ABSTRACT
The main responsibilities of the physiotherapist as part of the multidisciplinary team (MDT) include assessing the individual’s spasticity before the planned trial, and recording a selection of baseline outcome measures and agreeing the main goal of treatment with the individual and MDT. This chapter presents the physiotherapy guidelines for intrathecal baclofen (ITB) therapy. For the pump implant, chest physiotherapy should be carried out prior to surgery. For pump replacement, the initial steps include assessing the individual’s spasticity pre-operatively and recording baseline outcome measures and agree the main goal of continuing treatment. It is standard practice at a pump refill appointment for the individual’s spasticity management to be reviewed, the ITB pump refilled and the ITB/oral medications reviewed. The physiotherapist should assess individuals with a new ITB pump 4–6 weeks post-operatively to review their tone, spasms, joint range, level of function and goal achievement.
