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Physiotherapeutic procedures in patients with rheumatoid arthritis with maximum difficulties in the joints of the hand area
LEDVINOVÁ, Eva
This bachelor thesis is focused on physiotherapeutic methods used in patients with rheumatoid arthritis whose difficulties are mainly in the joints of their hand. Rheumatoid arthritis is a chronic inflammatory joint disease in most cases with a protracted course and it may cause joint deformations. These lead to handling issues which complicate normal daily activities of the patients. Thus this disease causes both physical disability of the patient and as well significantly disrupts their social and psychological life. In the first part, which is concerned with theory, I briefly outlined the functional anatomy and kinesiology of the upper limb and shoulder girdle. Furthermore there is a detailed description of rheumatoid arthritis, definition of the disease, its causes and occurrence, clinical features, laboratory and x-ray examination, differential and functional diagnosis and all the treatment possibilities. In the conclusion of theoretical part there is the prognosis of the disease and practical difficulties during the care of patients with rheumatoid arthritis. The aim of this thesis is to map the possibilities of physiotherapy in patients with rheumatoid arthritis and the use of physiotherapeutic procedures and methods in individual patients with this disease. The qualitative research method, in which three patients treated in Berta Spa in Třeboň participated, was used for the practical part of the thesis. The therapy was initiated by an entrance kinesiological analysis, including the specific examination such as the examination of joint-play in small joints of hands, examination of the gripping, palpation of muscle tonus in muscles of the upper limbs and goniometric examination of joints of the upper limbs. This was followed by nine individual therapies, during which we focused mainly on upper limb joints. At the last session an output kinesiological analysis was conducted and the patients were taught about the necessity to comply with regime measures. At the end they spoke about their subjective feelings connected with the therapy and with their Balneotherapy stay in the spa. The results of the treatment were recorded for each individual case. This bachelor thesis may serve as an educational material for students in medical fields, general public to increase awareness of rheumatoid arthritis and last but not least for patients themselves or their families.

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