Corina Sporea

@umfcd.ro/en

Faculty of Midwives and Nursing
University of Medicine and Pharmacy “Carol Davila”

https://researchid.co/corinas

Scopus Publications

Scholar Citations

Scholar h-index

Scholar i10-index

Scopus Publications

The Interplay Between Stress and Eating Attitudes: A Cross-Sectional Study Among Romanian Physical Therapy Students
Corina Sporea, Maria-Veronica Morcov, Claudiu Ionut Vasile, Ioana Elena Cioca, Oana Alina Apostol, Andrada Mirea, and Antoaneta Punga
MDPI AG
Background: University students often experience significant stress, which may contribute to disordered eating behaviors. Objectives: This study examines the relationship between perceived stress and eating attitudes among physical therapy students in Romania, exploring the impact on overall well-being and identifying predictors of maladaptive eating patterns. Methods: A cross-sectional survey was conducted with 192 students from the Faculty of Midwifery and Nursing, “Carol Davila” University of Medicine and Pharmacy. Two validated instruments were used: the Eating Attitudes Test (EAT-26) to assess eating behaviors and the Perceived Stress Scale (PSS-14) to measure stress levels. Statistical analyses included correlations, ANOVA, and regression models, with a significance threshold of p < 0.05. Results: Among respondents, 15.1% displayed disordered eating behaviors, with stress significantly correlating with EAT-26 subscales. Stress levels were predominantly moderate to high, with younger students reporting higher perceived stress. A significant positive correlation was found between perceived stress and disordered eating behaviors, particularly dieting and bulimia/food preoccupation. Female students reported higher stress levels than males; however, no significant gender differences were observed in disordered eating patterns. No significant associations were found between BMI, weight fluctuations, and EAT-26 scores, suggesting other factors may better explain disordered eating behaviors. Logistic regression identified perceived stress as a significant predictor of disordered eating risk, reinforcing its role in shaping maladaptive eating patterns. Conclusions: Stress significantly impacts eating attitudes, highlighting the need for targeted interventions to reduce stress and promote healthy coping mechanisms. Future research should investigate longitudinal patterns and the effectiveness of interventions aimed at improving student well-being. The limited sample size and the absence of sensitivity analyses are notable limitations that constrain the generalizability of the findings.

Evolution of Functional and Paraclinical Markers as Predictive Factors in Pediatric Late-Onset SMA Under Nusinersen Treatment: The Role of CSF pNF-H
Mihaela Badina, Gabriel Cristian Bejan, Corina Sporea, and Andrada Mirea
Romanian Association of Balneology
Spinal Muscular Atrophy (SMA) is a rare neurodegenerative disease caused by insufficient synthesis of SMN protein, characterized by progressive muscle weakness, atrophy, and complications affecting the respiratory and digestive systems. Disease severity tends to be greater when symptoms manifest at an earlier age. Since 2016, the FDA-approved drug nusinersen has provided a disease-modifying treatment option. Identifying predictive factors for patient outcomes over time remains essential. This retrospective study analyzed clinical and biological parameters in 42 patients (ages 13–215 months) with SMA types 2 and 3 over the first three years of nusinersen treatment. We assessed pNF-H levels in CSF and serum—neuronal proteins associated with neurodegeneration—as well as serum creatinine levels, a marker of muscle activity, and motor skill scores to evaluate pNF-H’s potential as a predictor of motor development. Elevated pNF-H levels were associated with a lower SMN2 gene copy number and more recent disease onset. Following nusinersen treatment, pNF-H levels stabilized at low values, likely due to basal metabolic activity. In SMA types 2 and 3, higher baseline CSF pNF-H levels correlated with improved performance over time. Additionally, higher serum creatinine levels and smaller changes in pNF-H during the loading phase or various periods of maintenance treatment were associated with better motor development outcomes at two and three years of treatment.

Predictive Clinical-Biological Markers Over the First 3 Years of Nusinersen Treatment in SMA Type 1 Patients
Mihaela Badina, Andrada Mirea, Corina Sporea, and Gabriel Cristian Bejan
Romanian Association of Balneology
Werdnig-Hoffmann disease, or type 1 Spinal Muscular Atrophy (SMA), is caused by insufficient SMN protein synthesis due to a genetic defect. Symptoms appear within the first 6 months of life, and without ventilatory support, life expectancy averages 2 years. This study aimed to monitor pNF-H neurofilament levels in cerebrospinal fluid (CSF) and serum, serum creatinine, and motor performance during nusinersen treatment to evaluate pNF-H as a predictor of motor outcomes. Biological samples and clinical outcomes from 34 participants were analyzed at 6 months, 1 year, 2 years, and 3 years post-treatment initiation. Most patients showed favorable outcomes, with improved motor assessment scores, increased serum creatinine, and decreased pNF-H levels in CSF and serum. Higher baseline pNF-H in CSF was linked to fewer SMN2 gene copies. The largest pNF-H decrease occurred during the nusinersen loading period, stabilizing at low levels through maintenance. Smaller changes in pNF-H from baseline correlated with better motor outcomes and higher serum creatinine at 2 and 3 years. Nusinersen treatment reduced pNF-H levels, reflecting decreased neuronal degradation, increased serum creatinine due to enhanced muscle activity, and improved motor function. High baseline pNF-H in SMA type 1 may indicate a poorer prognosis for motor improvement.

Exploring the Links Between Coping Strategies, Emotional Intelligence, and Age in Adolescents with Neuromotor Disabilities
Ioana Elena Cioca, Maria Veronica Morcov, Corina Sporea, Oana Alina Apostol, Angelo Pellegrini, and Elena-Nicoleta Bordea
MDPI AG
Background/Objectives: The aim of this study is to explore the relationship between emotional intelligence and coping strategies used by adolescents with disabilities, on the one hand to understand how emotional skills influence stress management and everyday challenges and, on the other hand, considering that it could help specialists to develop interventions and educational programs that support the improvement of emotional skills and coping strategies among adolescents with disabilities. Methods: This cross-sectional study included 100 Romanian adolescents with neuromotor disabilities aged 13 to 18 years (M = 15.2) divided into three groups according to the stages of adolescence: Group 1 (13 years—46 respondents), Group 2 (14 to 17 years—26 respondents), and Group 3 (18 years—28 respondents). They completed a questionnaire that assessed the emotional intelligence of the adolescents (positive impression, interpersonal, intrapersonal, stress management, adaptability, and general mood) as well as another one that assessed the possible cognitive emotional coping strategies (e.g., “blame self”, “acceptance”, “rumination”, “positive refocusing”, “refocus on planning”, “positive reappraisal”, “putting into perspective”, “catastrophizing”, and “blaming others”) that they may adopt in managing life situations related to their health problem. Results: Group 3 has significantly higher scores than Group 2 on the Interpersonal subscale and also significantly higher scores than Group 1 on the Stress management. Our analysis also revealed significant correlations between adaptive coping strategies and emotional intelligence domains across all groups, with positive associations between acceptance and stress management, as well as between positive refocusing and adaptability. Regression analysis identified adaptive coping strategies as significant predictors of emotional intelligence, explaining 29% of its variance. Conclusions: Our findings underscore the critical importance of targeted interventions to enhance emotional regulation and adaptive coping strategies in adolescents with neuromotor disabilities. By focusing on strengthening emotional intelligence and tailoring interventions to developmental stages, these programs can promote better emotional and social functioning, particularly in challenging situations.

The Role of the Six-Minute Walk Test in the Functional Evaluation of the Efficacy of Rehabilitation Programs After COVID-19
Diana-Lidia Tache-Codreanu, Lucian Bobocea, Iuliana David, Claudia-Camelia Burcea, and Corina Sporea
MDPI AG
Patients with COVID-19 suffering in the acute phase from both the sequelae of the disease and prolonged immobilization require a rehabilitation phase for functional recovery and a comprehensive functional evaluation. This study proposes using the 6-Minute Walk Test (6MWT) as a global functional assessment tool to quantify rehabilitation outcomes in post-COVID patients. Additionally, investigating the effect of High-Intensity Laser Therapy (HILT) on patients with musculoskeletal comorbidities was another key research question. Two post-COVID rehabilitation programs were retrospectively analyzed as follows: one consisting of kinesiotherapy combined with High-Intensity Laser Therapy for patients with musculoskeletal comorbidities and the other consisting of kinesiotherapy alone. Functional evaluation using 6MWT was conducted before and after 10 daily therapeutic sessions with 33 ambulatory patients divided into 2 groups (18 patients treated with HILT and kinesiotherapy vs. 15 patients treated with kinesiotherapy only). The 6MWT was successfully completed by 32 out of 33 patients (96.96%), with performance improvements ranging from 3% to 60% among patients. Statistical differences were also observed between the groups, suggesting that the 6MWT is a sensitive, objective, and valuable tool for functional assessment of post-COVID rehabilitation, supporting the potential benefits of HILT in enhancing functional recovery.

The Benefits of a Rehabilitation Program Following Medial Patellofemoral Ligament Reconstruction
Claudia-Camelia Burcea, Maria-Daniela-Antonia Oancea, Diana-Lidia Tache-Codreanu, Luminița Georgescu, Ioana-Cristina Neagoe, and Corina Sporea
MDPI AG
The medial patellofemoral ligament (MPFL) is critical for patellar stability. This study investigates the efficacy of a one-year physical therapy rehabilitation program following MPFL reconstruction using Synthetic Graft (SG) and Quadriceps Tendon Autograft (QTA). Thirty-five patients aged 18–38 underwent MPFL reconstruction (20 SG, 15 QTA). They participated in a structured rehabilitation program to improve their range of motion (ROM), muscle strength, pain management, and overall quality of life (QoL). The program included physiotherapy and MLS laser, Game Ready Therapy, EMS, TENS, TECAR, and lymphatic drainage. Before and after the program, assessments included knee flexion and extension using goniometry, muscle strength via the Medical Research Council (MRC) scale, knee circumference, pain intensity on the Visual Analogue Scale (VAS), and QoL with the EQ-5D instrument. Significant improvements were observed in knee flexion (37.57° vs. 114.71°, p < 0.001), muscle strength (MRC scale 1–4 points vs. 4–5 points, p < 0.001), and pain reduction (VAS 6.66 vs. 0.46, p < 0.001). The functional coefficient of mobility and QoL scores also markedly increased. Patients with QTA improved some parameters better than those with SG. These findings support the effectiveness of a comprehensive rehabilitation program in enhancing knee functionality, reducing pain, and improving QoL post-MPFL reconstruction. Personalized rehabilitation protocols are recommended to optimize recovery outcomes.

Impact of Nusinersen on Neurofilament, Creatinine Levels, and Motor Function in Pediatric Spinal Muscular Atrophy Rehabilitation: A Biomarker Analysis
Mihaela Badina, Corina Sporea, Gabriel Cristian Bejan, Andrada Mirea, and Daniela Adriana Ion
Romanian Association of Balneology
Background: Spinal amyotrophy is a rare, neurodegenerative disease, with progressive evolution, disabling until death in severe forms, but for which 3 disease-modifying drugs have recently been approved (in the last 8 years). In this context, it became necessary to find predictive factors for the evolution of patients and for the effectiveness of the treatment applied to personalize the therapy to obtain the best results according to the particularities of each patient. Objective: The objective of this retrospective study is to analyze the evolution of different clinical (motor functional scales) and paraclinical biomarkers (level of pNF-H neurofilaments in serum and cerebrospinal fluid and of serum creatinine) under treatment with nusinersen in various types of spinal muscular atrophy (SMA). Methods: We analyzed the biomarkers values for a group of 69 pediatric patients diagnosed with SMA in different stages of treatment over three years, depending on the type of SMA, the number of copies of the SMN2 gene, and the age at initiation of therapy. Results: We observed significant increases in the levels of pNF-H neurofilaments in both cerebrospinal fluid (CSF) and serum, with correlations to the age of symptom onset in patients and an inverse relationship to the number of copies of the SMN2 gene. These levels decreased during treatment with nusinersen, coinciding with increased serum creatinine values and improved motor functional assessment scores. The most pronounced effects were noted in patients with severe forms of the disease, such as SMA type 1, mainly when treatment was initiated at a younger age. Conclusion: The evolution of patients under disease-modifying treatments should be analyzed both for the evolution on specific motor functional scales, as well as against the biomarkers of neuronal degradation: pNF-H, present in CSF and serum, and serum creatinine, a marker of muscle activity. Administering the disease-modifying treatment promptly after diagnostic confirmation halts neural degradation and enhances the patient's motor function. Keywords: spinal muscular atrophy; neurofilaments; cerebrospinal fluid; biomarkers; nusinersen; creatinine; motor evolution

Transforming the Management of Articular Fractures in the Foot: A Critical Examination of Current Methods and Future Directions: A Review
Robert Daniel Dobrotă, Adrian Gheorghe Barbilian, Corina Sporea, and Dumitru Ferechide
MDPI AG
This study provides a comprehensive examination of the current methodologies and potential strategies for the treatment of articular fractures of the foot. In the field of orthopedic healthcare, these fractures present a significant challenge due to their complex nature and the fact that they affect the routines of patients. The motivation behind this study is based on two main concepts. The first one is represented by the use of emerging medical technologies and personalized medicine to bring a significant transformation in the management of foot fractures and give a better quality of treatment that is accepted by the patient. However, because there are inequities in the availability of the necessary medical care and equipment, as well as uneven incorporation in clinical settings, new technologies cannot be used to treat these types of fractures. Regarding the second concept behind this study, it is indicated that although current treatment methods are essential, they have a number of shortcomings when it comes to properly addressing these types of injuries. An approach is needed that takes into account the biomechanical points of view and the particularities of each patient. This approach could be applied in all hospital settings. Through this study, we want to highlight the progress made in recent years in surgical techniques such as 3D printing, minimally invasive surgery (MIS), and biological products. However, in the application of this new discovery, new obstacles have been discovered that prevent the efficient treatment of these types of injuries. This study examines the effectiveness and limitations of current treatments, as well as how differences in healthcare, such as available equipment, training of medical staff, and technological advances, affect patient outcomes in everyday life. This research wishes to emphasize that continuous innovation, interdisciplinary collaboration, and the use of an optimal approach that is appropriate for each patient, are essential. This study aims to provide new insights and useful recommendations for future research and clinical practice. The main role of this research is to improve the quality of life of patients and increase the standards of care in this complex field, which is in permanent evolution.

The dynamic of changes of pNFH levels in the CSF compared with the motor scales’ scores during three years of nusinersen treatment in children with spinal muscular atrophy types 2 and 3
Mihaela Badina, Corina Sporea, Gabriel Cristian Bejan, Andrada Mirea, and Daniela Adriana Ion
Romanian Association of Balneology
Abstract: Neurofilaments are crucial in neuronal cytoskeleton formation, influencing axonal growth and impulse modulation. This study focuses on understanding the dynamics of the phos-phorylated neurofilament heavy subunit (pNFH) in pediatric spinal muscular atrophy (SMA) pa-tients undergoing Nusinersen treatment. The presence of five neurofilament types, particularly pNFH, is explored as a potential biomarker. SMA, an autosomal recessive disease impacting motor neurons, is characterized by disease severity linked to the number of SMN2 gene copies. Approved drugs, including Nusinersen, have demonstrated efficacy in enhancing motor activity. Methods: A retrospective analysis was conducted on 18 pediatric SMA patients treated with Nusinersen from October 2018 to July 2023. Cerebrospinal fluid (CSF) samples were utilized to assess pNFH levels. Motor scales were employed to evaluate performance, focusing on patients with varying SMN2 gene copies. Results: Following the initiation of Nusinersen treatment, a substantial decrease in pNFH levels was observed in CSF samples. Motor scales indicated improved performance, partic-ularly in patients with more SMN2 copies. However, the correlation between pNFH levels and motor improvement was not strongly evident, suggesting a limited role as a prognostic indicator within this timeframe. Conclusion: Nusinersen effectively reduced pNFH levels in pediatric SMA patients, showcasing promising outcomes in motor function. However, the predictive value of pNFH remains inconclusive, emphasizing the need for further research. Study limitations, including the rarity of SMA, the absence of a control group, and the disease's dynamic nature over time, should be considered when interpreting these findings.

Functional results one-year following the anti-vegf therapy in macular pathology
Nicoleta Anton, Alina Mihaela Neacșu, Daniel Constantin Branișteanu, Ileana Ramona Barac, Aida Geamanu, Raluca Iancu, Ruxandra Angela Pârvulescu, Corina Sporea, Bogdan Doroftei, Camelia Margareta Bogdănici,et al.
Romanian Association of Balneology
This investigation aims at evaluating the functional results 1-year following anti-VEGF therapy in macular pathology. Material and method: This is a retrospective examination that was carried out on 57 patients with macular pathology out of 108 at Sf. Spiridon Hospital in Iasi. 57 patients with macular pathology were included in the investigation, respectively 57 eyes, 24 eyes with diabetic macular edema and 33 with neovascular age-related macular degeneration. Eyes in which less than 6 intravitreous injections were performed (less than one-year of follow-up) as well as those without oct control examinations and without adequate controls were excluded. Results: Visual acuity improves considerably after the therapy was performed in both patients experiencing diabetic macular edema (370 vs 320 microns) and in those with age-related macular degeneration (320 vs 260 microns), while the average thickness of the central macula decreases considerably after therapy. Conclusions: In this study, the therapy with intravitreal Aflibercept was associated with improving the functional and anatomical outcomes, keeping the increasing trend up to one-year of therapy in those who received a minimum of three injections.

Effectiveness of passive movement training in patients with cerebral palsy: A comparative analysis of robot-assisted therapy and electrical stimulation in hand rehabilitation
Corina Sporea, Maria Veronica Morcov, Mirela Morcov, and Andrada Mirea
Romanian Association of Balneology
Background: Cerebral palsy is a non-progressive neurodevelopmental condition that re-sults in varied degrees of disability, with upper limb functioning affected in over 80% of cases. The objective of this study was to investigate the impact of passive movement train-ing of the hand (PMT) with robot-assisted therapy (RAT) compared to PMT with function-al electrical stimulation (FES). Methods: Fifty-eight patients diagnosed with CP, aged be-tween 7 and 14 years, participated in a two-week rehabilitation program involving physi-cal therapy (PT) combined with either RAT or FES. Post-rehabilitation, we assessed the evolution of cylinder grip, finger extension, pinch grips, lateral grip, and three-point grip in each therapy group to determine the more effective passive movement training. Results: Both the RAT group (p < 0.001) and the FES group (p < 0.01) demonstrated a statistically significant improvement in all parameters. Patients who received PT and FES exhibited more significant improvement in each movement, except for the pinch index grip, where the RAT group showed superior results. Conclusions: Our findings indicate the positive effects of both PMTs on hand function rehabilitation. We recommend incorporating both therapies into rehabilitation programs for enhanced outcomes.

Marketing communication and perceived health care quality: Antecedents of physiotherapists’ job satisfaction
Mirela Morcov, Iuliana Raluca Gheorghe, Consuela Mădălina Gheorghe, Maria Veronica Maria Veronica, Corina Sporea, Marian Ghiță, and Victor Lorin Purcărea
Romanian Association of Balneology
The performance of a health care organization is impacted by how its management handles problems caused by disruptions in communication and shows concern for the ongoing enhancement of the communication process. Any health care organization’s marketing communication approach is essential since it has an impact on both personnel and consumer satisfaction. From the perspective of physiotherapists, the current study aims to explore the connections between the perceived quality of health care services, marketing communications and job satisfaction. The sample comprised 114 individuals, the majority of whom were women, and whose average age was 39,74 (±9,56). Their average experience in the health care organization was 12,44 years (± 8,95). A self-administered questionnaire that contained socio-demographic items and specific items to collect data about the importance of marketing communication, job satisfaction, and perceived quality, was used as the research instrument. The results revealed that physiotherapists’ job satisfaction is positively influenced by both marketing communication and the perceived quality of care. However, to be more effective, health care managers need to offer specialized trainings to physiotherapists in order to motivate them and strengthen reliability and responsiveness when providing services.

Findings regarding the relationship between parenting styles and sociodemographic parameters in families having children with cerebral palsy
Oana Alina Apostol, Maria Veronica Morcov, Corina Sporea, Mirela Morcov, Cristian Gabriel Morcov, and Ioana Elena Cioca
Romanian Association of Balneology
The ability of parents to provide the correct conditions for healthy development, support, and prepare children for maturity determines a child's physical, cognitive, emotional, and social growth. According to the literature, numerous factors influence parenting styles. This study aimed to investigate, using sociodemographic parameters, whether the parenting styles of fathers and mothers in families with disabled children differ from one another. The research was conducted at the "Dr. N. Robănescu" National Center of Neurorehabilitation for Children. It included 71 parents of children with cerebral palsy questioned using the Parenting Styles Questionnaire (PSQ), a Romanian-adapted version. Of the five examined parenting styles, the authoritative approach was the most prevalent. The results show a statistically significant difference in the means of uninvolved parenting styles between urban mothers and fathers, a statistically significant difference in the means of authoritarian, authoritative, and uninvolved parenting styles between married mothers and fathers, a statistically significant difference in authoritative parenting style between different education levels; there, was no significant difference in parenting style between different income levels; and a considerable difference in permissive parenting between various employment statuses. This research suggests that some sociodemographic parameters had impact on the parenting styles of our study group.

The impact of glaucomatous disease on lifestyle and healthy aging. Association between structural visual and auditory functional changes in glaucoma
Alina Mihaela Neacsu, Corina Sporea, Nicoleta Anton, Lucian Lapusneanu, Maria Cristina Andrei, Mihaela Cosman, and Dumitru Ferechide
Romanian Association of Balneology
Abstract: In the last decade, it was concluded that glaucomatous optic neuropathy is part of the neurodegenerative diseases in which destructive neuronal lesions are located not only in the structure of the retina, but they are also present at the level of the central visual and nervous pathways. The purpose of this study was to evaluate the degree of involvement of the auditory system in patients with Primitive Open Angle Glaucoma (POAG), the structural changes in the optic nerve, and to establish correlation between the hearing loss and structural changes in the optic nerve. Material and methods: It is a prospective, cross-sectional study on 32 eyes of 16 subjects with POAG in a study group and 24 eyes of 12 healthy subjects in control group, with a mean age of 62 years in both groups. Both groups underwent ophthalmological, audiological and brain magnetic resonance imaging (MRI) evaluation. Results: In the Study group patients, compared to the Control group, the average levels of the left Pure-tone audiometry (PTA), the cup/disc (C/D) area in both eyes, and the C/D ratio in both eyes are increased. Conclusions: Patients with POAG show changes in audiometry test in correlation with ophthalmological parameters demonstrating that the auditory system can be affected in glaucoma.

Changes in pNFH Levels in Cerebrospinal Fluid and Motor Evolution after the Loading Dose with Nusinersen in Different Types of Spinal Muscular Atrophy
Mihaela Badina, Gabriel Cristian Bejan, Corina Sporea, Liliana Padure, Andrada Mirea, Madalina-Cristina Leanca, Mihaela Axente, Florin Petru Grigoras, Mihaela Bejan, Elena-Silvia Shelby,et al.
MDPI AG
Aim and Objectives: The objective of our retrospective study was to investigate the changes in pNFH levels in cerebrospinal fluid, which is a reliable marker of neuronal damage, after the loading dose of nusinersen in different types of spinal muscular atrophy. Materials and Methods: We analyzed the spinal muscular atrophy types, the number of copies of the SMN2 gene, and the progression of the motor status using specific motor function scales in a group of 38 patients with spinal muscular atrophy types 1, 2, and 3. Results: We found a significant inverse correlation between pNFH levels and patient age, progress on functional motor scales, and nusinersen administration. Our results also revealed that the neurofilament levels in the cerebrospinal fluid were higher in patients with 2 SMN2 copies than those with more than 2 copies, although the association was not statistically significant due to the abnormal distribution of the values. Conclusions: We identified several predictors of favorable evolution under nusinersen treatment, including spinal muscular atrophy type 1, children aged ≤ 30 months, and the presence of only 2 copies of SMN2. Our study provides important insights into the use of pNFH as a biomarker to monitor disease progression and responses to treatment in patients with spinal muscular atrophy.

Time-Efficacy in SMA Type 1 and 2 Cases Treated with Nusinersen
Mihaela Axente, Corina Sporea, Andrada Mirea, Claudia-Camelia Burcea, and Daniela Adriana Ion
Romanian Association of Balneology
Spinal muscular atrophy is a neuromuscular degenerative disorder characterized by progressive apoptosis of motor neurons, with severe weakness and bulbar dysfunction. The aim of the study was to analyze the correlations between the moment of initiation of treatment (nusinersen) and clinical evolution, and also the change of electrophysiological parameters and motor scales, fol-lowed up for 2 years. This study was carried out between 2018 and 2022 on 60 SMA children (29 girls, 31 boys), (29 type 1 and 31 type 2; 29 with 2 copies of SMN2, 29 with 3 copies, and 2 with 4 copies), aged between 3 weeks and 196 months, divided into 2 groups according type of SMA. For both types of SMA, statistically significant negative correlations were found between the elapsed interval from the onset of the disease to the initiation of treatment and upper motor acquisitions (type 1: p < 0.0001, r = -0.713, type 2: p<0.001, r = -0.560) and between age at the beginning of treatment and improvement in motor function (type 1: p <0.0001, r =-0.726, type 2: p<0.001, r=-0.553). For patients with type 2 SMA, a negative correlation was also identified between age at the time of onset and motor evolution (p<0.05, r = -0.378). Electrophysiological parameters were strongly positive correlated with motor improvement (p<0.0001, r=0.600). Our study established the necessity of early SMA diagnosis and therapy beginning, and demonstrated that Compound Motor Action Potential can be a predictive factor in the disease's progression. Keywords: Compound Motor Action Potential; motor scales; Spinal Muscular Atrophy

New methodological aspects in rehabilitation after proximal humerus fracture
Claudia-Camelia Burcea, Vasile Bobu, Dumitru Ferechide, Ioana Cristina Neagoe, Gabriela Elena Lupușoru, Corina Sporea, and Mircea Ovidiu Denis Lupușoru
Romanian Association of Balneology
Proximal humerus fracture ranks third in the elderly after femoral neck fractures and distal radius fractures, and seventh in adults, and the risk of occurrence is related to advancing age. In this study we aimed to analyze the efficacy of a 24-weeks physical therapy programme based on a particular methodology consisting of the reprogramming of the specific proprioceptive neuromuscular facil-itation techniques added to the classical physical therapy and by introducing modern interactive therapies and technologies: Capacitive Resistive Electric Transference, Instrument Assisted Soft Tissue Mobilization, kinesiological tapes and PRAMA system, compared with classical physical therapy. Our study included 26 patients, aged between 18 and 55 years, with proximal humerus fracture, who complete the 24-weeks rehabilitation programme. We assessed pain, shoulder range of motion, muscle strength and the ability to perform activities of daily living. The statistical analysis was performed using IBM SPSS and Excel 2021. The results showed statistically significant im-provement in all shoulder motion, increased muscle strength, decreased pain, and a better ability to perform daily activities. The physical therapy programme based on the proposed particular methodology has proven to be more effective than classical physical therapy, both regarding the improvement of the movement parameters compared to the physiological values, as well as the symmetry of both shoulders.

Clinical and Electrophysiological Changes in Pediatric Spinal Muscular Atrophy after 2 Years of Nusinersen Treatment
Mihaela Axente, Andrada Mirea, Corina Sporea, Liliana Pădure, Cristina Manuela Drăgoi, Alina Crenguța Nicolae, and Daniela Adriana Ion
MDPI AG
In the new therapeutic era, disease-modifying treatment (nusinersen) has changed the natural evolution of spinal muscular atrophy (SMA), creating new phenotypes. The main purpose of the retrospective observational study was to explore changes in clinical evolution and electrophysiological data after 2 years of nusinersen treatment. We assessed distal compound motor action potential (CMAP) on the ulnar nerve and motor abilities in 34 SMA patients, aged between 1 and 16 years old, under nusinersen treatment, using specific motor scales for types 1, 2 and 3. The evaluations were performed at treatment initiation and 26 months later. There were registered increased values for CMAP amplitudes after 2 years of nusinersen, significantly correlated with motor function evolution in SMA type 1 patients (p < 0.005, r = 0.667). In total, 45% of non-sitters became sitters and 25% of sitters became walkers. For SMA types 1 and 2, the age at the treatment initialization is highly significant (p < 0.0001) and correlated with treatment yield. A strong negative correlation (r = −0.633) was observed for SMA type 1 and a very strong negative correlation (r = −0.813) for SMA type 2. In treated SMA cases, the distal amplitude of the CMAP and motor functional scales are important prognostic factors, and early diagnosis and treatment are essential for a better outcome.

Physical Therapy and Nusinersen Impact on Spinal Muscular Atrophy Rehabilitative Outcome
Andrada Mirea, Madalina Cristina Leanca, Gelu Onose, Corina Sporea, Liliana Padure, Elena-Silvia Shelby, Vlad Dima, and Cristina Daia
IMR Press
INTRODUCTION Spinal muscular atrophy (SMA) is a progressive neurological disease with autosomal recessive transmission that affects motor neurons, causing their loss and resulting in muscle waste and motor deficiency. Nusinersen, the first SMN2 pre-mRNA targeted therapy approved by the Food and Drug Administration and the European Medicines Agency, has demonstrated high efficacy in improving motor function, as well as respiratory and nutritional statuses. MATERIALS AND METHODS We observed 55 patients (children/adolescents) diagnosed with spinal muscular atrophy (SMA), who received nusinersen therapy. To investigate the benefits of physical therapy on rehabilitation outcomes, we compared the motor evolution of patients who received nusinersen and performed daily physical therapy (study group) to those of the control group, who received only nusinersen therapy. RESULTS Motor skill improvements were statistically significantly (p < 0.001) higher in the study group, being almost four times better (12.66%), effect size, in comparison to the control group (3.18%). CONCLUSIONS Physical therapy has provided superior results for those who receive it on a regular basis. These results include the correction of posture, reduction in stiffness, expansion of the range of motion and strengthening of muscles, thus allowing patients to do more movements and boosting their ability to perform everyday tasks.

Combination therapy with nusinersen and onasemnogene abeparvovec-xioi in spinal muscular atrophy type i
Andrada Mirea, Elena-Silvia Shelby, Mihaela Axente, Mihaela Badina, Liliana Padure, Madalina Leanca, Vlad Dima, and Corina Sporea
MDPI AG
Background: Spinal muscular atrophy (SMA) is a neuromuscular progressive disease, characterized by decreased amounts of survival motor neuron (SMN) protein, due to an autosomal recessive genetic defect. Despite recent research, there is still no cure. Nusinersen, an antisense oligonucleotide acting on the SMN2 gene, is intrathecally administered all life long, while onasemnogene abeparvovec-xioi, a gene therapy, is administered intravenously only once. Both therapies have proven efficacy, with best outcomes obtained when administered presymptomatically. In recent years, disease-modifying therapies such as nusinersen and onasemnogene abeparvovec-xioi have changed the natural history of SMA. Methods: We observed seven SMA type I patients, who received both therapies. We compared their motor function trajectories, ventilation hours and cough assist sessions to a control group of patients who received one therapy, in order to investigate whether combination therapy may be more effective than a single intervention alone. Results: Patients who received both therapies, compared to the monotherapy cohort, had the same motor function trajectory. Moreover, it was observed that the evolution of motor function was better in the 6 months following the first therapy than in the first 6 months after adding the second treatment. Conclusions: Our results suggest that early treatment is more important than combined therapy.

Clinical features and genetics in non-5q spinal muscular atrophy caused by acid ceramidase deficiency
Mihaela Axente, , , Elena-Silvia Shelby, Andrada Mirea, Corina Sporea, Mihaela Badina, Liliana Padure, Daniela Adriana Ion, ,et al.
S.C. JURNALUL PENTRU MEDICINA SI VIATA S.R.L
Spinal muscular atrophy (SMA) is a spectrum of genetically and clinically heterogeneous diseases leading to the progressive degeneration of peripheric motor neurons with subsequent muscle weakness and atrophy. More than 95% of the cases of SMA are represented by homozygous mutations of the SMN1 gene (5q-SMA). Because this disease represents the leading cause of death due to a genetic cause and due to the availability of genetic therapies which can now save the life of the patient and stop the progress of the disease, early diagnosis is crucial. This report presents the case of a 13-year-old patient admitted to our hospital in 2018 who presented a phenotype typical to 5q-SMA. Next-generation sequencing (NGS) and Sanger sequencing of the SMN1 gene were performed, and a negative result was obtained. Consequently, we continued testing using whole-exome sequencing and discovered three mutations in the ASAH1 gene (one pathogenic and two variants of uncertain significance). Pathogenic mutations in the ASAH1 gene are responsible for spinal muscular atrophy with progressive myoclonic epilepsy (SMA-PME) and Farber disease, which overlapped with our patient’s phenotype. Currently, there are 45 SMA cases caused by mutations in the ASAH1 gene reported worldwide; however, the present case is the first reported in Romania.

Innovative therapies in genetic diseases: Cystic fibrosis
Elena-Silvia Shelby, , Florina Mihaela Nedelea, Tanser Huseyinoglu, Relu Cocos, Mihaela Badina, Corina Sporea, Liliana Padure, Andrada Mirea, ,et al.
AMALTEA Medical Publishing House
Cystic fibrosis, also named mucoviscidosis, is the most frequent hereditary pulmonary disease and is produced by mutations in the CFTR gene, encoding an anionic channel for chloride and bicarbonate involved in the regulation of salt and bicarbonate metabolisms. Currently, about half of the patients with cystic fibrosis can benefit personalized therapy consisting in modulators, drugs which restore or improve the functionality and stability of CFTR. Moreover, presently, other therapies, such as gene therapy using the CRISP/CAS-9, modified antisense oligonucleotides or the insertion of the wild-type gene using nanolipidic particles or viral vectors, are being developed. This article aims to take stock of the principal types of cystic fibrosis therapies which have been approved or are in clinical trials.

Augmentation and Rehabilitation with Active Orthotic Devices
Gelu Onose, Maria Veronica Morcov, Corina Sporea, Andrada Mirea, and Vlad Ciobanu
Springer International Publishing

Benefits of upper limb functional electrical stimulation in children with spastic cerebral palsy
Corina SPOREA, , Dumitru FERECHIDE, and
CMMB-Colegiul Medicilor Municipiul Bucuresti
Aim: The aim of this study was to assess the effectiveness of Functional Electrical Stimulation in upper limb rehabilitation in children with cerebral palsy. Methods: 90 children with spastic cerebral palsy, age between 6 and 9 years, were randomized into two groups. 45 children, represented the control group, performed conventional physical and occupational therapy and robot-assisted therapy. In addition to the control group, the experimental group received functional electrical stimulation interventions with postural control on the affected upper limb. Results: The experimental group's motor performance after treatment (improved coordination by 8.2%, wrist flexion by 9.75°, three-fingered grasp strength by 1.04°, and functional limitation lowered by 5.93) was considerably better than the control group's which coordination increased by 5.5%, wrist flexion by 8.72°, three-fingered grasp strength by 0.7 and functional limitation decreased by 2.33. Conclusions: Functional electrical stimulation intervention was found to be an effective manner to improve motor performance, in terms of coordination, range of motion, and three-fingered grasp strength, visibly reducing functional limitation and improving performance in activities of daily living.

Influence of the upper limb motor deficit on functional independence in patients with cerebral palsy
Corina SPOREA, , Dumitru FERECHIDE, and
CMMB-Colegiul Medicilor Municipiul Bucuresti
Cerebral palsies (CPs) disturb the voluntary movement control at extremities’ level, entailing various disability degrees. In over 80% of the CP cases there is an upper limb disorder, mainly manifested by the decrease in hand control and the presence of contractures, which, in time, lead to the adoption of abnormal postures which affect the abilities of the CP patients’ hands. The aim of this study was to identify the way the motor deficit at upper limb level – reflected by coordination disturbances and by the condition of the three fingered (tripod) grasp – influences the CP patient’s functional independence. The study demonstrated the existence of significant correlations between Functional Independence Measure (FIM) score, coordination and three fingered grasp. It was proven that the unilateral coordination dysfunctions have a strong negative influence on the coordination of the opposite side and lead to a decrease of the functional independence level. Therefore, the rehabilitation treatment is recommended to be based on a bilateral training, both in order to improve coordination and to obtain a functional level of the three fingered grasp power and of the physiological amplitude at wrist flexion level.

RECENT SCHOLAR PUBLICATIONS

The Interplay Between Stress and Eating Attitudes: A Cross-Sectional Study Among Romanian Physical Therapy Students
C Sporea, MV Morcov, CI Vasile, IE Cioca, OA Apostol, A Mirea, A Punga
Journal of Clinical Medicine 14 (5), 1755 2025

Exploring the Links Between Coping Strategies, Emotional Intelligence, and Age in Adolescents with Neuromotor Disabilities
IE Cioca, MV Morcov, C Sporea, OA Apostol, A Pellegrini, EN Bordea
Children 11 (12), 1466 2024

The Role of the Six-Minute Walk Test in the Functional Evaluation of the Efficacy of Rehabilitation Programs After COVID-19
DL Tache-Codreanu, L Bobocea, I David, CC Burcea, C Sporea
Life 14 (11), 1514 2024

The Benefits of a Rehabilitation Program Following Medial Patellofemoral Ligament Reconstruction
CC Burcea, MDA Oancea, DL Tache-Codreanu, L Georgescu, IC Neagoe, ...
Life 14 (11), 1355 2024

Impact of Nusinersen on Neurofilament, Creatinine Levels, and Motor Function in Pediatric Spinal Muscular Atrophy Rehabilitation: A Biomarker Analysis
M Badina, C Sporea, GC Bejan, A Mirea, DA Ion
Balneo and PRM Research Journal 15 (2), 1-23 2024

Transforming the Management of Articular Fractures in the Foot: A Critical Examination of Current Methods and Future Directions: A Review
RD Dobrotă, AG Barbilian, C Sporea, D Ferechide
Journal of Personalized Medicine 14 (5), 525 2024

The dynamic of changes of pNFH levels in the CSF compared with the motor scales’ scores during three years of nusinersen treatment in children with spinal muscular atrophy
M Badina, C Sporea, GC Bejan, A Mirea, DA Ion
Balneo and PRM Research Journal 15 (1), 1-13 2024

755 Evolution of Functional and Paraclinical Markers as Predictive Factors in Pediatric Late-Onset SMA Under Nusinersen Treatment: The Role of CSF pNF-H
M Badina, GC Bejan, C Sporea, A Mirea
Balneo and PRM Research Journal 15 (4) 2024

754 Predictive Clinical-Biological Markers Over the First 3 Years of Nusinersen Treatment in SMA Type 1 Patients
M Badina, A Mirea, C Sporea, GC Bejan
Balneo and PRM Research Journal 15 (4) 2024

Functional results one-year following the anti-vegf therapy in macular pathology
N Anton, AM Neacșu, DC Branisteanu, IR Barac, A Geamanu, R Iancu, ...
Balneo and PRM Research Journal 14 (4) 2023

Effectiveness of Passive Movement Training in Patients with Cerebral Palsy: A Comparative Analysis of Robot-Assisted Therapy and Electrical Stimulation in Hand Rehabilitation
C Sporea, MV Morcov, M Morcov, A Mirea
Balneo and PRM Research Journal 14 (4) 2023

Marketing Communication and Perceived Health Care Quality: antecedents of Physiotherapists’ Job Satisfaction
M Morcov, IR Gheorghe, CM Gheorghe, MV Morcov, C Sporea, M Ghiță, ...
Balneo and PRM Research Journal 14 (4) 2023

Findings regarding the relationship between parenting styles and sociodemographic parameters in families having children with cerebral palsy
OA Apostol, MV Morcov, C Sporea, M Morcov, CG Morcov, IE Cioca
Balneo and PRM Research Journal 14 (4) 2023

The impact of glaucomatous disease on lifestyle and healthy aging. Association between structural visual and auditory functional changes in glaucoma
AM Neacsu, C Sporea, N Anton, L Lapusneanu, MC Andrei, M Cosman, ...
Balneo and PRM Research Journal 14 (3), 1-15 2023

Changes in pNFH Levels in Cerebrospinal Fluid and Motor Evolution after the Loading Dose with Nusinersen in Different Types of Spinal Muscular Atrophy
M Badina, GC Bejan, C Sporea, L Padure, A Mirea, MC Leanca, M Axente, ...
Medicina 59 (7), 1244 2023

New methodological aspects in rehabilitation after proximal humerus fracture
CC Burcea, V Bobu, D Ferechide, IC Neagoe, GE Lupușoru, C Sporea, ...
Balneo and PRM Research Journal 14 (2) 2023

Time-Efficacy in SMA Type 1 and 2 Cases Treated with Nusinersen
M Axente, C Sporea, A Mirea, CC Burcea, DA Ion
Balneo and PRM Research Journal 14 (2) 2023

Clinical and Electrophysiological Changes in Pediatric Spinal Muscular Atrophy after 2 Years of Nusinersen Treatment
M Axente, A Mirea, C Sporea, L Padure, CM Dragoi, AC Nicolae, DA Ion
Pharmaceutics 14 (10), 2074 2022

Physical therapy and nusinersen impact on spinal muscular atrophy rehabilitative outcome
A Mirea, MC Leanca, G Onose, C Sporea, L Padure, ES Shelby, V Dima, ...
Frontiers in Bioscience-Landmark 27 (6), 179 2022

Combination Therapy with Nusinersen and Onasemnogene Abeparvovec-xioi in Spinal Muscular Atrophy Type I
A Mirea, ES Shelby, M Axente, M Badina, L Padure, M Leanca, V Dima, ...
Journal of Clinical Medicine 10 (23) 2021

MOST CITED SCHOLAR PUBLICATIONS

Mobile Mechatronic/Robotic Orthotic Devices to Assist–Rehabilitate Neuromotor Impairments in the Upper Limb: A Systematic and Synthetic Review
G Onose, N Popescu, C Munteanu, V Ciobanu, C Sporea, MD Mirea, ...
Frontiers in neuroscience 12, 577 2018
Citations: 23

Clinical features and genetics in non-5q spinal muscular atrophy caused by acid ceramidase deficiency
M Axente, ES Shelby, A Mirea, C Sporea, M Badina, L Padure, DA Ion
JOURNAL of MEDICINE and LIFE 14 (3), 424-428 2021
Citations: 13

Improving the perspectives on quality of life for adolescents with cerebral palsy by medical textile
C Sporea, OA Orzan, MS Florescu, I Cristescu
INDUSTRIA TEXTILA EDITORIAL BOARD, 80 2020
Citations: 10

Time-Efficacy in SMA Type 1 and 2 Cases Treated with Nusinersen
M Axente, C Sporea, A Mirea, CC Burcea, DA Ion
Balneo and PRM Research Journal 14 (2) 2023
Citations: 4

Benefits of Upper Limb Functional Electrical Stimulation in Children with Spastic Cerebral Palsy
C Sporea, D Ferechide
Medicina Moderna - Modern Medicine 28 (2), 201-207 2021
Citations: 3

Augmentation and Rehabilitation with Active Orthotic Devices
G Onose, MV Morcov, C Sporea, A Mirea, V Ciobanu
Modern Approaches to Augmentation of Brain Function, 521-548 2021
Citations: 3

New methodological aspects in rehabilitation after proximal humerus fracture
CC Burcea, V Bobu, D Ferechide, IC Neagoe, GE Lupușoru, C Sporea, ...
Balneo and PRM Research Journal 14 (2) 2023
Citations: 2

Terapii inovative n bolile genetice: Fibroza chistică
ES Shelby, FM Nedelea, T Huseyinoglu, R Cocos, M Badina, C Sporea, ...
Romanian Journal of Pediatrics 70 (1), 16-20 2021
Citations: 2

The Benefits of a Rehabilitation Program Following Medial Patellofemoral Ligament Reconstruction
CC Burcea, MDA Oancea, DL Tache-Codreanu, L Georgescu, IC Neagoe, ...
Life 14 (11), 1355 2024
Citations: 1