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The effect of Pilates on stability and walking parameters in patients with multiple sclerosis.
Gabrielová, Anna ; Novotná, Klára (advisor) ; Kövári, Martina (referee)
The thesis investigates problems of walking and balance disorders in patients with multiple sclerosis and the effect of group Pilates lessons. The theoretical part provides an overview of the current knowledge about the disease - etiology, pathogenesis, diagnostics, types and symptoms of multiple sclerosis (MS) and the possibilities of therapy. The Pilates method, its history and principles of exercise are described. The aim of the practical part was to evaluate the effect of the Pilates program on walking and balance in MS patients. The group included 32 patients, 21 in the experimental group and 11 in the control group. The experimental group participated on the 10 - week Pilates program. Standardized gait and balance functional test were used for objective assessment; patient outcome measurements were used for subjective evaluation of exercise effect. More detailed gait parameters were obtained using the GAITRite instrument. Measurements were performed before and after therapy. Significant change - improvement (p < 0.05) was observed in some values of balance parameters, walking parameters and even in some subjective questionnaires. Therefore, we suggest, that group exercise lessons supervised by experienced instructor may be beneficial exercise therapy for people with MS and mild disability....
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Influence of electrical stimulation according to Jantsch on spastic paresis of wrist and fingers flexors in patients after stroke
Bushuyeva, Violeta ; Kövári, Martina (advisor) ; Demeková, Júlia (referee)
This thesis aims to evaluate the immediate effects of the electrostimulation according to Jantsch on spastic paresis of the wrist and finger flexors caused by a stroke. In the theoretic part is a short recherche of a modern findings about the stroke, the spastic paresis and a physical therapy in treatment of spasticity with close-up to an electrotherapy with antispastic effect. The practical part consist of one case report of a patient at whom was during hospitalisation applied the electrostimulation according to Jantsch each weekday - in total 8 times. The patient was examined before and immediately after the electrostimulation. An assessment originates in Five-step clinical assessment in spastic paresis by Gracies. Due to fast and quality examination of spasticity out of the original assessment by Gracies have been chosen theses parameters: the slow passive (Xv1) and active (XA) range of motion and the fast passive range of motion, in another name angle of catch (Xv3). The angle of spasticity (Xv1-Xv3) and the coefficient of spasticity ((Xv1-Xv3)/Xv1) was calculated subsequently. The gathered data imply that the electrostimulation according to Jantsch has an immediate effect on decreasing spasticity of the wrist and finger flexors. The effect on the active range of motion was measured after the...
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Effect of home-based resistance training on balance and gait performance in patients with multiple sclerosis
Štefánek, Adam ; Novotná, Klára (advisor) ; Kövári, Martina (referee)
Title: Effect of home-based resistance training on balance and gait performance in patients with multiple sclerosis. Objective: The aim of the first part of this diploma thesis is to introduce the newest and the most important knowledge about multiple sclerosis. This part also deals with the evaluation of the connection between resistance training and gait in patients with multiple sclerosis. The aim of the experimental part is to verify these findings, particularly the hypothesis whether regular home-based resistance training has influence on gait characteristics and postural stability in patients. Methods: The studied sample included 15 patients - 11 patients in the experimental group and 4 patients in the control group. Patients in the experimental group were educated about home- based resistance training that took place 3 times per week during 12-weeks long period. Patients in the control group perserved their usual training program. Gait characteristics were objectively measured using GAITRite system. Registered physical performance measures include gait speed and cadence, step length and duration. Another objective evaluation metthods included TUG (Timed Up and Go), FRT (Functional Reach Test) and LRT (Latreal Reach Test). Questionnaires were used to assess subjective perception of the gait,...
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Utilizing of electrical stimulation for decreasing of spasticity in stroke patient
Ustinova, Darya ; Demeková, Júlia (advisor) ; Kövári, Martina (referee)
1 Abstract Electrical stimulation by coupled impulses according to Hufschmidt was created with the primary goal of reducing spasticity. However, there are currently few studies that confirm or refute the effect of this type of electrical stimulation in reducing spasticity. The aim of this diploma thesis was to determine the effect of electrostimulation according to Hufschmidt on the reduction of biceps brachii spasticity in patients after stroke. In addition, the effect of electrical stimulation on increasing the active range of movement of the antagonist of the examined muscle and on the active function of the spastic limb was investigated. For these purposes, a non-randomized controlled pilot study was created, which involved a total of 16 probands, 8 - in the therapeutic group, 8 - in the control group. Five-step clinical assessment in spastic paresis according to Gracies were used for the examination. In the therapeutic group, electrostimulation took place 3 times a week, a total of 8 times. The intragroup difference was evaluated using the Friedman and Wilcoxon paired tests, the intergroup difference was subsequently evaluated using the Mann-Whitney U test. The significance level p = 0.05 applies to all tests. The measured values show that Hufschmidt's electrical stimulation has a positive effect on...
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The effect of prolonged stretching on spastic muscle contracture before and after Botulinum toxin A application
Miňová, Zuzana ; Hojková, Klára (advisor) ; Kövári, Martina (referee)
A large proportion of patients with central motoneuron lesions is at risk of spastic paresis and formation of contractures. One of the therapeutic techniques used in patients with spastic paresis is prolonged stretching. The theoretical part summarizes the knowledge regarding spastic paresis, its clinical evaluation, the development of contractures and therapeutic interventions, especially botulinum toxin (BTX) and stretching. The aim of this study was to compare the effectiveness of prolonged stretching on spastic muscle contracture before and after BTX application. In our retrospective comparative study there were included 30 patients divided into two groups. The first group consisted of 15 patients performing prolonged stretching of the m. rectus femoris (m. RF) for three months according to Guided Self-rehabilitation Contract of Professor J. M. Gracies. The second group (15 patients) performing the same procedure, but at the same time BTX was injected into the m. RF. We monitored the change in passive knee joint range of motion into flexion and the change in 10MWT time. Statistical evaluation showed that the difference in knee joint range of motion after three months of performing prolonged stretching was statistically insignificant (p=0.194). The difference in knee joint range of motion after...
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Balance training using biofeedback in people with multiple sclerosis
Sasínová, Jana ; Novotná, Klára (advisor) ; Kövári, Martina (referee)
The present thesis deals with the issue of balance disorders in patients with multiple sclerosis (MS) and the effect of individual balance training using biofeedback. It presents an overview of the current knowledge about MS - epidemiology, pathogenesis, diagnostics, types, symptoms and treatment methods. The thesis also describes principles of balance control of the human body, balance deficits in patients with MS and physiotherapeutic treatment. The aim of the experimental part was to evaluate the effect of the Homebalance® system on balance in MS patients and its comparison with conventionally used sensorimotor training. A total of 18 people took part in the research, 9 in the experimental group and 9 in the control group. Standardized tests and functional scales supplemented by standardized questionnaires on balance and gait were used to objectively assess balance. Measurements were performed before and after a series of therapies. After treatment, a significant improvement (p 0,05) was found in some tests and functional scales, but in none of subjective patient reported outcomes. Exercise using the Homebalance® system may be a suitable alternative to classical rehabilitation methods used for balance training in people with MS. Keywords Multiple sclerosis, balance impairment, Homebalance®,...
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The effect of Pilates on stability and walking parameters in patients with multiple sclerosis.
Gabrielová, Anna ; Novotná, Klára (advisor) ; Kövári, Martina (referee)
The thesis investigates problems of walking and balance disorders in patients with multiple sclerosis and the effect of group Pilates lessons. The theoretical part provides an overview of the current knowledge about the disease - etiology, pathogenesis, diagnostics, types and symptoms of multiple sclerosis (MS) and the possibilities of therapy. The Pilates method, its history and principles of exercise are described. The aim of the practical part was to evaluate the effect of the Pilates program on walking and balance in MS patients. The group included 32 patients, 21 in the experimental group and 11 in the control group. The experimental group participated on the 10 - week Pilates program. Standardized gait and balance functional test were used for objective assessment; patient outcome measurements were used for subjective evaluation of exercise effect. More detailed gait parameters were obtained using the GAITRite instrument. Measurements were performed before and after therapy. Significant change - improvement (p < 0.05) was observed in some values of balance parameters, walking parameters and even in some subjective questionnaires. Therefore, we suggest, that group exercise lessons supervised by experienced instructor may be beneficial exercise therapy for people with MS and mild disability....
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Influence of spasticity in patients with multiple sclerosis using method of electrical stimulation according to Jantsch
Pokorná, Anna ; Kövári, Martina (advisor) ; Kříž, Jiří (referee)
The electrical stimulation (ES) according to Jantsch was created with a primary aim to reduce spasticity, however its impact has been neither proved nor disproved by any study. Therefore, the aim of the thesis is to find out if this type of the ES can reduce spasticity of m. triceps surae within the patients with multiple sclerosis (MS). Apart from the spasticity, there was as well observed the influence of the ES on an active movement performed by the antagonists of spastic muscle and the walking speed. Fifteen probands participated in our pilot controlled non- randomized study, probands were divided into two groups - first with the application of the ES (STIM) and second without the application of the ES (NOSTIM) during the hospitalization. We used the concept of Jean-Michel Graciese - Five-step clinical assessment in spastic paresis during the examination process. From this protocol, we choose Tardieu scale to measure spasticity, examination to measure active range of motion and 10MWT. Furthermore, TUG was added. The measurements took place on the 1st, 4th and 8th day of the hospitalization. The intragroup difference was evaluated by the ANOVA for repetitive measures with Fisher's post- hoc test and the level of importance p=0.05. From acquired data it follows that the ES according to Jantsch...
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