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The influence of defect size and surgical technique on long-term morbidity in children with congenital diaphragmatic hernia
Rounová, Petra ; Rygl, Michal (advisor) ; Havránek, Petr (referee) ; Plánka, Ladislav (referee)
52 8 Summary The influence of defect size and surgical technique on the long-term morbidity of children with congenital diaphragmatic hernia Objective: The aim of this study is to evaluate the effects of diaphragm reconstruction using a synthetic non-absorbable patch from polytetrafluoroethylene (PTFE, Gore-Tex) and primary repair of diaphragm defects on the long-term morbidity in children after surgery of congenital diaphragmatic hernia (CDH), with a primary interest in the influence of these techniques on the occurrence of skeletal deformities and the development of pulmonary functions. One part of this study is to introduce a new objective method for perioperative evaluation of the size of diaphragmatic defects to enable comparison of results among various centres and methods used for diaphragmatic reconstruction. Another part of this study is to evaluate the validity of lung function assessment using four unique methods of Infant Pulmonary Function Tests (IPFT) in children under 13 kg of body weight. Material and Methods: A study of 69 patients operated on between 1996-2010 for CDH, in which the clinical part of the study was performed between the years 2009-2011. The clinical study evaluated anthropometric examination, pulmonary function testing and a questionnaire study which focused on long-term...
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Respiratory physiotherapy affects the quality of life of children with spinal muscular atrophy - How, when and why?
Havlištová, Michaela ; Smolíková, Libuše (advisor) ; Zounková, Irena (referee)
Bibliographic identification HAVLIŠTOVÁ, Michaela. Respiratory physiotherapy affects the quality of life of children with SMA - how, when and why? Prague: Charles University, 2nd Faculty of Medicine, Department of rehabilitation and sport medicine, 2012. 81 p. Supervisor Doc. PaedDr. Libuše Smolíková, Ph. D. Annotation This thesis deals with the influence respiratory function in children with spinal muscular atrophy (SMA). The theoretical part provides an overview of respiratory physiotherapy techniques that can be used in the care of the airways in people with SMA. The practical part deals with the question whether it is possible using the selected techniques of respiratory physiotherapy after six weeks of training to affect ventilatory parameters in children with SMA. The group of six probands with SMA I. - III. type in the range of the age from 3.5 to 12 years participated in this study. To objectively assess changes was performed spirometry efore the beginning of the therapy and after its conclusion. The main therapy was daily training with inspiratory breath simulator CliniFlo. After the finishing of therapy there was a positive change in all measured parameters except for vital capacity (VC) and maximal expiratory flow at 75% of FVC (MEF75), where the values didn't change. Statistically significant...
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Respiratory physiotherapy - part of a comprehensive treatment of Duchenne muscular dystrophy patients
Vargová, Zuzana ; Smolíková, Libuše (advisor) ; Slováčková, Lenka (referee)
Duchenne muscular dystrophy is a progressive muscular disease. This serious disease attacks not only the musculoskeletal system, but also the respiratory system. Respiratory system is one of the most influenced systems. The risks of respiratory problems increase with deteriorating condition of the patient due to muscle weakness. This work is focused on treatment of respiratory system. The aim of treatment is early prevention and solving of complications. These complications include not only scoliosis and cardial problems, but mainly inefficient cough, night hypoventilation, irregular night breathing and failure of respiratory system even during the day. The aim of the respiratory physiotherapy is to keep the right functionality of lungs for the longest time and to choose the correct method of the rehabilitation following the patient's condition deteriorating. Interventions suitable for the patients with the DMD are techniques that leads to increasing lung volume, manual and mechanical techniques of assisted coughing, and noninvasive ventilation. NIV is one of the preferred methods of treating nowadays. Another method is continual invasive ventilation and ventilation with tracheostomy. This treatment includes keeping hygiene of the airways, which is the basis for their throughput. The work also includes...
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Evaluation of pulmonary and postural functions in patients with chest wall deformity (Pectus carinatum)
Zbuzek, Daniel ; Bitnar, Petr (advisor) ; Smolíková, Libuše (referee)
Objective: The paper deals with the evaluation of the status of pulmonary and postural functions of the patients with pectus carinatum. Further, it deals with the development of pulmonary and postural functions after Welch surgery. Methods: Between the years 2010 and 2011 20 patients (19 men, 1 woman) went through Welch surgery at the Pediatric Clinic of the Faculty Hospital, Prague Motol. The average age of the group was 16,2 ± 1,2 years. Before surgery, pulmonary functions, respiratory muscle strength and posturography were evaluated. The received values were compared with the predicted, i.e. the controlled group, and in order to find mutual dependencies, also among themselves. 7 patients were repeatedly checked for pulmonary functions and posturography in the interval of 8,1 ± 3,0 months after their surgery. Pre and post - surgery values were compared. Results: Dynamic and static hyperinflation and also an increased patency of periphery respiratory tracts was found in 20 pre-surgery patients with PC. Testing of respiratory muscle strength showed significantly lower values than the predicted. Checking for posturography revealed the differences in postural system resulting, especially with complicated postural demands, in medio-lateral instability of the body. Worsening of the balance functions...
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Effects of Vojta's reflex locomotion on lung function
Drábková, Lenka ; Smolíková, Libuše (advisor) ; Bitnar, Petr (referee)
Introduction: The aim of this thesis is to answer a question if it is possible to influence ventilation parameters with an application of Vojta's reflex locomotion, which is one of the neurophysiologic techniques. The thesis confronts actual knowledge and relation between respiratory and postural function of "respiratory" muscles and the diaphragm and possibility of its reflex affection. Methods: With a spirometry we assess the impact of short-time activation of Reflex locomotion on the lung functions in a group of 21 healthy subjects in age 18 - 33 years. The study evaluates the effect of activation in two situations. First, it is instantaneous effect of Vojta's method on lung function. Second situation is the assessment of the time duration of evoked effect of activation and make out, if the changes are seen also after 25 minutes over the end of Vojta's stimulation. Results: Based on the interpretation of the both monitored situations, we set up an observation that short time activation of Vojta's reflex therapy has an effect on respiratory mechanics and thus on the spirometric values. At the other side we realize that not all of the changes were significant and some of them were unadvisable. Moreover all of them had very short persistency, after 25 minute none of the observed changes of lung...
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