SEARCH · Search PubMed

Results for “Recovery of Function”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

SourceResearch connectionFrom yearThrough year

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 73 records · Page 4Linked to original sources

PubMed1999

Stroke. Neurologic and functional recovery the Copenhagen Stroke Study.

Neurologic and functional recovery is dependent on a large variety of factors such as initial stroke severity, body temperature and blood glucose in the acute phase of stroke, stroke in progression, and treatment and rehabilitation on a dedicated stroke unit. The most important factor for recovery remains the initial severity of the stroke. In unselected patients 19% of the strokes are very severe, 14% are severe, 26% are moderate, and 41% are mild. In survivors, neurologic impairment after completed rehabilitation is still severe or very severe in 11%, moderate in 11%, mild in 47%, and 31% have achieved normal neurologic function. The ability to perform basic activities of daily living initially is reduced in three out of four patients with stroke. Most often affected is the ability to transfer, dress, and walk. After completed rehabilitation the group with moderate and severe disability is reduced from 50% to 25%, and the group with mild or no disability is increased from 50% to 75%. The prognosis of patients with mild or moderate stroke generally is excellent. Patients with severe stroke have a very variable recovery. Although the prognosis of patients with the most severe stroke is generally poor, one third of the survivors in this group are able to be discharged back to their own homes with no or only mild disability, if rehabilitated on a dedicated stroke unit. Functional recovery generally was completed within 3 months of stroke onset. Patients with mild stroke, however, recover within 2 months, patients with moderate stroke within 3 months, patients with severe stroke within 4 months, and patients with the most severe strokes have their functional recovery within 5 months from onset. Functional recovery is preceded by neurologic recovery by a mean of 2 weeks.

Activities of Daily Living↗

PubMed2005

Functional recovery of rat hind-limb allografts.

Few papers have assessed the long-term functional recovery of animal limb allografts. In this study, the functional recovery of rat limb allografts was serially and quantitatively investigated for a period of 1 year. The donor's hind limb was orthotopically transplanted into the recipient. Fifteen recipients with allografts were treated with FK506. Functional recovery of the grafted limb was assessed serially by cutaneous reaction test, walking track analysis, and electrophysiologic evaluation. Sensibility improved to a similar extent in both isografts and allografts, and the recovery rate at 1 year was 68 percent, compared to the normal side. Sciatic function index significantly improved to - 70 points after 1 year. The amplitude recorded from the gastrocnemius muscle significantly improved, and the ratio compared to the normal side was 43 percent. Limb isografts and allografts treated with FK506 showed no significant differences in functional recovery. The data can be used as a reference standard for future investigations.

Animals↗

PubMed2003

Cognitive screening predicts magnitude of functional recovery from admission to 3 months after discharge in hospitalized elders.

BACKGROUND: Many older adults lose functional ability during the course of acute illness and fail to recover function. We sought to determine whether performance on a cognitive screen at the time of hospital admission predicted the magnitude of functional recovery after hospitalization. METHODS: We studied 2557 patients from two teaching hospitals to examine the association between level of impaired performance on a cognitive status screen and maintenance and recovery of functioning from admission through 90 days after discharge. On admission, 14% had mildly impaired cognitive performance with three or four errors on the Short Portable Mental Status Questionnaire; 28% had moderate to severely impaired cognitive performance with five or more errors on the cognitive status screen or inability to complete the screen and a diagnosis of dementia. RESULTS: Performance on a brief cognitive screen on admission was strongly related to subsequent change in function. Among patients who needed help performing one or more activities of daily living at the time of admission, 23% of patients with moderate to severely impaired cognitive performance, 49% of patients with mildly impaired cognitive performance, and 67% of patients with little to no impairment in cognitive performance recovered ability to independently execute an additional activity of daily living by discharge (p <.001). Similar relationships were seen for change in instrumental activities of daily living and mobility. In multivariate repeated measures analyses of basic and instrumental activities of daily living and mobility on admission, discharge, and 30 and 90 days after discharge, patients with mildly impaired cognitive performance on admission showed less improvement than patients who did not have impaired cognitive performance, but more than those with moderate to severely impaired cognitive performance. The pattern of results did not change when patients with any signs of delirium were excluded. Patients with impaired cognitive performance were more likely to be admitted to a nursing home for the first time by 90 days after discharge. The odds ratios were 2.8 (95% confidence interval = 1.8-4.5) for patients with mildly impaired cognitive performance and 6.7 (95% confidence interval = 4.5-9.8) for patients with moderate to severely impaired cognitive performance. CONCLUSION: Cognitive screening at hospital admission can be used to stratify patients according to the magnitude of expected functional recovery after an acute illness that required hospitalization.

APACHE↗

PubMed2001

Exercise versus dobutamine-induced ST elevation in the infarct-related electrocardiographic leads: clinical significance and correlation with functional recovery.

BACKGROUND: The clinical significance of stress-induced ST elevation early after acute myocardial infarction and its relation to functional recovery remain controversial. The aims of this study were (1) to determine the incidence of ST elevation during dobutamine and exercise tests and (2) to assess the relative accuracy of exercise and dobutamine ST elevation for predicting functional recovery after acute myocardial infarction. METHODS AND RESULTS: We investigated 52 patients who underwent supine exercise (from 25 W to maximal charge) and dobutamine (from 5 to 40 microg/kg per minute and up to 1 mg atropine) stress electrocardiography in the same position. ST elevation was defined as new or worsening at >1 mm, 80 ms after J point. Echocardiography and quantitative angiography were available in all patients before hospital discharge. The follow-up resting echocardiogram was recorded 30 +/- 6 days after the acute event. ST elevation developed during 30 (58%) dobutamine and 24 (46%) exercise tests. The sum of ST elevation was higher during dobutamine testing (7.7 +/- 3.8 mm) than during exercise (5.5 +/- 2.5 mm) (P =.03). A low peak creatine kinase level was the single independent predictor of dobutamine-induced ST elevation. Functional improvement occurred in 35 patients. Two independent predictors of functional recovery were selected from multivariate analysis: dobutamine ST elevation (chi(2) = 9.1; P =.0026) and low peak creatine kinase level (chi(2) = 5.1; P =.025). When dobutamine ST elevation was not included in multivariate analysis, exercise-induced ST elevation emerged as an independent predictor of functional recovery (chi(2) = 5.0; P =.023). Significant linear correlation was found between the sum of ST elevation at peak dobutamine stress and the extent of functional recovery (r = 0.87; P <.0001). In contrast, no correlation was observed with exercise ST elevation (r = 0.06; P = not significant). CONCLUSIONS: Stress-induced ST elevation is an ancillary sign of viable myocardium that can recover. The sum of ST elevation at peak dobutamine stress correlates with the extent of functional recovery.

Adult↗

PubMed2004

Functional recovery of gait and joint kinematics after right hemispheric stroke.

OBJECTIVE: To gain insight into the relation between changes in gait patterns over time and functional recovery of walking ability in stroke patients. DESIGN: Cohort study. SETTING: Inpatient rehabilitation center of a university hospital in the Netherlands. PARTICIPANTS: Thirteen stroke patients admitted, or awaiting admission, for inpatient rehabilitation 3 weeks poststroke, and 16 healthy control subjects. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: At 3, 6, 12, 24, and 48 weeks poststroke, functional recovery of walking ability was assessed with the Rivermead Mobility Index (RMI) and the Functional Ambulation Categories (FAC). When possible, kinematics of the knee, hip, and pelvis were assessed through gait analysis in an 8 x 4 m gait laboratory. Minimal scores of 8 on the RMI and 4 on the FAC were necessary before patients were classified as functionally recovered. RESULTS: Patients whose joint kinematics during ambulation had recovered to within the range of the control group showed functional recovery of walking ability. However, some patients whose kinematics had developed toward an abnormal pattern also showed functional recovery. CONCLUSIONS: Recovery of joint kinematics toward a normal pattern is not required for functional recovery of walking ability. Early recognition of compensatory walking patterns that facilitate functional recovery may have implications for rehabilitation programs.

Adult↗

PubMed2002

Functional recovery and length of stay after recurrent hip fracture.

OBJECTIVE: To evaluate the functional recovery and the rehabilitation length of stay after the sequential fracture of both hips in elderly patients. DESIGN: A total of 372 in-patients with hip fractures consecutively admitted to our rehabilitation hospital were included in this retrospective study. A total of 333 out of 372 were admitted for rehabilitation of their first hip fracture, and the other 39 patients had a second contralateral fracture. The functional recovery was evaluated by the Barthel index. The comparison between the two groups was performed by unpaired t test. Stepwise linear multiple regression analysis was performed, including nine prognostic factors together with the number of hip fractures (first or recurrent) as independent variables and the Barthel index score on discharge as the dependent variable. The statistical analysis was repeated, substituting hospital length of stay for Barthel index. RESULTS: Both the functional recovery and the length of stay of the patients affected by recurrent fracture were similar to the ones of the patients suffering from a single fracture. Regression analysis showed that the previous hip fracture was associated neither with the Barthel index nor with the length of stay. CONCLUSIONS: Our data suggest that the functional recovery in elderly patients with hip fractures is not significantly influenced by a previous fracture of the contralateral hip and that no significant prolonged rehabilitation length of stay is needed after the recurrent fracture.

Age Factors↗

PubMed1992

Effects of high levels of fatty acids on functional recovery of ischemic hearts from diabetic rats.

In this study we determined the effects of high levels of fatty acids on recovery of heart function when present either during or after ischemia. Isolated working hearts from 6-wk streptozotocin diabetic and control rats perfused with 11 mM glucose were subjected to 25 min of global ischemia followed by 30 min of aerobic reperfusion. Four groups were studied: 1) 1.2 mM palmitate present before, during, and after ischemia; 2) 1.2 mM palmitate present before and during ischemia, followed by reperfusion in the absence of palmitate; 3) no palmitate before and during ischemia, followed by 1.2 mM palmitate during reperfusion; and 4) no palmitate before and during ischemia or during reperfusion. In control hearts, palmitate during reperfusion depressed recovery of function regardless of whether palmitate was present or absent during ischemia. In contrast, palmitate present during reperfusion did not depress recovery of mechanical function in the diabetic rat hearts. However, the presence of palmitate during ischemia itself in diabetic rat hearts was detrimental to recovery of mechanical function. The presence of palmitate during ischemia resulted in an accelerated rate of ATP loss and a decreased rate of lactate accumulation during ischemia, although this effect was similar in control and diabetic rat hearts. Our results demonstrate that high concentrations of fatty acids depress functional recovery of control rat hearts during the reperfusion period but depress recovery of function in diabetic rat hearts when present during ischemia itself.

Adenosine Triphosphate↗

PubMed1996

Hypertonic environment prevents depolarization and improves functional recovery from hypoxia in hippocampal slices.

Treatments that postpone hypoxic spreading depression (SD)-like depolarization (also called anoxic depolarization) facilitate recovery of function after transient cerebral hypoxia. Hypertonia reduces cerebral excitability, and we tested whether it also offers protection against SD-like depolarization and hypoxia. Oxygen was withdrawn from hippocampal slices bathed in normal artificial cerebrospinal fluid (ACSF) and, simultaneously, from slices cut from the same hippocampus but bathed in strongly hypertonic ACSF. Extracellular osmolarity (pi(o)) was increased by adding 100 mM mannitol or fructose to ACSF. Slices in normal pi(o) underwent SD-like negative extracellular voltage shift (delta Vo). The hypertonic slices usually showed no SD-like delta Vo but only a small, gradual negative voltage shift. Hypertonia also prevented the precipitate drop of interstitial calcium level ([Ca2+]o). When oxygenation and normal osmolarity were restored, synaptic transmission in the previously hypertonic slices recovered completely, but 3 h after reoxygenation orthodromically transmitted population spikes of the control slices recovered only 25.1% of the initial control amplitude. We conclude that hypertonic treatment during hypoxia improves subsequent recovery of synaptic function. The protection is probably due to the prevention of calcium uptake by blocking the SD-like depolarization, with the prevention of hypoxic cell swelling playing a lesser role.

Animals↗

PubMed1988

Threshold recovery functions following impulse noise trauma.

An analysis of the pure-tone threshold recovery functions obtained from 118 chinchillas exposed to high-level impulse noise showed that there are at least three distinctly different types of recovery function: type I--a recovery function for which the initial threshold shift recovers monotonically with increasing postexposure time; type II--a delayed recovery; i.e., for a period as long as 6 h following removal from noise, the pure-tone threshold remains elevated and stable before thresholds begin to follow a monotonic course of recovery; and type III--the growth function; i.e., over a period of at least 6 h following removal from the noise, pure-tone thresholds continue to get worse before they begin to follow a monotonic course of recovery. There is more permanent threshold shift (PTS), more sensory cell loss, and predictions of PTS and cell loss based upon initial measures of threshold shift are less accurate at those frequencies characterized by a type III recovery process than at those frequencies characterized by a type I recovery process.

Acoustic Stimulation↗

PubMed2000

Severe anaemia: implications for functional recovery during rehabilitation.

PURPOSE: This case report examines the hospital course and functional recovery of a geriatric patient with severe anaemia undergoing rehabilitation following total hip replacement. It serves to highlight the need for further study of the impact of anaemia on recovery in the rehabilitation setting as well as the importance of developing clinical guidelines for the appropriate medical management of anaemia in this patient population. METHODS: Single case report. RESULTS: The course of recovery during rehabilitation in a geriatric patient with severe post-operative anaemia was notably different from other geriatric patients undergoing rehabilitation following total hip replacement. The patient demonstrated a markedly reduced tolerance for therapies and prolonged length of stay, but did not experience cardiopulmonary complications during intensive rehabilitation. Her hematocrit responded nicely to treatment with human recombinant erythropoietin. Despite a prolonged recovery period, the patient ultimately progressed well and achieved a good functional outcome. CONCLUSIONS: The impact of anaemia on functional recovery in the acute inpatient rehabilitation setting as well as the theoretical risk of increased morbidity and mortality during prescribed therapeutic exercise has not been closely examined in the literature. Further study is indicated to examine the implications for anaemia on functional recovery and cardiopulmonary complications during rehabilitation. General guidelines should be developed for the management of anaemia in the rehabilitation setting.

Activities of Daily Living↗

PubMed1997

Functional recovery following neurorrhaphy of the rat sciatic nerve by epineurial repair compared with tubulization.

Recovery of motor function is often poor following transection injuries to peripheral nerves. The purpose of this study was to measure and compare functional recovery of the sciatic nerve in the rat following transection and neurorrhaphy with the use of a nerve guide tube and with traditional end-to-end epineurial repair. Muscle recovery was also evaluated following a crush injury, a model of an axonotmetic lesion. Recovery was assessed at 8, 16, and 32 weeks after injury by measuring the isometric contractile properties of the soleus muscle and at 8 and 16 weeks by measuring the conduction properties of the sciatic nerve. The mean conduction velocity of the sciatic nerve in the crush group and both transection groups was significantly slower than that of controls at both 8 and 16 weeks. Following a transection injury, the soleus became a significantly faster muscle as measured by time to peak twitch tension. By 32 weeks, the maximum isometric tension of the soleus muscle recovered to 90% that of the control group following a crush injury and to less than 70% following a transection injury and repair. Recovery was better in the epineurial repair group than in the tube repair group at 8 weeks, but no difference was found between the groups at 16 or 32 weeks. These results demonstrate that nerve guide tubes are a potential alternative to epineurial repair. The poor motor recovery following repair of transection injuries may be related to poor specificity of reinnervation.

Anastomosis, Surgical↗

PubMed1993

Effects of gradual reperfusion on postischemic metabolism and functional recovery of isolated guinea pig heart.

Gradual reperfusion improves recovery of the pump function of isolated guinea pig heart subjected to total ischemia. This effect is associated with the restoration of higher myocardial contents of ATP, adenine nucleotides, total Cr, and lactate level close to preischemic one, and reduced losses of tissue Cr, glutamate, and aspartate. Positive correlations between energy and functional indices in reperfused hearts indicate that resumption of aerobic energy production may be a crucial factor for postischemic functional recovery. The importance of metabolism of glutamate and aspartate for recovery of cardiac function is confirmed by good correlations between the pools of these amino acids and of ATP, adenine nucleotides, and the total Cr. The results suggest that a decrease in energy demand during the early phase of reperfusion promotes achievement of a better metabolic and functional status in the postischemic heart.

Adenine Nucleotides↗

PubMed1990

Antibodies to the neural cell adhesion molecule disrupt functional recovery in injured nerves.

Tubes containing specific monoclonal antibodies to the neural cell adhesion molecule (N-CAM) were applied to transected sciatic nerves to attempt to perturb the recovery of muscle function. Physiological recordings were used to estimate the return of function. The decline of implanted antibody over 28 days was estimated and negatively correlated with the degree of functional recovery. No significant immune responses were detected in response to the implanted material. The data implicated N-CAM as a significant component of nerve regeneration.

Animals↗

PubMed1999

Impact of the novel anti-convulsant vigabatrin on functional recovery following brain lesion.

GABAergic drugs can positively or negatively influence recovery of neurobehavioral function following brain injury. Direct potentiation of GABA-mediated inhibition at the post-synaptic receptor (i.e., via GABA, muscimol, diazepam, phenobarbital) after brain damage has been associated with impaired functional recovery. What remains unclear, however, is whether the mechanism of action by which GABA is augmented contributes to a drug's impact on the recovery process. Vigabatrin, a novel anti-convulsant that inhibits GABA-transaminase, was administered chronically after unilateral anteromedial cortex lesions and recovery from somatosensory deficits assessed. In contrast to the direct GABA receptor agonists, vigabatrin did not adversely impact (i.e., was neutral) recovery from neurobehavioral deficits at any of the anti-convulsant doses tested. Measurable secondary drug effects like sedation and hypothermia diminished over time and were reversible upon drug discontinuation. These results suggest that the degree to which a GABAergic agent impacts the recovery process after brain injury is dependent on the drug's mechanism of action.

Journal Article↗

PubMed2004

F-18-FDG uptake is a reliable predictory of functional recovery of akinetic but viable infarct regions as defined by magnetic resonance imaging before and after revascularization.

Identification of akinetic but viable myocardium is important for the selection of patients for coronary revascularization. In order to assess predictive values of end-diastolic wall thickness and dobutamine induced wall thickening obtained by magnetic resonance imaging (MRI) and [18F]Fluorodeoxyglucose uptake assessed by positron emission tomography (F-18-FDG-PET), these parameters were compared to recovery of left ventricular function after successful revascularization. Forty patients with chronic myocardial infarction and regional a- or dyskinesia by ventriculography underwent rest- and dobutamine-MRI studies (10 microg dobutamine/kg body weight/min) and F-18-FDG-PET. Viability of the infarct region was considered to be present if; 1) end-diastolic wall thickness was > or =5.5 mm; 2) dobutamine induced wall thickening > or =2 mm could be measured; and 3) normalized F-18-FDG-uptake was > or =50% in > or =50% of akinetic segments. Preserved end-diastolic wall thickness was found in 32/40 patients, functional improvement during dobutamine infusion in 26/40 patients and preserved F-18-FDG-uptake in 29/40 patients. After revascularization regional left ventricular function improved in 25/40 patients. Positive and negative predictive values and diagnostic accuracy were 78%, 100%, and 83% for preserved end-diastolic wall thickness, 92%, 93%, and 93% for dobutamine inducible contraction reserve and 86%, 100%, and 90% for preserved F-18-FDG-uptake. Quantitative assessment of dobutamine induced systolic wall thickening by MRI and F-18-FDG-uptake by PET are highly accurate techniques for the identification of viable myocardium and prediction of functional recovery after successful revascularization. Preserved end-diastolic wall thickness results in an overestimation of viable myocardium compared to functional improvement, but wall thickness <5.5 mm excludes recovery of regional function.

Adult↗

PubMed2004

Comparison of functional recovery of mildly hypokinetic versus severely dysfunctional left ventricular segments after revascularization in patients with ischemic cardiomyopathy.

Dysfunctional left ventricular (LV) segments showing contractile reserve during dobutamine stress echocardiography (DSE) are considered viable myocardium; functional recovery is expected after revascularization. Many segments, however, particularly mildly hypokinetic segments, do not recover. The reason for this failure is unknown. Two-dimensional echocardiography at rest and low-high-dose DSE were performed before revascularization in 114 consecutive patients with ischemic cardiomyopathy. Two-dimensional echocardiography at rest was repeated after 9 to 12 months. Segmental function was scored by a 5-point grading score. Functional recovery after revascularization was assessed in mildly hypokinetic (score 2, group I) and severely dysfunctional segments (score 3 to 5, group II). For each segment, functional recovery was defined as an improvement in functional score of > or =1 grade compared with the baseline score at rest. During low-dose DSE (up to 10 microg/kg/min), 183 group I segments (68%) and 438 group II (39%) segments had contractile reserve (p <0.0001). However, functional recovery was observed less frequently in group I segments (41%) than in group II segments (55%) with contractile reserve (p <0.005). During high-dose DSE (up to 40 microg/kg/min), in the group I segments with contractile reserve at the low dose, the sustained improvement pattern (indicating subendocardial scar) was prevalent (73%). After revascularization, 73% of segments with sustained improvement did not recover. Conversely, the biphasic response (indicating ischemically jeopardized myocardium) was observed only in 27% of group I segments. Functional recovery occurred in 39 of these segments (78%) (p <0.001 vs sustained improvement). Hence, mildly hypokinetic segments probably indicate the presence of subendocardial scars, and may explain the failure in functional recovery after revascularization.

Adult↗

PubMed1995

Multivariate analysis of factors influencing the functional recovery after finger replantation or revascularization.

A multivariate statistical analysis was utilized to study the influence of the four preoperative (age, mechanism of injury, level of injury, and type of amputation) and one postoperative (rehabilitation) variables on the functional recovery of the replanted or revascularized finger. Statistically significant differences are summarized as follows. The young age group have a better functional recovery due to better sensory recovery than the old age group. The crush injury group have a better functional recovery, with better scores in motion and patient satisfaction, than the avulsion injury group. The middle phalangeal injury group have a better functional recovery, with better score in motion and sensation than the proximal phalangeal injury group. There is no statistically significant difference in functional recovery between the revascularized and replanted fingers, but there is a significantly better sensory recovery in the revascularized finger. The rehabilitation group has a better functional recovery, with better score in motion, subjective symptoms, and patient satisfaction, than the nonrehabilitation group.

Adult↗

PubMed2004

Subcortical vascular lesions predict functional recovery after rehabilitation in patients with L-dopa refractory parkinsonism.

OBJECTIVES: To identify predictors of functional recovery after an intensive rehabilitation training in patients with gait disturbances and refractory parkinsonism. DESIGN: Observational study. SETTING: A hospital geriatric rehabilitation department ("Ancelle della Carità" hospital of Cremona). PARTICIPANTS: Thirty-eight subjects (mean age+/-standard deviation of 78.9+/-6.5; 66% women) with gait disturbances and L-dopa refractory parkinsonism consecutively admitted to a rehabilitation unit within 6 months were recruited. Exclusion criteria were obvious musculoskeletal disorders (severe leg arthritis, hemiparesis, recent stroke), recent surgery, delirium, physical impairment from other identifiable causes, and missing computed tomography (CT) scan. All subjects received an intensive standardized rehabilitative program including conventional physical therapy and specific gait training. MEASUREMENTS: The outcome measure of the rehabilitation training was the gain between admission and discharge on the Unified Parkinson Disease Rating Scale (delta-UPDRS). The following potential predictors were assessed using comprehensive geriatric assessment: physical health (Charlson Comorbidity Index, number of drugs), cognitive performance (Mini-Mental State Examination (MMSE)), functional status (Tinetti scale), depressive symptoms (Geriatric Depression Scale), nutritional status (serum albumin and body mass index), and subcortical cerebrovascular load (four classes of increasing severity based on diffuse leukoariosis, patchy lesions of the white matter, and lacunas on CT scan). Multivariate logistic regression with fixed adjustment for age, cognitive performance, and UPDRS on admission and stepwise selection of variables were used to identify independent predictors. RESULTS: Patients were divided into two groups of equal size based on the delta-UPDRS (high and low functional recovery: delta-UPDRS >8 and </=8, respectively). Of all variables, only subcortical cerebrovascular load predicted functional recovery at discharge (odds ratio adjusted for age, MMSE, and UPDRS on admission=2.3, 95% confidence interval=1.0-5.1). The adjusted proportion of patients with high functional recovery decreased with increasing subcortical cerebrovascular load: 83%, 61%, 44%, and 27% (adjusted P for trend=0.047). CONCLUSION: Subcortical cerebrovascular load is a predicting factor of successful rehabilitation in patients with L-dopa refractory parkinsonism.

Aged↗