Continuous intrathecal baclofen for children with spasticity and/or dystonia: Goal attainment and complications associated with treatment
Bibliographic record
Abstract
AIM: To describe complications and outcomes of intrathecal baclofen (ITB) therapy in children with spasticity and/or dystonia. METHODS: A prospective study of goal attainment after ITB therapy and a retrospective review of medical records for complications. The children were described as dystonia-predominant or spasticity-predominant and the subgroups were compared. Goals were assessed at baseline and goal attainment at 6 months post-implant. Data were analysed using Wilcoxon signed-rank test. The patients' goals were measured with the Canadian Occupational Performance Measure (COPM) and goal attainment scaling (GAS). Complication rates were calculated by dividing the number of complications by the duration of pump implantation. RESULTS: Twenty-five children were included, 16 with complete goal attainment data. The mean age was 10 years and 3 months. Eighty-eight percent had a diagnosis of cerebral palsy. The most common goals were improved positioning and transfers. A statistically significant increase (P < 0.001) in both domains of the COPM was demonstrated. The mean GAS T-score was significantly higher at 6 months post implant (P < 0.001). Seventy percent of the subjects achieved their goals at 6 months. The complication rate was 0.38 per year of pump operation, higher in subjects with dystonia (0.71) compared with those with spasticity (0.25). CONCLUSIONS: ITB results in statistically significant levels of satisfaction and goal attainment in children with spasticity and/or dystonia. GAS was a useful measure of goal attainment. While, ITB is effective for children with spasticity and dystonia, those with dystonia have a higher rate of complications.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".