Intrathecal Baclofen Injection Efficacy for Spasticity Management in Patients With Stroke: A Meta-Analysis.
Ki Deok ParkMin-Keun SongPublished in: Brain & NeuroRehabilitation (2024)
Although intrathecal baclofen injections have been used for spasticity management regarding stroke, spinal cord injury, and central nervous system diseases, their relative efficacy is controversial. This systematic review scoured 3 multinational electronic databases (Cochrane Library, MEDLINE, and Embase) to isolate relevant studies. We analyzed non-randomized studies and randomized control trials (RCTs) with direct comparisons against other spasticity management interventions for adult stroke patients. Risk of Bias (RoB) and the Risk of Bias Assessment tool for Non-randomized Studies evaluations were implemented with Cochrane's RoB tool. Meta-analysis was performed with Revman 5.4, and evidence validity was assessed with the Grading of Recommendations, Assessment, Development, and Evaluations method. Lastly, the intrathecal baclofen injection meta-analysis included 2 RCTs and 7 non-RCTs for assessing spasticity and 4 non-RCTs to measure gait velocity. Based on this data, intrathecal baclofen injection significantly impacted spasticity and gait speed. Thus, intrathecal baclofen injection can potentially treat severe spasticity unresponsive to conventional spasticity therapy. Furthermore, clinicians must consider individual patient characteristics and conditions when contemplating intrathecal baclofen injection for spasticity intervention.
Keyphrases
- spinal cord injury
- systematic review
- botulinum toxin
- upper limb
- cerebral palsy
- meta analyses
- ultrasound guided
- case control
- spinal cord
- neuropathic pain
- children with cerebral palsy
- double blind
- placebo controlled
- atrial fibrillation
- open label
- phase iii
- randomized controlled trial
- stem cells
- big data
- study protocol
- early onset
- young adults
- case report
- bone marrow
- cerebrospinal fluid
- blood brain barrier
- smoking cessation
- platelet rich plasma