Intrathecal Versus Oral Baclofen: A Matched Cohort Study of Spasticity, Pain, Sleep, Fatigue, and Quality of Life

摘要: Baclofen commonly is used to manage spasticity caused by central nervous system lesions or dysfunction. Although both intrathecal and oral delivery routes are possible, no study has directly compared clinical outcomes associated with these 2 routes of treatment.To compare levels, pain, sleep, fatigue, quality life between individuals receiving treatment versus baclofen.Cross-sectional matched cohort survey study.Urban academic rehabilitation outpatient clinics.Adult patients spasticity, treated baclofen for at least 1 year, 1:1 age, gender, diagnosis.Standardized surveys were administered during clinic appointments telephone.Surveys included the Penn Spasm Frequency Scale, Brief Pain Inventory, Epworth Sleepiness Fatigue Severity Life Satisfaction Questionnaire, Diener Scale.A total 62 subjects enrolled. The mean (standard deviation [SD]) age was 46 (11) years a duration 11 (6) 13 years, respectively. There 40 (64%) male 22 (36%) female subjects. Primary diagnoses spinal cord injury (n = 38), cerebral palsy 10), stroke multiple sclerosis 4). (SD) dose time 577 (1429) μg/day and 86 (50) mg/day, Patients experienced significantly fewer (1.44 [0.92] 2.37 [1.12]) less severe 2.16 [0.83]) spasms, respectively as measured Scale (P < .01; P .01). significant differences in groups. Subanalysis SCI mirrored results entire sample, decreases spasm frequency severity .01), but other group differences. percent change (21% [33%]) (3% [28%]) larger two prior date .02).Long-term reduced well greater stability. These benefits must be weighed against risks internal pump catheter placement considering therapy.