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Evaluation of balance in osteoporotic patients
Brožová, Kamila ; Sodomková, Gabriela (referee) ; Radvanský, Jiří (advisor)
In this days the osteoporosis is getting to the centre of interest because of its increasing. It is the worldwide problem. Physical activity is one of the main factors affecting the course of disease. Suitable physical activity is possible to reduce a risk of falls, fractures with following, frequently fatal complications. Finding the ma in problems lowering balance ability of endangered population groups and subsequently targeted physical program it possible to include in preventive program of safety locomotion and give support to enhance quality of life for endangered persons. Powered by TCPDF (www.tcpdf.org)
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Bone densitometry
ŠÍRKOVÁ, Eliška
According to the World Health Organization (WHO) osteoporosis is defined as: "Increasing of systemic disease of skeleton. The characteristic feature is the lack of bone substance and disorders of microarchitecture of bone tissue. The result of the disorder is disposition to fractures. Earlier the disease was not diagnosed until it got to the stage of occurrence of osteoporotic fracture. Nowadays it is anticipated by means of BMD. Especially women at the age of postmenopause and older men are invited for the medical check-up. However, younger people and even children are invited too. The main indications for the BMD measurement are women who stopped a hormonal curing by using estrogen or they are at the age of postmenopause. It is also recommended for patients with increased occurence of fractures caused by small force and for patients who had a big weight loss. Last, but not least, it is good for men in their seventies, patients who are considering the pharmacological treatment and of course patients with visible effects of the treatment. The densitometry medical check-up itself, known as DEXA, is painless and non-invasive method, using which we can find comprehensive information about the amount of bone mineral in examined section of bone. The parts, where the density is measured, are the parts that are the most abraded. These are vertebrae L1 L4, distal antebrachium, proximal femur, ribs and proximal humerus. It is necessary to check BMD patients with the same apparatus and software during the each medical check-up. For the checking measurement the patients comes every year. Nevertheless, not later than after the two years after the first medical check-up. The purpose of the thesis is research including two main points: analysis of the data acquired from densitometric station of 'Nemocnice České Budějovice a.s. and omparison of the data of patients with a regard to age, sex and the kind of disease. Based on the research it was found out, that division of the patients into groups according to the diagnosis is not conforming. 95% of patients are suffering from various stages of osteoporosis. Only 5% of patients have different diagnosis. Based on the data from the research it was found out that there are ten-times more women who undertook the medical check-up. It is clear, why mainly women undertake the osteoporosis medical check-up. The sudden change of metabolism of bones, mostly related to climacteric, the end of treatment using estrogen, or lactation, is difficult situation and it is very stressful for the whole organism.
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Access of patients to prevention and treatment of osteoporosis
NEDBALOVÁ, Martina
Osteoporosis is a progressive systemic skeletal disease characterized by low bone mass. Fractures of the vertebrae are the most common clinical manifestation of osteoporosis. Fractures of the vertebral bodies leads to loss of height patients , weight loss and damage to physical function. It is estimated that in the Czech Republic osteoporosis around 600,000 people. More and more, the number of hip fractures. The aim of this work was the first to identify the knowledge of patients about prevention of osteoporosis. 2nd To determine whether patients during treatment changed lifestyle. These targets were four research questions. What are the first patient knowledge of disease osteoporosis? As the second patient's adherence to preventive measures? As the third patient is adhering to proper diet and physical activity? As the fourth patient evaluate information related to the disease osteoporosis?To obtain the necessary information has been used qualitative research. Methods and data collection techniques that were used in the work were semi-structured interviews on a pre-prepared set of questions. The interviews were recorded on a tape recorder and then transcribed. Reached a total of eight respondents. Four respondents were "healthy" population and four respondents were with the disease osteoporosis. Respondents with disease osteoporosis were selected from the inpatient department of orthopedic purposive sampling. The respondent No. 4 with the disease of osteoporosis should be elderly woman, 58 years old. The respondent was contacted by telephone, agreed to be interviewed. On the day arranged meetings but refused to talk without mentioning the reason. The survey took place from 12. 2. 2014 to 10. 3. 2014.The results of the research showed that patients 'healthy' population do not have enough theoretical knowledge about this disease , because of the ignorance of the concept of osteoporosis . Furthermore, research shows that respondents " healthy" population adheres to proper diet and physical activity . Based on the testimony of respondents 'healthy' population was also found that the respondents have no information on possible treatment and examination of available while they are not interested to learn more about this disease , due to the fact that they are still healthy . The results also show that respondents with disease osteoporosis have enough theoretical knowledge. Respondents shall comply with proper diet and exercise. Only one respondent s disease osteoporosis , diet and physical activity does not comply . Furthermore, we found that respondents with disease osteoporosis are adequately informed about the prevention and treatment of osteoporosis , both by doctors and by nurses.The results of the survey show that respondents "healthy" population, despite the lack of information and experiences with this disease generally demonstrate their knowledge regarding this disease. It is different for respondents with disease osteoporosis who have demonstrated their knowledge in prevention and treatment are sufficiently informed about the disease osteoporosis. The practical outcome thesis is the proposal for an information booklet on the prevention of osteoporosis.
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Analysis of Response Variables of Bone Tissue under Mechanical Loading
Vosynek, Petr ; Daniel, Matej (referee) ; Janíček, Přemysl (referee) ; Návrat, Tomáš (advisor)
Dissertation summarizes the results of computational and experimental modeling in the field of biomechanics engineering. Analyses are focused on selected variables that complement or can supplement existing methods of prediction of bone fractures. In terms of computational modeling the variables are based on stress strain analysis. The greater part of the work has been aimed on experimental modeling which is used for monitoring the two dominant components of bone tissue, which are minerals and collagen fibers. The current most widely used variable for the description of bone loss (osteopenia, osteoporosis) is areal bone mineral density (BMD). This variable does not however provide any information about the change in total volume consequently change of mineral and collagen. Proposed mechanical values follow the loss of the two components during simulation of minerals loss (demineralization) and simulation of collagen loss (deproteinization) in vitro for long turkey bones
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Algorithm of imaging methods of injuries of the neck of the femur in the case of seniors
TOČÍKOVÁ, Miluše
The bachelor thesis deals with the incidence of femoral neck injury in the elderly. The work is divided into a theoretical and practical part. As the number of people of retirement age is growing, the rate of injuries associated with this age group has been increasing as well. It is necessary to accept the idea that age is a stage of human life, which every individual must eventually face. A femoral neck fracture is one of the causes of mortality and morbidity in the elderly. The incidence of this injury has been increasing both in developed countries and in the Czech Republic. A femoral neck fracture represents a threat for mobility and independence of seniors. Some people are then permanently dependent on mobility aids, while others remain in institutional care. The most common cause of femoral neck fractures in the elderly is a fall on their side, which is caused by a complex interaction of external and internal factors. The first imaging method used during a medical examination is sciagraphy, which is one of the oldest methods. It allows physicians to assess the preoperative condition of the hip joint and postoperative check-ups during the treatment by alloplasty or perioperative condition with the use of osteosynthesis. It is beneficial for the above-mentioned group of people to carefully assess the bone metabolism. A healthy bone is constantly reconstructed, it continuously breaks down and a new bone replaces it. With age, the degradation of bone prevails over bone formation and the bone begins to "thin". This disease is called osteoporosis. It is a disease that pertains to the civilisation diseases. It is often only diagnosed at an advanced stage, when it is already increasingly susceptible to fracture incidence. The factors of osteoporosis include an unhealthy lifestyle, hormonal changes in women after menopause, when there is a decrease in the level of calcium, a major weight loss etc. A painless, non-invasive method, by means of which a doctor can obtain comprehensive information about the amount of bone mineral in the examined part of the bone, is a densitometry test, or DXA. This test uses x-rays at two energy levels. The DXA method can be measured as a whole-body mineral content as well as any other part of the body. Other causes, which increase the risk of a femoral neck racture, are bone metastases. The proximal portion of the femur, including the femur neck, metastatically affects especially primary lung cancer, kidney cancer, thyroid, breasts in women and prostate in men. At an early stage, bone metastases are asymptomatic. Clinical symptoms such as pain can occur, when the metastatic process penetrates the periosteum and surroundings of the bone, thereby irritating the neural structures. Another symptom is the emergence of pathological fractures. Bone metastases are helping us uncover laboratory tests and diagnostic imaging methods, which include, for example, scintigraphy. Bone scintigraphy can detect a metastatic process much earlier than X-ray examination. The aim of the work was to describe the principles of individual imaging methods, which help doctors to determine the correct diagnosis, to learn more about the femoral neck injury in the elderly and about causes of their ocurence. Moreover, the two hypotheses were established: 1. The most frequently used method in case of a femoral neck injury is skiagraphic examination. 2. That is why more than a half of femoral neck injuries are diagnosed in the elderly. The practical part was elaborated on the basis of a quantitative research. The data needed for the research were obtained from case studies of patients hospitalized in the orthopedic department of the Hospital Tábor a.s., in the period from 1st April 2014 to 31st March 2015.
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Comparison of methods of ECLIA and ELISA in determining the beta-CrossLaps
KOŽANTOVÁ, Jana
Osteoporosis is a very old disease affecting a large majority of population. Its occurrence rate has been growing permanently. It is a systemic disease of bones for which the decrease in bone mass, i.e. of inorganic as well as organic bone part is characteristic. Typical symptoms are osteoporotic fractures. To perform an in time diagnostics of the disease, it is necessary to execute the necessary examinations. One of them is also the laboratory determination of markers of bone resorption and new creation for finding out the state of bone metabolism. The target of my bachelor thesis was to find out the level of the bone resorption marker (beta-CrossLaps) by means of ELISA and ECLIA methods on the same serum from patients with the diagnosed osteoporosis and to process statistically the results. In the next part I dealt with the structure and functions of bones. Then I focused on markers of bone formation and resorption. Finally I mentioned the bone metabolism and its control mechanisms. I concentrated mainly on the metabolism of calcium, D vitamin, parathormone and calcitonin. I carried out the practical part of my bachelor's thesis in the accredited private laboratory STAFILA, spol. s r. o. in České Budějovice. The procedure of my work followed the standard operating procedure of the laboratory. In the research, in total 66 serums of patients with osteoporosis were analysed by me. At first, I determined the concentration by beta-CrossLaps method based on the principle of sandwich ELISA on the appliance NexGen Four from TestLine company. Then I analysed the same samples on the automatic analyser IDS-iSYS from IDS company, this time by ECLIA method. Both appliances on which the determination was executed, principles of both methods, applied analytic sets and the procedures of analysis are described in the methodical part. In the next part of my bachelor's thesis, the results of my measuring are stated. At first I entered the concentrations beta-CrossLaps in ng/ml measured by both methods into the table and for the respective samples I stated the sex and years of birth of individual patients. Moreover I prepared a graph illustrating the share of men and women of various age categories in my research. The second graph shows the differences in values of beta-CrossLaps concentrations between both methods. Resulting concentrations were subject to regression analysis. I applied linear regression and Grubbs test for finding out the outlying values excluded from the further statistical processing. I performed Passing-Bablok regression based on the remaining values. As a result of regression equation and 95% CI of the slope B and intercept A, the proportional error of measuring was rejected but on the contrary, the systematic error was confirmed. Correlation coefficient R = 0,97 shows a very good linear dependency between both methods. It turned out by practice in the laboratory that the evaluation of concentrations beta-CrossLaps from the same patients on various appliances may show partially different values. I worked at two different analysers, each of them was based on another principle, with a different sensitivity and calibration. All of this could have the influence on the resulting concentration of individual samples. The advantage of automatic analyser IDS-iSYS is a quicker determination. Moreover it is possible to perform on this apparatus all the possible examination concerning the bone metabolism from D vitamin, parathormone, osteocalcin up to bone markers. It is advantage for the patients with osteoporosis as well as with other metabolic skeleton diseases. It follows from this that all the necessary examinations may be carried out on one apparatus.
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Risk factors for osteoporosis - knowledge and behavior of adolescent girls
KVASNÍKOVÁ, Martina
The thesis deals with the theme of risk factors for osteoporosis, knowledge and behavior of adolescent girls. The theoretical part of the thesis is divided into four chapters. The first chapter deals with the anatomy and physiology of bone. The second chapter discusses general information about osteoporosis. The third chapter summarizesthe prevention of osteoporosis and in the fourth chapter describes the treatment of osteoporosis. In the practical part of thesis was used method quantitative research. The target group consisted of 100 adolescent girls in the age range of 15-17 years of grammar school and vocational school in the České Budějovice. The girls were interviewed using a questionnaire, which consisted of questions related to osteoporosis. In thesis were determined two main objectives. The first of them was to map the knowledge of adolescent girls in the prevention of osteoporosis. The second objective is concerned with mapping the behavior of adolescent girls in the prevention of osteoporosis. The first research question dealt with by what kind of knowledge adolescent girls in the prevention of osteoporosis. The second research question was focused on the behavior of adolescent girls in the prevention of osteoporosis. According to the questionnaires can be concluded that the majority of respondents are not sufficiently informed about osteoporosis, but I find girls that basic information about the disease they have. Questionnaires filled in by teenage girls from the first and second years of grammer school and vocational school, therefore, the results are compared with one another. The survey shows that respondents from vocational school awareness of osteoporosis do not. Girls from grammer school have heard about this disease, but they can´t define it. The reason for this ignorance is that girls (from grammer school and from vocational school) have never been informed about osteoporosis. This fact mention the majority of the respondent girls. In most cases in the families of the respondents there is not osteoporosis or the girls do not know. On the following questions in the questioannarire girl (from both schools) have marked mostly option "not know". It were a questions whether sex hormones protects to some extent against osteoporosis. Furthermore, for which persons osteoporosis frequently occurs, whether the osteoporosis relate with calcium and vitamin D, or not. Schoolgirl from grammer school and vocational school mostly said that they consume milk and milk products several times a day or once a day. Of the 100 respondents sonly 18 girls said that do not drink alcohol. A total of 55 female students do not smoke and 23 female students smoke. The number of girl who smoke from vocational school is more than number of girls from grammer school. Schoolgirls of grammer school correctly think that physical activity can affect osteoporosis, the respondents of vocational school hold a different opinion. All of the girls regularly do sports, except for the two girls who do not purposefully movement. Based on the information from the questionnaire it would be appropriate that the teenager girls should be more informed about osteoporosis. There are several variations, such as educational material prepared for teenage girls or classes in school or self studying. Very important is the prevention of osteoporosis. The important role have a adequate nutrition and physical activity. Therefore, it is necessary to increase the knowledge of adolescent girls about the disease, so they can avoid.
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The role of a nurse in prevention of injuries with women patients with osteoporosis aiming at women in menopause
ŽAMBOCHOVÁ, Pavla
Injury rate among seniors has been increasing rapidly in the Czech Republic recently. Women in menopause with osteoporosis diagnosed form a large group. These are so called low-energy injuries, which are closely linked to increased mortality among old people. This issue is not only related to healthcare, but also to social and economic spheres. Proper education in prevention of injury occurrence in women with this diagnosis is one of the key means leading to reduction of the number of osteoporotic fractures. The Code of Ethics of the International Council of Nurses points out the obligation of a nurse to take responsibility in prevention sphere. The theoretical part of the thesis deals with characteristics of the menopause period, development of osteoporosis, the most frequent osteoporosis related injuries prevention, and an outline of social and economic impact of the injury rate. The practical part deals with a research performed on patients of the orthopaedic outpatient department of the Tábor Hospital. Six women with diagnosed osteoporosis in menopause were chosen. The main goal of the work was to find out what role a nurse from an orthopaedic outpatient department plays in prevention of injuries in women with osteoporosis, whether patients are aware of injury prevention possibilities, which form of provision of such information is best appreciated by the patients and whether the patients apply their knowledge of prevention to practice. A qualitative research in the form of non-standardized interview with open questions prepared in advance was performed. The interviews were conducted individually with each patient. A framework analysis based on the results from the interviews was performed and category groups formed. Processing of the results revealed that the information on prevention of injury in osteoporosis provided to the patients by the orthopaedic outpatient department was poor. Nurses are involved in this prevention activity just marginally or not at all. Complex identification of the problem might be the topic of further research. It might be necessary to find out whether insufficient time, poor knowledge of the problem or indifferent attitude to the problem is the reason. On the other hand only some of the patients apply their obtained knowledge to practice. We can however conclude from the interviews that provision of general information on prevention and the risks of injuries might inspire women to modification of their present way of life. Organization of group lectures with the possibility to obtain printed complex data of this society-wide problem seems to be a suitable form of providing information.
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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.
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Kinesiotherapy in patiens with osteoporosis
BRAŠNIČKOVÁ, Jana
Abstract The theme of this bachelor's thesis is kinesiotherapy in patients with osteoporosis. Osteoporosis is the disease of metabolism which causes the density of bone mass, the bone becomes less firm and tough. This disease can be asymptomatic in the long term, but it causes many physical and mental problems later, which markedly get worse the quality of life. The first symptoms of osteoporosis are chronic backaches and fractures caused by minimal strain. These pains often raise feelings of depression, anxiety and fear. The preconditions of origin of osteoporosis are genetic but they are formed also from the early childhood, that's why it is very important to follow healthy lifestyle which includes sufficient calcium and vitamine D intake, activity, proper diet and avoiding toxic influences from the birth. Kinesiotherapy is one of the most important ways of preventive and medical care of patients who are endangered by osteoporosis or suffer by this disease. It is aimed at the improvement of motoric stereotypes, muscular strenght, mobility, coordination and activation of deep stabilizing system. It teaches proper breathing, lying, sitting, standing, lifting and carrying loads, forward bend and relaxation. World Health Organization considers this disease as one of the biggest health problems of mankind. Therefore I think it is important to pay attention to these issues. The first part of this bachelor's thesis is aimed at theoretic knowledge, divided into general and special part. The general part includes knowledge about structure and function of a bone, defines osteoporosis, deals with its classification, its clinical symptoms, its diagnosing and risk factors. Next there are described the possibilities of therapy, preventive measures and the impact of osteoporosis. In the special part there is introduced the definition of kinesiotherapy, its medical effect and general principles which is important to follow during kinesiotherapy procedure. It deals with possibilities of kinesiotherapy according to clinical phases and then describes particular kineziotherapy methods suitable for patients with osteoporosis. The aim of a theoretical part was to outline the possibilities of kinesiotherapy of patient with osteoporosis. The second part of this thesis is my research. For this part was chosen the method of qualitative research. It was done as case history including anamnestic data, initial and final kinesiological analysis, the progress of therapy, conclusion and long-term rehabilitation plan. The data were collected during the interviews with patients, by observing of them, sampling of anamnesis, kinesiological screening and the analysis of data from medical documentation. The research set was formed by two patients diagnosed with osteoporosis. The research was carried out in rehabilitation ward Poliklinika Jih in České Budějovice during four weeks. Exercising took place twice a week for 20-30 minutes. Soft tissue techniques, mobilisations, post isometric relaxation, stretching, fitness, breathing and relaxation exercising, elements training of the back, exercising with a big ball, proprioceptive neuromuscular facilitation, sensomotoric stimulation and the activation of deep stabilizing system. The aim of the research was to compile and realize the most effective kinesiotherapy procedures for chosen patients diagnosed with osteoporosis. The results show that the chosen kinesiotherapy methods influenced positively the condition of both patients. It is evident that their backache and posture are much better. They evaluate the therapy as positive and useful for their health. From the kinesiologic point of view it is evident the improvement in breathing stereotype, posture and reduction of some asymmetry and muscular unbalance which negatively influenced physical and mental aspects of patients.
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