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The underutilization of intrathecal baclofen in poststroke spasticity. Top Stroke Rehabil 2011 May-Jun;18(3):195-202

Date

06/07/2011

Pubmed ID

21642057

DOI

10.1310/tsr1803-195

Scopus ID

2-s2.0-79958084023   19 Citations

Abstract

Stroke is one of the leading causes of adult disability in the United States, with a reported prevalence of 6.4 million people. Spasticity is one of the clinical features of the upper motor neuron syndrome seen after a stroke. The prevalence of spasticity after a stroke ranges from 17% to 42.6%, and an average of two-thirds of people with spasticity have upper and lower extremity involvement. Oral medications and botulinum neurotoxin injections are current treatments for problematic spasticity. However, these treatments are often limited by side effects or dose ceilings. Intrathecal baclofen (ITB) is a proven method for the management of disabling spasticity from multiple etiologies. Studies have demonstrated improved mobility, activities of daily living, and quality of life in spastic poststroke patients. Despite the benefits of ITB, fewer than 1% of stroke patients with severe disabling spasticity are being treated with ITB. This article will review the prevalence of severe poststroke spasticity and the rate of ITB use and will discuss reasons for its limited use in stroke survivors.

Author List

Dvorak EM, Ketchum NC, McGuire JR

Authors

Nicholas C. Ketchum MD Associate Professor in the Physical Medicine and Rehabilitation department at Medical College of Wisconsin
John R. McGuire MD Professor in the Physical Medicine and Rehabilitation department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Baclofen
Humans
Injections, Spinal
Muscle Relaxants, Central
Muscle Spasticity
Quality of Life
Stroke
United States