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The influence of flat feet onto the posture of children at school age
ŤUPOVÁ, Jana
The bachelor thesis is describing problems of the impact of flat feet on school age children´s posture. The foot is the organ that allows contact with the terrain. In case it´s functional component is changed pathologically to some extent, it fails to work properly and can change the whole posture of particular individual in pathological way. Flat feet is a condition of foot when the arch of the foot flattened partly or completely. Arch of the foot enables us flexible treading contact and is defined with three support points: calcaneus and the heads of the first and the fifth metatarsals. They develop and change during one´s lifetime. The appearance of flat feet during the first two years of life is considered as a physiological condition. The appearance of the flat feet later in childhood is viewed as a deformity and needs more examinations and some therapy. Some studies showed that early treatment of flat feet can prevent later unwanted manifestations, and that is why flat feet in children should not be underestimated. Flat feet in children is the most often cause for the visit at a doctor. Children´s flat feet is the topic that needs to be very often consulted at any level of the health care. It is not completely clear, when the foot is still considered as physiologically flat without any pathological cause and when it is considered as pathological flat feet. The purpose of the thesis was to describe links between flat feet and posture. The foot is the key area for motor system and that is why its disorder or malfunction can become the cause and also the consequence of chain functional disorders. That is the reason why the foot area should not be disregarded. Another goal was to suggest exercise units and search out appropriate exercises concerning described problems. Exercise unit was designed individually for each participant according to one´s needs. The first exercise unit has been modified gradually according to participants´ skills to master the exercise. The modification was however essential to keep children´s attention up during the therapy. The thesis consists of the theoretical and practical sections. The practical section contains information about the foot from anatomical, neurological, and kinesiological view and its pathology that is affecting posture. The therapy lasted 10 weeks, children have been exercising from ten to fifteen minutes a day with supervision of parents who were instructed about the exercise, and twice a week individually, under my supervision, and also in parents´ present. The investigation was carried out using interview with parents and children, and also using kinesiological analysis. There was carried out entry and exit assessments in children´s group. They were used to determine proper therapy at the start and also for the conclusion from results at the end. For each participant was designed proper therapy according to one´s needs. The goal of physiotherapy was determined as well as recommended certain type of exercise and proper exercise activity for all children in long time horizon. Our findings showed that proper therapy in children with flat feet can positively influence whole posture. When the entry and exit examinations were compared, we found that there was found greater range of ankle joint motion, positive change in flat feet condition, better body control, the change of breathing mechanics, and also participants´ personal view of better self body control. I have chosen the topic to bring closer problems of flat feet affecting body control in children. The foot area is an integral part of our body. When the arches of foot flatten, position of whole lower limb in joints and complete body posture is negatively affected.
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Physiotherapy in patients after fracture of the ankle joint
ROKŮSKOVÁ, Pavla
This Bachelor?s thesis deals with the theme of physiotherapy of patiens with a fractured ankle joints. An injury of ankle joint is one of many kinds of musculoskeletal injuries. As a result of an injury in this area appears a pathological situation for human organism which results in changes of local and distant parts of human body. Among important local problems of the physiotherapy treatment belong pain, swelling, limited mobility of the surrounding tissue and malfunction of muscles. The main role of physiotherapy is an elimination of local problems and a restoration of the proper function of ankle joints. Then the techniques of physiotherapy aim to the reeducation of walking and to avoid any incorrect movement streotypes and compensatory mechanisms. Therefore this therapy does not focused only on the ankle joint itself, but contains whole postural function of muscles in the whole human body. In the theoretical part of this thesis I describe the anatomy of human feet and ankle joints, the kinesiology of ankle joint and the biomechanism of human walking. Then etiology, diagnostics , treatment and complications of traumas of the ankle joint are mentioned. As an individual chapter there are therapeutic guidelines used at the time during healing, and of course, after healing of the fractures. In the research part of this thesis the qualitative method of research was used. This chapter was prepared as a list of case reports, which contain case history, initial examination, design and description of the therapy, final examination and long term physiotherapeutic plan. The utilized techniques for collecting data were interview and observation. The researched group consisted of two patients with diagnosed fracture of the ankle joint. These patients were selected from two ambulatory departments. One of the department is part of the Nemocnice Ceske Budejovice, a.s., and the other is part of Centrum lecebne rehabilitace Marie Kotrbove, s.r.o. Total duration of therapy was four weeks in both cases. At the beginning of therapy these patients were informed about the procedure the goal of therapy. The goal of this thesis was using theoretical and practical knowledge gained during studying of physiotherapy for the most effective treatment of patients. The first goal was to introduce complete knowledge of kinesiology and physiotherapy of the fractures of ankle joints. This part was achieved in the theoretical chapter of my thesis. The second goal was describing the possibilities of the therapeutic care and the following practical effectinevess. At the beginning of the study the question was set: Are the recommended methods of physiotherapy of patiens with fractured ankle joints effective?. The progress and outcome of therapy was judged in conservative treated cases as well as surgical treated cases of fractured ankle joints. In the conservative treated fracture the terapy was effective, swelling has been gone, the muscle strenght increased and the motion range extended. In the surgical treated case terapeutic progress was slowed down. But even there after the complex physiotherapy treatment success was achieved. Maximum level of all functions will be matter of further therapy. The results of research part has shown, the proper terapeutic methods were chosen. The results of this thesis will be provided to the whole physioterapic community. Benefit in clinical practice is in present processing and pointing out all possibilities of local and complex therapy of fractures in the area of ankle joint.
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Physiotherapy in patients after injuries of the spine and spinal cord
HAJNÁ, Petra
In connection with our lifestyle every year in our country but also abroad there is a growing number of people with spinal cord injuries. The spinal cord injury usually occurs while a spinal injury, where the spinal canal is compressed by luxated vertebra or bone fragments. Affected are more often young people, especially men. The most common causes are falls from height, accidents and sports injuries. A person with this condition not only has limitations in terms of loss of movement or sensitivity but is often threatened by various health complications. Therefore a complex care and intensive rehabilitation is very important, which is in the Czech Republic secured by the spinal program lasting 6-9 months. Rehabilitation is needed not only in the acute period after injury, but has a unique place in the chronic stage of spinal cord injury as well. The aim of this thesis was to explore issues of trauma and spinal cord injury from the perspective of physiotherapy. Based on the defined targets following research questions have been determined. What kinds of physiotherapy procedures may be used onpatients in the subacute stage and what procedures in the chronic stage of spinal cord lesion. A qualitative research in the form of case reports has been executed. Data was obtained from interviews, observation, document analysis and kinesiological analysis. Standard tests related to the spinal lesion were performed, only the most relevant tests and the results that were found during therapy in case reports were entered. The sample included four patients. Two patients in the subacute and two patients in the chronic stage of spinal cord injury lesion etiology. The research was conducted at the Spinal Unit Department of Traumatic Surgery, University Hospital Brno and at the Rehabilitation and restoration center Borovany. Physiotherapy in subacute phase of spinal cord injury is directed at the prevention of pressure sores, contractures, pain, maintaining optimal mobility of joints, focusing on respiratory rehabilitation, maintenance and strengthening of preserved motor potential, activation of the motor transient spinal cord lesion with efforts to activate the motor skills in the most distally way, improving the overall physical condition. The aim is to use and support functional ability of the patient to the fullest extent and quality with the subsequent effort to develop alternative mechanisms.Of the special methods the ones on the neurophysiological basis are the most commonly used treatment methods. An important part is the gradual verticalization of the patient, training equilibrium reactions such as training seat, support for upper limb, keeping in certain positions and functional training, thus the mobility on the bed, self-care, transfers, training wheel chair control, practicing functional replacement grip. Patients return to life with a big handicap, are often dependent on the assistance of others, learn to use a wheelchair and other aids. They have years of life ahead in which they have to cope with the conditions subsequent their injury. In the chronic period, it is important to maintain physical fitness, preventpossible complications, especially pressure sores and joint contractures. Physiotherapist addresses the consequences of overloading the exposed muscles, monitors the vertebral problems, joint pain or muscle imbalance. During this period, patients can attend ambulant physiotherapy or use maintenance stays in rehabilitation centers. The purpose of the study was to mention the basic and the most important areas in the care of spinal patients and to highlight the importance of physiotherapy comprehensive care not only within the spinal program, but also from the perspective of the long-term care of these patients as the rehabilitation should accompany the patient's whole life.
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Case study of physiotherapy treatment of a patient with the diagnosis of Multiple Sclerosis
BÁRTOVÁ, Adéla
The thema of this bachelor thesis is "Case study of physiotherapy treatment of a patient with the diagnosis of Multiple Sclerosis". The severity of multiple sclerosis incrementaly increases as the incidency of this disease - globaly and in the Czech Republic as well - rapidly grows year by year. Multiple sclerosis -as an autoaggressive chronic disease - is still incurable, however, plenty of changes in the diagnosis and the therapy have emerged during last years. This illness afflicts mostly persons during the productive period of their lifes. The patient is often without clinical symptoms during the first few years, which, until recently, misled to an idea that there is no urgent need to apply a long-term medical treatment. Today it is evident that only early executed diagnosis and early started therapy afterwards can prevent from the permanent neurologic impairment of the patient. Besides the pharmacological treatment, there is also physiotherapy which helps patients to live an active and valuable life. The point of this paper is to illustrate a complex view of this problem. The first, theoretical part deals with multiple sclerosis as a whole, with the goal to summarize the latest knowledge and findings about this disease. It describes the potential causes of the origin of the disease, its occurrence, particular symptoms, development of the disease, different types of the disease and the possible diagnosis together with the differential diagnosis. The ending of the theoretical part informs about the therapy comprising the pharmacological treatment and the complications it may bear, and the rehabilitation treatment summarizing therapy of all symptoms, which can appear. Nowadays, it is possible to find different approaches in the rehabilitation of multiple sclerosis. But according to many physiotherapy studies those methodologies, which are based on the neurophysiological fundamentals, were already very positively aplied on the patients. It is an objective of the practical part of my thesis to introduce one of these methodologies. The impact of an aplication of the individual physiotherapy, which utilizes the neurophysiological findings, can be evaluated by comparing the results from the entering and exit. This work is conceived as a case study in the form of casuistry. Qualitative research based on the data collection was chosen to verify the efficiency of the aplied physiotherapy. Data was obtained by interviews, observation, analyses of medical records and kinesiology testing. An entering and exit examination, comprised from the set of tests, were performed after the six months therapy to assess changes in the clinical conditions of the patient. These tests allows the therapist to comprehensively evaluate the effect of the rehabilitation on the patients with the central disabilities, particularly on the patients with multiple sclerosis. Tests were selected regarding the clinical signs of the disease. There were examinations done to test the balance, dysmetria, dysdiadochokinesia, scales of postural reactions, walking, muscle strength and spasticity. The test of grabbing ability was done to examinate the light motor skills and goniometry was aplied to determine the joint's range of mobility. The results of the research proven, that the individual physiotherapy employing findings in neurophysiology together with aerobic therapy and other techniques appropriately selected with the respect to the actual complications of the patient has a positive effect on the overall condition of the patient. This bachelor thesis can serve as a theoretical basis for the teaching needs or as an informational source for all, who are interested in the multiple sclerosis disease issue. It can also be an inspiration for physiotherapists on how to proceed in the rehabilitation of patients with multiple sclerosis.
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Physiotherapy of a displaced disc with reposition of a temporomandibular joint
BROŽKOVÁ, Aya
The topic of my bachelor thesis is physiotherapy of a displaced disc with reposition of a temporomandibular joint. It is a functional disorder, when the mandible disc is not in a physiological position and creates an obstacle for a condyle movement. When mouth is fully opened the disc does not return to its original position. This moment is characteristic with a clicking sound. Another symptom is inclining of the chin to the disordered site when the mouth is being opened. Main cause of TMD is stress, bad occlusion and a long-term micro trauma of TMJ. It is a topical issue, because an increase of stress in daily life causes also more TMD. Almost 70 % of the population has the TMD, in most of the cases the TMJ disc is in a wrong position. The therapy of this kind of disorder should be done by physiotherapist. Unfortunately knowledge of diagnosis and healing of the TMD is not sufficient. The disorder is recognized usually by dentists, who send a patient to a specialized clinic. The goal of my work was examining of mastication and neck muscle spasms. In the work there are also described physiotherapeutic possibilities of healing including postural strategy. I have created informational booklet for patients, in which saving method for TMJ healing, exercises, ergonomic principles and correct posture both when sitting and standing are presented. The research was done by 14 case analysis, analytic-inductive method and experimental work. Patients were randomly divided into three groups. As a first step TMJ and cervical spine of each patient and their posture were examined. The examination of TMJ consisted of diagnosis, extent and symmetry of an opening movement and palpation examination of the cervical spine. Therapy was six weeks long. Each patient was introduced to TMJ saving method, which is based on limitation of a TMJ movement, eating soft food and elimination of stress. In the first group (5 patients) the therapy was focused only on mastication muscles. Patients were supposed to be exercising to loosen the muscles of mastication. Exercises were chosen after palpation examination. Third group (4 patients) did neck muscle exercises and self massage. Second group (5 patients) did the therapy of both first and third group. Results of the therapy show, that there is a possible connection between TMD and cervical spine dysfunction. There were positive (evaluated subjectively) changes in both TMJ and in all groups. The condition of TMJ is influenced by neck muscle therapy and the condition of cervical spine is influenced by mastication muscle therapy. Best results had the second group. All patients but one improved (one lady had a TMJ inflammation). There were no deterioration of TMJ and cervical spine condition either. There were some worsening in group one and three. The best therapy is a combination of exercises of both mastication and neck muscles. I would like to point out a fact that TMJ is one of the most complicated and busy joints in human body. Both TMJ are connected to mandible so dysfunction of one joint can lead to problems with the other one. Physiotherapy is needed most in cases of functional disorder.
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Physiotherapy in the eyes of the general public
ZACHOVÁ, Pavla
This bachelor degree thesis offers an analysis of the views of the lay public, i.e., non-medical persons, about physiotherapy. Physiotherapy forms a part of the complex process of rehabilitation, and plays an important role in preventive, diagnostic and medical care. This thesis consists of two sections: theory and practical. The theory section deals with the history of physiotherapy, complex rehabilitation and the International Classification of Functioning, Disabilities and Health. The chapter entitled Physiotherapy explains the aims of this field, the training of physiotherapists and the scope of their work, as well as the diagnostic and therapeutic tools used. This chapter also includes a code of ethics, a list of professional associations, a code of standards for physiotherapists, and possibilities of payments for the provided physiotherapeutic services. The final chapter of the theory section gives the definition of the words ?massage? and ?massage therapist?. The practical section aims to find out the level of knowledge the general public has about the meaning of the word ?physiotherapy? and its associated expressions, the physiotherapist training system, the uses to which physiotherapy and spa care could be applied, and the role physiotherapy plays in the Czech health system. My survey took the form of a quantitative research, and the data were collected from responses given in the questionnaires. Target groups were people from the regions of Vysočina and South Bohemia. They were classified into four age groups. The questionnaire consisted of 22 questions and the collected results were processed using the occurrence analysis method, and also displayed graphically. The survey proved that the general public needs to be better informed about the field of physiotherapy and physiotherapy treatment conditions. For this reason, an informative brochure containing all necessary information for the non-medical section of the population has been issued. This bachelor degree thesis can be used as learning material for current and former students of physiotherapy, as well as by other medical and non-medical professionals. It also encourages us to think about how to raise the image of physiotherapy both amongst the general public and healthcare specialists.
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Possibilities of prevention of occupational damage to musculosceletal system of physiotherapists
LEŠÁKOVÁ, Jana
This work has dealt with possibilities to prevent the locomotive system?s damages suffered by professional physiotherapists. The goal of this work is to map the demands of the physiotherapist?s job and to propose preventive measures preventing locomotive system?s damages suffered by professional physiotherapists. Another goal of this work is to find out the actual state of the locomotive system of the chosen group of physiotherapists and to collect information relating to their ways of prevention and their care for their own musculoskeletal system. The work contains the theoretical and the practical parts. The physiotherapy has been defined in the theoretical part, two most frequent damages of the physiotherapists? locomotive system have been analysed, and possibilities of prevention have been described there. The practical part contains the quantitative pre-research and the qualitative research. The qualitative pre-research is based on findings and frank answers by physiotherapists from different health-care facilities (hospitals, health resorts, rest homes, rehabilitation centres), located mostly in the region South Bohemia. The quantitative pre-research was realised with questionnaires asking eleven questions. The qualitative research consists in inquiring of two physiotherapists. A conclusion has been drawn from the realised anamnesis, a kinesiologic analysis, and observations made during the physiotherapist?s work. Preventive measures have been suggested that could prevent the development of locomotive system?s damages. It is the secondary prevention in most cases. Further information was collected in Finland, in the town Rovaniemi during the student exchange. The stay in Finland enabled to compare preventive approaches relating to ergonomics and other risk factors during the physiotherapist?s work in Scandinavia and in the Czech Republic. It was concluded from the research that professional physiotherapists know the hazard relating to locomotive system?s damages. They also know prevention possibilities; however, not everybody of them has applied them adequately during his/her practice. This work can motivate all physiotherapists to think about results of practising physiotherapy for a long time and to improve measures preventing damages of their own locomotive system.
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BASAL STIMULATION IN A COMPREHENSIVE REHABILITATION
SOUKUPOVÁ, Kateřina
This bachelor thesis deals with the system of comprehensive rehabilitation and specifying its importance for physiotherapy. The theoretical part describes the system of comprehensive rehabilitation. It also focuses on the concept of basal stimulation, introduction of its origin, its current state in the Czech Republic and abroad, its nature, idea, general principles and its place in the system of comprehensive rehabilitation. Then the subject of interest of this concept is characterized, which is to promote the perception, mobility and communication of the client. When describing the elements of basal stimulation, those techniques are emphasised which, according to the obtained information and documents, might be used in physiotherapy. A separate chapter is devoted to physiotherapy for selected diagnosis, in which the basal stimulation is applied. Principles, procedures and applied concepts and methods are briefly summarised here. The practical part describes the process of research carried out in the day care centre Arpida o.s. in České Budějovice. The aim and the objective at the same time were to describe basal stimulation as the concept of comprehensive rehabilitation and to specify its importance for subsequent physiotherapy. This was done by qualitative research and created case studies of individual respondents, when information were taken from recorded medical history, biographical history, kinesiological analysis, evaluation of spasticity and examination of respiratory stereotype. Also information from the area of basal stimulation in the day care centre and information about the progress of physiotherapy were obtained. Subsequently the basal stimulation techniques were interconnected with the physiotherapeutic methods and concepts and the results were thoroughly recorded and evaluated. The results confirmed the positive influence of this scientific pedagogical ? nursing concept and the appropriateness of combination of its techniques with physiotherapy.
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Physiotherapy after Achilles tendo injuries
HERCOGOVÁ, Eva
At the present time there are more and more injuries of the Achilles tendon. We meet with varied opinions of the therapy which has connections with the injury status of the Achilles tendon. The task of this work is to find out the effect of two different physical therapy plans on the physical condition of patients. It follows the existence of differences in the total therapeutic length. It deals with the question of the application of the unit therapeutic plan for all the patients with the Achilles tendon injury. The synthesis of observations of Achilles tendon problems is the first aim of this work. The theoretical part of this work focuses on the synthesis of observations of Achilles tendon problems as well. The work defines different Achilles tendon injuries. The Achilles tendon rupture is described in detail. The pieces of knowledge about anatomy, investigation, diagnostic processes and possibilities of treatment which are mainly from physical therapy point of view are summarized. Complications, prognosis and prevention are mentioned in this work. The other aim of this work is to draw two different therapeutic plans of the homogeneous complex of two probands. The practical part of the work focuses on making varied therapeutic plans of the homogeneous complex of two probands since the time of removing the plaster bandage. The methodology of the qualitative research with techniques of the anamnestic conversation, observation and application of therapeutic plans withing the frame of two cases history one of which is total with the submission of physical therapy methods, concepts and physiatrics is mentioned and used. The other therapeutic plan misses physiatrics because not every rehabilitative places of work have the possibility to use the combined therapy. The results were evaluated by comparing of two output kinesiology analyses of the homogeneous complex of two probands. Both used therapeutic plans have positive effect in reference to motivation to a patient to another therapy, improving quantity of motion of ankle joint and increasing of muscular force. It is not possible to make the unified therapeutic plan for every patients with the Achilles tendon injury. It is necessary to follow the individualization which continues the detailed input checkup. It is also more profitable to include the complex physical therapy plan to the rehabilitaion.
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Possibilities of Physiotherapy in paraplegic athletes, floorball players
KAŠTÁNKOVÁ, Marta
In recent decades a care of people with spinal cord lesions has changed dramatically. A current available literature points to the fact that the quality of life, whether in physical, mental or health level achieved an improvement. The physical activity for people in a chronic phase of the spinal cord injury is a key issue that contributes to maintaining an optimal health condition. Atypical movement stereotype resulting from the movement on the wheel-chair conduces to a possible overload of the body structures and subsequent health problems. These difficulties then may limit people with special needs in the movement, work as well as self-sufficiency. An aim of a theoretical part of the thesis was to identify existing knowledge on the impact of the physical activity on the state of paraplegics, on possible health problems resulting from the overloading and what physiotherapeutic methods could affect these issues. An aim of a practical part was an application of theoretical procedures into practice in a treatment of three sporting paraplegics. In the practical part there was conducted a qualitative research at three randomly selected people, floorball players. Men aged between 24 to 29 years with the paraplegia with a height of the lesion of Th8 - Th11. An observation of the patients was carried out for five weeks. Then a kinesiology analysis and three case-studies were conducted. After it a subjective opinion on the impact of sport on the musculoskeletal system and mental state was investigated by an interviewing technique with a specific question. Difficulties with a shoulder joint were identified at all three monitored individuals. Individually assembled and guided therapy led to the improvement of the shoulder girdle function at all three persons, to a an overall improvement of the sitting posture on the wheel-chair, to a treatment of the muscle imbalances and to an alleviation of the spine pain. The interview results showed that a regular sporting activity had a positive impact on the patients´ mental status. However, it negatively affected them by increasing demands on the whole musculoskeletal system.
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