Goal Setting and Expectations

Every patient with severe spasticity has different goals they would like to achieve during their screening trial and during therapy. Depending on their current abilities and functioning, including degree of ambulation, goals could either be passive, active, or both.1

Goals That Can Be Achieved With ITB Therapy1,2

Active Goals Passive Goals

Improved mobility (eg, ambulation speed, safety, and quality of ambulation in the home or community), standing capacity, sitting balance or tolerance

Improved positioning

Increased ability and independence for activities of daily living (eg, dressing, cleaning, eating)

Improved wheelchair tolerance and transfers
Decreased time for activities of daily living Decreased caregiver burden and time needed for care
Reduced time for in-home exercises or stretching Reduced spasticity-related pain and stiffness
Improved participation, including improved endurance Prevention of complications (eg, contractures)
Discontinuation of oral antispastic medications
Reduced falls
Improved skin integrity

When setting goals, remember to be realistic about what can happen during the course of 1 day. Often patients and their families can be unrealistic and seek functional improvements that are unlikely to be obtained. Input for goals should come from many sources, including the treatment team, families or caregivers, and the patients themselves. These may change and develop over time, but should be agreed upon by everyone involved.3 Depending on the patient’s response during the screening test, additional goals may be set. After completing a successful trial, a discussion with the treatment team and the patient and their caregivers about the long-term treatment goals should occur to set expectations and guide continued therapy.1

See what is possible with Lioresal® Intrathecal (baclofen injection).

Safety and effectiveness in pediatric patients below the age of 4 have not been established.

"Even though he has cerebral palsy, we want our son to do as many regular activities as possible."

“My goal is to continue to be active and independent - and not let severe spasticity slow me or my family down.”

"My goal is to effectively manage my spasticity so I can continue to advance my career."

  1. Boster AL, Bennett SE, Bilsky GS, et al. Best practices for intrathecal baclofen therapy: screening test. Neuromodulation. 2016;19(6):616-622.
  2. Saulino M, Ivanhoe CB, McGuire JR, et al. Best practices for intrathecal baclofen therapy: patient selection. Neuromodulation. 2016;19(6):607-615.
  3. Elovic E, Brashear A. Chapter 9: Setting realistic and meaningful goals for treatment. In: Brashear A, Elovic E, eds. Spasticity: Diagnosis and Management. 2nd ed. New York, NY: Demos Medical Publishing, LLC, 2016.

Important Safety Information for Lioresal® Intrathecal (baclofen injection)

Abrupt discontinuation of intrathecal baclofen, regardless of the cause, has resulted in sequelae that include high fever, altered mental status, exaggerated rebound spasticity, and muscle rigidity, that in rare cases has advanced to rhabdomyolysis, multiple organ-system failure and death.

Prevention of abrupt discontinuation of intrathecal baclofen requires careful attention to programming and monitoring of the infusion system, refill scheduling and procedures, and pump alarms. Patients and caregivers should be advised of the importance of keeping scheduled refill visits and should be educated on the early symptoms of baclofen withdrawal. Special attention should be given to patients at apparent risk (e.g. spinal cord injuries at T-6 or above, communication difficulties, history of withdrawal symptoms from oral or intrathecal baclofen). Consult the technical manual of the implantable infusion system for additional postimplant clinician and patient information (see WARNINGS).

Indications and Usage


Select Warnings and Precautions

Adverse Reactions

Common Adverse Reactions

Serious Adverse Reactions

Postmarketing Experience

Use in Specific Populations

For more information, including BOXED WARNING, refer to Lioresal® Intrathecal (baclofen injection) prescribing information.