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The case study of a physiotherapeutic treatment of a patient with stroke and total hip arthroplasty
Čechová, Alena ; Pavlů, Dagmar (advisor) ; Hankovcová, Eva (referee)
Title: The case study of a physiotherapeutic treatment of a patient with stroke and total hip arthroplasty. Aim: The aim of this thesis is to analysis a theoretical knowledge about stroke and total hip arthroplasty and elaboration of physiotherapy treatment schedule in the form of an patient with these two diagnosis case study. Methods: This bachelor thesis elaborate stroke and total hip arthroplasty for femoral neck fracture. The thesis is divided into two parts - general and special. I deal with patient's diagnosis in general part of thesis. I describe ethiopatogenesis of stroke, ischemia in carotid artery in detail and I deal with chronic stroke rehabilitation. Further I elaborate anatomy and kinesiology of hip joint, femoral neck fracture and its treatment. In the end I combine these two diagnosis because femoral neck fracture is common complication of a stroke. Special part include case study of a patient with ischemic stroke and total hip arthroplasty. The physiotherapy treatment is described here in detail, also input and output kinesiology analysis, short - term and long - term therapy plan and evaluation of therapy effect are here. The case study was processed during my internship in the Military University Hospital in Prague at the Department of Physical Medicine and Rehabilitation in the...
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The case study of a physiotherapeutic treatment of a patient with stroke and total hip arthroplasty
Čechová, Alena ; Pavlů, Dagmar (advisor) ; Hankovcová, Eva (referee)
Title: The case study of a physiotherapeutic treatment of a patient with stroke and total hip arthroplasty. Aim: The aim of this thesis is to analysis a theoretical knowledge about stroke and total hip arthroplasty and elaboration of physiotherapy treatment schedule in the form of an patient with these two diagnosis case study. Methods: This bachelor thesis elaborate stroke and total hip arthroplasty for femoral neck fracture. The thesis is divided into two parts - general and special. I deal with patient's diagnosis in general part of thesis. I describe ethiopatogenesis of stroke, ischemia in carotid artery in detail and I deal with chronic stroke rehabilitation. Further I elaborate anatomy and kinesiology of hip joint, femoral neck fracture and its treatment. In the end I combine these two diagnosis because femoral neck fracture is common complication of a stroke. Special part include case study of a patient with ischemic stroke and total hip arthroplasty. The physiotherapy treatment is described here in detail, also input and output kinesiology analysis, short - term and long - term therapy plan and evaluation of therapy effect are here. The case study was processed during my internship in the Military University Hospital in Prague at the Department of Physical Medicine and Rehabilitation in the...
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Case study of physiotherapy treatment of a patient diagnosed with femoral neck fracture treated with DHS
Sárazová, Daniela ; Novotná, Irena (advisor) ; Veselá, Irma (referee)
Title: Case study of physiotherapy treatment of a patient diagnosed with femoral neck fracture treated with DHS. Objectives: The aim of this thesis is a summary of theoretical knowledge of femoral neck fractures and a case study of physiotherapy treatment of a patient, who suffered this fracture and underwent an osteosynthesis with DHS. Methods: This thesis is divided into two parts. The first, general part is based on the research of professional literature. It describes the anatomy and kinesiology of hip joint, trauma of the proximal femur area, especially femoral neck fractures, options of their treatment and recommended physiotherapy approaches and methods. The second, specialized part covers the case study of physiotherapy treatment of a patient diagnosed with femoral neck fracture, which was treated with DHS osteosynthesis. The case study includes the physiotherapy assessment of the patient before and after the treatment, process of the physiotherapy treatment and evaluation of the treatment effect based on the assessments. Results: The result of the physiotherapy treatment was general improvement of patient's condition. The most apparent changes were muscle strength improvement, range of motion improvement, better condition of soft tissues, better gait skills and regained independence of the...
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Nursing Care for seniors after hip joint fracture at after care Unit
JORDÁKOVÁ, Jitka
A femoral neck fracture is the most frequent injury among seniors. The solution is very demanding because of the senior polymorbidity. The treatment depends on the patient's overall condition whether the surgical or the conservative approach is applied. The aim of the work was to examine the specifics of the nursing care for a patient with a femoral neck fracture at a subsequent care department, further possibilities of subsequent care after the release from the subsequent care department and the quality of cooperation with the patient's family at the subsequent care department. Four research questions were set to achieve the goals. What specific activities do nurses apply to the nursing care for a patient with femoral neck fracture at a subsequent care department? What are the risks for a senior patient with femoral neck fracture? What are the possibilities of the further care for a patient after the release from the subsequent care department? What are the important areas of the cooperation with the family of a patient with the femoral neck fracture? Qualitative research was applied to the bachelor thesis preparation and the data collection was performed by means of semi structured interviews with nurses from the subsequent care department. The research results have shown that the nursing care for patients after the femoral neck fracture requires individual adaptation to each patient according to his/her condition, with the focus on the complex care, the risks or possible complications. It was also found out that the further possibilities of the care after patient release are dealt with by a social worker, who helps the patient's family find a social facility for the patient or provides information on possible home care. It was also found out that the cooperation with the patient's family is an individual matter and depends on the family relations. A multidisciplinary seminar focused on the issue of the nursing care for patients after the femoral neck fracture (Annex 1) is the output of the bachelor thesis.
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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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Physiotherapy in patients with Femoral neck fractures
PRINCOVÁ, Pavlína
This bachelor thesis focuses on physiotherapy for patients with fracture of the femur bone in the neck of the femur. The femur is the strongest and longest bone in the human body, securing the stability of the latter. A femoral neck fracture is a fracture in the narrowest place of the bone, where the long femur bone goes over to the head of femur, connecting the femur bone with the acetabulum. Considering the influence of high energetic effects on the bone, the most often during sports or accidents, fractures might occur with younger individuals. However, the fractures are more frequent with older individuals: especially women are more prone to these, in context with influence of postmenopausal osteoporosis. In the Czech Republic, according to statistics, approximately 10.000 individuals per year suffer from this injury, with a clear predominance of women. For 20% of all Czech women aged 60-65 years, there is a strong probability of falling at least once a year. With women aged 80-84 years, this probability increases to one third (Trča, Kudrna, Hořejší, 2008). The theoretical part of this work describes the anatomy of the femur and the pelvic bone building up a hip joint. Further on, biomechanics of the hip joint, including etiology, classification and diagnosis of the femur together with the possibility of operative or conservative medical treatment, are considered. The practical part is based on qualitative research, using observation and interviews. Out of observation methods, the following were chosen: aspection, palpation, goniometrical and anthropometrical examination, examination of walking, muscle shortening and muscle strength that are observed at the beginning, during and at the end of the therapy. Patients of Traumatologic Department of the Hospital of Ceske Budejovice a.s. were chosen for this research.Two groups of patients are being observed: The first group consists of a man treated in conservative way and a woman with 1.5 year old femur fracture, originally treated by osteosythesis, indicated for total endoprosthesis out of a reason of a necrosis. These both patients were being observed for 6 weeks. The second group - a woman treated by osteosynthesis ? proximal femoral nail and a man with total endoprosthesis - were being observed for 8 days of therapy treatment in an early stage after the surgical intervention. Prior to starting the therapy, all patients were informed about the methods and targets of the therapy.The aim of the work is to map physiotherapeutic methods used for treatment of patients after femoral neck fracture, including a short term and a long term plan. The short term plan is especially focused on retreat of swelling and pain, restoring the muscular strength and movement and on training of walking with two crutches. The long term plan goal is approaching the same quality of life preceding the injury, especially by securing a better stability as prevention of falling down.All studied patients show a relatively quick improvement of the swelling and of the pain, especially these patients treated operatively. Verticalization of the patient is another important element, which is allowed by the classical treatment not earlier than after six weeks being confined to bed. Compared with this method, the operative method is more advantageous, allowing an earlier descend of the bed, helping avoiding such complications as thromboembolic disease, pneumonia or forming decubitus.The main objective of this bachelor thesis is not to evaluate a better and more efficient treatment method for the corresponding case - the sample of patients being not representative enough for such a purpose, but to remind and sum up the different used methods and means of physiotherapy.
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