The Effect of Baclofen on the Gait of Hemiplegic Children Assessed by Means of Polarised Light Goniometry

Abstract

Gait was assessed by polarised light goniometry in 15 hemiplegic children aged 4−15 years. After initial clinical and goniometric assessment, baclofen 5−10 mg/day was started and increased over 4−6 weeks to a dose of 1−1.5 mg/kg/day. Assessment was repeated one week later. A statistically significant decrease in hip and knee flexion at the ‘toe-off’ phase of the gait cycle was found in both legs. Of the nine children who showed most change in goniometric assessment, five showed an obvious clinical improvement, two a slight improvement, one no change and one child's gait deteriorated. Of six children with minimal or no change goniometrically, four showed no change clinically, one minimal clinical improvement and one a deterioration clinically. Side effects included transient sedation (seven children), concentration difficulty (one child), behaviour disturbance (1 child) and nocturnal enuresis (three children). We concluded that although baclofen causes functional improvement in some hemiplegic children, its use should be carefully supervised in view of possible side effects and possible deterioration in gait.