|
|
Physiotherapy at Patiens after Breast Cancer
POCHOPOVÁ, Jana
The breast cencer is the world's most common cancer among women. It affects about 6 % of them and it is registered approximately 600 thousand new cases of the disease every year. The situation is not so satisfactory as well in the Czech Republic. It has been contained about 6500 new cases a year in recent years and about 2000 women die of this disease. The breast cancer is one of the disease which unfortunately can not be predicted or prevented. Despite this it is a type of cancer which can lead in most cases to cure the patient if it is soon detected. It is used the self-examination method for the soon detection of cancer which women should regularly realize and especially mammography screening. The treatment of breast cancer is linked to the emergence of certain problems that complicate subsequent convalescence of the patient. If it appears there are options how to fight them. It can be also prevented or at least significantly reduced. The issue of breast cancer is still very actual and it is the reason why I chose topic "Patients' physiotherapy after breast cancer treatment." for this bachelor thesis. This work consists of a theoretical and practical part. The theoretical part defines the basic concepts related to cancer, its development and anatomy. It also deals with the issue of breast cancer from etiology of the disease, the influence of risk factors and diagnosis to therapy. It also describes the risk of postoperative complications related to surgical procedure on the breast and removal lymph node and the possibility prevent these problems or fight effectively with appropriate therapy. Practical part of work includes monitoring of postoperative changes on patients with surgical procedure on breast and the therapy description focused on the prevention of formation of complications linked to surgical procedure or removal of already existing problems. The collection of primary data was carried out qualitative way through case studies, it was chosen the methodology of interview, observation (kinesiology analysis) and analysis of personal health documents. The research group consisted of two patients diagnosed with breast cancer who underwent surgical procedure at the Department of Surgery Hospitals Czech Budejovice, a. s. The goal in this work was determined to describe the effect of physiotherapy in the prevention of postoperative problems related to surgical procedure for cancer removal. Together with the aim of work the following research question was determined: What are the contributions of physiotherapy in the prevention of postoperative symptoms in patients with breast cancer? In both patients the therapy managed to achieve a functional and painless movement of the shoulder joint and the upper limbs on the affected side, free mobility in the thoracic region and improved breathing stereotype. There has been a release of abbreviated and strengthening of weak muscle groups. We also managed to release the postoperative scars, while the patients were instructed how to treat them in the future. Contribution physiotherapy is therefore positive. Patients were also educated on the need for regular exercise even after warming up arms and got recommendations for the care of the upper limb, diet, hygiene, sports or doing housework. The results of the research part showed that the implementation of physiotherapy in patients after surgery for breast cancer has a positive effect in the prevention of postoperative complications, thereby has accomplished the goal of the work. Bachelor thesis will be used by physiotherapists for completion of information about the possibilities of rehabilitation after breast cancer treatment and also as educational material for patients and others interested in this issue.
|
|
|
Physiotherapy for people with cerebral palsy from 15 to 30 years old
ŠKOPKOVÁ, Eva
For my bachelor thesis I chose topic Physiotherapy of Persons between fifteen and thirty Years of Age Suffering Cerebral Palsy. Number of patients with this disorder is still increasing, but since 50s of the 20th century neonatal care began to become better. Thanks to this improvement in medical care number of saved newborns, who would have earlier died because of the consequences of prematureness or diseases, is now higher. These children are often disabled by cerebral palsy. Cerebral palsy is an untreatable disease, whose displays can be influenced only by a well chosen therapy. Bachelor thesis has two basic parts. The first one is theoretical, which is divided into a general and special part. In the general part, I focused on the sum of theoretical knowledge about cerebral palsy, I paid attention to the characteristics of the disease, incidence, etiology, pathological anatomy and to the classification of cerebral palsy. Then I focused on the diseases associated with cerebral palsy. I describe physiotherapy of cerebral palsy patients with focus on reflexive locomotion in the special part of my bachelor thesis. The aim of my bachelor thesis is to summarize knowledge about cerebral palsy. Considering that one of the basic features of the treatment is physiotherapy, I devoted my attention to the most usually used methods in the treatment of cerebral palsy. The theoretical part is concerned with methods of reflex-locomotion (Vojtova metoda), of Redcord ? therapy and by the concept of Mr. and Mrs.Bobaths. In the practical part of my thesis I made a quality research, where I specified goals of my work, offered description of methodology, characteristics of a file, and I made three casuistries. A part of the casuistries were anamneistic data and making of preliminary and output exploration. These explorations included objective general assessment, establishing locomotive state according to professor Vojta, exploration of locomotive abilities and goniometric explorations too. All persons went through classification of spasticity according to Ashworth´s measures and exploration of shorten muscles was also done. Research was made in the ARPIDA centre in České Budějovice, it took three months (March, April and June/2013) ? investigation of one patient of all three took circa one month, in which 9 therapies were done. The aim of practical part is to bring physiotherapical plan for observed patients with cerebral palsy. Results show that short-termed treatment had positive effect on health state of all three observed patients. The most affected areas were stability, correction of axial organ, but hypertonus of muscles and empowerment of weakened muscles also became better. The bachelor thesis can be used as a source of information for orientation in the topic of cerebral palsy by students of physiotherapy, but can also serve as an educative material for patients between fifteen and thirty years of their age and by their parents. Thesis could also be an inspiration for physiotherapists, who could think about their own treatment therapies for patients with cerebral palsy with the usage of not so known method Redcord?.
|
|
|
The possibilities of physiotherapy treating children with evolutionary hip joints disorders
PEŠTUKOVÁ, Lucie
This bachelor thesis deals with the possibilities of physiotherapy treating children with evolutionary hip joint disorders. The theoretical part describes general background related to the issue. The content of the theoretical part brings a summary of findings related to the anatomic-physiologic relation of the hip joint, describes diagnostics and treatment of children affected by hip dysplasia and summarizes knowledge based on motor development of a child in relation to hip joints. Development Dysplasia of the Hip (DDH) belongs to the most frequent disorders of infant locomotor system and brings numerous morphological deviations that might include simple instability, subluxated or luxated femoral head or other serious pathologies. Therapy choice is then different, depending on the character of diagnosed deformities, and influences individual growth during development. Numerous factors contribute to DDH occurrence, originally the genetic factor used to be considered the main factor, new researches however mention influence of mechanic factors in prenatal live (e.g. foetus position during birth) as well as in postnatal live (e.g. forced deflection of legs immediately after birth or tight wrapping of an infant in swaddling clothes) and of higher hip capsular laxity. DDH treatment has undergone lots of changes during development. The Czech Republic is one of few states paying special attention to early detection and therapy. Research into the issue is linked to great figures like Zahradníček, Frejka, Pavlík and many more. Screening tests already start at maternity wards and continue to the following weeks of life in our conditions. Deviations are detected through clinical examinations performed by a paediatric orthopaedist and are based on images taken by various imaging methods. Therapy possibilities differ according to the joint damage character. Less serious hip joint deformities are treated by conservative methods including treatment with abduction aids including e.g. Frejka Pillow, Pavlík Stirrups and others. Surgery interventions and hospitalization have to be applied to more serious cases. DDH treatment is relatively successful nowadays and starts immediately after pathology detection. Nevertheless there are mixed opinions on treatment requirements among specialists. A lot of orthopaedists are satisfied with conservative treatment immediately after detection. Influence of this kind of therapy has its justification and its irreplaceable importance backed by numerous studies. Today?s physiotherapy tends to offer children with diagnosed DDH supportive rehabilitation methods that might enrich conservative treatment set by an orthopaedist. Cooperation with physiotherapists after successful treatment of children with DDH not only after surgical operations, but also after conservative treatment application is also developing. Children are often left to their own development after removal of abduction aids, which may be dangerous for future interplay of muscles (not activated before) after a long period of movement restriction. Qualitative research method in the form of elaborated case study of one patient with diagnosed DDH was chosen for the practical part. The thesis includes an introductory as well as final kinesiological analysis, description of the therapy course, the evaluation itself, communication with the mother and the physiotherapist in charge of the rehabilitation. The aim of the thesis was to point out the inseparable role of physiotherapy in treatment of children with DDH, to propose possible rehabilitation techniques for DDH treatment and to outline the way how Vojta method affects congenital hip joint disorders.
|
|
|
Effect of Physiotherapy on the treatment of tennis elbow
MARHOUN, Ondřej
Tennis elbow syndrome, also known as lateral epicondylitis, is a condition that affects the area called enthesis. Enthesis, the transition from tendon to bone, take part in transfer of mechanical energy produced by muscles to the movement. These days 1-3% of the world population suffer from this condition (Dungl, 2005; Goguin, Rush, 2003; Johnson, 2007). There are two stages of lateral epicondylitis. The acute stage occurs after previous overworking, contrary to the chronical stage, which developes as a result of long-term overworking and produces structural changes. In 75% of cases tendon m. extensor carpi radialis brevis is damaged. The therapy during the acute stage is succesful in 90% of cases. Therefore early start of the treatment is important (Dungl, 2005). There are many causes of lateral epicondylitis. Overworking of certain muscles is the most common exogenic cause. According to Véle (2007), it is mainly incoordination of these muscles, that leads to pathologies producing pain in the area of enthesis. Because of overworking, extensors of the wrist have higher oxygen consumption. Therefore a tendon, mostly m. extensor carpi radialis brevis tendon, haven´t sufficient oxygen intake and can´t work normally. It leads to fascia shortening and stiffness of muscle fascicle. The trigger points can also form inside of muscle fascicle. Trigger points are caused by neuromuscular synapse disorder. Stiff muscle fascicles cause increased tension in the muscle ligament. Because of it small microtraumata of the tendon structure, calcificated and non-calcificated cartilage and periosteum emerge. Microtraumata induce nociceptive stimulation, that cause pain (Faltus, 2010; Jarošová, 2010, Kolář, 2009). The aim of this thesis is to evaluate possibilities of treatment of tennis elbow and find out, whether kinesiotherapy and aplication of kinesiotaping have possitive influence on it. For this purpose a set of special exercises was created. The practical part of this thesis consists of qualitative study of three probands. Every proband should do once a day a set of specific exercises for five weeks and in addition, they attended special sessions seven times. In one case it was acute stage of lateral epicondylitis, probably because of long term stereotype movements of the wrist. Another two probands suffer from the chronical stage, probably due to everyday working on computer, that often leads to overworking of extensors. When working, all of probands usually used a lot of muscles in their movements, that should have been relaxed at the moment. In this way, patological motor stereotype can be created. It leads to cervical spine pain, shortening of the upper trapezius or pectoral muscles, diaphragm insufiention or rhomboid muscles weakening.
|
|
|
The physiotherapy in patients with compression fractures in the lumbar spine area
LUKŠAN, Filip
This bachelor?s thesis focuses on physiotherapy of patients with compression fractures of the lumbar spine. Compression fractures of lumbar vertebrae are caused by excessive dynamic pressure on the lumbar spine. These fractures come about both by reason of direct causes such as falls from heights or injuries from automotive accidents. Osteoporosis is another aspect. It is a generalized skeletal disease which causes bone mass degradation and is therefore an indirect cause of compression fractures of the lumbar vertebrae. Women over 70 years of age are the most frequent sufferers. The aim of this bachelor?s thesis is to map out physiotherapy methods used in patients with compression fractures of the lumbar vertebrae. The paper is divided into two major sections: theoretical and practical. The theoretical section describes the anatomical structures concerned, osteoporosis types and diagnostics, types and causes of lumbar vertebrae injuries and their mechanism. A further focus is diagnosing these injuries and potential treatments, i.e., conservative and surgical. Physiotherapeutic methodologies which may be use for these conditions are the topic of another chapter in the theoretical section. They include the Vojta method, sensorimotor stimulation, proprioceptive neuromuscular stimulation, spinal exercises, large ball exercises, dynamic neuromuscular stabilization, school of the back and physical therapy. Using these physiotherapeutic methodologies can result in a reduction in pain, support of the healing process and improvement of the functional stability of the lumbar vertebrae. A total of four probands were selected for the practical section and divided into two groups: patients immediately after a fracture and patients in whom the healing has been completed. All the patients were treated conservatively, i.e., using the Jewett brace. The first group consisted of two patients hospitalized in the České Budějovice, a.s. hospital. I took their history and carried out input and output kinesiology analyses. The therapy took 3?4 weeks. Using the methodologies mapped out in the theoretical section, I prepared my own physiotherapeutic procedure governing the entire therapy period. In these patients, the focus was put on positioning in bed, using the Jewett brace, the proper walking stereotype while using the brace, achievement of self-sufficiency and independence in daily activities along with strengthening the muscle corset. This therapy helped the patients transfer to home care in the shortest time possible. The second group consisted of two patients whose fractures have been healed but continued to suffer from pain in the lumbar region. Here too, I took their history and carried out the input and output kinesiology analyses. The therapy took 3?4 weeks. It focused on the activation of the deep muscle and strengthening the surface muscle using the methods of the lumbar spine dynamic stabilization, exercise on a large ball, proprioception and learning the principles of taking care of one?s back. The contribution made by this bachelor?s thesis lies in mapping out the methodologies to be used for these conditions and preparing the author?s own physiotherapeutic procedure for these issues.
|
|
|
Physiotherapy for patients with Spinal Muscular Atrophy - therapeutic use methods and assistive devices to delay neuromuscular spinal deformities
KUBIČKOVÁ, Karolína
In my bachelor work I look into the problems of the spinal muscular atrophy, assess both the effect of physiotherapy performed and utilization of compensation aids to control the progression of the disease. SMA presents an autosomal recessive genetic progressive disease of neuromuscular system, in the course of which muscular hypotonia, even atrophy develops. This process origins in a gradual deterioration of motoneutrons of frontal spinal corners. SMA ranks among rare hereditory diseases when both parents of the affected patient are bearers of a defective gen, although the illness doesn´t manifest in them themselves. The illness, in its medium and more advanced forms, starts usually its occurence in an early childhood. The rapidity of SMA progression differs in every individual. The patiens who suffer from this illness are mostly dependent on a wheelchair and their lifetime is substantially limited. Neither pathogenesis, nor treatment are currently known.One of major problems, which are brought by the illness, is the start of a backbone neuromuscular deformities which gradually deteriorates. A progressing scoliosis is often so significant that a surgical treatment becomes inevitable because compression of internal organs reaches such a condition that a conservative treatment is not sufficient any more. The patiens often complains of a back and hip painfulness. Viewed by physiotherapy, it seems inevitable to select a correct, individual therapy for every affected person and to recommend them suitable compensation aids. In particular, the choice of a wheelchair must be done with a proper care. Especially the quality of the sitting part and the part catering for a sufficient stability of the body, present the most important items to check while selecting a wheelchair. The importance of a proper wheelchair results from the fact that the SMA patiens spend in it most of their lifetime and that´s why the comfort of usage and the limitation of both backbone deformities and pelvis obliquities appears so important.In the theoretical part of my work I focused on the definition of SMA disease. I stated the classification of SMA and the therapy options. Next, I mentioned the physiotherapy methods, which are most often employed in therapy and compensation aids, which are inevitable for the SMA patiens and present a slowdown of the disease progression. A high quality and suitably selected compensation aid participates in a partial deceleration of occurence or progression of neuromuscular deformation of the backbone.This bachelor thesis aims at monitoring of physiothrapy application chances in SMA. It examines if the illness can be partially affected by employing physiotherapeutical methods. In addition, it deals with the availability and effectivity of compensation aids.
|
|
|
Possibilities of physiotherapy in patients with complications after total hip endoprosthesis in
FEREBAUEROVÁ, Martina
There is an increase of number of the total hip joint prosthesis arthroplasties in last years and also the patient age limit is falling down. This leads (for prosthesis determined lifetime) also to the increasing of the number of re-surgeries because of aseptic release. This kind of surgery is for patient more strenuous than primary surgery and so brings higher risks of the possible complications. Complications are not rare even after the primary surgery of the total hip joint prosthesis arthroplasy. Most frequented complication is higher mentioned aseptic release, which results from the organism reaction to the abrasive PE particles, which fall off the worn joint. Next highly frequented complication is the infection in the total prosthesis area, where the cause could be local or global. The next feared complication is the luxation of the prosthesis after total hip arthtroplasty. This luxation is very soring and the nerve damages are possible. The nerve damage is potential also due the surgery. Next complications: thrombosis embolism, different length of the limbs, active scar tissues, lymphedema, heterotopic ossification, periprosthetic fractures, mechanical damage of the artificial hip components. According to the time of complication occurrence may be complications sorted as: pre-surgery, early, late. Target of this work is mapping of the physiotherapeutic procedures used at the patients with the complications after the total hip joint prosthesis arthroplasty. Next target is the processing of casuistries and physiotherapeutic plan forming by chosen complications. As research array were chosen three probands with different complications. The first proband is patient after re-implatation of total hip joint arthroplasty because of infection, second proband is diagnosed different limb length, third is patient with the active scar tissue. Therapy has been treated by every single proband individually and was fitted individually according to patients diagnosis. Due whole therapy was the unit for comprehensive physical training and physiotherapeutic procedures set to contemporary probands condition. This consists of theoretic part and practical part. Theoretic part deals with topics as hip joint anatomy, hip joint aloplastic and complications, which could because of aloplastic occurred, re-implantation of total prosthesis athroplatsty and in meant problematic used physiotherapeutic procedures. The qualitative research was chosen for the practical part of work. Results are worked out as casuistries using the methods of interview, spectating, secondary data analysis and kinesiological testing. The physiotherapeutic plan design is based to initial kinesiological test. Therapy was treated according to this plan. The output kinesiological test was worked out in the end of therapy and after results evaluation was designed long-term physiotherapeutic plan. The therapy was treated 4-5 weeks to every patient. The results say that by all patients came improvement of the movement extent in the operated hip joint, also to the pain reduce or pain elimination, increasing of the muscle power and the walking stereotype. However, some of the pathological movement stereotypes and muscle shorting still remain or were just partially reduced. Altogether, with the total hip joint prosthesis arthroplasty patients with different complications are connected strong muscular dysbalances and disrupted stereotypes of movement and walking. These changes are caused by antalgic position in the joint. Shortly, if the hip joint is long-term affected, then will be the affect evinced on the global deportment.
|
|
|
Physiotherapy Achilles tendo rupture incurred during sport
BERNÁ, Kateřina
The Bachelor thesis deals with the theme of "Physiotherapy of rupture of the Achilles tendon due to sport". The rupture of the Achilles tendon is most common by young men who are dedicated to professional or solely amateur sporting activity. Pathologies of the Achilles tendon are becoming more common due to an increase in sports facilities and better access to leisure sports. In the case of a tendon injury, the patient is forced to undergo treatment. Currently there are three ways of treatment: conservative, optative, and miniinvasive treatments by percutaneous technique. The latter two techniques are a popular choice among active people and athletes. The theoretical part summarizes the knowledge of the Achilles tendon, the anatomy, physiology and biomechanics. This part also deals with the emergence of rupture (its causes), clinical contexts and tests. Finally, there is a description of the various types of therapy of rupture, physiotherapy and possible contraindications during treatment. In the theoretical part, I also included a set of preventive measures which make it possible to prevent injuries. The importance of these principles is in the fact that their compliance is disappearing in the field of professional sports. The practical part was processed by qualitative research and includes targets and research questions, methods of work, the course of therapy and a description of the processed results in the form of case reports of patients. The task of set target is suggestion and realization of individual physiotherapy in patients with rupture of Achilles tendon. The research question focuses on monitoring changes in the investigated parameters after physiotherapy. The methodology section includes a characteristic of the study sample which consists of two patients diagnosed with total rupture of the Achilles tendon, both were treated at the Department of Rehabilitation of the Hospital in České Budějovice, JSC. Patients suffered an injury during sport activities (basketball, football) and subsequently they underwent operations in the form of an open operation. In this part of thesis a description of the input and output tests will be found. First, data was collected from anamnestic of patiens. Each examination of kinesiology analysis were then evaluated. The techniques of data collection were interviews and observations. The process of physiotherapy treatments recorded several local problems, which were necessary to focus while therapy was in occuring: swelling of the surrounding tissues, limitation of movement, change of soft tissue in the ankle and instep, weakened musculature leg and thigh, and rigidity of Achilles tendon. It was also necessary to conduct reeducation of walk and proprioception training with patients. After application provided physiotherapy treatment was observed in two patients improvement of values of somatometric measurements (circumference thigh, calf muscle, ankle, head of metatarsals), momentum in the ankle joint in dorsiflexion and plantarflexion and improve of muscle strength especially in the m. quadriceps femoris and m. triceps surae. Tasks of the thesis were fulfilles and the research question is answered. Results will be made public for professional physiotherapy public and the results should be useful for clinical practice of physiotherapists and for students in modern physiotherapy techniques in the diagnosis.
|
|
|
Stress incontinence and the possibilities of targeted rehabilitation
VYHLÍDALOVÁ, Denisa
The topic of my bachelor thesis is stress incontinence and options of targeted physiotherapy. The first section contains theoretical background concerning mentioned problems. The theoretical section summarizes anatomical and physiological facts about urinary system and pelvic floor, and the theory of incontinence. There are described types of urinary incontinence and their causes. As next, there are mentioned the options of diagnostics and treatment especially of stress incontinence. Incontinence, i.e. involuntary leakage of urine, is one of the most widespread female inconveniences of recent years. It brings many problems, not only physical ones but also mental, and so that it has negative impact on quality of the life. This involuntary leakage of urine is not an illness to all intents and purposes but symptom with various causes. The most common cause are weakened muscles of pelvic floor, which belong to the deep stability system. They significantly support the whole stability system of the trunk. These muscles and fasciae of pelvic floor provide proper stabilization of urinary bladder, urethral closure, and urethra in proper position and by this they assure continence, especially when intra abdominal pressure increases. The muscles of pelvic floor and diaphragm participate together in breathing. The frequency of incidence of urinary incontinence increases depending upon the age. One of the incontinence types is stress incontinence. Urine leakage is always related to physical activity. Urine leakage happens when intra abdominal pressure increases and happens without contraction of detrusor. Unlike against other disorders, it is possible to fight successfully against incontinence not using only drugs and operative surgery. The treatment of incontinence is in recent years relatively successful and with the help of proper and regular exercise it is possible to prevent it. According to some recommendations, when treating stress incontinence, physiotherapy should be chosen as a primary treatment. The goal of physiotherapy is the effort to help patient to be able to activate muscles of pelvic floor in situations when the leakage of urine is expected. There was used the method of qualitative research in practical section of the thesis, using case studies of 2 patients suffering from stress incontinence. The thesis contains entry and final kinesiologic analysis completed with the query CONTILIFE, the plan with adequate exercises and measures, and the final success rate of the treatment. The goal of the thesis was to point out significant role of physiotherapy in the treatment of patient with stress incontinence, then outline the available rehabilitation methods and propose complex of appropriate exercises and measures. There was created a booklet with the list of exercises for each patient. Patients have exercised using these single exercises being previously instructed about them for eight weeks, and they were simultaneously controlled on regular basis. Patients were observed in a complex manner so that the individual therapy was made for each of them according to individual problems, revealed in entry kinesiologic analysis. Final results of this study showed that the chosen therapy was successful and patients mention not only subjective feeling of improvement of their incontinence problems during the day, but also an improvement of their physical condition and relief from the pain of the cervical and lumbar spine due to a complex approach and individual therapy.
|
|
|
Physiotherapy in patients after cardiac interventions
VÝBORNÁ, Markéta
In my thesis I tried to focus on the issue of physiotherapy and curative rehabilitation by the patients after cardio-surgical interventions during their stay in a hospital facility. In the opening part I am presenting a brief overview of used cardio-surgery techniques and accesses with their short evaluation. I dealt in brief with the issue of wound healing and the scar formation, including a summary of the most important post-operation complications and accesses, which enable to avoid these complications. One of partial tasks solved in my thesis was the search of physiotherapeutic techniques after the heart operations. Here I focused especially on modern and recently used strategies. I adduce their short definition and explanation of possible benefits resulting from their use. In the second part of my work I am directly evaluating the progress of physiotherapy of two patients with the identical diagnosis who were operated on by two different techniques. Both the patients were taken to the planned performance ? the exchange of the aortic valve as a consequence of their stenosis and present insufficiency at the cardio-surgical department of the hospital in České Budějovice. In one case the classical medial sternotomy was performed, in the other case it was decided to perform a mini-invasive intervention ? the right-side mini-thoracotomy. With both the observed patients the same exercise was practiced just from the first day of the physiotherapy. During the whole period the values of vital functions were carefully checked and registered. The physical and mental state of patients was also followed including the painfulness of the wound. I collected the data for my thesis by means of interviews with the physiotherapist and the patients participated in the observation. I also elaborated a detailed casuistic and analysis of patients? personal data. I cooperated actively with the present staff. The exercises were done twice a day, in the morning and in the afternoon. The whole rehabilitation unit lasted approximately 15 minutes each time. The exercise was started in the bed where simple mobilization exercises were done, some elements of the breath and vascular gymnastics and elements of Vojta?s reflexive locomotion. Gradual verticalization of the patient enabled us to use even more complicated exercises. The exercise was finished with a walk in the corridor and on the stairs. Some respiration aids were used, described in the following part. From the rehabilitation process, which was in progress on both the patients immediately from the first rehabilitation day, results clearly that the patient with medial sternotomy (a woman) showed a considerably greater painfulness every day, which was very limiting for her. Even her mental condition was worse. This patient was not able to perform with a delay of several days those exercises, practiced by the patient with the mini-invasive entry already without any troubles. Considerable differences were also found in the walking, both in the distance and in posture while walking.
|
guest ::
