Author

Year

Country

Research Design

PEDro

Sample Size

High Jr et al.

(2010)

USA

PEDro=8

N=23

Population: TBI. Placebo (n=11): Mean Age=39.1 yr; Time Post Injury=5.1 yr.

Active rhGH (n=12): Mean Age=36.1 yr; Time Post Injury=11 yr.

Intervention: Participants were randomized to either a growth hormone replacement injection (rhGH) group or a placebo injection. Initially the drug was administered at 200 ug, followed by a 200 ug increase every month until the dosage reached 600 ug. Both groups received these injections for one year.

Outcome Measure: Wechsler Adult Intelligence Scale-III, Delis-Kaplan Executive Function System.

1.        Overall study results did not show great improvements on the majority of assessments between groups.

2.        There was a significant improvement on the Finger tapping demonstrated in the treatment group.

3.        Processing Speed Index: the treatment group improved significantly over the one-year period (p<0.050). The control group showed improvement at the end of the first 6 mo (p<0.010) but this was not seen at the end of the 1 yr.

4.        Significant improvement was also noted on the Wisconsin Card Sorting Test (executive functioning) for the treatment group (p<0.010).

5.        On the California Verbal learning Test-II improvement was noted for the treatment group on learning and memory.

Moreau et al.

(2013)

France

PCT

N=50

Population:  TBI. Treatment Group (TG, n=23): Mean Age=37.9 yr; Gender: Male=19, Female=4; Mean Time Post Injury=7.8 yr; Mean GCS=8.1. Control Group (CG, n=27): Mean Age=37.1 yr; Gender: Male=24, Female=3; Mean Time Post Injury=5.5 yr; Mean GCS=9.4.

Intervention: Participants were allocated to receive GH therapy (TG, 0.2-0.6mg/d) or no treatment (CG) for 1yr. Outcomes were assessed before (T1) and after (T2) treatment.

Outcome Measures: Activities of Daily Living (ADL); Quality of Life Brain Injury (QOLBI); Verbal Memory (VM); Rey Complex Figure (RCF); Reaction Time (RT).

1.        Both groups showed significant improvement in instrumental ADL (iADL, p=0.001) at T2, but not personal ADL (pADL).

2.        Both groups showed significant improvement in QOLBI total scores (p=0.019) and intellectual (p=0.001), functional (p=0.023), and personal (p=0.044) subscores at T2, but not physical, psychological, and social subscores.

3.        Both groups showed significant improvement (p<0.050) in aspects of attention (RT), memory (VM), and visuospatial (RCF) abilities at T2.

4.        The TG showed significantly greater improvement in QOLBI functional (p=0.023) and personal (p=0.019) subscores, as well as RCF (p=0.037), but no significant difference was found for other outcome measures.

5.        There was a significant correlation (p<0.050) between QOLBI total and pADL (r=0.49).

6.        There was a significant negative correlation (p<0.01) between attention (RT) and pADL (r=-0.59) and iADL (r=-0.56).

Reimunde et al.

(2011)

Spain

Cohort

N=19

Population: TBI; Gender: Male=19, Female=0. With Growth Hormone Deficiency (GHD) Group (n=11): Mean Age=53.36 yr; Mean Time Post Injury=44.55 mo. Without GHD group (n=8): Mean Age=47.12 yr; Mean Time Post Injury=46.6 mo.

Intervention: Those with GHD received recombinant human GH (rhGH), subcutaneously (0.5 mg/d for 20d then 1 mg/d for 5 d). Those without GHD were given a placebo. Cognitive rehabilitation was given to everyone (1 hr/d, 5d for 3 mo).

Outcome Measure: Weschler Adult Intelligence Scale (WAIS).

1.        Results of the WAIS indicated that the control group improved significantly on the digits and manipulative intelligence quotient (p<0.050).

2.        For those in the treatment groups improvement was noted in cognitive parameters: understanding digits, numbers and incomplete figures (p<0.050) and similarities vocabulary, verbal IQ, Manipulative IQ, and total IQ (p<0.010).