Publications by authors named "Kumru H"

Context: A previously healthy 40-year-old woman experienced a sudden complete tetraplegia (C8, AIS-A).

Findings: MRI revealed a C6/C7 disc herniation surrounded by an epidural haematoma.

Conclusion/clinical Relevance: Physicians must recognize acute, non-traumatic disc herniation as a potential cause of spinal cord injury, urging prompt diagnosis and intervention.

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Objective: The potential risk of inducing ventricular arrhythmias was explored by employing pulsed field ablation (PFA) through the administration of both monophasic and biphasic waveform deliveries.

Methods: PFA was applied to specific locations in the right ventricle (RV, n = 5 sites) in swine (n = 2), utilizing identical settings with consistent amplitude, pulse width, and a number of pulses for both monophasic and biphasic waveforms. PFA deliveries were precisely timed in 10-ms intervals across the entire T wave.

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(1) Background: Restoring arm and hand function is one of the priorities of people with cervical spinal cord injury (cSCI). Noninvasive electromagnetic neuromodulation is a current approach that aims to improve upper-limb function in individuals with SCI. The aim of this study is to review updated information on the different applications of noninvasive electromagnetic neuromodulation techniques that focus on restoring upper-limb functionality and motor function in people with cSCI.

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Introduction: Long-term analgesic effect of intrathecal baclofen was reported in individuals with spinal cord injury. We conducted a prospective study to evaluate the effect of intrathecal baclofen on subtypes of neuropathic pain and its interference with general activity.

Materials And Methods: Nine spinal cord injury individuals who presented with severe spasticity and moderate to severe neuropathic pain received intrathecal baclofen via an implanted pump.

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Transcutaneous multisegmental spinal cord stimulation (tSCS) has shown superior efficacy in modulating spinal locomotor circuits compared to single-site stimulation in individuals with spinal cord injury (SCI). Building on these findings, we hypothesized that administering a single session of tSCS at multiple spinal segments may yield greater enhancements in muscle strength and gait function during stimulation compared to tSCS at only one or two segments. In our study, tSCS was applied at single segments (C5, L1, and Coc1), two segments (C5-L1, C5-Coc1, and L1-Coc1), or multisegments (C5-L1-Coc1) in a randomized order.

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Radiofrequency ablation (RFA) of the medial branch nerve is a widely used therapeutic intervention for facet joint pain. However, denervation of the multifidus muscle is an inevitable consequence of RFA. New ablation techniques with the potential to prevent muscle denervation can be designed using computational simulations.

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(1) Background: Respiratory muscle weakness is common following cervical spinal cord injury (cSCI). Transcutaneous spinal cord stimulation (tSCS) promotes the motor recovery of the upper and lower limbs. tSCS improved breathing and coughing abilities in one subject with tetraplegia.

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(1) Background: Restoring arm and hand function is a priority for individuals with cervical spinal cord injury (cSCI) for independence and quality of life. Transcutaneous spinal cord stimulation (tSCS) promotes the upper extremity (UE) motor function when applied at the cervical region. The aim of the study was to determine the effects of cervical tSCS, combined with an exoskeleton, on motor strength and functionality of UE in subjects with cSCI.

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Background: Functional neurological disorders have rarely been described in patients recovering from Covid-19 or after vaccination but they are probably under diagnosed.

Material And Methods: Six patients referred for rehabilitation of persistent symptoms and/or sequelae of Coronavirus disease 2019 (COVID-19) were diagnosed with functional neurological disorders. A literature review was conducted to identify reported cases of functional neurological disorders after Covid-19 infection or vaccination.

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(1) Background: the use of Mesenchymal Stromal Cells (MSC) in emerging therapies for spinal cord injury (SCI) hold the potential to improve functional recovery. However, the development of cell-based medicines is challenging and preclinical studies addressing quality, safety and efficacy must be conducted prior to clinical testing; (2) Methods: herein we present (i) the characterization of the quality attributes of MSC from the Wharton's jelly (WJ) of the umbilical cord, (ii) safety of intrathecal infusion in a 3-month subchronic toxicity assessment study, and (iii) efficacy in a rat SCI model by controlled impaction (100 kdynes) after single (day 7 post-injury) and repeated dose of 1 × 10 MSC,WJ (days 7 and 14 post-injury) with 70-day monitoring by electrophysiological testing, motor function assessment and histology evaluation; (3) Results: no toxicity associated to MSC,WJ infusion was observed. Regarding efficacy, recovery of locomotion was promoted at early time points.

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Article Synopsis
  • Researchers explored how different vibration frequencies affect spinal cord reflexes and pain perception, hypothesizing that frequency influences both.
  • In a study with 9 healthy participants, vibrations at 50, 150, and 250 Hz were applied to the leg muscle, measuring reflexes and pain responses before, during, and after vibration.
  • Results showed that lower frequencies significantly suppressed spinal cord reflexes more than higher frequencies, but there was no impact on warmth or heat pain perception, suggesting potential applications for reducing reflex excitability in spastic patients.
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  • Patients with spinal cord injury (SCI) are at greater risk for sleep-disordered breathing (SDB), which can negatively affect their recovery and quality of life, but sleep tests are rarely conducted due to logistical challenges.
  • A study evaluated a smartphone-based system to monitor SDB by collecting data on oxygen levels, sound, and movement during sleep for 19 SCI patients and 19 able-bodied controls.
  • Results showed that SCI patients had a significantly higher apnea-hypopnea index (AHI), with 63% experiencing moderate-to-severe SDB compared to 21% of controls, indicating a need for improved monitoring in this population.
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Purpose: This prospective, observational cohort study investigated the effects of multidisciplinary rehabilitation of post Covid-19 sequelae and persistent symptoms and their impact on patients' functioning and quality of life.

Methods: From 58 patients referred for neurorehabilitation, 43 were eligible for and participated in the present study. Before and after 8 weeks of rehabilitation, patients underwent physical, neuropsychological and respiratory evaluations and assessment of functional independence, impact of fatigue and quality of life.

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Electrical enabling motor control (eEmc) through transcutaneous spinal cord stimulation offers promise in improving hand function. However, it is still unknown which stimulus intensity or which muscle force level could be better for this improvement. Nine healthy individuals received the following interventions: (i) eEmc intensities at 80%, 90% and 110% of abductor pollicis brevis motor threshold combined with hand training consisting in 100% handgrip strength; (ii) hand training consisting in 100% and 50% of maximal handgrip strength combined with 90% eEmc intensity.

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Impaired trunk stability is frequent in spinal cord injury (SCI), but there is a lack of quantitative measures for assessing trunk function. Our objectives were to: (a) evaluate trunk muscle activity and movement patterns during a reaching task in SCI patients, (b) compare the impact of cervical (cSCI) and thoracic (tSCI) injuries in trunk function, and (c) investigate the effects of a startling acoustic stimulus (SAS) in these patients.Electromyographic (EMG) and smartphone accelerometer data were recorded from 15 cSCI patients, nine tSCI patients, and 24 healthy controls, during a reaching task requiring trunk tilting.

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Article Synopsis
  • The study investigates the effects of transcranial direct current stimulation (tDCS) combined with nerve stimulation on motor recovery in acute stroke patients with severe motor impairment.
  • Conducted with 19 patients, the research compared a real tDCS treatment group with a sham (placebo) group, conducting assessments before and after the treatment at various intervals.
  • Results indicated that while both groups showed some motor improvement over time, there were no significant differences between the real and sham stimulation groups, suggesting severe motor impairment may limit the effectiveness of tDCS interventions.
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Background: Outlet constipation is a major problem in spinal cord injury (SCI) patients. We aimed to study the efficacy of external anal sphincter (EAS) infiltration with type-A botulinum toxin (BTX-A) in motor incomplete SCI patients with outlet constipation.

Methods: Double blind, randomized, placebo controlled, comparative study in 16 motor incomplete SCI subjects.

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Background: Coronavirus disease 2019 (COVID-19) patients present long-lasting physical and neuropsychological impairment, which may require rehabilitation.

Objectives: The current cross-sectional study characterizes post COVID-19 sequelae and persistent symptoms in patients in an outpatient rehabilitation program.

Methods: Thirty patients [16 post-ICU and 14 non-ICU; median age = 54(43.

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Trunk stability is essential to maintain upright posture and support functional movements. In this study, we aimed to characterize the muscle activity and movement patterns of trunk flexion during an arm reaching task in sitting healthy subjects and investigate whether trunk stability is affected by a startling acoustic stimulus (SAS). For these purposes, we calculated the electromyographic (EMG) onset latencies and amplitude parameters in 8 trunk, neck, and shoulder muscles, and the tilt angle and movement features from smartphone accelerometer signals recorded during trunk bending in 33 healthy volunteers.

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