Effects of chronic baclofen use on active movement in an individual with a spinal cord injury

Abstract

Study Design: Case report.Objectives: To describe a case of chronic use of oral baclofen in a patient with spinal cord injury limiting lower extremity movements. Setting: Frazier Rehab Institute, Louisville, Kentucky and University of Louisville. Report: A 24-year-old male with a C5 AIS-B spinal cord injury received a neurophysiological examination pre and post cessation of the use of oral baclofen. The initial results revealed no motor activity below the level of the lesion during reinforcement maneuvers or active movements. Following discontinuance of baclofen, motor activity was detected in upper and lower extremity muscles during some tasks. Locomotor patterns during stepping on a treadmill with body weight support did not reveal excessive overactivity of the lower extremity muscles. The patient was also able to perform squats independently at 35-40% body weight support when standing on a treadmill.Conclusion:Baclofen is typically prescribed for the management of spasticity in individuals with spinal cord injury. The interaction of reduced spasticity on functional tasks is not well understood, raising an important limitation of neurological exams and classifications done under heavy dosages of medication. © 2012 International Spinal Cord Society All rights reserved.