The Experts below are selected from a list of 291 Experts worldwide ranked by ideXlab platform

Cynthia L. Comella - One of the best experts on this subject based on the ideXlab platform.

  • minimal clinically important change in the toronto western Spasmodic torticollis rating scale
    Parkinsonism & Related Disorders, 2018
    Co-Authors: Alberto J Espay, Richard Trosch, Gustavo Suarez, Jonathan Johnson, Dominic Marchese, Cynthia L. Comella
    Abstract:

    Abstract Objectives To characterize the minimal clinically important change (MCIC) after treatment in cervical dystonia patients using the Toronto Western Spasmodic torticollis Rating Scale (TWSTRS). Methods Changes in the TWSTRS from an observational study of abobotulinumtoxinA in the routine management of cervical dystonia (NCT01314365) were analyzed using the Patient Global Impression of Change (PGIC) as anchor. Results For the overall population (N = 304, baseline TWSTRS-Total score 43.4 ± 19.4), the MCIC for the TWSTRS Total score was −11.9 (95%CI: −13.9, −10.0; p  Conclusions A 3-point change is the minimal clinically important change after treatment using TWSTRS as endpoint with higher cutoffs for greater baseline disease severity. For an average trial population (TWSTRS-total: 40–45), a 12-point decrease is clinically meaningful.

  • Teaching tape for the motor section of the toronto western Spasmodic torticollis scale
    Movement disorders : official journal of the Movement Disorder Society, 1997
    Co-Authors: Cynthia L. Comella, Christopher G. Goetz, Glenn T. Stebbins, Teresa A. Chmura, Susan B. Bressman, Anthony E. Lang
    Abstract:

    The Toronto Western Spasmodic torticollis Rating Scale (TWSTRS) assesses the character and severity of cervical dystonia (CD). We developed a teaching tape of the TWSTRS scoring for the motor symptoms of CD. The tape provides investigators with visual representations of each component of the motor section of the TWSTRS as agreed upon by three independently scoring raters. The rate of agreement for the nondichotomous components was always significant, with a Kendall's coefficient of concordance W ranging between 0.98 and 0.76 (p < 0.01 for all measures). For the two dichotomous components, a weighted kappa coefficient was also significant at 0.86 for lateral shift and 0.89 for sagittal shift (p < 0.01 for both measures). Scale deficiencies identified by the raters were an explicit definition of midline for assessment of range of motion, the absence of a separate scoring category assessing dystonic tremor, and the specification of duration for the effect of sensory tricks. These observations should be taken into account in future revisions of the TWSTRS and in refinements of other rating scales for CD.

  • dysphagia after botulinum toxin injections for Spasmodic torticollis clinical and radiologic findings
    Neurology, 1992
    Co-Authors: Cynthia L. Comella, Caroline M Tanner, Lori Defoorhill, Claire Smith
    Abstract:

    We prospectively evaluated the frequency, severity, and radiologic features of swallowing abnormalities following Botox treatment of Spasmodic torticollis. We performed both clinical and radiologic evaluations of swallowing before and following Botox in 18 consecutive cervical dystonia patients receiving their first Botox treatment. Before Botox, 11% of the patients had clinical symptoms of dysphagia and 22% had radiologic signs of a peristaltic abnormality. After Botox, the signs and symptoms of dysphagia in these patients did not change, but an additional 33% developed new dysphagic symptoms and 50% of the patients developed new peristaltic abnormalities by radiologic studies. Complaints of swallowing difficulty were always associated with abnormal radiologic findings. Neither the total Botox dose nor Hotox into particular muscles differed between those with dysphagia and those without.

  • botulinum toxin injection for Spasmodic torticollis increased magnitude of benefit with electromyographic assistance
    Neurology, 1992
    Co-Authors: Cynthia L. Comella, Caroline M Tanner, Aron S Buchman, Nancy Browntoms, Christopher G. Goetz
    Abstract:

    To determine the usefulness of EMG-assisted botulinum toxin (BOTOX) injections for the treatment of Spasmodic torticollis (ST), we randomized 52 ST patients into two groups and studied them prospectively. In one group [(E+C)RX, N = 28], the muscles were selected for BOTOX injection using both clinical and EMG examination and then injected with EMG assistance. In the second group [(C)RX, N = 24] the muscles were selected for BOTOX injection based solely on clinical examination and injected without EMG assistance. The percentage of patients showing any improvement after BOTOX was similar in both the (E+C)RX and (C)RX groups. A significantly greater magnitude of improvement was present in the (E+C)RX group, as well as a significantly greater number of patients with marked improvement. In particular, patients with retrocollis, head tilt, and shoulder elevation demonstrated additional benefit with EMG-assisted BOTOX injection. EMG assistance may be effective because the technique increases the ability to effectively identify and treat the deep cervical muscles.

Victor S C Fung - One of the best experts on this subject based on the ideXlab platform.

  • the toronto western Spasmodic torticollis rating scale reliability in neurologists and physiotherapists
    Parkinsonism & Related Disorders, 2012
    Co-Authors: Melani J Boyce, Colleen G Canning, Neil Mahant, John G Morris, Jane Latimer, Victor S C Fung
    Abstract:

    Abstract Introduction Inter-rater reliability for the Toronto Western Spasmodic torticollis Rating Scale has been determined for neurologists, but not for physiotherapists. We assessed the inter-rater reliability of scoring the clinical severity subscale of the Toronto Western Spasmodic torticollis Rating Scale by two physiotherapists and two neurologists. Methods Seven individuals with cervical dystonia were assessed on video a total of 23 times. The assessments were randomized and rated by all raters. Results Reliability for all raters considered together, assessed by the Intraclass Correlation Coefficient (ICC 2,1) was 0.74 (p  Conclusion The clinical severity subscale of the Toronto Western Spasmodic torticollis Rating Scale can be assessed with good inter-rater reliability when physiotherapists and neurologists are represented in the same rater pool.

Jane Latimer - One of the best experts on this subject based on the ideXlab platform.

  • the toronto western Spasmodic torticollis rating scale reliability in neurologists and physiotherapists
    Parkinsonism & Related Disorders, 2012
    Co-Authors: Melani J Boyce, Colleen G Canning, Neil Mahant, John G Morris, Jane Latimer, Victor S C Fung
    Abstract:

    Abstract Introduction Inter-rater reliability for the Toronto Western Spasmodic torticollis Rating Scale has been determined for neurologists, but not for physiotherapists. We assessed the inter-rater reliability of scoring the clinical severity subscale of the Toronto Western Spasmodic torticollis Rating Scale by two physiotherapists and two neurologists. Methods Seven individuals with cervical dystonia were assessed on video a total of 23 times. The assessments were randomized and rated by all raters. Results Reliability for all raters considered together, assessed by the Intraclass Correlation Coefficient (ICC 2,1) was 0.74 (p  Conclusion The clinical severity subscale of the Toronto Western Spasmodic torticollis Rating Scale can be assessed with good inter-rater reliability when physiotherapists and neurologists are represented in the same rater pool.

John G Morris - One of the best experts on this subject based on the ideXlab platform.

  • the toronto western Spasmodic torticollis rating scale reliability in neurologists and physiotherapists
    Parkinsonism & Related Disorders, 2012
    Co-Authors: Melani J Boyce, Colleen G Canning, Neil Mahant, John G Morris, Jane Latimer, Victor S C Fung
    Abstract:

    Abstract Introduction Inter-rater reliability for the Toronto Western Spasmodic torticollis Rating Scale has been determined for neurologists, but not for physiotherapists. We assessed the inter-rater reliability of scoring the clinical severity subscale of the Toronto Western Spasmodic torticollis Rating Scale by two physiotherapists and two neurologists. Methods Seven individuals with cervical dystonia were assessed on video a total of 23 times. The assessments were randomized and rated by all raters. Results Reliability for all raters considered together, assessed by the Intraclass Correlation Coefficient (ICC 2,1) was 0.74 (p  Conclusion The clinical severity subscale of the Toronto Western Spasmodic torticollis Rating Scale can be assessed with good inter-rater reliability when physiotherapists and neurologists are represented in the same rater pool.

Neil Mahant - One of the best experts on this subject based on the ideXlab platform.

  • the toronto western Spasmodic torticollis rating scale reliability in neurologists and physiotherapists
    Parkinsonism & Related Disorders, 2012
    Co-Authors: Melani J Boyce, Colleen G Canning, Neil Mahant, John G Morris, Jane Latimer, Victor S C Fung
    Abstract:

    Abstract Introduction Inter-rater reliability for the Toronto Western Spasmodic torticollis Rating Scale has been determined for neurologists, but not for physiotherapists. We assessed the inter-rater reliability of scoring the clinical severity subscale of the Toronto Western Spasmodic torticollis Rating Scale by two physiotherapists and two neurologists. Methods Seven individuals with cervical dystonia were assessed on video a total of 23 times. The assessments were randomized and rated by all raters. Results Reliability for all raters considered together, assessed by the Intraclass Correlation Coefficient (ICC 2,1) was 0.74 (p  Conclusion The clinical severity subscale of the Toronto Western Spasmodic torticollis Rating Scale can be assessed with good inter-rater reliability when physiotherapists and neurologists are represented in the same rater pool.