Rehabilitation After Intrathecal Baclofen Pump Placement

• Your body might feel weak after the pump placement surgery.
• You will need to practice sitting and transfers before you leave the hospital. 

A baclofen pump is a “hockey-puck” size pump that is surgically placed just under the skin of your abdomen. A thin tube, called a catheter, connects the pump to the fluid area around your spinal cord. Baclofen from the pump delivered to the spinal cord can help decrease spasticity, stiffness or tightness in the muscles of your arms and legs. 

Two incisions were made when your baclofen pump was placed-—one on your abdomen and one at the middle of your back. You might have some discomfort or be tender at these areas for a few days. 

You should wear an abdominal binder full-time for at least 12 weeks after surgery. An abdominal binder is a wide elastic band that fits around your waist and attaches with Velcro. It helps to prevent swelling at the pump site. You should avoid “fiddling” with the pump because this might cause it to become loose. 

Physical and/or occupational therapy might be appropriate during your hospital stay and might include: 

• Range of motion exercises: A therapist will gently move your legs and arms at different speeds. 
• Bed mobility and transfers: You might need more assistance with bed mobility and transfers than before surgery. You’ll be shown how to log roll. It is important that your back is fully supported during transfers. You might need to use a mechanical lift (hoyer) or sliding board for a while after surgery. 
• Checking the fit of your wheelchair and braces 
• Walking: If you were able to stand and walk before surgery you might be able to begin standing and walking before you leave the hospital. However, because your legs will be weak after surgery, you might need to use a walker, crutches, or a wheelchair until you are stronger. 

• For six weeks after your surgery, avoid twisting your back when you roll in bed by log rolling. Your hips and shoulders should move together as a unit when you log roll. Also, be very gentle when you bend your body forward or back, reach overhead or twist when you are sitting, standing or lying down. 

If you have people who help you move, they should also be very gentle. Any forceful bending, pulling or twisting could dislodge or pinch the catheter on your baclofen pump. 

• Avoid straight leg raises or other aggressive hamstring stretches for 6 weeks. You should continue with any other stretching and exercises for your arms and legs. 
• You can lie on your stomach (prone lying) after the pump site is fully healed and does not hurt any more. Pressure should be evenly distributed over your entire abdomen. Avoid concentrated or uneven pressure directly over your pump site. 
• Check seatbelts, straps and other pads on your wheelchair, gait trainer/stander or other positioning equipment. You will need to adjust your equipment if you have pressure over the pump site. 
• Ask your doctor if it is okay for you to use a harness for gait training (e.g. Lite Gait). Some physical therapy treatments, such as electrical stimulation and ultrasound, should not be used within 6 inches of the pump.

If you had your baclofen pump placed to decrease pain and improve positioning, you might not require additional therapy after you leave the hospital. You can go back to the exercises and stretches that you did before your surgery, except for hamstring stretching. 

If you had your baclofen pump placed to improve your mobility, you should participate in outpatient physical and/or occupational therapy. Your health care provider will tell you when you can start outpatient therapy. 

Please ask your health care provider if you have specific questions about returning to sports, recreational activities or travel.