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Instrumental dynamic investigation methods in rehabilitation medicine
Jačisko, Jakub ; Kobesová, Alena (advisor) ; Hrazdíra, Luboš (referee) ; Malá, Jitka (referee)
Introduction: The subject of this thesis were two dynamic diagnostic methods of the musculoskeletal system: dynamic ultrasound examination and instrumental objectification of postural functions (measurement of the pressure produced by abdominal). Methods and objectives: Based on literature review and consensus of international experts, the aim was to create comprehensive dynamic diagnostic protocols for joints that are currently not available in the literature. Another objective was to create research articles describing the most common interventions under ultrasound guidance and also original educational materials for beginners in musculoskeletal ultrasound. Another objective was to verify whether clinical tests of postural stability correlate with objectively measured pressure produced by abdominal wall in healthy subjects and then on subjects with low back pain. Another part of the study aimed to verify if there is a correlation between the pressure produced by abdominal wall and intrabdominal pressure measured by anorectal probe. The last part of the project compared the pressure produced by abdominal cavity in patients with low back pain before and after several weeks of physiotherapy. Results: Dynamic diagnostic protocols and educational materials in the form of video galleries were created....
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Correlation between evaluation of functional postural tests and ability to expand abdominal wall in low back pain population.
Krausová, Eliška ; Jačisko, Jakub (advisor) ; Kobesová, Alena (referee)
The theoretical part: The theoretical part of thesis shortly describes anatomy and kinesiology of lumbar spine. The second chapter contains the causes of LBP and alerts to red flags. Muscle stabilization system of spine and intraabdominal pressure are themes of other chapters. Techniques of intraabdominal pressure measurement and questionnaires of quality of life were described at the end of the theoretical part. Methodology: 36 patients (22 female, mean age = 41.86, 16 male, mean age = 40.07) with low back pain were evaluated in three positions. Every proband filled Oswestry Disability Index (ODI) before the examination. Trunk orthosis DNS Brace evaluated 8 seconds intraabdominal pressure in three tests - breathing stereotype test, diaphragm test and hip flexion test. DNS instructor evaluated the same three tests by aspection and palpation. The first half of the probands was evaluated first with DNS Brace, the second half of probands was evaluated first with DNS instructor. Results: A statistically significant correlation (r=0,479, p=0,003) between evaluations DNS Brace and DNS instructor was demonstrated in one out three DNS tests - diaphragm test. There was not a statistically significant correlation in the other two tests. There was not a statistically significant correlation between DNS Brace...
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The use of the OhmTrak device in self-treatment of patients with back pain
Tyburcová, Marie ; Kobesová, Alena (advisor) ; Jačisko, Jakub (referee)
Introduction: Impaired trunk stabilization is a frequent cause of chronic low back pain (CLBP). Trunk stabilization training can reduce back pain. Aim: To determine the effect of the OhmTrak (OT) trunk stabilization training device following Dynamic Neuromuscular Stabilization (DNS) principles in patients with CLBP. Methods: A single-blind randomized clinical trial. The investigator did not know to which group the participant belonged. 20 patients with CLBP were randomly divided into 2 groups. 10 patients included in the experimental group underwent six-week DNS training focusing on optimal trunk stabilization. The participants had a treatment session with a physiotherapist once a week. Experimental group patients were educated in self- treatment with the OT device which they performed for 15 minutes 5 times a week. The control group patients (n=10) underwent the same rehabilitation program of the same duration and frequency including the self-treatment. Control group participants performed self-treatment without the OT device. Before the start and at the end of the 6 weeks therapy program the ability to activate the abdominal wall was assessed using DNS Brace device in all participants from both groups. All patients from both groups completed the Oswestry Disability Index (ODI) questionnaire at...
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Ulnar nerve entrapment syndromes and their therapy
Kuneš, Lukáš ; Giannelli, Karolína (advisor) ; Jačisko, Jakub (referee)
The ulnar nerve is the second most commonly affected peripheral nerve after the median nerve by compression neuropathy. Nerve compression most often occurs in the cubital tunnel. Less often, the nerve is compressed by Struthers' arcade in the arm or in the Guyon's canal in the wrist. The research part of the thesis summarizes the findings of the anatomy, pathophysiology and etiology of ulnar nerve entrapment syndromes. The issue of risk factors is also discussed, including the influence of the work environment and sports activities. Diagnosis consists of a thorough clinical examination and electrodiagnostics in combination with the use of modern imaging methods, especially diagnostic ultrasound and magnetic resonance. Pharmacological, orthotic, and surgical treatment options are briefly described. More space is devoted to physiotherapeutic interventions, which includes the possibilities of kinesiotherapy and physical-therapeutic methods. The practical part presents case reports of three patients with compression of the ulnar nerve in various anatomical strains. Patients were clinically examined before therapy, 3 days after therapy, and during the follow up after 20 days from the end of therapy. All patients were improved subjectively and sensorimotoricaly during the study period. All achieved the...
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Side difference in morphology of the medial humeral epicondyle in context of the ulnar neuropathy of elbow.
Radvanská, Edita ; Mezian, Kamal (advisor) ; Jačisko, Jakub (referee)
The ulnar neuropathy of the elbow (UNE) is the second most common compression neuropathy in the upper extremity. The studies of impact of bone morphology on the origin of the ulnar neuropathy are inconsistent. According to the recently published retrospective analysis of 880 cases of the cubital tunnel syndrome, the incidence of the ulnar neuropathy is more often on the left side, independent of handedness. The theoretical part of this thesis contains a summary of recent literature with an emphasis on the etiology, basics of diagnostics, treatment and rehabilitation of the UNE. The experimental part is made of the measurement of ten parameters of humerus bones. The aim of this experiment was to decide whether some of these measures were different compared to the other side. There were statistically significant differences in 4 of 9 crucial parameters, where the right side was bigger than the left side, therefore we believe the influence of bone morphology on the origin of the UNE cannot be excluded. The results may help towards a better understanding of the etiopathogenesis of the origin of the UNE and therefore be a valuable starting point for other studies of prevention, diagnosis and therapy of the UNE.
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Correlation between clinical evaluation by functional postural tests and ability to activate abdominal wall measured by digital pressure sensors
Stříbrný, Martin ; Jačisko, Jakub (advisor) ; Kobesová, Alena (referee)
The theoretical part of the diploma thesis describes the role of abdominal muscles in intra-abdominal pressure and the effect on postural stabilization. The issue of postural stabilization was analyzed in a physiological situation and frequent pathologies related with inadequate postural stabilization have been described. The current possibilities of evaluating the activity of abdominal muscles and intra-abdominal pressure were presented. Methodology: 25 healthy probands (mean age 22.4 years, SD ± 1.76) were evaluated in five posturally different situations - breathing stereotype test, intra-abdominal pressure regulation test, diaphragm test, hip flexion test and arm elevation test. Testing was performed with a prototype of the DNS Brace digital pressure sensor. The resulting pressure values of the abdominal wall expansion were correlated with the corresponding postural tests according to the DNS concept, which were performed by two DNS instructors with more than five years of experience. Results: A statistically significant correlation (p = 0.001 to 0.24) between abdominal wall pressure values and palpation-evaluated postural tests was demonstrated in four of the five tested positions. Correlation was strong in diaphragm test (r = 0.75 and 0.661) and mean in other tests (r = 0.567 to 0.415). Only...
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