Abstract：
BACKGROUND: Cerebral Palsy (CP) is a group of permanent, but not unchanging, disorders of movement and/or posture and motor function, which are due to a non-progressive interference, lesion, or abnormality of the developing/immature brain. One clinical presentation is muscle spasticity, which leads to a significant impact on the individual\'s functionality and quality of life. Spasticity treatment is multidisciplinary and includes pharmacological and physical intervention; intrathecal baclofen shows a positive effect in severe spasticity and suboptimal response to oral drugs, while local injection of Botulinum toxin type A (BTXA) improves muscle tone, motion and pain.
OBJECTIVE: The aim of this study was to evaluate the efficacy of the combined intrathecal baclofen infusion (ITB) - botulinum toxin treatment in the management of spasticity in CP.
METHODS: 8 patients with spastic tetraparesis were enrolled. All patients were treated with intrathecal Baclofen; in lower limbs, no spastic symptoms appeared, while marked spasticity was noted in upper limbs. We injected the right and left Biceps Brachial (BB) and Flexor Digitorum Superficialis (FDS) muscles with botulinum toxin type A. All patients underwent Myometric measurement, Ashworth Scale, Numerical Rating Scale, and Visual Analogic Scale evaluation before infiltration (T0), 30 days after injection (T1), 60 days after injection (T2), and 90 days after treatment (T3).
RESULTS: All data demonstrated an improvement in spasticity, pain, quality of life, and self-care during the study, with p < 0.05. No side effects appeared.
CONCLUSIONS: This study demonstrated the efficacy and safety of intrathecal baclofen infusion and botulinum toxin combined treatment in the management of spasticity, pain, quality of life, and selfcare in CP patients.
OBJECTIVE: The aim of this study was to evaluate the efficacy of the combined intrathecal baclofen infusion (ITB) - botulinum toxin treatment in the management of spasticity in CP.
METHODS: 8 patients with spastic tetraparesis were enrolled. All patients were treated with intrathecal Baclofen; in lower limbs, no spastic symptoms appeared, while marked spasticity was noted in upper limbs. We injected the right and left Biceps Brachial (BB) and Flexor Digitorum Superficialis (FDS) muscles with botulinum toxin type A. All patients underwent Myometric measurement, Ashworth Scale, Numerical Rating Scale, and Visual Analogic Scale evaluation before infiltration (T0), 30 days after injection (T1), 60 days after injection (T2), and 90 days after treatment (T3).
RESULTS: All data demonstrated an improvement in spasticity, pain, quality of life, and self-care during the study, with p < 0.05. No side effects appeared.
CONCLUSIONS: This study demonstrated the efficacy and safety of intrathecal baclofen infusion and botulinum toxin combined treatment in the management of spasticity, pain, quality of life, and selfcare in CP patients.
摘要：
背景：脑瘫（CP）是一组永久性的，但不是不变的，运动和/或姿势和运动功能障碍，这是由于非渐进干扰，病变,或发育中/未成熟大脑的异常。一种临床表现是肌肉痉挛，这对个人的功能和生活质量产生了重大影响。痉挛治疗是多学科的，包括药物和物理干预;鞘内注射巴氯芬对严重痉挛和口服药物反应不佳显示出积极作用，而局部注射A型肉毒杆菌毒素（BTXA）可改善肌肉张力，运动和疼痛。
目的：本研究的目的是评估鞘内注射巴氯芬（ITB）-肉毒杆菌毒素联合治疗对CP痉挛的疗效。
方法：8例痉挛性四瘫患者。所有患者均鞘内注射巴氯芬；在下肢，没有出现痉挛症状,而上肢明显痉挛。我们向左右肱二头肌（BB）和下腰屈肌（FDS）肌肉注射A型肉毒杆菌毒素。AshworthScale,数值评级量表，和渗透前视觉类比量表评估(T0)，注射后30天（T1），注射后60天（T2），治疗后90天（T3）。
结果：所有数据显示痉挛改善，疼痛,生活质量,在研究过程中自我照顾，p<0.05。没有出现副作用。
结论：这项研究证明了鞘内注射巴氯芬和肉毒杆菌毒素联合治疗痉挛的有效性和安全性，疼痛,生活质量,CP患者的自我护理。
目的：本研究的目的是评估鞘内注射巴氯芬（ITB）-肉毒杆菌毒素联合治疗对CP痉挛的疗效。
方法：8例痉挛性四瘫患者。所有患者均鞘内注射巴氯芬；在下肢，没有出现痉挛症状,而上肢明显痉挛。我们向左右肱二头肌（BB）和下腰屈肌（FDS）肌肉注射A型肉毒杆菌毒素。AshworthScale,数值评级量表，和渗透前视觉类比量表评估(T0)，注射后30天（T1），注射后60天（T2），治疗后90天（T3）。
结果：所有数据显示痉挛改善，疼痛,生活质量,在研究过程中自我照顾，p<0.05。没有出现副作用。
结论：这项研究证明了鞘内注射巴氯芬和肉毒杆菌毒素联合治疗痉挛的有效性和安全性，疼痛,生活质量,CP患者的自我护理。
