Skip to main content
Log in

Effects of baclofen on oral counting, arithmetic, and symbol decoding: An explorative multiple-baseline design across subjects

  • Published:
International Journal of Rehabilitation and Health

Abstract

Sedation is a well-recognized side effect of the antispasticity medication baclofen. The literature discussing baclofen has shown that it is detrimental to memory and learning in individuals with known cognitive dysfunction. There is no information on how baclofen effects the function of individuals with normal baseline cognition despite frequent clinical reports of symptoms. This study explored the effect of baclofen on counting, arithmetic, and symbol decoding over a 9-week period of time on five adult males with traumatic spinal cord injury and no known cognitive dysfunction. We employed a repeated-measures, multiple baseline, double-blind, single-subject research design. The independent variable was antispasticity medication treatment, where the levels were 40 and 80 mg/day of baclofen versus placebo treatment. The dependent variables were speed and accuracy of counting integers, solving arithmetic problems, and decoding symbols. Slope and trend analysis of these data showed no change in counting and arithmetic tasks for all five subjects between each phase of the study. Changes were evident regarding ability to decode symbols, with varying trends across phases and subjects. Results of this study showed that baclofen, in low to moderate doses, did not seem to affect subjects' performance of oral counting or solving arithmetic problems. Baclofen did affect subjects' performance of symbol decoding, but with no consistent trend. These results suggest that further study of problem solving and memory funtion during baclofen administration would be useful.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • American Medical Association (1993).AMA Drug Evaluations, AMA, Chicago, pp. 407–410.

    Google Scholar 

  • Batshaw, M. L., and Perret, Y. M. (1986).Children with Handicaps: A Medical Primer, Paul H. Brookes, Baltimore.

    Google Scholar 

  • Burke, D., Andrews, C. J., and Knowles, L. (1971). The action of a GABA derivative in human spasticity.Neurol. Sci. 14: 199–208.

    Google Scholar 

  • Cartlidge, N. E. F., Hudgson, P., and Weightman, D. (1974). A comparison of baclofen and diazepam in the treatment of spasticity.J. Neurol. Surg. 23: 17–34.

    Google Scholar 

  • Duncan, G. W., Shahani, B. T., and Young, R. R. (1976). An evaluation of baclofen treatment for certain symptoms in patients with spinal cord lesions.Neurology 26: 441–446.

    PubMed  Google Scholar 

  • Feldman, R. G., Kelly-Hayes, M., Conomy, J. P., and Foley, J. M. (1978). Baclofen for spasticity in multiple sclerosis. Double-blind crossover and three-year study.Neurology 28: 1094–1098.

    PubMed  Google Scholar 

  • From, A., and Heltberg, A. (1975). A double-blind trial with baclofen (Lioresal) and diazepam in spasticity due to multiple sclerosis.Acta Neurol. Scand. 51: 158–166.

    PubMed  Google Scholar 

  • Gadow, K. (1986a).Children on Medication, Vol. 1, College Hill Press, San Diego, CA.

    Google Scholar 

  • Gadow, K. (1986b).Children on Medication, Vol. 2, College Hill Press, San Diego, CA.

    Google Scholar 

  • Gilman, A. G., Rall, T. W., Nies, A. S., and Taylor, P. (1990).The Pharmacologic Basis of Therapeutics, 8th ed., Macmillan, New York, pp. 479–480.

    Google Scholar 

  • Guyatt, G., Sackett, D., Taylor, D. W., Chong, J., Roberts, R., and Pugsley, S. (1986). Determining optimal therapy—randomized trials in individual patients.N. Engl. J. Med. 314: 889–892.

    PubMed  Google Scholar 

  • Harris, F., and Jenson, W. (1985). Comparisons of multiple-baseline across persons designs and AB designs with replication: Issues and confusions.Behav. Assess. 7: 121–127.

    Google Scholar 

  • Hassan, H., and McLellan, D. L. (1980). Double-blind comparison of single doses of DS 103-282, baclofen and placebo for suppression of spasticity.J. Neurol. Neurosurg. Psychiat. 48: 1132–1136.

    Google Scholar 

  • Hersen, M., and Barlow, D. (1976).Single Case Experimental Designs: Strategies for Studying Behavior Change, Pergamon Press, New York, pp. 35–69.

    Google Scholar 

  • Hinderer, S. R. (1990). The anxiolytic effect of baclofen as it relates to spasticity reduction.Am. J. Phys. Med. Rehab. 69(5): 254–258.

    Google Scholar 

  • Hinderer, S. R., Lehmann, J. F., Price, R., de Lateur, B. J., White, O., and Deitz, J. (1990). Spasticity in spinal cord injury: Quantitative effects of baclofen and placeto treatment.Am. J. Phys. Med. Rehab. 69(6): 311–317.

    Google Scholar 

  • Hudgson, P., and Weightman, D. (1970). Baclofen in the treatment of spasticity.Br. Med. J. 4 15–17.

    Google Scholar 

  • Jones, R. F., Burke, D., Marosszeky, J. E., and Gillies, J. D. (1970). A new agent for the control of spasticity.J. Neurol. Neurosurg. Psychiat. 33: 464–468.

    PubMed  Google Scholar 

  • Kazdin, A. E. (1976). Statistical analyses for single-case experimental design. In Hersen, M., and Barlow, D. (eds.),Single-Case Experimental Designs: Strategies for Studying Behavior Change, Pergamon Press, New York, pp. 265–316.

    Google Scholar 

  • Kazdin, A. E. (1982).Single-Case Research Designs: Methods for Clinical and Applied Settings, Oxford University Press, New York, pp. 126–151.

    Google Scholar 

  • Landau, W. M. (1974). Spsticity: The fable of a neurological demon and the emperor's new therapy.Arch. Neurol. 31: 217–219.

    PubMed  Google Scholar 

  • Martin, J. E., and Epstein, L. (1976). Evaluating treatment effectiveness in cerebral palsy.Phys. Ther. 64: 285–294.

    Google Scholar 

  • McLellan, D. L. (1977). Co-contraction and stretch reflexes in spasticity during treatment with baclofen.J. Neurol. Neurosurg. Pschiat. 40: 30–38.

    Google Scholar 

  • McLellan, D. L. (1983). The drug treatment of spasticity.Int. Rehab. Med. 5: 141–152.

    Google Scholar 

  • Ottenbacher, K. J. (1986).Evaluating Clinical Change: Strategies for Occupational and Physical Therapists Williams & Wilkins, Baltimore, pp. 137–166.

    Google Scholar 

  • Parsonen, B., and Baer, D. (1978). The analysis and presentation of graphic data. In Kratochwill, T. (ed.),Single-Case Research: Strategies for Evaluating Change, Academic Press, New York.

    Google Scholar 

  • Patterson, H. R., Gustafson, E. A., and Sheridan, E. S. (1984).Current Drug Handbook, W. B. Saunders, Philadelphia.

    Google Scholar 

  • Pedersen, E., Arlien-Soborg, P., Grynderup, V., and Henriksen, O. (1984). GABA derivative in spasticity.Acta Neurol. Scand. 6: 257–266.

    Google Scholar 

  • Physician's Desk Reference (1995). Medical Economics, Montvale, NJ, pp. 1065–1066.

  • Revusky, S. H. (1967). Some statistical treatments compatible with individual organism methodology.J. Exp. Anal. Behav. 10: 319–330.

    PubMed  Google Scholar 

  • Reynolds, E. H. (1983). Mental effects of antiepileoptic medication: A review.Epilepsia 24 (Suppl. 2): S85-S95.

    PubMed  Google Scholar 

  • Tukey, J. W. (1977).Exploratory Data Analysis, Addison-Wesley, Reading, PA.

    Google Scholar 

  • University of Washington Department of Rehabilitation Medicine (1983). Unpublished data from the Regional Spinal Cord Injury Unit.

  • White, O. (1972). A pragmatic approach to the description of progress in the single case.Dissert. Abstr. Int. 32: 508A. (University of Washington Microfilms No. 72-08618).

    Google Scholar 

  • White, O. (1984). Selected issues in program evaluation: Arguments for the individual.Adv. Spec. Educ. 4: 69–121.

    Google Scholar 

  • Young, J. S., Burns, P. E., Bowen, A. M., and McCutchen, R. (1982).Spinal Cord Injury Statistics, Good Samaritan Medical Center, Phoenix, AZ.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hinderer, S.R., Liberty, K. Effects of baclofen on oral counting, arithmetic, and symbol decoding: An explorative multiple-baseline design across subjects. Int J Rehab Health 2, 41–55 (1996). https://doi.org/10.1007/BF02213563

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02213563

Key Words

Navigation