improvements in SIP scores were noted overall (repeated-measures ANOVA, P<.001) and at 3 (P=.003) and 12 months (P<.001). The combined average Ashworth Scale score of the upper and lower limbs decreased by 1.27±0.76 (P<.001) at 3 months and by 1.39±0.73 (P<.001) at 12 months from baseline, which was significant overall (repeated-measures ANOVA, P<.001). Strength in the unaffected side did not change overall (repeated-measures ANOVA, P=.321) or at either 3 (P=.553) or 12 months (P=.462). Minimal adverse events and device complications were reported. Conclusions: There was significant improvement in function, QOL, and spastic hypertonia at 3 and 12 months after implant, without adversely affecting muscle strength of the unaffected limbs. Data suggest that ITB therapy is a safe and efficacious treatment for spastic hypertonia resulting from stroke.

AB - Ivanhoe CB, Francisco GE, McGuire JR, Subramanian T, Grissom SP. Intrathecal baclofen management of poststroke spastic hypertonia: implications for function and quality of life. Objectives: To evaluate the impact of intrathecal baclofen (ITB) on function and quality of life (QOL) and to obtain efficacy and safety data in poststroke spastic hypertonia. Design: Prospective open-label multicenter trial with follow-up at 3 and 12 months. Setting: Twenty-four stroke treatment centers in the United States. Participants: Ninety-four stroke participants (age range, 24-82y) with spastic hypertonia. Seventy-four participants underwent ITB pump implantation. Intervention: Participants were implanted with an ITB pump. Main Outcome Measures: FIM instrument and QOL (Sickness Impact Profile [SIP]) changes, spastic hypertonia (Ashworth Scale), and safety. Results: FIM scores improved overall in repeated-measures analysis of variance (ANOVA) (P=.005) and by 3.00±7.69 (P=.001) at 3 months and by 2.86±10.13 (P=.017) at 12 months. Significant improvements in SIP scores were noted overall (repeated-measures ANOVA, P<.001) and at 3 (P=.003) and 12 months (P<.001). The combined average Ashworth Scale score of the upper and lower limbs decreased by 1.27±0.76 (P<.001) at 3 months and by 1.39±0.73 (P<.001) at 12 months from baseline, which was significant overall (repeated-measures ANOVA, P<.001). Strength in the unaffected side did not change overall (repeated-measures ANOVA, P=.321) or at either 3 (P=.553) or 12 months (P=.462). Minimal adverse events and device complications were reported. Conclusions: There was significant improvement in function, QOL, and spastic hypertonia at 3 and 12 months after implant, without adversely affecting muscle strength of the unaffected limbs. Data suggest that ITB therapy is a safe and efficacious treatment for spastic hypertonia resulting from stroke.

UR - http://www.scopus.com/inward/record.url?scp=33750479523&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33750479523&partnerID=8YFLogxK

U2 - 10.1016/j.apmr.2006.08.323

DO - 10.1016/j.apmr.2006.08.323

M3 - Article

VL - 87

SP - 1509

EP - 1515

JO - Archives of Physical Medicine and Rehabilitation

JF - Archives of Physical Medicine and Rehabilitation

SN - 0003-9993

IS - 11

ER -