Comparison of Oral Diazepam and Baclofen on Hand Function in Spastic Cerebral Palsy: A Prospective Randomised Study

Abstract

Abstract Introduction: Children with cerebral palsy (CP) demonstrate poor hand function due to spasticity in the flexors muscles of the upper limbs. Impairment of the upper limb function can impact on self-care abilities, activities of daily living, education, leisure activities and vocational outcomes. Oral baclofen and diazepam are commonly used as antispastic agents in patients where generalised reduction in tone is desired. There are no studies comparing the effect of diazepam and baclofen on hand function in spastic CP. Materials and Methods: A total of 61 spastic CP children were enrolled in a single-blinded randomised prospective study. Diazepam and baclofen were given in weekly incremental doses. Spasticity reduction was measured by Modified Ashworth Scale (MAS) and hand function by prehensile activities. Results: In the diazepam group, the baseline MAS score was 1.95 ± 0.4 and it was 1.83 ± 0.64 in the baclofen group. A statistically significant (P < 0.001) improvement in the mean MAS score compared to baseline (MAS score: diazepam 1.62 ± 0.40 and 1.40 ± 0.36 and baclofen 1.56 ± 0.59 and 1.30 ± 0.48, respectively) was seen in both the groups at the 1st and 3rd months. Inter-group comparison showed no significant difference. Improvement in hand function was found to be significant only after 3 months. Conclusion: Spasticity reduction contributed to improvement in hand functions in both the groups after 3 months. Both the drugs have a similar effect in terms of spasticity reduction and hand function improvement.