{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T00:10:36Z","timestamp":1792195836923,"version":"4.4.0"},"reference-count":31,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2020,7,14]],"date-time":"2020-07-14T00:00:00Z","timestamp":1594684800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Mult Scler"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Intrathecal baclofen (ITB) is traditionally reserved for non-ambulatory patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To investigate outcomes of ITB in ambulatory multiple sclerosis (MS) patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Changes in outcome measures were estimated by a mixed effect model, while the complication rate was calculated using a logistic regression. Predictors of non-ambulatory status were identified by Cox model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>In all, 256 patients received an ITB test injection and 170 underwent ITB surgery. Aggregate Modified Ashworth Scale (MAS) scores for the ambulatory ITB cohort decreased from 13.5\u2009\u00b1\u20096.96 to 4.54\u2009\u00b1\u20094.18 at 5\u2009years ( p\u2009&lt;\u20090.001). There was no significant change in walking speed 1\u2009year post ITB surgery (0.45\u2009m\/second\u2009\u00b1\u20090.30 vs 0.38\u2009m\/second\u2009\u00b1\u20090.39, p\u2009=\u20090.80) with 77.8% of patients remaining ambulatory which decreased to 41.7% at year 5. Longer MS disease duration (hazard ratio (HR): 1.04; 95% confidence interval (CI): 1.01\u20131.07; p\u2009=\u20090.018) and lower hip flexor strength (HR: 0.40; 95% CI: 0.27\u20130.57; p\u2009&lt;\u20090.001) predicted non-ambulatory status after surgery. Complications were more likely in the ambulatory cohort (odds ratio (OR): 3.30, 95% CI: 2.17\u20135.02; p\u2009=\u20090.017).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>ITB is effective for ambulatory MS patients without compromising short-term walking speed, although a higher complication rate was observed in this cohort.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1352458520936912","type":"journal-article","created":{"date-parts":[[2020,7,14]],"date-time":"2020-07-14T11:10:03Z","timestamp":1594725003000},"page":"933-941","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":10,"title":["Long-term outcomes of intrathecal baclofen in ambulatory multiple sclerosis patients: A single-center experience"],"prefix":"10.1177","volume":"27","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1668-4753","authenticated-orcid":false,"given":"Justin R","family":"Abbatemarco","sequence":"first","affiliation":[{"name":"Mellen Center for Multiple Sclerosis Treatment and Research, Neurological Institute, Cleveland Clinic Foundation, Cleveland, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Austin","family":"Griffin","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Cleveland Clinic Foundation, Cleveland, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noble G","family":"Jones","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Duke University, Durham, NC, USA\/Kessler Institute for Rehabilitation, Department of Physical Medicine and Rehabilitation, Rutgers New Jersey Medical School, West Orange, NJ, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Hartman","sequence":"additional","affiliation":[{"name":"Mellen Center for Multiple Sclerosis Treatment and Research, Neurological Institute, Cleveland Clinic Foundation, Cleveland, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keith","family":"McKee","sequence":"additional","affiliation":[{"name":"Mellen Center for Multiple Sclerosis Treatment and Research, Neurological Institute, Cleveland Clinic Foundation, Cleveland, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhini","family":"Wang","sequence":"additional","affiliation":[{"name":"Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic Foundation, Cleveland, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean J","family":"Nagel","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Center for Neurological Restoration, Neurological Institute, Cleveland Clinic Foundation, Cleveland, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andre G","family":"Machado","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Center for Neurological Restoration, Neurological Institute, Cleveland Clinic Foundation, Cleveland, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francois","family":"Bethoux","sequence":"additional","affiliation":[{"name":"Mellen Center for Multiple Sclerosis Treatment and Research, Neurological Institute, Cleveland Clinic Foundation, Cleveland, OH, USA\/Department of Physical Medicine & Rehabilitation, Neurological Institute, Cleveland Clinic Foundation, Cleveland, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2020,7,14]]},"reference":[{"key":"bibr1-1352458520936912","doi-asserted-by":"publisher","DOI":"10.1155\/2014\/354906"},{"key":"bibr2-1352458520936912","doi-asserted-by":"publisher","DOI":"10.3109\/17482968.2011.580849"},{"key":"bibr3-1352458520936912","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(85)90228-4"},{"key":"bibr4-1352458520936912","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198906083202303"},{"key":"bibr5-1352458520936912","doi-asserted-by":"publisher","DOI":"10.3171\/jns.2002.96.6.1052"},{"key":"bibr6-1352458520936912","doi-asserted-by":"publisher","DOI":"10.1002\/mus.20900"},{"key":"bibr7-1352458520936912","doi-asserted-by":"publisher","DOI":"10.3310\/hta7400"},{"key":"bibr8-1352458520936912","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-7091-9029-6_9"},{"key":"bibr9-1352458520936912","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-005-0060-4"},{"key":"bibr10-1352458520936912","doi-asserted-by":"publisher","DOI":"10.1016\/j.msard.2018.10.009"},{"key":"bibr11-1352458520936912","doi-asserted-by":"publisher","DOI":"10.1111\/ner.12447"},{"key":"bibr12-1352458520936912","doi-asserted-by":"publisher","DOI":"10.3171\/2017.5.JNS162925"},{"key":"bibr13-1352458520936912","doi-asserted-by":"publisher","DOI":"10.1191\/026921599677595404"},{"key":"bibr14-1352458520936912","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2015.09.352"},{"key":"bibr15-1352458520936912","doi-asserted-by":"publisher","DOI":"10.1177\/1352458510395056"},{"key":"bibr16-1352458520936912","doi-asserted-by":"publisher","DOI":"10.1016\/j.clineuro.2011.10.046"},{"key":"bibr17-1352458520936912","doi-asserted-by":"publisher","DOI":"10.1007\/s11910-012-0320-5"},{"key":"bibr18-1352458520936912","doi-asserted-by":"publisher","DOI":"10.3109\/00207454.2013.812084"},{"key":"bibr19-1352458520936912","doi-asserted-by":"publisher","DOI":"10.1249\/00005768-198820020-00010"},{"key":"bibr20-1352458520936912","doi-asserted-by":"publisher","DOI":"10.1097\/01376517-200412000-00005"},{"key":"bibr21-1352458520936912","doi-asserted-by":"publisher","DOI":"10.1191\/1352458506ms1232sr"},{"key":"bibr22-1352458520936912","doi-asserted-by":"publisher","DOI":"10.1038\/sj.sc.3101647"},{"key":"bibr23-1352458520936912","doi-asserted-by":"publisher","DOI":"10.1159\/000121223"},{"key":"bibr24-1352458520936912","doi-asserted-by":"publisher","DOI":"10.1310\/tsr1304-74"},{"key":"bibr25-1352458520936912","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-9993(03)00134-5"},{"key":"bibr26-1352458520936912","first-page":"9","volume":"104","author":"Vender 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