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OBJECTIVE To determine the effect of subacute administration of methylphenidate on recovery from moderate to moderately severe closed head injury. DESIGN Double-blind placebo-controlled with random assignment. Patients were enrolled when their Galveston Orientation and Amnesia Test score was at least 65. Drug/placebo treatment began the day following(More)
BACKGROUND While spasticity is commonly treated with oral agents or botulinum neurotoxin (BoNT) injection, these treatments have not been systematically compared. METHODS This study performed a randomised, double-blind, placebo-controlled trial to compare injection of BoNT-Type A into spastic upper limb muscles versus oral tizanidine (TZD), or placebo, in(More)
BACKGROUND Amantadine hydrochloride is one of the most commonly prescribed medications for patients with prolonged disorders of consciousness after traumatic brain injury. Preliminary studies have suggested that amantadine may promote functional recovery. METHODS We enrolled 184 patients who were in a vegetative or minimally conscious state 4 to 16 weeks(More)
OBJECTIVE To update the 2008 American Academy of Neurology (AAN) guidelines regarding botulinum neurotoxin for blepharospasm, cervical dystonia (CD), headache, and adult spasticity. METHODS We searched the literature for relevant articles and classified them using 2004 AAN criteria. RESULTS AND RECOMMENDATIONS Blepharospasm: OnabotulinumtoxinA(More)
BACKGROUND Intrathecal baclofen (ITB) effectively reduces muscle hypertonia; however, associated complications influence its utility and acceptance. OBJECTIVE To systematically review the literature on procedure- and device-related complications associated with ITB infusion therapy for adult muscle hypertonia of spinal or cerebral origin. METHODS The(More)
OBJECTIVE To assess the incidence of medical complications in patients with recent traumatic disorders of consciousness (DOCs). DESIGN Data on adverse events in a placebo controlled trial of amantadine hydrochloride revealed no group difference, which allowed these events to be reanalyzed descriptively as medical complications experienced by the 2 groups(More)
OBJECTIVE Investigate the impact of race on productivity outcome after traumatic brain injury (TBI) and evaluate the influence of confounding factors on this relationship. DESIGN Inception cohort of 1083 adults with TBI for whom 1-year productivity follow-up data were available. RESULTS Univariable logistic regression indicated that race was a(More)
OBJECTIVES To evaluate predictors of early impaired self-awareness after traumatic brain injury (TBI); to examine interrelationships of the perceptions of patient, clinician, family, and significant other of how patients are functioning after TBI; and to determine how early impaired self-awareness helps to predict employability at rehabilitation discharge.(More)
BACKGROUND Impaired self-awareness (ISA) is common among patients with severe traumatic brain injury (TBI) and contributes to poorer functional outcome. There is keen interest in improving the understanding of this disorder as the neuroanatomic substrate of posttraumatic ISA is poorly understood. OBJECTIVE Determine whether (1) greater number of brain(More)
OBJECTIVE Examine (1) coactivation between tibialis anterior (TA) and medial gastrocnemius (MG) muscles during stance phase of gait in patients with moderate-to-severe resting hypertonia after stroke or traumatic brain injury (TBI) and (2) the relationship between coactivation and stretch velocity-dependent increase in MG activity. METHODS Gait and(More)