Poster 25: Intrathecal baclofen therapy in ambulatory patients with multiple sclerosis: effect on gait speed

Objective: To evaluate whether intrathecal baclofen (ITB) therapy causes a decrease in gait speed in ambulatory patients with multiple sclerosis (MS). Design: Longitudinal pre-post intervention study (24-wk follow-up). Setting: Spasticity clinic within a large outpatient comprehensive care center for MS. Participants: Patients with intractable lower-extremity spasticity, definitively diagnosed with MS and able to walk at least 25ft with or without support. Intervention: Implantation of a programmable ITB infusion system. All patients received inpatient and/or outpatient physical therapy after surgery. Main Outcomes Measure: Gait speed calculated from the Timed 25-Foot Walk. Results: 8 patients were analyzed (75% women; mean age, 37.4±6.1y; mean disease duration, 9.7±7.9y; median Expanded Disability Status Scale [EDSS] score, 6.5). There was no significant change in EDSS score during the study. There was statistically significant improvement of Modified Ashworth Scale scores between baseline and all follow-up visits. There was no statistically significant change in gait speed. Average gait speed was .48±.35m/s at baseline, .46±.41m/s at 4 weeks, .41±.37m/s at 12 weeks, and .48±.40m/s at 24 weeks. Conclusions: Our results suggest that ITB therapy improves severe spasticity, but does not affect gait speed measured on a short distance in ambulatory MS patients, up to 6 months after surgery. Further study is needed to assess the effect of ITB on gait endurance, gait quality, and patient quality of life.