Publications by authors named "Matthias Walter"

Unlabelled: Cervical spinal cord injury (SCI) impairs sensorimotor and autonomic functions. We investigated the effects of lumbosacral transcutaneous spinal cord stimulation (tSCS) on urinary bladder, bowel, and sexual function as well as cardiovascular and sensorimotor functions in one individual with chronic clinically motor-complete cervical SCI, 11 years post-injury. Following 30 sessions of lumbosacral tSCS, the individual presented with improved urinary bladder compliance as well as anorectal function in parallel with mitigation of the severity of autonomic dysreflexia during filling cystometry and anorectal manometry.

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Background: In May 2021, the second edition of International Standards to document remaining Autonomic Function after Spinal Cord Injury (ISAFSCI) was published.

Objectives: To transcreate the 2021 ISAFSCI (2nd ed.) to German and to assess its feasibility in the subacute phase following spinal cord injury/disease (SCI/D).

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Background: Internships can constitute up to one third of the curriculum and during these internships, the foundation for developing specific health professional competencies is formed. The clinical learning environment (CLE) is a critical determinant of the overall quality of internships in health profession education, shaping students' professional competencies and experiences.

Objective: This systematic review aims to identify and categorize assessment tools available for evaluating the quality of the CLE in health professions education.

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Objectives: To improve precision of secondary resection (SR) after positive surgical margin (PSM) detection by frozen section (FS) during nerve-sparing (NS) robot-assisted radical prostatectomy (RARP) by employing a personalised three-dimensional (3D)-printed prostate model derived from pelvic magnetic resonance imaging (MRI). This model was used to mark positive surgical margins (PSM) and guide intraoperative SR during NS-RARP.

Patients And Methods: Prospective multicentre cohort study with 100 patients undergoing NS-RARP between September 2018 and August 2021.

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Article Synopsis
  • A systematic literature review was conducted to evaluate the effects of commonly used medications on neurological recovery after acute spinal cord injury (SCI), with studies sourced from major databases until March 2021.
  • *Out of 394 studies analyzed, around 42% of animal experiments showed positive disease-modifying effects from drugs like methylprednisolone and melatonin, while morphine and ethanol were linked to negative outcomes.
  • *The findings suggest a need for more human-centered research to explore the potential benefits of drugs like melatonin and atorvastatin for improving recovery after SCI, despite varying research methodologies across studies.
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Background: Most of the worldwide population is overweight and suffers from the resulting musculoskeletal comorbidities such as knee osteoarthritis or back pain. Practice guidelines recommend weight loss interventions for individuals suffering from these conditions. This systematic review investigated whether including a weight loss intervention in the musculoskeletal therapy of these individuals was cost-effective compared to administering the musculoskeletal therapy alone.

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Background: Spinal cord injuries (SCI) often result in cardiovascular issues, increasing the risk of stroke and cognitive deficits.

Objectives: This study assessed cerebrovascular reactivity (CVR) using functional magnetic resonance imaging (fMRI) during a hypercapnic challenge in SCI participants compared to noninjured controls.

Methods: Fourteen participants were analyzed ( = 8 with SCI [unless otherwise noted], median age = 44 years; = 6 controls, median age = 33 years).

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Background: A low level of cardiorespiratory fitness [CRF; defined as peak oxygen uptake ([Formula: see text]O2peak) or peak power output (PPO)] is a widely reported consequence of spinal cord injury (SCI) and a major risk factor associated with chronic disease. However, CRF can be modified by exercise. This systematic review with meta-analysis and meta-regression aimed to assess whether certain SCI characteristics and/or specific exercise considerations are moderators of changes in CRF.

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Botulinum toxin-A (BoNT-A) injections into the external urethral sphincter are an established therapeutic procedure for reducing bladder outlet obstruction in patients with detrusor sphincter dyssynergia (DSD) due to spinal cord injury (SCI). Given the paucity of data on patients with DSD but without SCI, we aimed to assess the efficacy of intrasphincteric BoNT-A injections in this cohort. For this retrospective study, we screened all patients who underwent their first intrasphincteric BoNT-A injection at our institution between 2015 and 2021.

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The aim of this retrospective exploratory study was to investigate the prevalence of unfavorable findings during video-urodynamic studies (VUDS) in patients with minimally conscious state (MCS)/unresponsive wakefulness syndrome (UWS) and whether management of the lower urinary tract (LUT) was adjusted accordingly. A retrospective chart review was conducted to screen for patients diagnosed with MCS/UWS at our rehabilitation center between 2011 and 2020. Patients 18 years or older were included and underwent baseline VUDS after being diagnosed with MCS/UWS.

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Despite the risk of developing catheter-associated urinary tract infections (CAUTI), catheter reuse is common among people with spinal cord injury (SCI). This study examined the microbiological burden and catheter surface changes associated with short-term reuse. Ten individuals with chronic SCI reused their catheters over 3 days.

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Hand osteoarthritis (OA) is a common form of OA, for which education and exercise are considered the first-line treatment. The aim of the present study was to examine pain and perceived hand function in participants following 3 months of digitally delivered first-line treatment for hand OA. Three-hundred-and-seventy-nine of 846 participants with clinical signs and symptoms of hand OA completed the study.

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Overactive bladder (OAB) is a global problem reducing the quality of life of patients and increasing the costs of any healthcare system. The etiology of OAB is understudied but likely involves supraspinal network alterations. Here, we characterized supraspinal resting-state functional connectivity in 12 OAB patients and 12 healthy controls (HC) who were younger than 60 years.

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Sexual dysfunction is a common consequence for women with spinal cord injury (SCI); however, current treatments are ineffective, especially in the under-prioritized population of women with SCI. This case-series, a secondary analysis of the Epidural Stimulation After Neurologic Damage (E-STAND) clinical trial aimed to investigate the effect of epidural spinal cord stimulation (ESCS) on sexual function and distress in women with SCI. Three females, with chronic, thoracic, sensorimotor complete SCI received daily (24 h/day) tonic ESCS for 13 months.

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The value of disposable, single-use catheters has come under scrutiny in recent years with a growing attention on environmental sustainability. Intermittent catheterization (IC) is a widely available and minimally invasive technique for management of lower urinary tract dysfunction. Effective IC for individuals with neurogenic lower urinary tract dysfunction can promote their independence and improve quality of life.

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Introduction: Electrical spinal cord neuromodulation has emerged as a leading intervention for restoring autonomic functions, such as blood pressure, lower urinary tract (LUT), bowel, and sexual functions, following spinal cord injury (SCI). While a few preliminary studies have shown the potential effect of non-invasive transcutaneous spinal cord stimulation (tSCS) on autonomic recovery following SCI, the optimal stimulation parameters, as well as real-time and long-term functional benefits of tSCS are understudied. This trial entitled "Non-invasive Neuromodulation to Treat Bladder, Bowel, and Sexual Dysfunction following Spinal Cord Injury" is a pilot trial to examine the feasibility, dosage effect and safety of tSCS on pelvic organ function for future large-scale randomized controlled trials.

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Article Synopsis
  • - The study investigated the effects of fesoterodine on autonomic dysreflexia (AD) in 12 individuals with chronic spinal cord injury (SCI), focusing on its impact on urinary tract function over a 12-week treatment period.
  • - Results showed significant improvements in lower urinary tract function, with many participants experiencing increased bladder capacity and a decrease in detrusor pressure; AD severity and frequency also decreased notably.
  • - Overall, fesoterodine was effective in reducing AD symptoms and improving quality of life related to urinary incontinence, without adversely affecting cognitive or bowel functions.
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Article Synopsis
  • This study analyzed heart rate (HR) and blood pressure (BP) data from 21 individuals with spinal cord injuries undergoing penile vibrostimulation (PVS) or urodynamic studies (UDS) to understand heart response during autonomic dysreflexia (AD).
  • Out of 47 recorded AD episodes, bradycardia was observed in 43% during PVS and 30% during UDS at AD threshold, indicating significant heart rate changes correlated with increases in systolic BP.
  • The study suggests that continuous cardiovascular monitoring during these procedures is essential to detect severe AD early and prevent potential life-threatening complications by ensuring systolic BP doesn't reach dangerously high levels.
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Individuals with cervical spinal cord injury (SCI) experience deleterious changes in cardiac structure and function. However, knowledge on when cardiac alterations occur and whether this is dependent upon neurological level of injury remains to be determined. Transthoracic echocardiography was used to assess left ventricular structure, function, and mechanics in 10 male individuals (median age 34 years, lower and upper quartiles 32-50) with cervical ( = 5, c-SCI) or thoracolumbar ( = 5, tl-SCI) motor-complete SCI at 3- and 6-months post-injury.

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Article Synopsis
  • This study looked at how safe epidural spinal cord stimulation (eSCS) is for people with spinal cord injuries (SCI).
  • The researchers followed 14 participants at medical centers in Minnesota and monitored their health after receiving eSCS.
  • They found no major problems from the surgery or the device, and eSCS seemed just as safe for SCI patients as it is for treating chronic pain.
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Study Design: Secondary data analysis.

Objective: To characterize heart rate (HR) changes during autonomic dysreflexia (AD) in daily life for individuals with chronic spinal cord injury (SCI).

Setting: University-based laboratory/community-based outpatient.

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Objective: Individuals with spinal cord injury (SCI) report using cannabis to self-manage chronic pain and spasticity. However, its safety and efficacy are not well understood. As more women with SCI are pursuing motherhood, clinicians must consider the possibility of maternal cannabis use and its impact on fetal development.

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