head JofIMAB
Journal of IMAB - Annual Proceeding (Scientific Papers)
Publisher: Peytchinski Publishing Ltd.
ISSN: 1312-773X (Online)
Issue: 2022, vol. 28, issue1
Subject Area: Medicine
DOI: 10.5272/jimab.2022281.4260
Published online: 01 March 2022

Case report
J of IMAB. 2022 Jan-Mar;28(1):4260-4263
Mariya GramatikovaORCID logo Corresponding Autoremail, Stamenka MitovaORCID logo,
Department Kinesitherapy, Faculty of Public Health, Health Care and Sports, South-West University, Blagoevgrad, Bulgaria.

Purpose: To monitor and analyze physiotherapeutic potential before and after implantation of an intrathecal baclofen infusion pump for treating spasticity in a child with cerebral palsy.
Material: We present a 6-year-old girl with a massive spastic dystonic motor disorder, after hypoxic brain damage, based on an aspiration event in 2017. The first 6 months after the accident, the child is in a coma, 8 months in a state of awake coma. He has been conscious since the beginning of 2019. The diagnosis is bilateral spastic-dyskinetic paralysis, structural epilepsy, suspected cerebral blindness, subluxation of the hip joints bilaterally. For the period from coma to now, the child has received the following treatment: gastrostomy, replacement with Button, application of ventriculo-peritenoic shunt, botulinum toxin therapy, implantation of intrathecal baclofen infusion pump for treating spasticity. From the third month after the accident until now, physiotherapy is performed 3-4 times a week, monitoring the condition and changes in the functional capabilities of the child.
Results: Before the baclofen pump, physiotherapy is mostly preventive against contractures and ankylosis. The child's functional capabilities and learning in motor activities are severely limited by central spasticity. 6 months after the placement of the baclofen pump, muscle tone decreased, and the child's physiotherapeutic potential increased.
Conclusions: The physiotherapeutic potential is significantly increased after implantation of an intrathecal baclofen infusion pump, as muscle tone is significantly reduced.

Keywords: pediatric neurorehabilitation, functional neurosurgery, baclofen pump, spasticity,

pdf - Download FULL TEXT /PDF 494 KB/
Please cite this article as: Gramatikova M, Mitova S. Physiotherapeutic potential before and after implantation of intrathecal baclofen infusion pump for treating spasticity in child with cerebral palsy. J of IMAB. 2022 Jan-Mar;28(1):4260-4263. DOI: 10.5272/jimab.2022281.4260

Corresponding AutorCorrespondence to: Assoc. Prof. Mariya Gramatikova, PhD, Department of Kinesitherapy, Faculty of Public Health, Healthcare and Sports, South-West University Neofit Rilski; 66, Ivan Mihaylov, 2700 Blagoevgrad, Bulgaria; E-mail: mari_gramatikova@abv.bg

1. Ryan JM, Cassidy EE, Noorduyn SG, O'Connell NE. Exercise interventions for cerebral palsy. Cochrane Database Syst Rev. 2017 Jun 11;6(6): CD011660. [PubMed]
2. Novak I, Morgan C, Fahey M, Finch-Edmondson M, Galea C, Hines A, et al. State of the Evidence Traffic Lights 2019: Systematic Review of Interventions for Preventing and Treating Children with Cerebral Palsy. Curr Neurol Neurosci Rep. 2020 Feb 21;20(2):3. [PubMed]
3. Hasnat MJ, Rice JE. Intrathecal baclofen for treating spasticity in children with cerebral palsy. Cochrane Database Syst Rev. 2015 Nov 13;(11):CD004552. [PubMed]
4. Avramova M. [Specialized kinesitherapy in children with child cerebral palsy.] [in Bulgarian] Sports and Science. 2019; 63(Extraordinary Issue):234-247. [Internet]
5. Avramova M. Effectiveness of Specialized Kinesitherapy in Children with Spastic Hemiplegic Cerebral Palsy. J of IMAB. 2021 Jul-Sep;27(3):3842-3846. [Crossref]   
6. Avramova М. [The effect of Doman-Delacato and Perfetti methods in children with spastic hemiplgic cerebral palsy.] [in Bulgarian] Knowl Int J. 2018 Dec;28(2):449-454. [Crossref]
7. Pettersson K, Wagner P, Rodby-Bousquet E. Development of a risk score for scoliosis in children with cerebral palsy. Acta Orthop. 2020 Apr;91(2):203-208. [PubMed]
8. Murphy RF, Mooney JF 3rd. Current concepts in neuromuscular scoliosis. Curr Rev Musculoskelet Med. 2019 Jun;12(2):220-227. [PubMed]
9. Hagglund G, Pettersson K, Czuba T, Persson-Bunke M, Rodby-Bousquet E. Incidence of scoliosis in cerebral palsy. Acta Orthop. 2018 Aug;89(4):443-447. [PubMed]
10. Cloodt E, Wagner P, Lauge-Pedersen H, Rodby-Bousquet E. Knee and foot contracture occur earliest in children with cerebral palsy: a longitudinal analysis of 2,693 children. Acta Orthop. 2021 Apr;92(2):222-227. [PubMed]
11. Gramatikova M. Application of muscle inhibiting techniques to children with cerebral palsy. J of IMAB. 2020 Oct-Dec;26(4):3353-3355. [Crossref]
12. Parashkevova P, Deleva R, Mincheva P, Andreev A. A Study on Use of Neurodynamic Tests among Neurorehabilitation Professionals. J of IMAB. 2019 Jan-Mar;25(1):2438-2442. [Crossref ]
13. Filipova M, Popova D, Bogomilova S, Nenova G. Kinesitherapeutic approach in patients with ischemic stroke treated with venous thrombolysis. J of IMAB. 2020 Oct-Dec;26(4):3371-3373 [Crossref].

Received: 05 September 2021
Published online: 01 March 2022

back to Online Journal