F-2-04-05
INTRATHECAL APPLICATION OF BACLOFEN IN TREATEMENT OF SPASTICITY
Vjekoslav Nankovic, Z. Kejla, D. Kvesic (University Clinic for Traumatology, Zagreb, Croatia)
Spastic syndrome is a frequent consequence of spinal cord injury, which often cannot be controlled by standard enteral or parenteral medication.
Implantation of a subcutaneous, programmable pump for intrathecal application of Baclofen (Synchromed) was performed in a group of 11 patients during 1993-1996. The dose was gradually increased up to the efficient dose ranging from 200 to 500μg daily. After the implantation of subcutaneous pump, a time required for achievement of sufficient dose averaged 5 weeks, after which muscular spasticity of extremities significantly diminished from 4 to 1 grade according to the Ashwort scale.
Intrathecal application of Baclofen proved to be an efficient tool in the treatment of posttraumatic spastic syndrome in a selected group of patients.
F-2-04-06
THERAPEUTIC EXERCISE MACHINE FOR THE HIP AND KNEE
(2) EFFECTS OF CONTINUOUS PASSIVE RANGE-OF-MOTION EXERCISE ON SPASTICITY
Naofumi Tanaka, Yasutomo Okajima, Akio Kimura, Shigeo Uchida, Masaya Taki, Seiji lwata (Tsukigase Rehab. Ctr., Keio Univ., Japan), Yutaka Tomita, Toshio Horiuchi (Science & Technology, Keio Univ., Japan), Koji Nagata, Taisuke Sakaki (Yaskawa Electronic Co., Japan).
We studied the effects of continuous passive range-of-motion exercise (CPROM-E) on spasticity in spastic patients and normal subjects. Our machine carries out CPROM-E of the lower extremity copying the therapists' motion, estimates the joint angles and the load torques of the subject's knee and hip, and records the surface electromyograms (EMGs) of the subject's quadriceps femoris and hamstrings. During the CPROM-E in 60 sessions, the torques and the EMGs significantly decreased in the spastic patients, while these values did not change in the normal subjects. The relationships between the joint angle and the load torque of the hip of the spastic patients were found to be different from these of the normal subjects. These results suggest that the CPROM-E with our machine may have beneficial effects in the management of spasticity.
