Abstract:
:The purpose of this study was to estimate the overall cost of managing focal spasticity after stroke (CVA) and traumatic brain injury (TBI) and the cost impact of individual treatments. Sixty physicians described management strategies over six treatment visits for four focal spasticity case studies (one upper and one lower extremity case for CVA and TBI). Mean and median per-case costs were determined across physicians; median per-case costs of physicians who did or did not report use of specific treatments were compared. Mean per-case costs of managing spasticity are as follows: CVA upper, $5,131; CVA lower, $5,384; TBI upper, $14,615; and TBI lower, $13,966. Median per-case costs for strategies including botulinum toxin type A (BTX-A) were less than those without BTX-A in CVA upper; median costs for strategies including oral baclofen were more than those without baclofen in CVA lower. Fewer total treatments were reported with BTX-A than without; more total treatments were reported with baclofen than without. No individual treatment had a significant impact on median treatment costs in TBI. Physician-reported spasticity management costs are substantial. Despite higher drug costs for BTX-A compared with oral therapies like baclofen, strategies for managing spasticity in CVA that include BTX-A may cost less than those without BTX-A.
journal_name
Neurorehabil Neural Repairjournal_title
Neurorehabilitation and neural repairauthors
Radensky PW,Archer JW,Dournaux SF,O'Brien CFdoi
10.1177/154596830101500108keywords:
subject
Has Abstractpub_date
2001-01-01 00:00:00pages
57-68issue
1eissn
1545-9683issn
1552-6844journal_volume
15pub_type
杂志文章abstract:BACKGROUND:Functional connectivity is defined as the temporal correlation between spatially remote neurophysiological events. This method has become particularly useful for studying neuroplasticity to detect changes in the collaboration of brain areas during cortical reorganization. METHODS:In this article, the author...
journal_title:Neurorehabilitation and neural repair
pub_type: 杂志文章
doi:10.1177/1545968311418674
更新日期:2012-02-01 00:00:00
abstract:BACKGROUND:Long-term use of a foot-drop stimulator applying functional electrical stimulation (FES) to the common peroneal nerve improves walking performance even when the stimulator is off. This "therapeutic" effect might result from neuroplastic changes. OBJECTIVE:To determine the effect of long-term use of a foot-d...
journal_title:Neurorehabilitation and neural repair
pub_type: 临床试验,杂志文章
doi:10.1177/1545968309349939
更新日期:2010-02-01 00:00:00
abstract:BACKGROUND:Many physical interventions can improve locomotor function in individuals with motor incomplete spinal cord injury (iSCI), although the training parameters that maximize recovery are not clear. Previous studies in individuals with other neurologic injuries suggest the intensity of locomotor training (LT) may...
journal_title:Neurorehabilitation and neural repair
pub_type: 杂志文章,随机对照试验
doi:10.1177/1545968317731538
更新日期:2017-10-01 00:00:00
abstract:BACKGROUND:Fatigue is a debilitating symptom in multiple sclerosis (MS). Previous studies showed no association between fatigue as perceived by the patient and physiological measures of fatigability. OBJECTIVE:The authors investigated associations between perceived fatigue and measures of fatigability after correction...
journal_title:Neurorehabilitation and neural repair
pub_type: 杂志文章
doi:10.1177/1545968311416991
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND:Predicting walking outcomes poststroke is a challenge for clinicians. OBJECTIVE:To identify the extent to which exercise dose (repetitions of leg movements) in the first week of a comprehensive stroke unit stay predicts discharge mobility. METHODS:A cohort study was conducted on 200 consecutive people admi...
journal_title:Neurorehabilitation and neural repair
pub_type: 杂志文章
doi:10.1177/1545968312439628
更新日期:2012-10-01 00:00:00
abstract:BACKGROUND:Recovery from stroke is often said to have "plateaued" after 6 to 12 months. Yet training can still improve performance even in the chronic phase. Here we investigate the biomechanics of accuracy improvements during a reaching task and test whether they are affected by the speed at which movements are practi...
journal_title:Neurorehabilitation and neural repair
pub_type: 杂志文章,随机对照试验
doi:10.1177/1545968317693112
更新日期:2017-06-01 00:00:00
abstract:BACKGROUND AND PURPOSE:Poststroke functional outcome and discharge disposition are influenced by age, lesion location and size, severity of neurological insult, prior functional ability, and social support. The effect of admission ambulation velocity on length of stay and discharge disposition has not been previously r...
journal_title:Neurorehabilitation and neural repair
pub_type: 杂志文章
doi:10.1177/1545968304272762
更新日期:2005-03-01 00:00:00
abstract:OBJECTIVE:To examine whether cerebral activity during passive movements decreases with time after stroke, and if reduced activity in the representation for the upper extremity can be reversed with training. METHODS:Brain activity was measured by functional magnetic resonance imaging (fMRI) during passive wrist flexion...
journal_title:Neurorehabilitation and neural repair
pub_type: 临床试验,杂志文章
doi:10.1177/1545968306296965
更新日期:2007-07-01 00:00:00
abstract::Neuroplasticity is critical for learning, memory, and recovery of lost function following neurological damage. Noninvasive brain stimulation (NIBS) techniques can induce neuroplastic changes in the human cortex that are behaviorally relevant, raising the exciting possibility that these techniques might be therapeutica...
journal_title:Neurorehabilitation and neural repair
pub_type: 杂志文章
doi:10.1177/1545968314562649
更新日期:2015-09-01 00:00:00
abstract::Background. Motoneuron loss is a severe medical problem that can result in loss of motor control and eventually death. We have previously demonstrated that partial motoneuron loss can result in dendritic atrophy and functional deficits in nearby surviving motoneurons, and that treatment with androgens can be neuroprot...
journal_title:Neurorehabilitation and neural repair
pub_type: 杂志文章
doi:10.1177/1545968319860485
更新日期:2019-08-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:The question of the best therapeutic window in which noninvasive brain stimulation (NIBS) could potentiate the plastic changes for motor recovery after a stroke is still unresolved. Most of the previous NIBS studies included patients in the chronic phase of recovery and very few in the subacute...
journal_title:Neurorehabilitation and neural repair
pub_type: 杂志文章
doi:10.1177/1545968314565465
更新日期:2015-09-01 00:00:00
abstract::Previous literature has suggested that reflex sympathetic dystrophy, also known as complex regional pain syndrome (CRPS) type 1, is a relatively common finding after a stroke. However, much of this data was obtained before patients routinely received early intensive inpatient rehabilitation. The purpose of this study ...
journal_title:Neurorehabilitation and neural repair
pub_type: 杂志文章
doi:10.1177/154596830001400107
更新日期:2000-01-01 00:00:00
abstract:BACKGROUND:Confidence about balance may be an important factor affecting self-efficacy for daily activities after stroke. OBJECTIVE:The authors investigated whether confidence changes and the parameters that may predict changes in self-perceived balance within the first year of community reintegration. METHODS:In thi...
journal_title:Neurorehabilitation and neural repair
pub_type: 杂志文章
doi:10.1177/1545968312437941
更新日期:2012-10-01 00:00:00
abstract::Stroke recovery research involves distinct biological and clinical targets compared to the study of acute stroke. Guidelines are proposed for the pre-clinical modeling of stroke recovery and for the alignment of pre-clinical studies to clinical trials in stroke recovery. ...
journal_title:Neurorehabilitation and neural repair
pub_type: 共识发展会议,杂志文章,实务指引
doi:10.1177/1545968317724285
更新日期:2017-08-01 00:00:00
abstract:BACKGROUND:Objective measures of functional walking remain scarce for individuals with incomplete spinal cord injury (ISCI). Hence, the authors developed the Spinal Cord Injury Functional Ambulation Profile (SCI-FAP), which encompasses the timed performance of 7 tasks, such as walking and negotiating obstacles, doors, ...
journal_title:Neurorehabilitation and neural repair
pub_type: 杂志文章
doi:10.1177/1545968310381250
更新日期:2011-03-01 00:00:00
abstract:OBJECTIVE:Recent reports have indicated that bone marrow stromal cells (BMSCs) have the potential to improve neurological function when transplanted into models of central nervous system (CNS) disorders, including traumatic spinal cord injury. In this study, the authors aimed to clarify the underlying mechanism through...
journal_title:Neurorehabilitation and neural repair
pub_type: 杂志文章
doi:10.1177/1545968308315596
更新日期:2008-09-01 00:00:00
abstract::Background. After stroke, recovery of movement in proximal and distal upper extremity (UE) muscles appears to follow different time courses, suggesting differences in their neural substrates. Objective. We sought to determine if presence or absence of motor evoked potentials (MEPs) differentially influences recovery o...
journal_title:Neurorehabilitation and neural repair
pub_type: 杂志文章
doi:10.1177/1545968319850138
更新日期:2019-07-01 00:00:00
abstract:BACKGROUND:The neural correlates of training-induced improvements of cognitive functions after brain damage remain still scarcely understood. In the specific case of aphasia, although several investigations have addressed the issue of the neural substrates of functional recovery, only a few studies have attempted to as...
journal_title:Neurorehabilitation and neural repair
pub_type: 临床试验,杂志文章
doi:10.1177/1545968306294735
更新日期:2007-03-01 00:00:00
abstract:BACKGROUND:Physical rehabilitation programs can lead to improvements in mobility in people with multiple sclerosis (PwMS). OBJECTIVE:To identify which rehabilitation program elements are employed in real life and how they might affect mobility improvement in PwMS. METHODS:Participants were divided into improved and n...
journal_title:Neurorehabilitation and neural repair
pub_type: 杂志文章,多中心研究
doi:10.1177/1545968319834893
更新日期:2019-04-01 00:00:00
abstract:PURPOSE:Walking speed is a cardinal indicator of poststroke gait performance; however, no consensus exists regarding the optimal treatment method(s) for its enhancement. The most widely accepted criterion for establishing the contribution of treatment to walking speed is the gain in speed. The actual speed, however, at...
journal_title:Neurorehabilitation and neural repair
pub_type: 杂志文章,评审
doi:10.1177/1545968308315997
更新日期:2008-11-01 00:00:00
abstract::Implementation is the use of strategies to adopt and integrate evidence-based health interventions and to change practice patterns. In their article, "Implementation-the missing link in the research translation pipeline," Lynch et al1 report that only a small fraction of published stroke rehabilitation research in lea...
journal_title:Neurorehabilitation and neural repair
pub_type: 评论,杂志文章
doi:10.1177/1545968318794904
更新日期:2018-09-01 00:00:00
abstract:BACKGROUND:Functional electrical stimulation (FES) allows active exercises in stroke patients with upper extremity paralysis. OBJECTIVE:To investigate the effect of motor training with FES on motor recovery in acute and subacute stroke patients with severe to complete arm and/or hand paralysis. METHODS:For this pilot...
journal_title:Neurorehabilitation and neural repair
pub_type: 杂志文章,随机对照试验
doi:10.1177/1545968308324548
更新日期:2009-02-01 00:00:00
abstract:BACKGROUND:Neuromuscular electrical stimulation (NMES) of the muscles underlying the pharynx and faucial pillars affects the excitability of corticobulbar projections in a frequency- and duration-specific manner. The anterior hyomandibular (submental) muscles are primary targets for the clinical application of NMES to ...
journal_title:Neurorehabilitation and neural repair
pub_type: 杂志文章
doi:10.1177/1545968309360417
更新日期:2010-07-01 00:00:00
abstract:OBJECTIVES:The purpose of this study was to establish the minimal detectable change (MDC) and clinically important differences (CIDs) of the physical domains of the Stroke Impact Scale (SIS) and to assess the proportions of patients' change scores exceeding the MDC and CIDs after stroke rehabilitation. METHODS:Seventy...
journal_title:Neurorehabilitation and neural repair
pub_type: 杂志文章,随机对照试验
doi:10.1177/1545968309356295
更新日期:2010-06-01 00:00:00
abstract:STATEMENT OF PROBLEM:To develop and evaluate a self-administered health-related quality of life (HRQOL) measure for peripheral neuropathy. METHODS:A field test measure of 162 items was developed that included the RAND-36 Health Survey as a generic core and a neuropathy-targeted supplement whose content was driven by r...
journal_title:Neurorehabilitation and neural repair
pub_type: 杂志文章
doi:10.1177/154596830001400202
更新日期:2000-01-01 00:00:00
abstract:BACKGROUND:Step length asymmetry (SLA) is a common hallmark of gait poststroke. Though conventionally viewed as a spatial deficit, SLA can result from differences in where the feet are placed relative to the body (step position strategy), the timing between foot strikes (step time strategy), or the velocity of the body...
journal_title:Neurorehabilitation and neural repair
pub_type: 杂志文章
doi:10.1177/1545968314567149
更新日期:2015-09-01 00:00:00
abstract:BACKGROUND:Our ability to sense movement is essential for motor control; however, the impact of kinesthesia deficits on functional recovery is not well monitored in the spinal cord injury (SCI) population. One problem is the lack of accurate and reliable tools to measure kinesthesia. OBJECTIVE:The purpose of this stud...
journal_title:Neurorehabilitation and neural repair
pub_type: 杂志文章
doi:10.1177/1545968315591703
更新日期:2016-03-01 00:00:00
abstract:BACKGROUND:Individuals with unilateral vestibular hypofunction (UVH) alter their movement and reduce mobility to try to stabilize their gaze and avoid symptoms of dizziness and vertigo. OBJECTIVE:To determine if individuals with UVH 6 weeks after surgery demonstrate altered head and trunk kinematics during community a...
journal_title:Neurorehabilitation and neural repair
pub_type: 杂志文章
doi:10.1177/1545968318770271
更新日期:2018-04-01 00:00:00
abstract:BACKGROUND:Low-frequency repetitive transcranial magnetic stimulation (rTMS) over the unaffected motor cortex may improve motor function of the paretic hand after stroke. However, low-frequency rTMS might adversely affect bimanual movement by decreasing transcallosal function. OBJECTIVE:The authors investigated whethe...
journal_title:Neurorehabilitation and neural repair
pub_type: 杂志文章,随机对照试验
doi:10.1177/1545968311433295
更新日期:2012-10-01 00:00:00
abstract::Background. Although dopaminergic medication improves dual task walking in people with Parkinson disease (PD), the underlying neural mechanisms are not yet fully understood. As prefrontal cognitive resources are involved in dual task walking, evaluation of the prefrontal cortex (PFC) is required. Objective. To investi...
journal_title:Neurorehabilitation and neural repair
pub_type: 杂志文章
doi:10.1177/1545968320924430
更新日期:2020-07-01 00:00:00