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M Baumberger

Publications and source records attributed to M Baumberger.

7 recordsLinked to original sources
PubMed2006

Developing core sets for persons with spinal cord injuries based on the International Classification of Functioning, Disability and Health as a way to specify functioning.

OBJECTIVE: The objective of this paper is to outline the proposed development process for the ICF Core Sets for Spinal Cord Injury (SCI) and to invite clinical and consumer experts to actively participate in this process. ICF Core Sets are selections of categories of the International Classification of Functioning, Disability and Health (ICF) that are relevant to persons with a specific condition or in a specific setting. METHOD: The project is a cooperation between the ICF Research Branch of the World Health Organization (WHO) Collaboration Centre of the Family of International Classifications (DIMDI, Germany), the Classification, Assessment and Terminology (CAT) team and the Disability and Rehabilitation (DAR) team at WHO, the International Spinal Cord Society (ISCoS) and International Society for Physical and Rehabilitation Medicine (ISPRM) and partner institutions across the world. The project will consist of four worldwide studies to be conducted from 2006 to 2007 with a proposed ICF Core Set Consensus Conference to be held in 2007. ICF categories relevant for SCI are to be identified by means of (I) an empirical study, (II) a systematic review of outcomes and measures used in SCI research (III) an expert survey and (IV) focus groups and semistructured interviews with persons with SCI. Consensus about items that have to be part of a Comprehensive and of a Brief ICF Core Set for SCI will be reached in a final ICF Core Set Consensus Conference. Subsequent field testing will be necessary to validate this first version of ICF Core Sets for SCI. INVITATION FOR PARTICIPATION: The development of ICF Core Sets is an inclusive and open process. Anyone who wishes to actively participate in this process is invited to contact the project coordinator (Monika.Scheuringer@med.uni-muenchen.de or http://www.icf-research-branch.org/research/spinalcord-injuries.htm). Individuals, institutions and associations can be formally associated as partners of the project.

Database Management Systems↗
PubMed2006

[Preclinical diagnosis of traumatic paraplegia or tetraplegia -- a prospective study in 100 patients].

OBJECTIVE: To avoid neurological deterioration, traumatic spinal cord injury has to be recognized as early as possible. Aim of the study was to analyze alterations of the neurological level of injury in the preclinical interval. METHODS: In a prospective observational study the clinical diagnoses of 100 patients referred to the Swiss Paraplegic Centre in Nottwil, Switzerland, were compared to the preclinical diagnoses. RESULTS: In 12 patients we observed neurological deterioration for more than 2 spinal segments. Six of these patients had been diagnosed preclinically with paraplegia at a neurological level of T4 or T5, whereas the evaluation in the hospital showed cervical spinal cord injury and tetraplegia. CONCLUSION: Possible reasons for this neurological deterioration can be secondary damages of the nervous tissue due to vascular, metabolic or biochemical mechanisms, transportation trauma or insufficient preclinical diagnostics. There is no evidence for a higher risk of secondary tissue damage for patients with cervical spinal cord injury. None of the six patients had additional injuries of the spinal cord or the vertebral column in the thoracic region, therefore transportation trauma is also unlikely. It is more likely that preclinical diagnoses were incorrect, what could have been avoided by consequent sensory and motor testing at the upper extremities.

Adult↗
PubMed2003

Deep vein thrombosis and heterotopic ossification in spinal cord injury: a 3 year experience at the Swiss Paraplegic Centre Nottwil.

STUDY DESIGN: Retrospective review of patient data. OBJECTIVES: (i) To determine the incidence and time of deep vein thrombosis (DVT) under low molecular weight heparin (LMWH) prophylaxis in spinal cord injury (SCI), (ii) to determine the incidence and time of heterotopic ossification (HO) and (iii) to assess a possible aetiologic relationship in the pathogenesis of DVT and HO. SETTING: Swiss Paraplegic Centre, Nottwil. METHODS: We analyzed the incidence of DVT and HO in 1209 SCI patients (275 first rehabilitations) at the Swiss Paraplegic Centre Nottwil from 1998 to 2000. Clinical files and laboratory data were scrutinised for particularities preceding DVT and HO. RESULTS: The incidence of DVT was 6.55% for first rehabilitation compared to only 1.59% in all patients hospitalised. DVT was complicated by pulmonary embolism (PE) in 1.45% and 0.47% respectively. Incidence of HO was 8% for first rehabilitation and 1.82% for all patients hospitalised. In first rehabilitation patients the peak for DVT occurred around day 30 contrary to HO with a peak around day 120. In single patients HO was identified by MRI as a rapidly progressing process. Laboratory profiles were inflammatory in both HO and DVT. Increased physical activity preceding HO was observed in four patients. In two patients acute HO was complicated by ipsilateral DVT. CONCLUSION: Prophylaxis with LMWH and elastic stockings significantly reduces the frequency of DVT during first rehabilitation in SCI. DVT and HO are both associated with laboratory parameters of non-infectious inflammation. The later onset of HO coinciding with ongoing mobilisation, argues for a different pathogenetic mechanism. Acute HO of the hip region appears to favour ipsilateral DVT by well known thrombogenic mechanisms.

Adolescent↗
PubMed2002

The importance of posture on the isokinetic assessment of spasticity.

OBJECTIVE: To measure spasticity of the knee flexors and extensor muscles in two different hip positions. SETTING: Swiss Paraplegic Center Nottwil, Switzerland. METHODS: Twenty spinal cord injured (SCI) patients with complete lesions were tested with a torque-velocity dynamometer in the following positions: (1) supine with a hip angle of 0 degrees; (2) sitting with a hip angle of 90 degrees. The excursion of the knee was measured for both positions using a goniometer. Two flexion/extension movements of the knee were performed at a speed of 10 degrees per sec. A further four flexion/extension movements over the same trajectory were made at a speed of 120 degrees per sec. Eccentric peak torques were measured continuously during movement of both legs for both speeds. RESULTS: At a speed of 120 degrees per second, there was a significant difference in stretch reflex of the hamstrings and quadriceps femoris muscles for the two positions (Wilcoxon's paired t-test, P<0.05). Excitability was higher for the quadriceps femoris muscles in supine than in sitting position. For the hamstrings, the effect was reversed. Significant differences between sitting and supine position were not found for the speed of 10 degrees per sec. Test-retest reliability was high for the movements of 120 degrees per sec but low for 10 degrees per sec. CONCLUSIONS: Our findings indicate that for a reliable and comparable measurement of spasticity, an exact description of test position and procedure is essential.

Adult↗
PubMed2002

Characteristics of sleep apnea syndrome in tetraplegic patients.

OBJECTIVE: To include a larger number of tetraplegics than in previous studies, in order to more reliably characterize the pathogenesis and predisposing factors of sleep apnea in tetraplegia. METHODS: Sleep breathing data and oxymetric values were investigated in 50 randomly selected tetraplegic patients and discussed in context with age, gender, BMI, neck circumference, type and height of lesion, time after injury, spirometric values and medication. A non-validated short questionnaire on daytime complaints was added. RESULTS: Thirty-one patients out of 50 had an RDI > or =15, defined as sleep disordered breathing (SDB); 24 of them combined with an apnea index of 5 or more, these cases were diagnosed as sleep apnea syndrome (SAS). SAS was apparent in 55% and 20% of the studied men and women, respectively. Regression analyses showed no significant correlation between RDI and lesion level, ASIA impairment scale or spirometric values. In contrast, a significant correlation between RDI and age, BMI, neck circumference and time after injury could be shown. Kruskal-Wallis test for dichotomous non-parametric factors, such as gender, cardiac medication and daytime complaints, showed significant differences with regard to RDI. In contrast to able-bodied people with SAS, daytime complaints were only present in tetraplegic patients with severe pathology (RDI>40). CONCLUSION: Incidence of SAS is high in tetraplegia, particularly in older male patients with large neck circumference, long standing spinal cord injury and under cardiac medication. As tetraplegics with RDI between 15 and 40 reported no daytime complaints and often have normal BMI, these tetraplegics are not clinically suspicious for SAS. The increased use of cardiac medication in tetraplegics with SAS may implicate a link between SAS and cardiovascular morbidity, one of the leading causes of death in tetraplegia.

Adult↗