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Musculoskeletal Ultrasound in Physical and Rehabilitation medicine: possibilities in the assessment of selected morphological changes of upper limb
Giannelli, Karolína ; Mezian, Kamal (advisor) ; Hrazdíra, Luboš (referee) ; Nedělka, Tomáš (referee)
This thesis deals with the issue of ultrasound diagnostics and ultrasound-guided interventional procedures in selected pathological changes of the upper limb. Ultrasound examination directly in specialists' offices, including rehabilitation physicians, has been a worldwide trend in the last two decades. The main advantages include the possibility of assessing the pathological findings directly related to the clinical examination. The benefit is speeding up the establishment of an accurate diagnosis and initiating adequate treatment. Indirectly, the costs associated with examination by other imaging techniques and therapy are reduced. This thesis aims to present diagnostic and therapeutic options for selected morphological changes in the upper limb, including less common pathologies, such as case reports of intramuscular haemangiomas, whose diagnosis was significantly contributed by ultrasound examination. In addition to diagnosis, ultrasound is used to navigate interventions, increasing the safety and effectiveness of these procedures. The research part of this thesis is focused on identifying the optimal site of median nerve injection in carpal tunnel syndrome. This study is a prospective, randomized, blinded study with 46 patients with carpal tunnel syndrome. We compared the effect of two...
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Conservative therapy of ulnar neuropathy at the elbow
Pavlů, Jiří ; Mezian, Kamal (advisor) ; Sládková, Petra (referee)
Title: Conservative therapy of ulnar neuropathy at the elbow Aims: The main goal of this work is to create a comprehensive visual educational material, the so-called patient brochure for patients with a diagnosis of neuropathy of the ulnar nerve in the elbow. The second goal is to present the application of Priessnitz wrap in the diagnosis of ulnar nerve neuropathy in two case reports. A partial goal of this work is to summarize the issues concerning the knowledge of neuropathy of the ulnar nerve in the elbow landscape and its conservative treatment in the form of theoretical research. Methods of work: The method of content analysis of literary sources was used to create the work, on the basis of which a theoretical search was created. Following this, patient brochures were created. The practical part of the work involved two patients with a diagnosis of neuropathy of the ulnar nerve in the elbow. Both patients were treated with an educational interview between the parties to the regime measures and instruction in the application of Priessnitz compress. In addition to the targeted specific examination, the patients were given a QuickDASH questionnaire to complete, and therefore the questioning method was used. Furthermore, the method of comparison was used in comparing the results of input and...
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Objectice evaluation of postural function of abdominal muscles and intra-abdominal pressure
Novák, Jakub ; Kobesová, Alena (advisor) ; Mezian, Kamal (referee) ; Janoušek, David (referee)
Objective evaluation of postural function of abdominal muscles and intra-abdominal pressure Abstract This dissertation deals with an important mechanism of trunk stabilization, the increase of intra-abdominal pressure. Intra-abdominal pressure is created by the coordinated contraction of the diaphragm, along with the abdominal and pelvic floor muscles. Intra-abdominal pressure works in all directions, stabilizing the trunk while reduceing axillary compression of the spine. Intra-abdominal pressure is increased during activities that require demands on the stabilization of the spine. Intra-abdominal pressure and trunk muscle activity can be measured in several different invasive and non-invasive ways. In rehabilitation medicine, anorectal or gastroesophageal probes are most often used to measure intra-abdominal pressure and measurements are often supplemented by evaluation of muscle activation using electromyography. However, these measurements are costly, time consuming and inconvenient for patients. The most common tool for evaluating trunk stabilization in rehabilitation practice is digital palpation of abdominal wall tension. However, this evaluation method is subjective. Therefore, new pressure sensors have been developed that allow non-invasive assessment of abdominal wall tensionand thus also the...
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Inter-rater Reliability of the Box and Block Test in People after Stroke
Markovcová, Lucie ; Rybářová, Kateřina (advisor) ; Mezian, Kamal (referee)
The name of the thesis: Interrater Reliability of the Box and Block Test in People after Stroke Introduction: Czech extended version of the Box and Block Test (BBT) manual has been developed recently, thus the reliability needed to be reestablished. The BBT is often used in occupational therapy. Aim: The main aim is to determine the interrater reliability of BBT administered according to this manual in people after stroke. A secondary objective is to determine the variability of BBT results measured by the same rater. The research question is to determine the percentage agreement between the two raters. Methodology: 20 people after stroke were tested using the BBT. A video was made of the attendance testing. This was independently scored by two raters, A and B, whose scores were correlated to determine interrater reliability. The percentage agreement of these values was also determined. Values measured by the same rater from the attendance testing and from the video were correlated to determine the variability of the results. Spearman's correlation coefficient (rs) was used for correlation. Results: The interrater reliability values of three BBT trials of dominant and nondominant upper extremity ranged from rs = .987 - .999 confirming a very high correlation. Exact agreement or agreement with a...
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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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Sonographic evaluation of the ischial nerve in individuals with radicular symptoms S1
Kurková, Simona ; Machač, Stanislav (advisor) ; Mezian, Kamal (referee)
Bibliographical record: KURKOVÁ, Simona. Sonographic evaluation of sciatic nerve in individuals with radicular symptoms S1, Charles University, 2nd Faculty of Medicine, Department of Rehabilitation and Sports Medicine, 2019, p. 99, Thesis Supervisor: Mgr. Stanislav Machač Ph.D. Abstract The thesis deals with radicular symptomatics S1 and sonographic imaging and evaluation of sciatic nerve in individuals with unilateral radicular manifestation. The theoretical part describes anatomy and biomechanics of nerve structures, radicular syndrome and its clinical image, diagnostics and treatment. The theory also includes the less known extraspinal causes manifesting themselves as radicular syndrome, the effects of which may be equally important in differential diagnosis. It describes classical and new possibilities of nerve imaging with emphasis on sonography and approach of new procedures such as MRI tractography. In the practical part, the aim of the thesis is to evaluate morphological changes of sciatic nerve in patients with unilateral symptomatic S1 by sonographic imaging of the nerve during its course, from the subgluteal groove to the popliteal groove. It also examines the relationship between the pathophysiology and symptomatology of these patients, comparing whether changes in nerve size correlate with...
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Musculoskeletal ultrasound. Possibilities of selected morphological changes evaluation in the lower extremity.
Mezian, Kamál ; Navrátil, Leoš (advisor) ; Dylevský, Ivan (referee) ; Otáhal, Jakub (referee)
1 Abstract The aim is to investigate whether the distal femoral cartilage (DFC), Achilles tendon (AT) and plantar fascia (PF) were different between healthy young women wearing high-heel shoes (HHS) (> 5 cm) and flat shoes (< 1.4 cm). Measurements from aforementioned structures were obtained by using ultrasound. There were 910 measurement parameters analyzed in total. There were 34 women in the HHS group (mean age 31.1±6.4 years; BMI 21.6 ± 2.3 kg/m2 ) and 57 women in the control group (mean age; 29.5 ± 7.3 years; BMI 22.5 ± 3.4 kg/m2 ). Wearing HHS resulted in thickening of the right medial DFC (2.00 ± 0.41 mm) and left AT (4.07 ± 0.48 mm) in women wearing HHS compared to flat shoes (1.96 ± 0.35 mm, 3.76 ± 0.66 mm, respectively). This might be interpreted as secondary to chronic overload. PF thicknesses were similar both within and between group. Our findings have shown significant thickening of the right medial DFC and left AT in women wearing HHS and these changes might be interpreted as secondary to chronic overload. Further follow-up studies are definitely awaited to provide a better insight into understanding the musculoskeletal consequences of this "social" issue ever-existing in ladies lives. The secondary aim of the thesis comprises two case reports: 1. the first is describing the usefulness of MSK...
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