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More MS news articles for September 2003

Intrathecal baclofen therapy in ambulatory patients with multiple sclerosis: Effect on gait speed

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=13680633&dopt=Abstract

Arch Phys Med Rehabil. 2003 Sep;84(9):E10
Francois A. Bethoux, MD; Deborah M. Miller, PhD; Darlene Stough, RN
Cleveland Clinic Foundation, Cleveland, OH

Objective:

To evaluate whether intrathecal baclofen (ITB) therapy causes a decrease in gait speed in ambulatory patients with multiple sclerosis (MS).

Design:

Longitudinal pre-post intervention study (24-wk follow-up).

Setting:

Spasticity clinic within a large outpatient comprehensive care center for MS.

Participants:

Patients with intractable lower-extremity spasticity, definitively diagnosed with MS and able to walk at least 25ft with or without support.

Intervention:

Implantation of a programmable ITB infusion system.

All patients received inpatient and/or outpatient physical therapy after surgery.

Main Outcomes Measure:

Gait speed calculated from the Timed 25-Foot Walk.

Results:

8 patients were analyzed (75% women; mean age, 37.4+/-6.1y; mean disease duration, 9.7+/-7.9y; median Expanded Disability Status Scale [EDSS] score, 6.5).

There was no significant change in EDSS score during the study.

There was statistically significant improvement of Modified Ashworth Scale scores between baseline and all follow-up visits.

There was no statistically significant change in gait speed.

Average gait speed was.48+/-.35m/s at baseline,.46+/-.41m/s at 4 weeks,.41+/-.37m/s at 12 weeks, and.48+/-.40m/s at 24 weeks.

Conclusions:

Our results suggest that ITB therapy improves severe spasticity, but does not affect gait speed measured on a short distance in ambulatory MS patients, up to 6 months after surgery.

Further study is needed to assess the effect of ITB on gait endurance, gait quality, and patient quality of life.