Eighteen studies were included in the review. The total number of participants included in the review was unclear as a result of overlap in the different study populations.
Effects of ITB on spastic CP.
Of 49 measures of impairment, 20 (5 level I, 7 level II, 1 level III, 4 level 4, 3 level V) found a statistically significant improvement with ITB relative to placebo or no treatment, 10 (7 level II, 3 level III) found an improvement that was not statistically assessed, one (level V) found a statistically significant deterioration, 5 (2 level II, 3 level III) found a deterioration that was not statistically assessed, and 13 (1 level I, 3 level II, 1 level III, 6 level IV, 2 level IV) found no change.
Of 22 measures of functional limitation/activity, 6 (all level IV) showed a statistically significant improvement with ITB relative to placebo or no treatment, 7 (1 level III, 6 level V) showed an improvement that was not statistically assessed, none showed a deterioration, and 9 (1 level I, 2 level II, 6 level IV) showed no change.
One level V measure of disability/participation showed an improvement with ITB relative to placebo or no treatment, which was not statistically assessed.
One level IV measure of societal limitation/context found a deterioration with ITB that was not statistically assessed.
No human studies examining the pathophysiology of ITB were found.
With the exception of one study, adverse effects and medical complications of ITB were not specifically available for participants with CP. Complications related to catheter and pump occurred with equal frequency as adverse events. The most common adverse effects with ITB were somnolence and hypotonia; headache, nausea and vomiting were also common. Infections and cerebrospinal fluid leaks occurred less often.
Effects of ITB on dystonic CP.
Two level IV measures found a significant positive effect of ITB on impairment, 3 level V measures found a positive effect that was not statistically evaluated, 1 level V study found a negative effect that was not statistically evaluated, and 1 level V study found no change in impairment.
One level V measure found a positive effect of ITB on functional limitation/activity and 1 level V measure found no change in functional limitation/activity. No studies measured the effects of ITB on disability/participation or societal limitation/context.
The effects of ITB on dystonia were studied in 15 individuals. Of these, there was one complication of lethargy and 3 complications of infection (one meningitis).
Where available, the numbers of participants showing positive, negative or unchanged results as a result of ITB were also presented for each outcome measure in each study.