Effect of continuous intrathecal baclofen therapy in children: a systematic review.
Annemieke I Buizer, Brian H M Martens, Casey Grandbois van Ravenhorst and 3 others
PMID 30187921WHAT IT FOUND
Most evidence is low quality.
Spasticity and dystonia likely improve, but functional gains are small. Complications are common. Goals must be defined carefully for each child.
Key findings
01The review included 33 studies, but only one provided level II evidence; the rest were low-quality case reports or cohort studies.
02Spasticity and dystonia showed moderate-to-large improvements, but functional outcomes like gross motor skills showed only small effects.
03Complications such as infection and pump failure were not reported systematically, but the estimated rate is 0.40 per pump per year.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
Only one study had a control group; the rest were low-quality observational studies. The single randomized trial was small (17 children) and not blinded. Patient groups were heterogeneous, mixing cerebral palsy with other rare neurological conditions. Follow-up times varied widely from one month to nine years. Effect sizes in uncontrolled studies may be overestimated. Complications were not reported systematically in the included studies.
The easy way to misread this
Do not interpret the large effect sizes for spasticity as proof that the treatment improves functional independence. Most evidence comes from uncontrolled studies where effect sizes may be overestimated, and functional gains were small.