SX04
Examination of Timed 25-Foot Walk Performance in Ambulatory Patients with MS Utilizing Intrathecal Baclofen Therapy: A 24-Month Retrospective Analysis

Thursday, May 25, 2017
B2 (New Orleans Convention Center)
Amy Thiessen, PT , MS Center of Excellence, Oklahoma Medical Research Foundation, Oklahoma City, OK
Kimberly A Andrew, SPT , College of Allied Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK
Jennifer Smith, PA , MS Center of Excellence, Oklahoma Medical Research Foundation, Oklahoma City, OK
Tania Reyna, MD , MS Center of Excellence, Oklahoma Medical Research Foundation, Oklahoma City, OK
Amy Thiessen, PT , MS Center of Excellence, Oklahoma Medical Research Foundation, Oklahoma City, OK
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Background: Intrathecal Baclofen (ITB) has been shown to be an effective treatment for spasticity in patients with Multiple Sclerosis (MS).  ITB therapy has demonstrated benefit to the maintenance of walking speed in ambulatory patients with a variety of diagnoses including MS.  MS disease progression over time may play a factor in overall disability and deterioration of ambulation quality and speed.

Objectives: Examine the correlational relationship and stability of Timed 25-Foot Walk (T25FW) and duration of ITB in ambulatory patients with MS. 

Methods: Researchers performed post-hoc chart analysis of T25FW performance in patients with multiple sclerosis who received an ITB pump and were ambulatory at the time of pump implantation.  All measurements were part of standard of care and examination procedures. All patients included were diagnosed with MS and identified as ambulatory at time of ITB pump placement.  Twelve patients were identified (female 50%, mean age 51 years). T25FW measurements were recorded during regular visits following ITB pump placement for up to 24 months (730d). Average length of ITB therapy was 10 months (304d).  Data analyzed by individual trend lines and regression analysis.   

Results: At 24 months, individual trend lines demonstrate stable T25FW for subjects following ITB pump placement.  Regression analysis of all subjects reveals significant improvement in T25FW times over the course of the study (p=0.047). 

Conclusions: Ambulatory patients with MS and spasticity may benefit from ITB therapy, as evidenced by the stability of T25FW performance. This correlation data can be used to help identify potential outcomes for patients considering ITB therapy.  Depending on severity, the disease progression inherent with MS can confound the ambulatory abilities of patient with and without ITB therapy over longer time durations.  Patients using ITB therapy require continued monitoring for functional status and disease progression.