Laura Bonouvrié1, Jules Becher2, Dan Soudant3, Annemieke Buizer4, Willem van Ouwerkerk5, Georges Vles6, R Jeroen Vermeulen7. 1. VU University Medical Center, Department of Rehabilitation Medicine, Postbus 7057, 1007 MB Amsterdam, The Netherlands. Electronic address: l.bonouvrie@vumc.nl. 2. VU University Medical Center, Department of Rehabilitation Medicine, Postbus 7057, 1007 MB Amsterdam, The Netherlands. Electronic address: Jg.becher@vumc.nl. 3. Maastricht University Medical Center+, Department of Neurology, Postbus 5800, 6202 AZ Maastricht, The Netherlands. Electronic address: D.soudant@mumc.nl. 4. VU University Medical Center, Department of Rehabilitation Medicine, Postbus 7057, 1007 MB Amsterdam, The Netherlands. Electronic address: Ai.buizer@vumc.nl. 5. VU University Medical Center, Department of Neurosurgery, Postbus 7057, 1007 MB Amsterdam, The Netherlands. Electronic address: W.vouwerkerk@vumc.nl. 6. Maastricht University Medical Center+, Department of Orthopedic Surgery, Postbus 5800, 6202 AZ Maastricht, The Netherlands. Electronic address: J.vles@mumc.nl. 7. Maastricht University Medical Center+, Department of Neurology, Postbus 5800, 6202 AZ Maastricht, The Netherlands. Electronic address: Jeroen.vermeulen@mumc.nl.
Abstract
INTRODUCTION: Intrathecal baclofen (ITB) treatment is applied in patients with spastic cerebral palsy (SCP), dystonic cerebral palsy (DCP) and progressive neurological disease (PND). Our aim was to investigate whether ITB treatment has a different effect on activities of daily life (ADL) in these groups. METHOD: A retrospective and cross-sectional survey was conducted using a questionnaire to assess the qualitative effect of ITB (Likert scale) on different domains of functioning (mobility, personal care, communication, comfort) and satisfaction with the results. Groups were compared using non-parametric statistics. RESULTS: Questionnaires were completed for 68 patients (39 SCP, 13 DCP, 16 PND). Satisfaction scores were relatively high in all groups (7-8) and the positive effect on personal care and communication was similar in all groups. The PND group had the shortest follow-up and scored significantly less favourably for the effect on mobility and comfort. DISCUSSION: This is the first study to show that ITB treatment has similar effects on personal care and communication in stable and progressive neurological disease. The decrease in mobility in the PND group is likely due to the progressive nature of the disease. The different effect on comfort between groups is mainly due to the smaller effect on startles in the PND group.
INTRODUCTION: Intrathecal baclofen (ITB) treatment is applied in patients with spastic cerebral palsy (SCP), dystonic cerebral palsy (DCP) and progressive neurological disease (PND). Our aim was to investigate whether ITB treatment has a different effect on activities of daily life (ADL) in these groups. METHOD: A retrospective and cross-sectional survey was conducted using a questionnaire to assess the qualitative effect of ITB (Likert scale) on different domains of functioning (mobility, personal care, communication, comfort) and satisfaction with the results. Groups were compared using non-parametric statistics. RESULTS: Questionnaires were completed for 68 patients (39 SCP, 13 DCP, 16 PND). Satisfaction scores were relatively high in all groups (7-8) and the positive effect on personal care and communication was similar in all groups. The PND group had the shortest follow-up and scored significantly less favourably for the effect on mobility and comfort. DISCUSSION: This is the first study to show that ITB treatment has similar effects on personal care and communication in stable and progressive neurological disease. The decrease in mobility in the PND group is likely due to the progressive nature of the disease. The different effect on comfort between groups is mainly due to the smaller effect on startles in the PND group.
Authors: Laura A Bonouvrié; Jules G Becher; Johan S H Vles; R Jeroen Vermeulen; Annemieke I Buizer Journal: Ann Neurol Date: 2019-05-21 Impact factor: 10.422