Abstract：
:Sporadic cases of recovery from persistent vegetative state (PVS) after administration of intrathecal baclofen (ITB) have been reported without giving any possible explanation for its paradoxical effect. We summarize our recent findings on 5 patients with PVS treated with ITB and make some speculations on the mechanisms responsible for the observed clinical improvement. The patients developed spasticity and were judged eligible for ITB therapy. Two weeks after pump implantation, patients began to show a clinical improvement that, at the end of the 6 months' follow-up, was stable in all but 1 patient, ranging from a mere increased alertness to a full recovery of consciousness, as revealed by changes of the Coma Recovery Scale-Revised (CRS-R) score. Our findings suggest that ITB might favor a variable degree of clinical improvement. A proposal for a pharmacodynamic explanation of this effect has not been formally put forward. We hypothesize 2 possible mechanisms: first, a modulation confined to spinal cord segmental activities and to neuronal centripetal outputs reaching the cortex; and second, a modulation of sleep-wake cycles that, although present, may be dysregulated and interfere with alertness and awareness. Although our research is confined to a few subjects, it provides follow-up information by means of the CRS-R that is a validated standardized neurobehavioral instrument expressly designed for use in patients with PVS. Our observations indicate that further systematic investigation of the mechanisms and the putative clinical applications of ITB should be undertaken.
journal_name
Arch Phys Med Rehabiljournal_title
Archives of physical medicine and rehabilitationauthors
Sarà M,Pistoia F,Mura E,Onorati P,Govoni Sdoi
10.1016/j.apmr.2009.01.012subject
Has Abstractpub_date
2009-07-01 00:00:00pages
1245-9issue
7eissn
0003-9993issn
1532-821Xpii
S0003-9993(09)00205-6journal_volume
90pub_type
杂志文章abstract：OBJECTIVE:To characterize the association between traumatic brain injury (TBI) and chronic pain and pain disability in the context of comorbid conditions, posttraumatic stress disorder (PTSD), and depression to better inform care of combat veterans. DESIGN:Retrospective cohort study. SETTING:Medical centers and commu...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章
doi：10.1016/j.apmr.2017.03.026
更新日期：2017-08-01 00:00:00
abstract：OBJECTIVE:To determine whether physical activity may affect cognitive performance in patients with Parkinson's disease by measuring reaction times in patients participating in the Berlin BIG study. DESIGN:Randomized controlled trial, rater-blinded. SETTING:Ambulatory care. PARTICIPANTS:Patients with mild to moderate...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.apmr.2013.10.020
更新日期：2014-05-01 00:00:00
abstract：OBJECTIVE:To determine the impact of long-term, body weight-supported locomotor training after chronic, incomplete spinal cord injury (SCI), and to estimate the health care costs related to lost recovery potential and preventable secondary complications that may have occurred because of visit limits imposed by insurers...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章
doi：10.1016/j.apmr.2017.10.003
更新日期：2018-03-01 00:00:00
abstract：:The postacute continuum of nonhospital-based services has experienced rapid growth over the past decade because of a variety of economic factors. Medicare's prospective payment system for inpatient hospital stays combined with the diagnostic requirements of patients in acute medical rehabilitation and the growth of ma...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章
doi：10.1016/s0003--999(3()95)81395--0
更新日期：1995-12-01 00:00:00
abstract：:A recently developed abdominal muscle test (AMT), using four levels of difficulty to assess abdominal muscle strength, was validated by examination of the functional interrelationship between the individual muscles during the AMT, and by determining the relationship between the AMT level of difficulty and electromyogr...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章
doi：
更新日期：1994-09-01 00:00:00
abstract：OBJECTIVES:To confirm and extend previous results involving repetitive transcranial magnetic stimulation (rTMS) aimed at alleviating refractory central neuropathic pain (CNP). To evaluate pain relief in detail and to assess ongoing benefits after one year of treatment. DESIGN:Prospective observational study. SETTING:...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章
doi：10.1016/j.apmr.2018.04.013
更新日期：2018-11-01 00:00:00
abstract：OBJECTIVE:To examine for differences in joint position sense (JPS) between knees with reconstructed anterior cruciate ligaments (ACLs) and uninjured knees by using a functional weight-bearing measurement method. DESIGN:Two-way repeated-measures in a convenience sample. SETTING:An Australian university rehabilitation ...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章
doi：10.1016/s0003-9993(03)00007-8
更新日期：2003-06-01 00:00:00
abstract：OBJECTIVES:To identify common pain descriptors used by people with physical disability-related pain and to suggest words that are likely to prompt responses in clinical interviews and assessments. DESIGN:Open-ended interviews were coded and then contrasted with responses to a pain questionnaire, obtained through mail ...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章
doi：10.1016/j.apmr.2004.01.034
更新日期：2005-01-01 00:00:00
abstract：OBJECTIVE:To determine whether paretic arm reaching performance is improved in bilateral compared with unilateral conditions. DESIGN:Cohort study. SETTING:University human performance laboratory. PARTICIPANTS:Thirty-two subjects with chronic stroke (57+/-14y; on Fugl-Meyer Assessment arm score, 37+/-14). INTERVENTI...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章
doi：10.1016/j.apmr.2005.05.006
更新日期：2005-11-01 00:00:00
abstract：OBJECTIVES:To describe the prevalence of greater trochanteric pain syndrome (GTPS); to determine whether GTPS is associated with iliotibial band (ITB) tenderness, knee osteoarthritis (OA), body mass index (BMI), or low back pain (LBP); and to assess whether GTPS is associated with reduced hip internal rotation, physica...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章,多中心研究
doi：10.1016/j.apmr.2007.04.014
更新日期：2007-08-01 00:00:00
abstract：OBJECTIVE:To test the effectiveness of the GivMohr sling in reducing subluxation while providing joint compression through a flaccid limb, using the criterion standard of radiography for measuring subluxation. DESIGN:Anteroposterior 0 degree radiographs were taken of each subject: 1 of the unaffected shoulder and 3 of...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 临床试验,杂志文章,多中心研究
doi：10.1016/j.apmr.2005.07.291
更新日期：2005-12-01 00:00:00
abstract：OBJECTIVES:To develop functional ability levels for the Spinal Cord Injury Functional Index (SCI-FI) and to validate them using calibration and reliability samples. DESIGN:Three-phase strategy involved (1) performing quantitative synthesis of SCI-FI data to create item maps; (2) using a panel of experts to identify fu...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章
doi：10.1016/j.apmr.2014.11.008
更新日期：2015-08-01 00:00:00
abstract：OBJECTIVE:To compare quadriceps fatigability during maximal concentric contractions in persons with multiple sclerosis (MS) and healthy subjects. DESIGN:Observational study. SETTING:Hospital rehabilitation department. PARTICIPANTS:Persons with MS (n=38) and healthy subjects (n=14) were included (N=52). Torque of the...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章
doi：10.1016/j.apmr.2016.12.014
更新日期：2017-07-01 00:00:00
abstract：OBJECTIVE:To determine outcomes of surviving patients who underwent transfemoral amputation as part of treatment for lower extremity malignancy at a mean 15 years postoperatively, with a minimum 2-year follow-up. DESIGN:Retrospective, case control. SETTING:Tertiary care university medical center. PATIENTS:Thirty-fiv...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章
doi：10.1053/apmr.2002.27461
更新日期：2002-02-01 00:00:00
abstract：OBJECTIVE:To investigate the effects of pulsed magnetic fields (PMF) and pulsed electromagnetic fields (PEMF) on healing in experimental Achilles tendon inflammation in the rat. DESIGN:Prospective randomized trial. SETTING:University medical school. METHODS:Exposure of the Achilles tendon and injury by a weight of 9...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1016/s0003-9993(97)90232-x
更新日期：1997-04-01 00:00:00
abstract：OBJECTIVE:To determine the effectiveness of an ankle-foot orthosis (AFO) on mobility, walking, and balance in people with stroke. DATA SOURCES:The following databases were searched from inception to November 2011: Cochrane Stroke, Movement Disorders and Injuries Groups, MEDLINE, Embase, CINAHL, AMED, PsycINFO, and the...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章,meta分析,评审
doi：10.1016/j.apmr.2012.12.025
更新日期：2013-07-01 00:00:00
abstract：OBJECTIVE:To assess the rehabilitation needs of stroke survivors in Chennai, India, after discharge from the hospital. DESIGN:Mixed-methods research design. SETTING:Home-based. PARTICIPANTS:Stroke survivors (n=50; mean age ± SD, 58.9±10.5y) and primary caregivers of these stroke survivors (n=50; mean age ± SD, 43.1±...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章
doi：10.1016/j.apmr.2016.02.008
更新日期：2016-09-01 00:00:00
abstract：:Intracerebral hemorrhage is an unusual complication of autonomic dysreflexia and can be fatal if massive bleeding occurs with brain herniation. We report the case of a man in his midthirties with incomplete tetraplegia who suffered right putaminal hemorrhage during an episode of autonomic dysreflexia. Prompt recogniti...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章
doi：10.1016/j.apmr.2004.03.021
更新日期：2005-03-01 00:00:00
abstract：OBJECTIVE:To determine immunogenicity and optimum timing for administering the 23-valent pneumococcal vaccine after spinal cord injury (SCI). DESIGN:Double-blind, randomized, placebo control study. SETTING:SCI unit in a tertiary care medical center and community. PARTICIPANTS:Eighty-seven persons with recent SCI. I...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1016/s0003-9993(98)90410-5
更新日期：1998-12-01 00:00:00
abstract：OBJECTIVE:To test the hypothesis that use of a cane in the nondominant hand during challenging balance tasks would significantly decrease loss of balance in patients with peripheral neuropathy while transferring from bipedal to unipedal stance on an unsteady surface. DESIGN:Nonrandomized control study. SETTING:Tertia...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章
doi：10.1016/s0003-9993(96)90032-5
更新日期：1996-05-01 00:00:00
abstract：OBJECTIVE:To determine whether dextrose prolotherapy offers clinical benefits in patients with shoulder pain and bursitis. DESIGN:Double-blinded, randomized controlled trial. SETTING:Outpatient rehabilitation department of a single medical center. PARTICIPANTS:Patients (N=50) who had received a diagnosis of shoulder...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章
doi：10.1016/j.apmr.2020.08.010
更新日期：2021-02-01 00:00:00
abstract：:The prevention of pressure sores for patients with spinal cord injuries includes pressure relief through the patient shifting position and, thus, weight. We have designed a microprocessor-based device to mount on the seat of a conventional wheelchair. This device has applications in hospital rehabilitation programs fo...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章
doi：10.1016/0003-9993(86)90067-5
更新日期：1986-03-01 00:00:00
abstract：OBJECTIVES:To determine preliminary efficacy and to identify baseline characteristics predicting who would benefit most from fast walking training plus a step activity monitoring program (FAST+SAM) compared with fast walking training (FAST) alone in persons with chronic stroke. DESIGN:Randomized controlled trial with ...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.apmr.2016.01.039
更新日期：2016-09-01 00:00:00
abstract：:Hyposexuality is a common problem in stroke patients. Some stroke patients, however, may present with hypersexuality. We report three stroke patients who demonstrated hypersexuality and deviant sexual behavior after stroke. Abnormal sexual behavior was noted by members of the stroke rehabilitation team while the patie...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章
doi：
更新日期：1986-06-01 00:00:00
abstract：OBJECTIVE:To evaluate long-term outcomes of a noninvasive cortical stimulation technology in the treatment of fibromyalgia (FM). DESIGN:After trial follow-up survey of subjects who had completed a randomized, controlled, double-blind study of noninvasive cortical stimulation therapy some 45 months previously. SETTING...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.apmr.2012.04.006
更新日期：2012-10-01 00:00:00
abstract：OBJECTIVE:To define further the relation between unipedal stance testing and peripheral neuropathy. DESIGN:Prospective cohort. SETTING:Electroneuromyography laboratory of a Veterans Affairs medical center and a university hospital. PATIENTS:Ninety-two patients referred for lower extremity electrodiagnostic studies. ...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章
doi：10.1053/apmr.2001.17830
更新日期：2001-02-01 00:00:00
abstract：:The Centers for Disease Control and Prevention (CDC) published "The Report to Congress on the Management of Traumatic Brain Injury in Children" in the spring of 2018. The report is a call to action for professionals providing care for children with traumatic brain injury in the health, social, and educational sectors ...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章
doi：10.1016/j.apmr.2018.05.012
更新日期：2018-11-01 00:00:00
abstract：OBJECTIVE:To compare cardiorespiratory responses between pool floor walking and overground walking (OW) in people poststroke. DESIGN:Cross-sectional study. SETTING:University-based therapeutic exercise facility. PARTICIPANTS:Participants (N=28) were comprised of 14 community-dwelling individuals poststroke (5.57±3.5...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章
doi：10.1016/j.apmr.2017.09.112
更新日期：2018-03-01 00:00:00
abstract：OBJECTIVE:To examine and describe regional variation in outcomes for persons with stroke receiving inpatient medical rehabilitation. DESIGN:Retrospective cohort design. SETTING:Inpatient rehabilitation units and facilities contributing to the Uniform Data System for Medical Rehabilitation from the United States. PAR...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章,多中心研究
doi：10.1016/j.apmr.2013.07.018
更新日期：2014-01-01 00:00:00
abstract：:Muscle spasm is often considered to be a prominent feature operating in chronic low back spin syndrome (LBP). The present study compared levels of paralumbar muscle activity, determined by an electromyogram (EMG), for LBP patients and normal subjects during periods of rest and voluntary muscular contraction. The resti...
journal_title：Archives of physical medicine and rehabilitation
pub_type： 杂志文章
doi：
更新日期：1981-04-01 00:00:00
