Effects of Intrathecal Baclofen Pump on Leisure Participation Among Children With Cerebral Palsy

PURPOSE: The purpose of this study was to gain a better understanding of the effects that intrathecal baclofen (ITB) therapy had on multiple components of leisure participation among children with cerebral palsy (CP).

RATIONALE: The reduced spasticity and pain accomplished through ITB therapy may allow the child to increase participation in social activities with peers, spend more time in the community, perform leisure activities without the assistance of adults, and participate in activities that require more movement. However, this effect has not been proven.

DESIGN: A quasi-experimental study using a one-way, repeated-measures, within-subjects design was used.

PARTICIPANTS: Participants included 10 children with CP (ages 3–22 yr) referred from the Waisman Center who agreed to ITB therapy initiation.

METHOD: Quantitative data on leisure activities were collected from the caregivers of children with CP who agreed to ITB therapy initiation. Data were collected using the Children’s Assessment of Participation and Enjoyment (CAPE) and the Canadian Occupational Performance Measure (COPM).

ANALYSIS: A one-way repeated-measures analysis of variance was performed on CAPE outcomes. For confirmatory analysis, performance and satisfaction related to leisure goals from the COPM were assessed using visual representations.

RESULTS: This study found that ITB therapy did not have a significant effect on the location, social involvement, diversity, intensity, and enjoyment of participation in leisure activities at the p < .05 level; however, ITB therapy did have a positive effect on participation in and satisfaction with leisure activities.

DISCUSSION: Understanding the effectiveness of ITB therapy can guide therapists when educating and assisting families with identifying realistic goals to increase leisure participation for children with CP.

IMPACT STATEMENT: Although ITB has a positive effect on spasticity and pain management, the translation to increased leisure participation for children with CP is unclear. Future studies should be conduced with a higher methodological rigor to validate the results of this pilot study and allow for further generalization to the population with CP.