Brain Neurorehabil.  2015 Sep;8(2):104-108. 10.12786/bn.2015.8.2.104.

Dose-dependent Changes in Gait Pattern after Intrathecal Baclofen Bolus Injection in Adult Ambulatory Cerebral Palsy: A Case Report

• Shin YK
• Kim AR
• Chang JW
• Chang WS
• Lee DS
• Cho SR

• KMID: 2165198
• DOI: http://doi.org/10.12786/bn.2015.8.2.104

Abstract

Intrathecal baclofen (ITB) therapy has been proven to reduce severe spasticity in cerebral palsy (CP). However, few results reported the objective gait pattern change after ITB bolus injection in adult ambulatory CP. We therefore evaluated observational and kinematic gait patterns at different ITB bolus injection doses. We performed a test trial of 3-day ITB bolus injections at doses of 12.5 microg, 25 microg, and 50 microg in ambulatory CP. We evaluated modified Ashworth scale, visual analogue scale, observational gait scale, and kinematic gait analysis after ITB bolus injection. Intrathecal administration of low-dose baclofen 25 microg was successfully used not only for the treatment of spasticity but also for the treatment of gait disturbance, whereas the higher dose baclofen 50 microg induced foot drop and deteriorated gait pattern. We experienced dose-dependent changes in gait pattern confirmed by the observational and kinematic gait assessments after ITB bolus injection in adult ambulatory CP.

Keyword

baclofen; cerebral palsy; gait

MeSH Terms

Adult*
Baclofen*
Cerebral Palsy*
Foot
Gait*
Humans
Muscle Spasticity
Baclofen

Figure

• 

  Fig. 1 Kinematic change in gait analysis after the intrathecal bolus injection of 50 µg baclofen. When compared with before injection (A), after intrathecal bolus injection of 50 µg baclofen (B), pelvic anterior tilt was decreased at the sagittal plane and asymmetric pelvic rotation improved at the transverse plane. Knee flexion was also decreased in the swing phase at the sagittal plane. However, the patient showed right foot drop and foot internal rotation was appeared after injection at swing phase.

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