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Proprioception disorder as a physiotheraphy complication
 MAŠÁT, Pavel
This thesis deals with the disorder of proprioception in diabetics with an amputated lower extremity and factors influencing subsequent physiotherapy. The main goal of this thesis was to bring this problem closer and design a therapeutic procedure in order to improve the patient´s postural and locomotion functions. The incidence of diabetes mellitus illness is rising violently and lower extremity amputations mean its worst complication. In the theoretical part I have first defined the term of proprioception and characterized the important proprioreceptors. I have approached the basic mechanisms of the transfer of the inner and outer stimuli into the CNS. An important part of the theory is also presented by the section devoted to proprioception disorders and their examination. Further on I have focused on the description of diabetes mellitus and the complications that are connected to it. Most problems linked to diabetes influence the proprioception negatively. In the last section of the theoretical part I focus on amputations where I also mention their consequences on the ability to receive proprioceptive information. All these parts gather information about the causes of proprioception disorders which subsequently complicate physiotherapy significantly. The practical part was processed through a qualitative research. The research includes the probands´ elaborated case studies containing individual anamneses, examinations and conducted therapeutic units. An important part is made up by the input and output kineziologic analyses. In the practical part I have tried to apply the obtained theoretical knowledge into excercise units. I have carried out the research for my practical part in the Technical Orthopedics Center in České Budějovice. I have chosen 4 probands of both sexes between the ages of 60 to 65 to carry out my research. All participants had femural amputation. Two probands were suffering from diabetes with a proven diabetic neuropathy. Other two were diagnosed with diabetes without diabetic neuropathy, therefore their proprioception was violated only through the extremity loss. All participants were equipped with the first prosthetics with similar structural components. Therapy took place individually, for a time period of five weeks. Excercise units took place twice a week for 60 minutes. They included excercises according to the individual needs of the probands. The main goal of the therapy was a practice of stable stand and coordinated walk. I carried out the research evaluation on the basis of the input and output examination. I compared the individual results of probands suffering from diabetic neuropathy and those not suffering from this illness. Through the carried-out research I wanted to point to the fact that even diabetics with a femural amputation in the lower extremity may reach a high quality of lifestyle through a well-designed rehabilitation care. That is why this thesis may serve not only as educational material for sanitary staff but also for the amputated themselves.
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3 Mašát, Petr
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