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General Rehabilitation

A Retrospective Study Comparing Effective Intrathecal Baclofen Dosage Amongst Patients with Spasticity Disorders

Saturday, October 25, 2025
8:00 AM - 9:15 AM MT
Location: Kiosk 7

    Primary Author(s)

  • Jennifer Viola, DO

    Resident Physician
    Johns Hopkins University PM&R Program
    Baltimore, Maryland

    • Poster Presenter(s)

  • AH

    Amna Haider, DO

    Resident
    Johns Hopkins University PM&R Program
    Baltimore, Maryland

    • Primary Author(s)

  • R. Samuel Mayer, MD

    Professor, Dept of PM&R
    Johns Hopkins University School of Medicine
    Baltimore, Maryland

    • Co-Author(s)

  • BY

    Bingqing Ye, Other

    Business Analytics Program Manager
    Johns Hopkins Hospital
    Baltimore, Maryland

  • KD

    Kelly N. Daley, PT

    Dir. Clinical Informatics and Analytics
    Johns Hopkins Medicine
    Baltimore, Maryland

    • Poster Presenter(s)

  • Jenny Xu, MD

    Resident
    Johns Hopkins University PM&R Program
    Baltimore, Maryland

Disclosure(s):
R. Samuel Mayer, MD: No financial relationships to disclose
Jenny Xu, MD: No financial relationships to disclose
Background and/or Objectives: Intrathecal baclofen (ITB) is an effective spasticity treatment for people who are unable to tolerate oral medications or have refractory spasticity that is administered into the cerebrospinal fluid through a catheter from an implanted intrathecal baclofen pump (ITBP). There are variations in the literature on the average ITBP dose used to treat spasticity associated with various conditions and no specific dosing guidelines. This study investigates effective ITBP dosing among patients treated for spasticity at Johns Hopkins Medicine.

Design: Retrospective chart review

Setting : Outpatient clinic visits

Participants : 49 adults who had at least one outpatient ITBP refill visit from 2022 to 2024

Interventions: Not applicable

Main Outcome Measures: Stable effective dose of ITB is defined as three outpatient visits for participants treated for spasticity in the diagnostic categories of spinal cord injury (SCI), traumatic brain injury (TBI) and stroke, demyelinating disease (multiple sclerosis, transverse myelitis, neuromyelitis optica), cerebral palsy (CP), and inherited and/or neurodegenerative neurological conditions with the same dose at all three visits.

Results: Of the 49 participants, 21 (42.9%) had a stable effective dose of ITB. The average dose for participants with a stable ITB dose was 472.135 mcg/day, and the average dose for all participants at the most recent outpatient visit was 384.5033 mcg/day. 26.3% of ambulatory participants and 53.3% of non-ambulatory participants had a stable effective dose of ITB. The average dose for ambulatory and non-ambulatory participants at the most recent outpatient visit was 278.6379 mcg/day, and 453.8634 mcg/day, respectively.

Conclusions: There were no statistically significant differences among participants treated for spasticity due to SCI, TBI and stroke, demyelinating disease, CP, and inherited and/or neurodegenerative conditions. Ambulatory patients used smaller ITB doses and were less likely to be on a stable dose.