Metabolic profile of complete spinal cord injury in pons and cerebellum: A 3T 1H MRS study.

The aim of this exploratory study was the assessment of the metabolic profiles of persons with complete spinal cord injury (SCI) in three region-of-interests (pons, cerebellar vermis, and cerebellar hemisphere), with magnetic resonance spectroscopy, and their correlations to clinical scores. Group differences and association between metabolic and clinical scores were examined. Fifteen people with chronic SCI (cSCI), five people with subacute SCI (sSCI) and fourteen healthy controls were included.

Functional connectivity and amplitude of low-frequency fluctuations changes in people with complete subacute and chronic spinal cord injury.

After spinal cord injury (SCI), reorganization processes and changes in brain connectivity occur. Besides the sensorimotor cortex, the subcortical areas are strongly involved in motion and executive control. This exploratory study focusses on the cerebellum and vermis.

Mean kurtosis-Curve (MK-Curve) correction improves the test-retest reproducibility of diffusion kurtosis imaging at 3 T.

Diffusion kurtosis imaging (DKI) is applied to gain insights into the microstructural organization of brain tissues. However, the reproducibility of DKI outside brain white matter, particularly in combination with advanced estimation to remedy its noise sensitivity, remains poorly characterized. Therefore, in this study, we investigated the variability and reliability of DKI metrics while correcting implausible values with a fit method called mean kurtosis (MK)-Curve.

Exercise Capacity, Functioning and Quality of Life 12 Weeks after Traumatic Thoracic Spinal Cord Injury.

Background: A spinal cord injury (SCI) leads to patho-physiological changes that can affect physical and psychological performance. The aim of this observational study was to evaluate the relationship between exercise capacity, functioning and quality of life in patients 12 weeks after traumatic paraplegia participating in early rehabilitation.

Material And Methods: 13 patients participated in this study and performed cardio-pulmonary exercise testing (CPET) on an arm-crank ergometer to determine peak exercise capacity (VO2peak).

S1 Guidelines on Bone Impairment in Spinal Cord Injury.

During the acute and chronic phase of spinal cord injury (SCI) bone turnover and structure are affected. Bone mineral density of lower limbs is decreased up to 28%-50% below that of age-matched peers at 12-18 mo post injury. Coexisting secondary etiologies of osteoporosis may be present, and during ageing additional loss of bone occurs.

Osteoporosis in the lower extremities in chronic spinal cord injury.

Study Design: Cross-sectional study.

Objectives: To investigate the effect of chronic motor complete spinal cord injury (SCI) and sex on bone densitometry parameters of the hip, femoral neck, tibial epiphysis, and diaphysis and on long bone fractures.

Setting: SCI rehabilitation center.

Exoskeleton gait training after spinal cord injury: An exploratory study on secondary health conditions.

Objective: To explore changes in pain, spasticity, range of motion, activities of daily living, bowel and lower urinary tract function and quality of life of individuals with spinal cord injury following robotic exoskeleton gait training.

Design: Prospective, observational, open-label multicentre study.

Methods: Three training sessions per week for 8 weeks using an Ekso™ GT robotic exoskeleton (EKSO Bionics).

Risk factors for hypocalcaemia after completion hemithyroidectomy in thyroid cancer.

Background: Hypocalcaemia (HC) is the most common complication after thyroid surgery in differentiated thyroid cancer and leads to a prolongation of the hospital stay. While risk factors for HC after total thyroidectomy (TE) are well investigated, only few studies have been published about HC risk factors after completion of thyroidectomy. Our aim was to identify potential risk factors for HC after completion of TE and to compare these incidences with figures from primary total TE.

Gait training after spinal cord injury: safety, feasibility and gait function following 8 weeks of training with the exoskeletons from Ekso Bionics.

Study Design: Prospective quasi-experimental study, pre- and post-design.

Objectives: Assess safety, feasibility, training characteristics and changes in gait function for persons with spinal cord injury (SCI) using the robotic exoskeletons from Ekso Bionics.

Setting: Nine European rehabilitation centres.

Nutritional blood parameters and nutritional risk screening in patients with spinal cord injury and deep pressure ulcer-a retrospective chart analysis.

Study Design: Retrospective chart review.

Objectives: To describe (i) the nutritional blood parameters (NBP) and the nutritional risk screening (NRS) in patients with spinal cord injury (SCI) and pressure ulcers (PU) III and IV according to the EPUAP classification, and (ii) the relationship between both NBP and NRS.

Setting: SCI acute care and rehabilitation clinic in Switzerland.

[Intraoperative parathyroid hormone measurement is the best predictor of postoperative symptomatic hypocalcemia].

Background: The goal of this study is to evaluate risk factors for transient postoperative hypocalcemia (HC) and to define cutoff values for perioperative parathyroid hormone (PTH) and calcium parameters (Ca) to reduce the morbidity of symptomatic HC.

Materials And Methods: At our tertiary referral hospital (Luzerner Kantonsspital, Switzerland), a total of 353 patients underwent total thyroidectomy between 2006 and 2013 and were analyzed retrospectively in terms of HC risk. The serum values of calcium and PTH were measured at strictly defined time intervals, and patients' symptoms and the necessity of treatments were determined from patients' charts.

Biophysical skin properties of grade 1 pressure ulcers and unaffected skin in spinal cord injured and able-bodied persons in the unloaded sacral region.

Aim Of The Study: To examine biophysical skin properties in the sacral region in spinal cord injury (SCI) patients suffering from a grade 1 pressure ulcer (PU) defined as non-blanchable erythema (SCI/PU), SCI patients in the post-acute phase (SCI/PA) and able-bodied participants (CON). Also, for SCI/PU patients, both the affected skin and healthy skin close to the PU were examined.

Study Design: An experimental controlled study with a convenience sample.

Novel Sensor Technology To Assess Independence and Limb-Use Laterality in Cervical Spinal Cord Injury.

After spinal cord injury (SCI), levels of independence are commonly assessed with standardized clinical assessments. However, such tests do not provide information about the actual extent of upper limb activities or the impact on independence of bi- versus unilateral usage throughout daily life following cervical SCI. The objective of this study was to correlate activity intensity and laterality of upper extremity activity measured by body-fixed inertial measurement units (IMUs) with clinical assessment scores of independence.

Multi-Day Recordings of Wearable Sensors Are Valid and Sensitive Measures of Function and Independence in Human Spinal Cord Injury.

Wearable sensor assessment tools have proven to be reliable in measuring function in normal and impaired movement disorders during well-defined assessment protocols. While such assessments can provide valid and sensitive measures of upper limb activity in spinal cord injury (SCI), no assessment tool has yet been introduced into unsupervised daily recordings to complement clinical assessments during rehabilitation. The objective of this study was to measure the overall amount of upper-limb activity in subjects with acute SCI using wearable sensors and relate this to lesion characteristics, independence, and function.

A novel algorithm for detecting active propulsion in wheelchair users following spinal cord injury.

Physical activity in wheelchair-bound individuals can be assessed by monitoring their mobility as this is one of the most intense upper extremity activities they perform. Current accelerometer-based approaches for describing wheelchair mobility do not distinguish between self- and attendant-propulsion and hence may overestimate total physical activity. The aim of this study was to develop and validate an inertial measurement unit based algorithm to monitor wheel kinematics and the type of wheelchair propulsion (self- or attendant-) within a "real-world" situation.

The characteristics of posttraumatic syringomyelia.

Study Design: Retrospective cross-sectional study.

Objectives: To investigate the characteristics of posttraumatic symptomatic syringomyelia after spinal cord injury (SCI).

Setting: Swiss Paraplegic Centre, Nottwil, Switzerland.

Functional Electrical Stimulation in Spinal Cord Injury: Clinical Evidence Versus Daily Practice.

Functional electrical stimulation (FES) has clinical evidence in the rehabilitation of patients with spinal cord injury as indicated by several studies. Both inpatients and outpatients benefit from the therapeutic effect of the FES. The application areas are multifaceted and can be customized on the need for patients.

Long-bone fractures in persons with spinal cord injury.

Study Design: Retrospective data analysis.

Objectives: To document fracture characteristics, management and related complications in individuals with traumatic spinal cord injury (SCI).

Setting: Rehabilitation centre for SCI individuals.

Study participation rate of patients with acute spinal cord injury early during rehabilitation.

Study Design: Retrospective observational study.

Objectives: To investigate the study participation rate of patients with acute spinal cord injury (SCI) early during rehabilitation after conveying preliminary study information.

Setting: Single SCI rehabilitation center in Switzerland.

Challenges to measure hydration, redness, elasticity and perfusion in the unloaded sacral region of healthy persons after supine position.

Aim Of The Study: To combine measurement methods of biophysical skin properties in a clinical setting and to measure baseline values in the unloaded sacral region of healthy persons after lying 30 min in supine position.

Methods: Hydration (Corneometer® CM 825), redness (Mexameter® MX 18), elasticity (Cutometer® MPA 580) and perfusion (PeriFlux System 5000) of the skin in the sacral region of 10 healthy participants (median age: 26.9 years) were measured consecutively in the laying position by two trained examiners.

Changes in Strength, Sensation, and Prehension in Acute Cervical Spinal Cord Injury: European Multicenter Responsiveness Study of the GRASSP.

Objective: To investigate the internal and external responsiveness and recovery profiles of the Graded Redefined Assessment of Strength, Sensibility, and Prehension (GRASSP) instrument in revealing changes in upper limb function within the first year following cervical spinal cord injury (SCI).

Method: A European prospective, longitudinal, multicenter study assessing the GRASSP at 1, 3, 6, and 12 months after cervical SCI. Subtests of GRASSP were compared to the upper extremity motor (UEMS) and light touch scores (LT) according to the International Standards of Neurological Classification of Spinal Cord Injury (ISNCSCI), the Spinal Cord Independence Measure self-care subscore (SCIM-SS), as well as a clinician-rated outcome measure (CROM) of clinical relevance.

Effective Treatment of Posttraumatic and Postoperative Edema in Patients with Ankle and Hindfoot Fractures: A Randomized Controlled Trial Comparing Multilayer Compression Therapy and Intermittent Impulse Compression with the Standard Treatment with Ice.

Background: After ankle and hindfoot fractures, edema has a major impact on the time for surgical intervention and may increase the risk of wound complications and infection postoperatively. The aim of this study was to evaluate the efficacy of multilayer compression and intermittent impulse compression therapy in reducing ankle and hindfoot edema compared with the standard treatment with elevation and ice.

Methods: This was a randomized, controlled, single-blinded clinical trial using a repeated-measures design.

The effect of arm position and bed adjustment on comfort and pressure under the shoulders in people with tetraplegia: a randomized cross-over study.

Study Design: Randomized, within-in participant cross-over study.

Objective: The purpose of this study was to determine the effect on comfort and pressure of lying with the shoulders and bed in different positions for people with tetraplegia.

Setting: Rehabilitation hospital.