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Application of physiotherapy in treating myasthenia gravis
Ondráčková, Radka ; Smolíková, Libuše (advisor) ; Zounková, Irena (referee)
Myasthenia gravis is an autoimmune disease affecting the neuromuscular transmission. It manifests in muscular weakness and tiredness, which characteristically fluctuate and change throughout the time. The most typically affected muscles are extraocular, mimic, oropharyngeal and the muscles of lower and upper extremities. An examination of affected groups of muscles and preserving the function of respiratory muscles are essential. The danger of respiratory difficulties is aggravated by worsening physical condition, which comes as a consequence of muscular weakness and with the onset of the myasthenic crisis. This paper is aimed at using physiotherapy in treating a myasthenic patient. Considering the patient's condition, a respiratory physiotherapy, orofacial stimulation and kinesiotape may be used in therapy of these patients. The case study mentions also sensorimotor stimulation and nordic walking to improve physical fitness. The aim of the therapy is timely prevention of potential complications and their solving. The paper contains a case study of a myasthenic patient.
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Thymectomy and immune mechanisms in patients with myasthenia gravis
Jakubíková, Michala ; Nevšímalová, Soňa (advisor) ; Bojar, Martin (referee) ; Špalek, Peter (referee)
Myasthenia Gravis (MG) is an autoimmune disease affecting neuromuscular transmission, in which the thymus is considered pathogenic organ. Earlier ideas suggesting that MG is only the receptors disease have been proven wrong. There are immunopathological changes in both target structures [specific receptors for acetylcholine (AChR] muscle-specific tyrosine kinase (MuSK) and low-density lipoprotein 4 (Lrp4)], the thymus, as well as in peripheral lymphoid organs. Initial findings of the humoral immunity defect with the decisive role of the pathologic autoantibodies, were corrected with findings of the immune dysregulation at the level of T lymphocytes. According to today's knowledge, the development and maintenance of MG involves almost all cell types of immune function in the autoimmune inflammation: helper CD4+ T lymphocytes, cytotoxic CD8+ T lymphocytes, regulatory CD4+CD25+ T lymphocytes, Th17 lymphocytes, B lymphocytes and plasma cells. Thymus plays a dominant immunopathogenetic role in younger patients with MG, while extrathymic mechanisms are applied in older patients. As a result of that, the thymectomy (TE) is generally accepted as part of treatment for MG. However, there is still no data verified by a prospective controlled study, which would demonstrate a useful result of this treatment...
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Nursing care of patients with myasthenia gravis.
HŮLOVÁ, Jiřina
The bachelor thesis deals with the issue of nursing care for a patient with myasthenia gravis. The goal of this thesis is to map the nursing care for a patient with myasthenia gravis. Two research questions were formulated, which identified the specifics of nursing care for a patient with myasthenia gravis in a standard department and the specifics of nursing care for these patients on an artificial lung ventilator. In the theoretical part, there the characteristics of the disease, clinical picture of the disease, the disease progression, including the occurrence of myasthenic crisis is given. Nursing care for a patient with myasthenia gravis is described in more detail. The empirical part contains a description of realized qualitative research. The research technique was semi-structured interview, data were analyzed using the open coding method, paper-pencil technique. The interview contained 31 questions divided into four main parts, focusing on nurses' knowledge of myasthenia gravis disease, specifics of nursing care for a patient with myasthenia gravis, risks and regimen measures in a patient with myasthenia gravis and patient education, including cooperation with family. In the case of nurses from acute care beds (ARO / ICU), the interview was extended by the fifth area mapping the specifics of care for a patient with myasthenia gravis in the acute department. The research group consisted of ten nurses, four of whom work in the ICU or ARO departments. Then, 5 categories were created by analyzing the interviews, some of which are subdivided into sub-categories. The presentation of the results is presented using these categories; if relevant, direct statements of informants are presented, specifying the specifics of nursing care for patients with myasthenia gravis in standard departments or departments of ARO / ICU. The findings show that considering this topic there is the need to pay attention to bedsores, hygiene, catering, and very important is education of patients and their relatives. Nursing care at the standard departments and departments of ARO / ICU varies, the difference can primarily be seen in the emphasis on acute care departments in the respiratory tract, prevention of pressure ulcers that can also occur in the airways, prevention of nosocomial infections. At the ARO / ICU, nurses must also be more prepared for the sudden deterioration in the patient's condition, which is followed by subsequent nursing care, there an endotracheal tube, or a tracheostomy cannula is used. Following the findings, it is also advisable to recommend health care providers to develop a nursing standard for a patient with myasthenia that is not available in any of the standard departments where the research was conducted. The contribution of the bachelor thesis can be seen in depicting the complexity of nursing care for patients with myasthenia gravis, including an indication of areas to which nurses must pay increased attention, pointing out the differences in the provision of nursing care for patients with myasthenia gravis in standard and ARO / ICU departments. The results of the thesis can be used by nurses who take care of these patients, but above all they can be a guide for nurses who do not yet have experience with these patients. These findings can be used by these nurses when they are forced to provide nursing care to these patients.
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Myasthenia gravis from the perspective of a nurse.
FEJERČÁKOVÁ, Monika
Bachelor thesis deals with the issue of autoimmune disease Myasthenia gravis. It focuses mainly on nursing care from a nurse'spoint of view. Thesis describes diseases, clinical symptoms of Myasthenia gravis, prognosis, treatment and nursing process in patients with Myasthenia gravis. A very important part of my work is the look and role of the nurse. The aim of the work was to find out the nurses' view of Myasthenia gravis. For qualitative survey was chosen using the semi-structured interview method. The research group was made up of nurses from neurological departments of selected hospitals. The method chosen was interrogation and deep interviewing, in the presence of one interviewer per participant. The analysis of the acquired data was carried out using the hand coding method. The results of the bachelor thesis confirmed the necessity of organizing seminars and lectures on Myasthenia gravis, because the interviewed nurses did not have specialized information about the disease. We also recommend that a standard of nursing care for patients with Myasthenia gravis is developed at each department of neurology. A very important part is also the education of patients. Benefits of thesis results in improving nursing care for patients with Myasthenia gravis, based on organized seminars, education and development of standards in the Department of Neurology.
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The possibilities of physiotherapy in patients with Myasthenia gravis. Subtitle: Diagnostics and therapy
Vítková, Michaela ; Jeníček, Jakub (advisor) ; Konopáčová, Eva (referee)
Title of thesis: The possibilities of physiotherapy in patients with Myasthenia gravis. Diagnostics and therapy. Abstract: This bachelor thesis discusses the possibilities of physiotherapy in patients with the neurological disease, Myasthenia Gravis. A physical therapy can be an important part of the treatment in myasthenic patients. The theoretical part of the thesis includes all the important information about Myasthenia Gravis - clinical symptoms, pathogenesis, diagnostics, treatment and selected physiotherapeutic methods. The practical part contains the case study of two selected pacients. The goal of the practical part was to find out what physiotherapeutical methods are suitable for patients with Myasthenia gravis and if a regular physical activity contributes to good health. The therapy was divided into two parts where one part took two weeks. The standardized scores were used to compare the results before and after the therapy. These scores are described in the theoretical part of the thesis. The output examination confirmed an improvement in both cases. Key words: Myasthenia Gravis, physiotherapy, self-treatment, PNF, Kenny method, Bobath concept, respiratory physiotherapy, Brunkow method
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Thymectomy and immune mechanisms in patients with myasthenia gravis
Jakubíková, Michala ; Nevšímalová, Soňa (advisor) ; Bojar, Martin (referee) ; Špalek, Peter (referee)
Myasthenia Gravis (MG) is an autoimmune disease affecting neuromuscular transmission, in which the thymus is considered pathogenic organ. Earlier ideas suggesting that MG is only the receptors disease have been proven wrong. There are immunopathological changes in both target structures [specific receptors for acetylcholine (AChR] muscle-specific tyrosine kinase (MuSK) and low-density lipoprotein 4 (Lrp4)], the thymus, as well as in peripheral lymphoid organs. Initial findings of the humoral immunity defect with the decisive role of the pathologic autoantibodies, were corrected with findings of the immune dysregulation at the level of T lymphocytes. According to today's knowledge, the development and maintenance of MG involves almost all cell types of immune function in the autoimmune inflammation: helper CD4+ T lymphocytes, cytotoxic CD8+ T lymphocytes, regulatory CD4+CD25+ T lymphocytes, Th17 lymphocytes, B lymphocytes and plasma cells. Thymus plays a dominant immunopathogenetic role in younger patients with MG, while extrathymic mechanisms are applied in older patients. As a result of that, the thymectomy (TE) is generally accepted as part of treatment for MG. However, there is still no data verified by a prospective controlled study, which would demonstrate a useful result of this treatment...
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Application of physiotherapy in treating myasthenia gravis
Ondráčková, Radka ; Smolíková, Libuše (advisor) ; Zounková, Irena (referee)
Bibliographic record ONDRÁČKOVÁ, Radka. Application of physiotherapy in treating myasthenia gravis. Prague: Charles University, 2nd Faculty of Medicine, Department of Rehabilitation and Sports Medicine, 2015, p. 90, Supervisor of the work: Doc. PaedDr. Libuše Smolíková, Ph.D. Abstract Myasthenia gravis is an autoimmune disease affecting the neuromuscular transmission. It manifests in muscular weakness and tiredness, which characteristically fluctuate and change throughout the time. The most typically affected muscles are extraocular, mimic, oropharyngeal and the muscles of lower and upper extremities. The danger of respiratory difficulties is aggravated by worsening physical condition, which comes as a consequence of muscular weakness and with the onset of the myasthenic crisis. The work is focused on the use of respiratory physiotherapy and aerobic physical activity in patients with myasthenia gravis. The aim is to verify the effect of respiratory physiotherapy and aerobic physical activity to improve lung function and condition, and the disease stabilization. Keywords Myasthenia gravis, neuromuscular disease, physiotherapy, respiratory physiotherapy, aerobic training
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Application of physiotherapy in treating myasthenia gravis
Ondráčková, Radka ; Smolíková, Libuše (advisor) ; Zounková, Irena (referee)
Myasthenia gravis is an autoimmune disease affecting the neuromuscular transmission. It manifests in muscular weakness and tiredness, which characteristically fluctuate and change throughout the time. The most typically affected muscles are extraocular, mimic, oropharyngeal and the muscles of lower and upper extremities. An examination of affected groups of muscles and preserving the function of respiratory muscles are essential. The danger of respiratory difficulties is aggravated by worsening physical condition, which comes as a consequence of muscular weakness and with the onset of the myasthenic crisis. This paper is aimed at using physiotherapy in treating a myasthenic patient. Considering the patient's condition, a respiratory physiotherapy, orofacial stimulation and kinesiotape may be used in therapy of these patients. The case study mentions also sensorimotor stimulation and nordic walking to improve physical fitness. The aim of the therapy is timely prevention of potential complications and their solving. The paper contains a case study of a myasthenic patient.
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