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Ines Bersch-Porada

Doktorand

Ines Bersch-Porada
Doktorand
ines.bersch@gu.se


Avd för ortopedi vid Institutionen för kliniska vetenskaper (Mer information)
Göteborgsvägen 31
431 80 Mölndal
Besöksadress: R-huset, plan 4 , 431 80 Mölndal

Om Ines Bersch-Porada

AVHANDLING/THESIS - Upper and Lower Motoneuron Lesions in Tetraplegia - Diagnostic and Therapeutic Implications of Electrical Stimulation

Disputation/Dissertation
Datum: 2019-10-25 Tid: 13:00 -15:30

Plats/Place: Hörsal aulan, R-huset, Sahlgrenska Universitetssjukhuset/Mölndal
Huvudhandledare: Jan Fridén
Bihandledare: Jòn Karlsson
Opponnent: Páll Ingvarsson, Landspitali Universitetssjukhus, Reykjavik
Island
Betygsnämnd: Kate Himmelmann, Kurt Pettersson och Björn Rydevik

Link to the thesis and a short summary can be found here on Ines's profile page:

Swedish title: Övre och nedre motorneuronskador vid tetraplegi - Diagnostiska och terapeutiska implikationer för elektrisk stimulering

This thesis examines principles and mechanisms for how electrical stimulation affects the brain, spinal cord, nerves and muscles of people with high spinal cord injury.

A spinal cord injury at the neck level is a life-changing trauma
A spinal cord injury at the neck level is a catastrophic event that often leaves the person paralyzed in all four extremities (tetraplegia) for the rest of the life. Typically, the lack of hand function is the most incapacitating consequence of this life-changing trauma. For tetraplegic persons, regaining hand and arm function is one of the most often expressed needs, even more than recovering walking. Major progress has been made over the last decade to restore hand control by muscle-tendon or nerve transpositions from functional to non-functional muscles or nerves

- The thesis focuses on improving and applying of diagnostic and therapeutic electrical stimulation in the arms and hands of spastic and flaccid paralyzed patients with tetraplegia. For this purpose, the topographic distribution of stimulation points (motor points) for the extensors and flexors of the forearm and the hand was mapped in able persons by electrical stimulation. The electrical stimulation according to this mapping led to remarkable findings in patients with high cervical spinal cord injuries, explains Ines Bersch, head of the Swiss Paraplegic Centre’s International FES Centre for Treatment and Education in Switzerland. She is a graduated physiotherapist.

The electrical stimulation according to this mapping led to remarkable findings in patients with high cervical spinal cord injuries. One of the thesis's main findings was that the presence of partially denervated muscles is considerably higher among the flexor than in extensor forearm muscles.

- This may explain the surgical and clinical observation of a better functional outcome after surgical nerve transfer to the extensors compared to some disappointing results after nerve transfer to the flexors.

Early onset of electrical stimulation after injury improves the conditions
A consequence therefore was to perform an interventional study to investigate whether it is possible to preserve the muscle structure in denervated muscles by electrical stimulation.

- The result was positive, and it is likely that early onset of electrical stimulation after injury improves the conditions for successful reinnervation after nerve transfers. In addition, the time between spinal cord injury and nerve transfer may be prolonged without impairing the outcome.

Electrical stimulation and reconstructive tetraplegia together provide quality of life
One of her other studies investigated the effect of electrical stimulation on neuromodulation.

- It was examined if robot-controlled exercises together with functional electrical stimulation could increase the voluntary strength of movements in incomplete tetraplegia. The only available system for robot-controlled training is adapted to the lower limbs and therefore this study was performed on the lower extremities. it was shown that the combination of electrical stimulation and robot-controlled, voluntary initiated training increased the recruitment of motor units and muscle strength in the legs.

In summary: the studies have shown that the two treatment methods in the rehabilitation of persons with tetraplegia, the electrical stimulation and reconstructive tetraplegia hand and arm surgery, can supplement each other to provide more independence and quality of life.

Senaste publikationer

Motor Point Topography of Fundamental Grip Actuators in Tetraplegia: Implications in Nerve Transfer Surgery
Ines Bersch, S. Koch-Borner, Jan Fridén
Journal of Neurotrauma, Artikel i vetenskaplig tidskrift 2019
Artikel i vetenskaplig tidskrift

Electrical stimulation-a mapping system for hand dysfunction in tetraplegia
Ines Bersch, S. Koch-Borner, Jan Fridén
Spinal Cord, Artikel i vetenskaplig tidskrift 2018
Artikel i vetenskaplig tidskrift

Visar 1 - 2 av 2

2019

Motor Point Topography of Fundamental Grip Actuators in Tetraplegia: Implications in Nerve Transfer Surgery
Ines Bersch, S. Koch-Borner, Jan Fridén
Journal of Neurotrauma, Artikel i vetenskaplig tidskrift 2019
Artikel i vetenskaplig tidskrift

2018

Electrical stimulation-a mapping system for hand dysfunction in tetraplegia
Ines Bersch, S. Koch-Borner, Jan Fridén
Spinal Cord, Artikel i vetenskaplig tidskrift 2018
Artikel i vetenskaplig tidskrift

Visar 1 - 2 av 2

Sidansvarig: Katarina Olinder Eriksson|Sidan uppdaterades: 2016-10-11
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