Prospective 12-Month Study of Intrathecal Baclofen Therapy for Poststroke Spastic Upper and Lower Extremity Motor Control and Functional Improvement

Schiess, Mya C.; Oh, Irene; Stimming, Erin Furr; Lucke, Joseph F.; Acosta, Fernando; Fisher, Stanley; Simpson, Richard K.

doi:10.1111/j.1525-1403.2010.00308.x

Cited by 31 publications

(33 citation statements)

References 29 publications

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“…Even if medications are not sufficient, interventional therapies should be coupled with rehabilitation to reduce spastic tone, facilitate a return of functional motor control, facilitate functional independence, and improve quality of life in areas that pertain to the patient's deficits. 59 …”

Section: Discussionmentioning

confidence: 99%

A Review of Spasticity Treatments: Pharmacological and Interventional Approaches

Chang

Ghosh

Yanni

et al. 2013

Crit Rev Phys Rehabil Med

172

134

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Spasticity is a velocity-dependent increase in muscle tone and uncontrolled, repetitive, involuntary contractions of skeletal muscles. Spasticity presents as upper motor neuron symptoms in patients with central nervous system pathology such as stroke, spinal cord injury, brain injury, or multiple sclerosis. As a result, a patient can have significant pain and limited mobility, which can lead to decreased quality of life and difficulty maintaining personal care. In this article we discuss mechanisms, indications, efficacy, and side effects of the most accepted current treatments. Currently available treatment options include oral medications and interventional procedures. Oral medications comprise centrally acting agents, such as baclofen, clonidine, and tizanidine, as well as anticonvulsants such as benzodiazepines and gabapentin and peripherally acting dantrolene. Interventional procedures include focal injections of botulinum toxin, phenol or alcohol, and an intrathecal baclofen pump. Surgical treatments include selective dorsal rhizotomy and neurectomy. We found that there are several treatments available with data to support their use, but many still need further research to prove their efficacy and develop optimal utilization.

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Section: Discussionmentioning

confidence: 99%

A Review of Spasticity Treatments: Pharmacological and Interventional Approaches

Chang

Ghosh

Yanni

et al. 2013

Crit Rev Phys Rehabil Med

172

134

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“…Half of the survivors will have a significant long-term disability [1]. Proprioception deficits of the paretic side are thought to be common after stroke, and they play an important role in the poor recovery of activities of daily living and mobility [2,3,4]. Despite these data, there is little detailed information about the proprioceptive deficits in stroke patients, especially in the non-paretic extremities [5,6].…”

Section: Introductionmentioning

confidence: 99%

Position Sense of the Hemiparetic and Non-Hemiparetic Ankle after Stroke: Is the Non-Hemiparetic Ankle also Affected?

Yalçın

Akyuz²,

Önder³

et al. 2012

Eur Neurol

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Background and Purpose: Researchers have shown an increased interest in proprioception deficits of the paretic side in hemiplegic patients. However, far too little attention has been paid to the proprioception sense of the non-hemiparetic side. The objective of this research was to determine whether the position sense of the ankles, especially of the non-paretic side, is affected in stroke patients. Methods: 20 inpatients with stroke and 10 healthy control subjects were evaluated using an isokinetic dynamometer. Proprioceptive error scores (in degrees) for passive reproduction of joint position tests (PRJPTs) were measured. Results: Error values of PRJPT for 5° plantarflexion, 10° plantarflexion, and 15° dorsiflexion were significantly higher in patients on both the paretic and non-paretic side compared with the control group dominant side. Conclusion: The impaired results of PRJPT in both the paretic and non-paretic ankles of stroke patients are surprising when one expects that the non-paretic side would be preserved under the control of the healthy hemisphere.

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“…Previous concerns that an intrathecally administered medication is not selective and, thus, will result in weakness of the noninvolved side were unfounded. [47][48][49] ITB therapy has been shown to be effective in managing PSS, 49 potentially enhancing functional recovery of gait 47 and upper limb use, 50 and improving quality of life.…”

Section: Intrathecal Baclofen Therapymentioning

confidence: 99%

Poststroke Spasticity Management

Francisco

McGuire

2012

Stroke

128

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Prospective 12-Month Study of Intrathecal Baclofen Therapy for Poststroke Spastic Upper and Lower Extremity Motor Control and Functional Improvement

Cited by 31 publications

References 29 publications

A Review of Spasticity Treatments: Pharmacological and Interventional Approaches

A Review of Spasticity Treatments: Pharmacological and Interventional Approaches

Position Sense of the Hemiparetic and Non-Hemiparetic Ankle after Stroke: Is the Non-Hemiparetic Ankle also Affected?

Poststroke Spasticity Management

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