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Balance disorders of patients after stroke
PEROUTKOVÁ, Aneta
The bachelor's thesis deals with the relationship between stroke and postural stability and its disorders, because according to Kolář (c2009), people who have had the disease have neurological, structural and functional disorders that significantly affect postural stability. The aim of the bachelor's thesis was to write down basic information about stroke and postural stability on the basis of which it was possible to carry out the practical part, which consisted in the therapy using posturography in 4 patients with postural stability disorders specifically after this disease. The theoretical part is divided into chapters where basic information about CMP, distribution and etiology, clinical picture, diagnosis and investigation methods are described. There is also a chapter on the postural-articular system, postural stability disorders and their testing. In particular, NeuroCom's computerized dynamic posturography is described in the chapter, as it has been used to treat patients. In the individual subchapters, the tests for the Smart Equitest System and Balance Master System modules are described in detail separately. In the practical part of the thesis, the case reports of four patients with stability disorders after a stroke are presented, who first underwent an initial examination, which consisted of taking a medical history, an initial posturograph examination and a kinesiological analysis, which included information about active and passive ranges of motion, muscle strength, tone, deep and superficial sensory status and taxa. Subsequently, posturographic therapy was applied and selected individually for each patient based on the results of the initial examination. In the end, for all patients, however, the most important factors were training an even distribution of weight between the two limbs during task performance, improved whole-body sensation and especially weakened DK, and smoother COG control. After the application of the therapy for two months, the posturograph and the input and output kinesiological analysis were compared. Based on this comparison, it was then possible to assess which tested aspects were subsequently affected by the therapy. In particular, the patients experienced an increase in gait speed, an increase in the efficiency of the weakened limb, a greater responsiveness to changes in the external environment, a more even distribution of load between the two limbs, and an increase in the contribution of the vestibular system in influencing postural stability. The bachelor thesis is intended primarily for students and professionals.
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The Effectiveness of Cognitive Training in Patients after Traumatic Brain Injury or Stroke
Kozáková, Eva ; Kulišťák, Petr (advisor) ; Stehlík, Luděk (referee)
Recently, the literature concerned with the possibilities and limitations of working memory training has been growing rapidly. Nonetheless, there are still no clear answers about the principles of its effectiveness or transfer effect. The main questions we ask are about effectiveness of cognitive training in patients after stroke or TBI. To our knowledge this group hasn't been studied in this context yet. To do this, we compare two types of cognitive training - extensively studied N-back training (n=11) and still more popular group cognitive therapy (n=9) with a placebo control group (n=5) who recieves "training" in a simple computer game. The placebo control group then continues in N-back training. Our hypothesis is that after 3 weeks the two trainings should lead to significantly higher gains in cognitive tests scores than the placebo condition. Also, we expected N-back to be more effective than group cognitive training in domains more closely related to executive control. We tested attention, fluid intelligence, short-term and working memory. We also recorded participants well-being. Following training, there were no significant differences between N-back and group training. N-back group scored significantly higer on Trail Making Test A than control group (p=0,026). Although our study doesn't...
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Possibilities of Using ICF and WHODAS 2.0 Questionnaire in Patients with Upper Limb Movement Disorders from an Occupational Therapist's Perspective
Antálková, Kateřina ; Sládková, Petra (advisor) ; Kotková, Karla (referee)
OF THE DIPLOMA THESIS Name, Surname: Bc. Kateřina Antálková Supervisor: MUDr. Bc. Petra Sládková, Ph. D. Title of the diploma thesis: Possibilities of Using ICF and WHODAS 2.0 Questionnaire in Patients with Upper Limb Movement Disorders from an Occupational Therapist's Perspective Abstract of the diploma thesis: This thesis deals with the issue in subjects with upper limb mobility disorders, specifically with central hemiparesis, from the perspective of an occupational therapist. Objective functional assessment will be carried out using the International Classification of Functioning, Disability and Health (ICF), and subjective assessment will be carried out using the WHODAS 2.0 questionnaire, WHO Disability Assessment Schedule 2.0. This thesis focuses on subjects with upper limb mobility disorders. All subjects will have the same basic diagnosis, which is right or left central hemiparesis, and should be no more than 3-4 years after a stroke, over 18 years of age, with no upper age limit, or subjects after traumatic brain injury (TBI). The practical part will include patients with a disability level ranging from 1-3, they must not have plegia or contracture, they must be without aphatic deficit and severe cognitive deficit - mild cognitive impairment may be present, but the ability to understand...
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Availability of occupational therapy care in patients with acquired brain injury after discharge from a rehabilitation center
Novotná, Barbora ; Hoidekrová, Kristýna (advisor) ; Angerová, Yvona (referee)
Title: Availability of Occupational Therapy Care in Patients with Acquired Brain Injury after Discharge from a Rehabilitation Center Abstract: At present, there is no standardised outpatient care that would be seamlessly linked to complex inpatient care and ensure the availability of specialised neurorehabilitation in all necessary areas (occupational therapy, physiotherapy, speech therapy and psychology). The main aim of the study was to evaluate the availability of occupational therapy care after discharge from a rehabilitation center after acquired brain injury at the Rehabilitation Institute Kladruby within the Cranioprogram and to create a current list of contracted health care providers for outpatient occupational therapy in the Czech Republic for adults. A questionnaire survey was used in the study, which was conducted on 50 respondents who participated in the Cranioprogram at the Rehabilitation Institute Kladruby. The mean age was 53, 4 (SD ± 15, 1) years and 14 women and 36 men participated. A list of contracted health service providers for ambulatory physiotherapy, occupational therapy, speech therapy and psychology was requested from individual insurance companies. The data results show that 32 respondents attend at least 1 outpatient rehabilitation during the first month after the end of...
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Ability to Transfer Learned Skills in Activities of Daily Living to Everyday Life in Patients with Acquired Brain Injury; Focusing on patients after stroke
Česáková, Kamila ; Nováková, Olga (advisor) ; Hoidekrová, Kristýna (referee)
Title: Ability to Transfer Learned Skills in Activities of Daily Living to Everyday Life in Patients with Acquired Brain Injury Abstract: The thesis deals with the topic of transfer of skills mainly from the area of activities of daily living learned in therapy to everyday life in patients after stroke. It is a case study within the framework of qualitative research, the main aim of which was to describe the process of transfer of learned skills from the field of ADL to everyday life over a longer period of time. The reason for choosing this topic was that although transfer of learned skills is crucial for rehabilitation and patient return to the home environment, it is still not given enough attention. The aim of the theoretical part was mainly to describe the elements influencing the transfer of learned skills to everyday life and the occupational therapist's possibilities to support this process in therapy and its evaluation. The practical part was conducted with four patients for 6-8 months. For each patient, 6 therapy sessions were first conducted, followed by two visits, each 2-3 months apart, during which a semi-structured interview took place. The aim of the practical part was to test different techniques and approaches in practice as well as to evaluate the transfer afterwards. In particular, the...
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Variability of Performance of Healthy Adults and Post-Stroke Patients in the Box and Block Test
Kotrbová, Kateřina ; Vondrová, Kateřina (advisor) ; Matoušová, Zita (referee)
Author: Bc. Kateřina Kotrbová Supervisor: Mgr. Kateřina Vondrová Title: Variability of Performance of Healthy Adults and Post-Stroke Patients in the Box and Block Test Abstract: Introduction: Occupational therapists commonly use the standardized Box and Block Test (BBT) to measure upper limb manual dexterity in individuals with stroke. A consensus lacks among evaluators regarding the frequency of BBT trials. The aim: To recommend the number of attempts for testing individuals with stroke using BBT in the age group of 20-64 years (inclusive). A partial objective is to propose indication and contraindication criteria for testing these individuals using BBT and to assess the impact of BBT on their subjective levels of pain, fatigue, and tension/stress using an emotional scale. Methodology: The author conducted a one-time testing using three consecutive BBT attempts. The experimental group consisted of 24 individuals with stroke. The control group comprised a healthy population of the same gender, with similar dominant limbs, and of similar age. Data were analyzed using the statistical program R, using t-tests and ANOVA tests. Results: A statistically significant difference (α = 0.05) was described in the experimental group between the results of the first attempt and the average results of three BBT...
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The need for enteral nutrition in patients after a stroke
Špalková, Šárka ; Vágnerová, Tereza (advisor) ; Klempíř, Jiří (referee)
Introduction: The diploma thesis focuses on the issue of nutritional support for patients after a stroke. Aims: In the theoretical part, the characteristics of ischemic stroke (iCMP) and hemorrhagic stroke (hCMP) were described. Subsequently, risk factors and prevention of stroke were described. The last part of the theory dealt with nutrition and procedures for introducing different types of diets and enteral nutrition in patients after a stroke. The aim of the practical part was to monitor the procedure during the nutrition consultation in patients who have recently experienced one of the events (iCMP or hCMP). Methods: Data for the thesis were obtained at the Neurological Clinic of the 1st Faculty of Medicine of the Charles University and VFN in Prague from February to April 2023. Various nutritional support was retrospectively monitored in patients who experienced an ischemic stroke and a hemorrhagic stroke. The duration of hospitalization, height, weight, BMI, age and associated diseases were also determined for the patients. Data processing and statistical evaluation was done in Microsoft Excel. Results: The study compared different types of nutritional support in 51 patients who were hospitalized in one intensive care unit and three standard wards. Most patients (49%) were only prescribed a...
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The effect of transcranial direct current stimulation on upper limb functional motor recovery in stroke patients
Počepická, Kateřina Konstancie ; Grünerová Lippertová, Marcela (advisor) ; Vogner, Martin (referee)
The topic of this bachelor thesis is the influence of non-invasive transcranial direct current stimulation on the results of upper limb functional motor rehabilitation in patients after stroke. The clinical tests evaluating the improvement were Fugl-Meyer Assessment, Nine hole peg test and Hand grip strenght test. In the theoretical part I discussed stroke, its etiopathogenesis, risk factors and rehabilitation after stroke. The theoretical part includes a review of studies investigating the effect of transcranial direct current stimulation not only after stroke. The methodology of the thesis describes how the patients were selected for the study, how they were divided into groups, individual clinical examinations and therapy. The experimental group underwent transcranial stimulation during therapy, whereas the control group underwent sham stimulation. Stimulation was performed every weekday for 20 minutes for two weeks. In the practical part there is a table with a summary of the patients, tables with the measured data of each test and the results, which include the described graphs. The measured data were entered into excel spreadsheets and then processed as bar graphs. In the graph, the limbs are divided into healthy and paretic. The results of the Nine hole peg test and Hand grip strenght test,...
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Visual - motor coordination in stroke patients
Gazdíková, Johana ; Krivošíková, Mária (advisor) ; Gerlichová, Markéta (referee)
The thesis deals with visual-motor coordination in patients after stroke. The main aim of the thesis is to describe the relationship between visuomotor and graphomotor coordination in selected patients after stroke, in subacute and chronic phase of the disease. The main contribution of the thesis should be a better understanding of the relationship between graphomotor and visuomotor skills. The outcome of the thesis is a pilot validation of the relationship between visuomotor and graphomotor skills in a research group of patients. The theoretical part of the thesis summarizes the knowledge about fine motor skills. It then deals mainly with visuomotor skills, specifically defining the concepts of visual perception, visual-motor integration and visual-motor coordination. Subsequently, the paper describes the level of visuomotor skills in patients after stroke. The theoretical part concludes with the possibilities of assessing visuomotor skills and the impact of this disorder on the activities of daily living. The practical part of the thesis deals with the evaluation of the level of graphomotor and visuomotor skills in patients after stroke. Two test batteries were used for the assessment: the Handwriting Assessment Battery for Adults (HAB) for the assessment of writing parameters and the Pediatric...
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Informing the lay public about stroke and its prevention
Butala, Žaneta ; Tomová, Šárka (advisor) ; Klokočková, Šárka (referee)
The bachelor's thesis "The lay public's awareness of stroke and its prevention" examines the lay public's awareness of stroke and its prevention in the Czech Republic and Slovakia. The aim of the work was to determine the level of awareness of the lay public about stroke and its prevention options, with regard to comparing the situation in the Czech Republic and Slovakia. The theoretical part of the work provides a complete overview of the basic anatomy of the brain, including its vascular supply, the mechanisms of this disease, symptomatic manifestations, diagnostic procedures, therapeutic options and preventive measures related to cerebrovascular accident. The empirical part contains the results of the own exploratory investigation. The exploratory research method was a survey available in both language versions - self-edited. The survey was distributed via an online form. A total of 334 duly completed forms were included in the research, 241 from the Czech Republic and 93 from the Slovak Republic. Results: The obtained data point to significant variability in awareness of stroke between the two investigated countries, while there is a noticeable difference in the level of awareness of this issue in the Czech Republic and Slovakia. It has been proven that awareness regarding the prevention of...
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