Table 1.
Data Extracted From Reviewed Intervention Studies.
| Study | Study Design | Dx | n | Sex | Mean Age, Years (Range or SD) | Time Since Injury, Months (Range or SD) | Intervention (Dosage) | Intervention Length | Co-interventions | Outcome Variables | Results | |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Acler (2009)27 | RSPC | Stroke | 12 | 5 F | 7 M | 70 (8) | 10–28 | LDOPA (25–100 mg/day) | 5 weeks | PT in 2 and 5 weeks | RMA, 9-HPT, TMS, 10-meter walk | Levodopa group better than placebo on 9-HPT and 10-meter walk test. Cortical silent period longer in levodopa group and correlated with 9-HPT; unchanged in placebo group. |
| Brunstrom (2000)45 | CR | CP | 1 | 1 F | 16 | N/A | LDOPA (100–200 mg/d) | 2 weeks (continuing) | ADL, kinematics and EMG during ball reach task | Patient improved on ball reach task in ability to maintain static arm position; co-contraction decreased in 5/6 muscles during task. Functional improvements also reported. | ||
| Cramer (2009)38 | RDP | Stroke | 33 | 10 F | 23 M | 61.5 (14) | 7 (3.5) | Ropinirole (0.25–4 g/day); PT | 9 weeks | PT 60 min gait and 30 min arm training 2×/wk × 4 weeks | SIS-16, FM, BI, gait velocity, and endurance | No significant differences between the ropinirole and placebo groups on any measure. |
| Crisostomo (1988)32 | RDP | Stroke | 8 | 1 F | 7 M | 60.7 (47–73) | 6.5 days (3 −10 days) | AMPH (10 mg); PT | 1 day (1 dose) | One 45-min session of active paretic arm use | FM | Dextroamphetamine group had significantly greater improvements than placebo on FM. |
| Floel (2005)25 | RDPC | Stroke | 9 | 3 F | 6 M | 66.1 (9.5) | 44.4 (8.4) | LDOPA (100 mg); motor training task | 1 day (1 dose) | Thumb motor training two 30-min sessions | Motor training task outcome | Levodopa group performed better than placebo on motor training task. |
| Gorgoraptis (2012)39 | RDPC | Stroke | 16 | 2 F | 14 M | 58 (14) | 18 (21) | Rotigotine (4 mg/d) | 7–11 days | Motricity Index, Box and Blocks, 10-meter walk, grip and pinch dynamometry, 9-HPT | No significant differences between rotigotine and placebo groups on any measure. | |
| Grade (1998)34 | RDP | Stroke | 21 | 10 F | 11 M | 71.3 (3.6) | 18.3 days (3.7 days) | MPH (5–60 mg/d) | 3 weeks | Inpatient rehabilitation daily up to 3 weeks | FM, modified FM | Methylphenidate group significantly higher than placebo on modified FIM, positive trend for FM. |
| Kakuda (2011)28 | CR | Stroke | 5 | 2 F | 3 M | 61 (56–66) | 64 (18–143) | LDOPA (100 mg/d); OT and TMS | 7 weeks LDOPA; 15 days OT/TMS | One session motor training per condition | MAS, FM, WMFT | All improved on FM and WMFT. 3/5 patients improved on MAS (no statistical analyses). |
| Koeda (1998)41 | CR | TBI | 1 | 1 F | 9.3 | 22 | LDOPA (50–200 mg/d) | 3 months (continuing) | ADL | Patient had decreased rigidity and improvement in rolling over, maintaining sitting position, and walking on knees. | ||
| Lal (1998)40 | CR | TBI | 12 | N/A | 27.1 (17–54 | 16.9 (3.7–5.2) | LDOPA (300–1000 mg/d) | 3–24 months (some continuing) | ADL | All showed improvements in mobility, and 9/11 patients became more independent. | ||
| Lokk (2011)31 | RDP | Stroke | 78 | 30 F | 48 M | 64 (9.8) | 2.2 (1.1) | LDOPA (125 mg/d) and/ or MPH (20 mg/d); PT | 3 weeks | NDT: basic functional mobility, sensory, cognitive training 45 min × 5 days × 3 weeks | FM, BI, NIHSS | Levodopa and methylphenidate group showed significantly greater improvements than placebo between baseline and 6 months on the NIHSS and BI. |
| Maric (2008)46 | RDPC | SCI | 12 | 4 F | 8 M | 50.9 (23–72) | 1.9 (1–4) | LDOPA (200 mg/d); PT | 6 weeks | PT 2×/day for 30–45 min on functional training; robotic locomotor training when able 45 min 5 day/wk | ASIA motor score, WISCI-II, SCIM-II | No significant differences between levodopa and placebo groups on any measure. |
| Radhakrishna (2017)47 | RDP | SCI | 45 | 5 F | 39 M | 40 (20–62) | 12.4 years (2.5 years) | LDOPA (100–750 mg) and/ or buspirone (10–75 mg) | 1 day (1 dose) | EMG activity from 8 muscles | 8/25 patients receiving levodopa and buspirone showed significant changes in EMG activity. No patients receiving placebo, levodopa or buspirone alone, had significant changes in EMG activity. | |
| Restemeyer (2007)24 | RDPC | Stroke | 10 | 6 F | 4 M | 62 (12) | 58 (9 months to 20 years) | LDOPA (100 mg); PT | 1 day (1 dose) | Paretic arm dexterity training for two 60-min sessions | 9-HPT, TMS, ARAT, hand grip dynamometry | No differences between levodopa and placebo groups on any measure. |
| Rosenthal (1972)44 | CR/DP | CP | 9 | 8 F | 1 M | 31 (10.9) | N/A | LDOPA (0.5–2 g) | 4–12 months (some continuing) | Coordination/dexterity tasks, SCMAT, ADL, APMTB | 5/7 improved in handwriting, 6/7 in motor function, 3/3 in SCMAT, 3/3 in Ayres Perceptual Motor Test Battery, 6/6 in walking, 6/9 in sitting posture, and 5/9 in ADL. | |
| Rosser (2008)26 | RDPC | Stroke | 18 | 5 F | 13 M | 66.4 (6.8) | 40 (25) | LDOPA (150 mg/d) | 2 days | One session of procedural motor training | FTT, SRTT | Levodopa group performed better than placebo on SRTT. |
| Samuel (2017)29 | RS | Stroke | 8 | 1 F | 7 M | 63.3 (39–72) | 8.5 days (5–12 days) | LDOPA (100 mg/d); OT, PT, VR-based motivational visuomotor feedback training | 2 weeks | 1 hour PT/OT for all + 30 min VR or 30 min conventional PT × 2 weeks | FM, ARAT, kinematic measures | Levodopa and VR group improved more than levodopa PT control group on both FM and ARAT. |
| Scheidtmann (2001)23 | RDP | Stroke | 47 | 21 F | 26 M | 62.3 (11.3) | 1.4 (0.9) | LDOPA (100 mg/d); PT | 3 weeks | Inpatient PT for 6 weeks (3 with drug) | RMA | Levodopa group had significantly greater improvements than placebo on RMA; improved walking ability and upper extremity function faster and better. |
| Shiller (1999)42 | CR | TBI | 1 | 1 M | 18 | 15 years | Amantadine (200–300 mg/d); PT | 6 weeks | “Comprehensive rehabilitation” | Fine and gross motor movements, ADL | Patient had clinically significant improvement in bed-towheelchair transfer time, but slight nonsignificant improvements in time to put shirt on and propel wheelchair 75 feet | |
| Sonde (2007)30 | RDP | Stroke | 25 | 13 F | 12 M | 77.6 (65–91) | 8 days (7.6–9.3 days) | LDOPA (50–100 mg/d), and/ or AMPH (10–20 mg/d); PT | 2 weeks | Balance, transfer and functional motor training 5×/week × 2 weeks | FM, BI, ADL | No significant group differences. |
| Tardy (2006)36 | RDPC | Stroke | 8 | 8 M | 60 (46–70) | 18.8 days (9–35 days) | MPH (20 mg); motor training task | 1 day (1 dose) | NIHSS, BI, FTT, MAS, fMRI, Hand grip dynamometry, trunk control test, target pursuit task | Compared with placebo, methylphenidate group demonstrated a significant improvement on FTT, and hyperactivation of the ipsilateral primary sensorimotor cortex correlated with FTT scores. | ||
| Walker-Batson (1995)33 | RDP | Stroke | 10 | 6 F | 4 M | 64.5 (48–73) | 22.8 days (16–30 days) | AMPH (10 mg/ session); PT | 10 sessions, 1 session every 4 days | Practiced Fugl-Meyer Tasks for 10 sessions | FM | Dextroamphetamine group improved significantly compared with placebo on FM at 1-week and 12-month follow-up. |
| Wang (2014)35 | RSP | Stroke | 9 | 2 F | 7 M | 52.9 (11.9) | ≤ 1 | MPH (20 mg); tDCS | 1 day (1 dose) | Inpatient rehabilitation | TMS, Purdue Pegboard Test | Combination treatment (methylphenidate and tDCS) produced significantly greater improvement on Purdue Pegboard Test than tDCS or methylphenidate alone. |
Abbreviations: M, male; F, female; SD, standard deviation; Dx, diagnosis; R, randomized; S, single-blind; D, double-blind; P, placebo-controlled; C, crossover; CR, case report; FM, Fugl-Meyer Assessment; FIM, Functional Independence Measure; NIHSS, National Institutes of Health Stroke Scale; RMA, Rivermead Motor Assessment; BI, Barthal Index; 9-HPT, 9-hole peg test; RMI, Rivermead Mobility Index; ADL, activities of daily living; NEADL, Nottingham Extended ADL Scale; MAS, Motor Assessment Scale; WMFT, Wolf Motor Function Test; ARAT, Action Research Arm Test; FTT, finger tapping test; SRTT, Serial Reaction Time Task; mRS-Up, modified Rankin score-up; APMTB, A.J. Ayres Perceptual Motor Test Battery; SCMAT, Southern California Motor Accuracy Test; WISCI-II, Walking Index for Spinal Cord Injury II; SCIM-II, Spinal Cord Independence Measure II; SIS-16, Stroke Impact Scale 16; ASIA, American Spinal Injury Association score; fMRI, functional magnetic resonance imaging; tDCS, transcranial direct current stimulation; TMS, transcranial magnetic stimulation; EMG, electromyography; PT, physical therapy; OT, occupational therapy; LDOPA, levodopa; AMPH, dextroamphetamine; MPH, methylphenidate; SCI, spinal cord injury.