GMS German Medical Science最新文献

{"title":"Pathology in the legal framework of European and German medical device law: Operation, use and in-house manufacture of in vitro diagnostic medical devices.","authors":"Andy Kahles, Hannah Goldschmid, Anna-Lena Volckmar, Daniel Kazdal, Ulrich M Gassner, Michael Vogeser, Monika Brüggemann, Karl-Friedrich Bürrig, Vanessa Kääb-Sanyal, Christa Flechtenmacher, Peter Schirmacher, Albrecht Stenzinger","doi":"10.3205/000335","DOIUrl":"10.3205/000335","url":null,"abstract":"<p><p>Institutes for pathology act as operators, users and in-house manufacturers of in vitro diagnostic medical devices and are subject to national and European regulations depending on their function. The entry into force of the EU regulation on medical devices (Regulation (EU) 2017/745, MDR) and the EU regulation on in vitro diagnostic medical devices (Regulation (EU) 2017/746, IVDR) resulted in a need for regulatory adjustments to German medical device law. This has created a new legal framework in which institutes for pathology operate, depending on their function as users, operators or in-house manufacturers of in vitro diagnostic medical devices. This overview of the current legal situation represents a snapshot and provides an up-to-date overview of the landscape of European and German medical device law.</p>","PeriodicalId":39243,"journal":{"name":"GMS German Medical Science","volume":"22 ","pages":"Doc09"},"PeriodicalIF":0.0,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11570832/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142669505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Significance of EEG-electrode combinations while calculating filters with common spatial patterns.","authors":"Dominik Wetzel, Paul-Philipp Jacobs, Dirk Winkler, Ronny Grunert","doi":"10.3205/000334","DOIUrl":"10.3205/000334","url":null,"abstract":"<p><strong>Objective: </strong>Common spatial pattern (CSP) is a common filter technique used for pre-processing of electroencephalography (EEG) signals for imaginary movement classification tasks. It is crucial to reduce the amount of features especially in cases where few data is available. Therefore, different approaches to reduce the amount of electrodes used for CSP calculation are tried in this research.</p><p><strong>Methods: </strong>Freely available EEG datasets are used for the evaluation. To evaluate the approaches a simple classification pipeline consisting mainly of the CSP calculation and linear discriminant analysis for classification is used. A baseline over all electrodes is calculated and compared against the results of the approaches.</p><p><strong>Results: </strong>The most promising approach is to use the ability of CSP to provide information about the origin of the created filter. An algorithm that extracts the important electrodes from the CSP utilizing these information is proposed.The results show that using subject specific electrode positions has a positive impact on accuracy for the classification task. Further, it is shown that good performing electrode combinations in one session are not necessarily good performing electrodes in another session of the same subject. In addition to the combinations calculated using the developed algorithm, 26 additional electrode combinations are proposed. These can be taken into account when selecting well-performing electrode combinations. In this research we could achieve an accuracy improvement of over 10%.</p><p><strong>Conclusions: </strong>Carefully selecting the correct electrode combination can improve accuracy for classifying an imaginary movement task.</p>","PeriodicalId":39243,"journal":{"name":"GMS German Medical Science","volume":"22 ","pages":"Doc08"},"PeriodicalIF":0.0,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11463027/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142394073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Error assessment of subjective estimates of linear breast dimensions versus the objective method.","authors":"Parthena Karavasili, Helga Henseler","doi":"10.3205/000333","DOIUrl":"10.3205/000333","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The study aimed to investigate the subjective method of estimating linear breast dimensions in comparison to the objective method.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The reproducibility and accuracy of the subjective method of estimating linear breast dimensions during a simplified breast shape analysis were examined. Four linear breast dimensions including the distance from the sternal notch to the nipple, distance from the nipple to the inframammary fold, distance from the nipple to the midline and under-breast width were evaluated based on subjective estimates. Images from 100 women with natural breasts and without any history of breast surgery were reviewed by two examiners three times each. The cases were obtained from a large database of breast images captured using the Vectra Camera System (Canfield Scientific Inc., USA). The subjective data were then compared with the objective linear data from the Vectra Camera System in the automated analysis. Statistical evaluation was conducted between the three repeated estimates of each examiner, between the two examiners and between the objective and subjective data.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The intra-individual variations of the three subjective estimates were significantly greater in one examiner than in the other. This trend was consistent across all eight parameters in the majority of the comparisons of the standard deviations and variation coefficients, and the differences were significant in 14 out of 16 comparisons (p&lt;0.05). Conversely, in the comparison between the subjective and objective data, the estimates were closer to the measurements in one examiner than the other. In contrast to the reproducibility observed, the assessment of the accuracy revealed that the examiner who previously presented with less reproducibility of the estimated data overall showed better accuracy in comparison to the objective data. The overall differences were inconsistent, with some being positive and others being negative. Regarding the distances from the sternal notch to the nipple and breast width, both examiners underestimated the values. However, the deviations were at different levels, particularly when considering the objective data from the Vectra Camera System as the gold standard data for comparison. Regarding the distance from the nipple to the inframammary fold, one examiner underestimated the distance, while the other overestimated it. An opposite trend was noted for the distance from the nipple to the midline. There were no differences in the estimates between the right and left sides of the breasts. The correlations between the measured and estimated distances were positive: as the objective distances increased, the subjective distances also increased. In all cases, the correlations were significant. However, the correlation for the breast width was notably weaker than that for the other distances.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The error assessment of the","PeriodicalId":39243,"journal":{"name":"GMS German Medical Science","volume":"22 ","pages":"Doc07"},"PeriodicalIF":0.0,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11367253/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142120839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Position statement on genuine physiotherapy research at German university hospitals.","authors":"Susanne G R Klotz, Andrea Bökel, Maria Friderichs-Nedohibchenko, Isabelle Stickdorn, Barbara Vogel, Bernd Doods, Franziska Feldmann, Mirko Ghiazza, Markus Giehl, Annika Hoberg, Lynn Jansen, Daniel Kohlhofer, Ralf Leonhardt, Sebastian-Florian Meier, Carina Müller, Miriam Pannzek, Simone Schwarz, Martina Traut, Maria Urdahl","doi":"10.3205/000332","DOIUrl":"10.3205/000332","url":null,"abstract":"<p><p>In addition to patient care, physiotherapy is increasingly important in research at university hospitals. Genuine physiotherapy research plays a decisive role in this. This position statement describes the opportunities, benefits, framework conditions, challenges, and research priorities of genuine physiotherapy research at German university hospitals.</p>","PeriodicalId":39243,"journal":{"name":"GMS German Medical Science","volume":"22 ","pages":"Doc06"},"PeriodicalIF":0.0,"publicationDate":"2024-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11176936/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141332099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Self-help support: The Alzheimer's telephone from the user's perspective.","authors":"Alexander Kurz, Ina Maria Fischer, Vildan Dogan, Carolin Kurz","doi":"10.3205/000331","DOIUrl":"10.3205/000331","url":null,"abstract":"<p><strong>Background: </strong>Telephone counseling is an important form of support for informal carers of persons with dementia. The quality and benefit of this kind of service have rarely been evaluated in Germany.</p><p><strong>Methods: </strong>We developed a survey to assess the quality of telephone counseling. We conducted an online survey among 201 users of the telephone hotline \"Alzheimer-Telefon\" (Alzheimer's telephone service) provided by the German Alzheimer's Association after the consultation. The aim of the study was to determine whether this form of telephone support meets certain quality criteria and the callers' needs.</p><p><strong>Results: </strong>Of the 201 participants, 80% were female. The mean age of the callers was 51 years. 74% of cases were one-off consultations; 26% of the callers sought advice twice or more often. The most common reasons for calling included behavioral changes (45%) and finding a nursing home (41%). Other family members were significantly (p=0.036) more likely to seek local respite options. Based on the 201 online questionnaires evaluated, most callers were highly satisfied with the counseling services provided by the Alzheimer's telephone service. Those seeking advice were particularly satisfied with the appreciative and empathetic communication style of the advisors and their professional competence. This also applies to the accessibility of the telephone. More than three quarters were fully satisfied with the information they received. Almost half of the callers were sure that the advice would help to solve their issue. 14% of people seeking advice were uncertain about how to implement the suggested solutions.A further survey would be worthwhile to determine to what extent the topics of the consultation can be implemented. The feedback from relatives who use the Alzheimer's telephone repeatedly could be used for this purpose - the repetition rate is currently 25% and the trend is rising. Results could be interesting for successful counseling and for the development of further support services.</p><p><strong>Conclusion: </strong>The telephone hotline is a useful component of dementia care in Germany and an important contribution to the National Dementia Strategy.</p>","PeriodicalId":39243,"journal":{"name":"GMS German Medical Science","volume":"22 ","pages":"Doc05"},"PeriodicalIF":0.0,"publicationDate":"2024-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11176817/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141332100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Joint recommendations on cost calculation and estimation in paediatric clinical trials.","authors":"Gabriele Ahne, Julia Nagel, Axel R Franz, Antje Neubert, Kristina Schachtrup, Simone Helms, Sebastian Klammt, Matthias Schwab","doi":"10.3205/000330","DOIUrl":"10.3205/000330","url":null,"abstract":"<p><p>The conduct of clinical trials in paediatrics is essential to improve drug therapy in children. In Europe, paediatric clinical trials have been supported by the European Paediatric Regulation since 2007, but there is still a great need for high-quality clinical trials. The personnel and time required to conduct clinical trials in accordance with EU Regulations 536/2014 and 745/2017 is considerably higher compared to other studies, such as observational studies. It is important that this additional workload for the trial centre is fully compensated, also taking into account EU state aid rules. In paediatric trials, it is necessary to take into account the special requirements of paediatric and adolescent medicine when calculating the additional costs. Within the framework of the pan-European paediatric study network c4c/GermanNetPaeT, a working group dealt with specific aspects of cost calculation in order to support paediatric study centres in internal cost calculation as well as in the subsequent preparation of financing requirements for industrial sponsors or public funders. In several workshops the working group developed a cost calculation template with the content derived from the \"Joint recommendations for a total services account as a factor in simplifying contracts\" of the Deutsche Hochschulmedizin (DHM, German University Medicine), the Netzwerk der Koordinierungszentren für Klinische Studien (KKS Network, Network of Coordinating Centres for Clinical Trials) and the Verband Forschender Arzneimittelhersteller (vfa, German Association of Research-Based Pharmaceutical Companies). By estimating the specific time required for measures and investigations as part of a sample study, the background to the increased time required was discussed and a list with aspects to be considered for cost calculation was compiled together with the study centres. The paediatrics-specific aspects mentioned in detail are intended to increase understanding of the particular problem of higher costs for clinical trials involving children and adolescents and the need for correspondingly appropriate remuneration. This transparent and comprehensible presentation of the higher financial requirements for both the study centres and the financial supporters is intended to promote the high-quality conduct of clinical trials in paediatric study centres in the long term.</p>","PeriodicalId":39243,"journal":{"name":"GMS German Medical Science","volume":"22 ","pages":"Doc04"},"PeriodicalIF":0.0,"publicationDate":"2024-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11106673/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141077048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modification of velopharyngeal closure pressures during phonation by neuromuscular electrical stimulation in healthy individuals.","authors":"Simone Miller, Katharina Peters, Martin Ptok, Michael Jungheim","doi":"10.3205/000329","DOIUrl":"https://doi.org/10.3205/000329","url":null,"abstract":"<p><strong>Introduction: </strong>Rhinophonia aperta may result from velopharyngeal insufficiency. Neuromuscular electrical stimulation (NMES) has been discussed in the context of muscle strengthening. The aim of this study was to evaluate in healthy subjects whether NMES can change the velopharyngeal closure pattern during phonation and increase muscle strength.</p><p><strong>Method: </strong>Eleven healthy adult volunteers (21-57 years) were included. Pressure profiles were measured by high resolution manometry (HRM): isolated sustained articulation of /a/ over 5 s (protocol 1), isolated NMES applied to soft palate above motor threshold (protocol 2) and combined articulation with NMES (protocol 3). Mean activation pressures (MeanAct), maximum pressures (Max), Area under curve (AUC) and type of velum reactions were compared. A statistical comparison of mean values of protocol 1 versus protocol 3 was carried out using the Wilcoxon signed rank test. Ordinally scaled parameters were analyzed by cross table.</p><p><strong>Results: </strong>MeanAct values measured: 17.15±20.69 mmHg (protocol 1), 34.59±25.75 mmHg (protocol 3) on average, Max: 37.86±49.17 mmHg (protocol 1), 87.24±59.53 mmHg (protocol 3) and AUC: 17.06±20.70 mmHg.s (protocol 1), 33.76±23.81 mmHg.s (protocol 3). Protocol 2 produced velum reactions on 32 occasions. These presented with MeanAct values of 13.58±12.40 mmHg, Max values of 56.14±53.14 mmHg and AUC values of 13.84±12.78 mmHg.s on average. Statistical analysis comparing protocol 1 and 3 showed more positive ranks for MeanAct, Max and AUC. This difference reached statistical significance (p=0.026) for maximum pressure values.</p><p><strong>Conclusions: </strong>NMES in combination with articulation results in a change of the velopharyngeal closure pattern with a pressure increase of around 200% in healthy individuals. This might be of therapeutic benefit for patients with velopharyngeal insufficiency.</p>","PeriodicalId":39243,"journal":{"name":"GMS German Medical Science","volume":"22 ","pages":"Doc03"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11034089/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140858541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differences in velopharyngeal pressures during speech sound production in patients with unilateral cleft lip and palate (UCLP) and healthy individuals.","authors":"Simone Miller, Johanna Kallusky, Rüdiger Zimmerer, Frank Tavassol, Nils-Claudius Gellrich, Martin Ptok, Michael Jungheim","doi":"10.3205/000328","DOIUrl":"https://doi.org/10.3205/000328","url":null,"abstract":"<p><strong>Background: </strong>During articulation the velopharynx needs to be opened and closed rapidly and a tight closure is needed. Based on the hypothesis that patients with cleft lip and palate (CLP) produce lower pressures in the velopharynx than healthy individuals, this study compared pressure profiles of the velopharyngeal closure during articulation of different sounds between healthy participants and patients with surgically closed unilateral CLP (UCLP) using high resolution manometry (HRM).</p><p><strong>Materials and methods: </strong>Ten healthy adult volunteers (group 1: 20-25.5 years) and ten patients with a non-syndromic surgically reconstructed UCLP (group 2: 19.1-26.9 years) were included in this study. Pressure profiles during the articulation of four sounds (/i:/, /s/, /ʃ/ and /n/) were measured by HRM. Maximum, minimum and average pressures, time intervals as well as detection of a previously described 3-phase-model were compared.</p><p><strong>Results: </strong>Both groups presented with similar pressure curves for each phoneme with regards to the phases described and pressure peaks, but differed in total pressures. An exception was noted for the sound /i:/, where a 3-phase-model could not be seen for most patients with UCLP. Differences in velopharynx pressures of 50% and more were found between the two groups. Maximum and average pressures in the production of the alveolar fricative reached statistical significance.</p><p><strong>Conclusions: </strong>It can be concluded that velopharyngeal pressures of patients with UCLP are not sufficient to eliminate nasal resonance or turbulence during articulation, especially for more complex sounds. These results support a general understanding of hypernasality during speech implying a (relative) velopharyngeal insufficiency.</p>","PeriodicalId":39243,"journal":{"name":"GMS German Medical Science","volume":"22 ","pages":"Doc02"},"PeriodicalIF":0.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11034380/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140869943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Die EU-Verordnung für In-vitro-Diagnostika (IVDR) in der Praxis: Umsetzung und Anwendung - Ergebnisse einer öffentlichen Veranstaltung der Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF) im März 2023.","authors":"Michael Vogeser, Monika Brüggemann, Kristina Brandt, Uta Ceglarek, Volker Gieskes, Niclas Hitziger, Andy Kahles, Ernst Klar, Dirk Roggenbuck, Henning Schliephake, Ortwin Schulte, Sascha Wettmarshausen, Uwe Zimmermann, Ulrich Sack, Albrecht Stenzinger","doi":"10.3205/000327","DOIUrl":"10.3205/000327","url":null,"abstract":"<p><p>In order to discuss first experiences with the implementation of the EU Regulation on In Vitro Diagnostic Medical Devices (IVDR) about one year after its entry into force, the German Association of the Scientific Medical Societies (AWMF e.V.) organized a full-day public webinar. Overall, it became clear that the implementation of the IVDR still poses significant challenges for laboratory medicine and pathology. Corrections at the political level and implementation with a sense of proportion are required. Before the long-term goal of the IVDR, i.e. the increase in patient safety, can be realized, the prevention of disadvantages for patients due to gaps in care must be strived for in the medium term by all parties involved.</p>","PeriodicalId":39243,"journal":{"name":"GMS German Medical Science","volume":"22 ","pages":"Doc01"},"PeriodicalIF":0.0,"publicationDate":"2024-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10952015/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140185951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Review of the effectiveness of neuromuscular electrical stimulation in the treatment of dysphagia - an update.","authors":"Simone Miller,&nbsp;Katharina Peters,&nbsp;Martin Ptok","doi":"10.3205/000310","DOIUrl":"https://doi.org/10.3205/000310","url":null,"abstract":"<p><strong>Background: </strong>Neuromuscular electrical stimulation (NMES) has been used as a treatment option in the therapy of dysphagia for several years. In a previous review of the literature, it was concluded that NMES might be a valuable adjunct in patients with dysphagia and in patients with vocal fold paresis. However, due to different stimulation protocols, electrode positioning and various underlying pathological conditions, it was difficult to compare the studies which were identified and it was concluded that more empirical data is needed to fully understand the benefits provided by NMES. The purpose of this systematic review is, therefore, to evaluate recent studies regarding a potential effectiveness of transcutaneous NMES applied to the anterior neck as a treatment for dysphagia considering these different aspects.</p><p><strong>Method: </strong>For this systematic review, a selective literature research in PubMed has been carried out on 5^th May 2021 using the terms <i>electrical stimulation AND dysphagia</i> and screened for inclusion criteria by two reviewers in Rayyan. The search resulted in 62 hits.</p><p><strong>Results: </strong>Studies were excluded due to their publication language; because they did not meet inclusion criteria; because the topical focus was a different one; or because they did not qualify as level 2 studies. Eighteen studies were identified with varying patient groups, stimulation protocols, electrode placement and therapy settings. However, 16 studies have reported of beneficial outcomes in relation with NMES.</p><p><strong>Discussion: </strong>The purpose of this systematic review was to evaluate the most recent studies regarding a potential effectiveness of NMES as a treatment for oropharyngeal dysphagia considering different aspects. It could generally be concluded that there is a considerable amount of level 2 studies which suggest that NMES is an effective treatment option, especially when combined with TDT for patients with dysphagia after stroke and patients with Parkinson's disease, or with different kinds of brain injuries. Further research is still necessary in order to clarify which stimulation protocols, parameters and therapy settings are most beneficial for certain patient groups and degrees of impairment.</p>","PeriodicalId":39243,"journal":{"name":"GMS German Medical Science","volume":" ","pages":"Doc08"},"PeriodicalIF":0.0,"publicationDate":"2022-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9284430/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40645807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}