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Öğe Accuracy of the methods used to estimate glomerular filtration rate compared to 24-hour urinary creatinine clearance in patients with chronic spinal cord injury(Taylor & Francis Ltd, 2023) Hazer, Burcu; Onder, Fatih Oguz; Metli, Neslihan Bilge; Aslan, Sirin Baran; Yalcin, Elif; Akyuz, MufitObjective To compare the accuracy of glomerular filtration rate (GFR) estimation by 24-hour urinary creatinine clearance with GFR estimation by the Modification of Diet in Renal Disease (MDRD) equation, the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation, the Mayo Clinic Quadratic equation (MCQE), and the modified Cockcroft-Gault formula in patients with spinal cord injury (SCI). Design Cross-sectional study. Participants Fifty-nine consecutive subjects, who were admitted to our hospital SCI rehabilitation and no additional acute medical disorders, were enrolled in this study. A 24-hour urine sample was collected for the determination of 24-hour urinary creatinine clearance, which was assumed as the standard technique for estimation of the GFR. The accuracy of several estimation formulas includes the 4-variable MDRD equation, the 6-variable MDRD equation, the Cockcroft and Gault equation, the CKD-EPI equation, and the MCQE. Results GFRs calculated by the Cockcroft-Gault equation and 4-variable MDRD were significantly different from the 24-hour urinary creatinine clearance, whereas there were no significant differences in GFRs calculated by CKD-EPI (P = 1.000), Mayo Clinic Quadratic formula (P = 0.794), and 6-variable MDRD equations (P = 0.435) and 24-hour urinary creatinine clearance. Both the 6-variable MDRD equation and CKD-EPI were accurate within +/- 20 of the reference methods in 52.54% of the subjects. Conclusions Among the methods used for estimation of the GFR including the 4- and 6-variable MDRD, the CKD-EPI, the modified Cockcroft-Gault equation, and the MCQE, the 6-variable MDRD equation and the CKD-EPI demonstrated best performance to estimate the GFR. However, none of the formulas were sufficient to estimate the GFR in SCI patients accurately.Öğe The effect of electromyography triggered electrical stimulation to abdominal muscles on sitting balance, respiratory functions, and abdominal muscle thickness in complete spinal cord injury: a randomized controlled trial(Lippincott Williams & Wilkins, 2024) Bayraktar, Handan E. N.; Yalcin, Elif; Sipal, Meric S.; Akyuz, Mufit; Akinci, Meltem G.; Delialioglu, Sibel U.Complete thoracic spinal cord injury (SCI) results in a loss of innervation to the abdominal muscles, which affects trunk stability and performance of activities of daily living from a sitting position. Respiratory function is also affected, leading to frequent pulmonary complications. Given the importance of trunk stability and respiratory function, we investigated the effects of electromyography triggered electrical stimulation (EMG-ES) applied to the abdominal muscles on sitting balance, respiratory functions and abdominal muscle thickness in individuals with complete thoracic SCI. This randomized controlled study included 34 participants with complete thoracic SCI who were randomly allocated to the experimental group (n = 17) and the control group (n = 17). During the 4-week intervention period, the experimental group received EMG-ES to their abdominal muscles, while the control group received isometric abdominal exercises three times per week. Both groups continued with their routine rehabilitation program (active or passive range of motion exercises, stretching, and balance coordination exercises). The primary outcome measures were the modified functional reach test (mFRT) and trunk control test (TCT). Secondary outcome measures included a pulmonary function test (PFT) and the bilateral abdominal muscle thicknesses using ultrasonography. At the end of the study, the experimental group showed significantly greater improvements in both primary outcomes. The mean difference in pre-post changes between the groups for the mFRT area was 242.8 cm(2) [95% confidence interval (CI): 181.3-329.8; effect size 0.92; P < 0.001] and 5.0 points for TCT (95% CI: 3.9-6.0; effect size 0.98, P < 0.001). The increase in the abdominal muscle thickness was also significantly greater in the experimental group (P < 0.001) without significant differences in the PFT (P > 0.05). We conclude that adding EMG-ES of abdominal muscles may further improve sitting balance and abdominal muscle thickness in individuals with complete thoracic SCI. Copyright (c) 2024 Wolters Kluwer Health, Inc. All rights reserved.Öğe THE EFFECTS OF THE LEVEL OF SPINAL CORD INJURY ON LIFE SATISFACTION AND DISABILITY(Literatura Medica, 2020) Karatas, Gulsah; Metli, Neslihan; Yalcin, Elif; Gunduz, Ramazan; Karatas, Fatih; Akyuz, MufitIntroduction - Spinal Cord Injury (SCI) may often lead to significant disability in affected individuals and reduce life satisfaction. Herein we aimed to investigate the effects of the level of injury on disability and life satisfaction as well as the relation between life satisfaction and disability. Methods - Patients with at least one-year history of SCI were included. Demographic-clinical data of patients were recorded. The Craig Handicap Assessment and Reporting Technique-Short Form (CHART-SF) was used for quantifying the degree of patients' disability. Life satisfaction was assessed by the Satisfaction with Life Scale (SWLS). Results - Of the 76 patients, 21 (27.6%) were tetraplegic and 55 (72.4%) were paraplegic. SWLS was found to be similar in tetraplegic vs. paraplegic patients (P=0.59), whereas CHART parameters such as physical independence, mobility, occupation, and total CHART value were significantly higher in paraplegic patients (P=0.04, P=0.04, P=0.001 and P=0.01, respectively). Social integration was found similarly high in both groups. There was a positive correlation between elapsed time after the injury and CHART physical independence, occupation and the level of economic sufficiency (P<0.01, P<0.01, P=0.01). Excluding the economic sufficiency (P=0.02), there was not any other association between the rest of CHART parameters and SWLS. Conclusions - According to our findings, although the level of injury seems to be influential on disability, it seems to have no significant effect on life satisfaction. Since the only thing that positively affects life satisfaction is economic sufficiency, more emphasis should be placed on regulations that increase the return to work in patients.
