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The need for enteral nutrition in patients after a stroke
Špalková, Šárka ; Vágnerová, Tereza (advisor) ; Klempíř, Jiří (referee)
Introduction: The diploma thesis focuses on the issue of nutritional support for patients after a stroke. Aims: In the theoretical part, the characteristics of ischemic stroke (iCMP) and hemorrhagic stroke (hCMP) were described. Subsequently, risk factors and prevention of stroke were described. The last part of the theory dealt with nutrition and procedures for introducing different types of diets and enteral nutrition in patients after a stroke. The aim of the practical part was to monitor the procedure during the nutrition consultation in patients who have recently experienced one of the events (iCMP or hCMP). Methods: Data for the thesis were obtained at the Neurological Clinic of the 1st Faculty of Medicine of the Charles University and VFN in Prague from February to April 2023. Various nutritional support was retrospectively monitored in patients who experienced an ischemic stroke and a hemorrhagic stroke. The duration of hospitalization, height, weight, BMI, age and associated diseases were also determined for the patients. Data processing and statistical evaluation was done in Microsoft Excel. Results: The study compared different types of nutritional support in 51 patients who were hospitalized in one intensive care unit and three standard wards. Most patients (49%) were only prescribed a...
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Specifics of speech and language therapy intervention in adults after stroke
Králová, Tereza ; Horynová, Jana (advisor) ; Klenková, Jiřina (referee)
The thesis focuses on the specifics of speech therapy intervention in adults after stroke in the acute and subacute phase of the disease. The thesis is divided into two main parts, namely the theoretical part and the empirical part. The theoretical part of the thesis defines the concept of stroke and summarizes the knowledge in the field of etiology, symptomatology, diagnosis and prevention. It also defines the individual communication disorders associated with stroke (i.e. aphasia, dysarthria, dyspraxia, dysphagia and cognitive-communication disorders), their classification, aetiology, symptomatology, diagnosis and therapy. The empirical part of the thesis is focused on a qualitative research investigation, the main aim of which is to identify and describe the specifics of speech therapy intervention in people after stroke in the acute and subacute phase of the disease, when the patient is hospitalized in a hospital. The research investigation is carried out by direct observation of the work of a clinical speech therapist in a hospital setting in patients after stroke in the acute and subacute phase of the disease, as well as by analysis of medical reports and documents. From the results of direct observation and document analysis, five case studies of patients hospitalized in the hospital just...
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Prevalence of neurodegenerative disorders in patients with esophageal achalasia
Jerie, Martin ; Vojtěch, Zdeněk (advisor) ; Šonka, Karel (referee) ; Bronský, Jiří (referee)
Introduction: Achalasia is a primary motility disorder of the esophagus due to degeneration neurons in myenteric plexus. Although the exact pathogenesis is unknown, autoimmune and neurodegenerative processes seem to be involved. We thus hypothesized that the prevalence of neurodegenerative and/or neuroinflammatory disorders (NDD) with autoimmune component could be higher among patients with achalasia and vice versa as the background pathogenetic mechanisms might be similar. Methods: This was a prospective, observational, comparative questionnaire-based study. Patients with achalasia from a gastroenterology center and patients with NDD from neurology centers in the Czech Republic were enrolled. Patients from achalasia group were then examined by neurologist and neurological patients by gastroenterologist, including further testing to confirm or rule out either NDD and achalasia, respectively. We assessed the prevalence of both achalasia and NDD and compared them with prevalences in general population. Results: A total of 150 patients with achalasia and 112 patients with NDD were enrolled. We observed an increased prevalence of NDD among patients with achalasia (6.0 % (9/150) as compared to the estimated 2.0 % prevalence of NDD in general population, p=0.003). In the NDD group, 32 out of 112 patients...
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The effect of dysphagic diet on the prevencion of malnutrition risk in the elderly
ZEMANOVÁ, Adéla
This thesis, entitled "Effect of dysphagic diet on the prevention of malnutrition risk in the elderly", deals with the dysphagic diet, which is a diet for swallowing disorders. Swallowing disorders are most commonly seen after stroke, in neurodegenerative diseases, head, neck and oesophageal tumours, and in critically ill patients or the elderly. For this thesis, I chose to conduct both quantitative and qualitative research involving two hospitals and one social service facility for the elderly. I divided the practical part into two subchapters. In the first, I discuss the processing of the observational data. Here I describe what kind of diet is served to patients with dysphagia in a particular facility, what technological procedures are used in its preparation and what meals are most frequently served in the facility. In the second part, the five-day menus of each facility are evaluated and compared with the values from the facility's dietary system. The research showed that if the patient consumed all the food given to him, he would not be at risk of malnutrition, as it is energetically sufficient and covers the needs of the elderly. However, in only two facilities did the patients receive a varied diet, and in one facility the meals or individual foods were more often repeated. The aesthetics of the food in none of the facilities corresponded to my idea of an attractive appearance of the prepared food, nor did the technological preparation of the food in any of the facilities correspond to the requirements of a textured diet - pureed. Therefore, it is likely that patients will not tolerate the diet because of the low variety, poor technological preparation, or the way it is served, because, as they say, we eat with our eyes. The intake would then be insufficient and could lead to a risk of malnutrition. It is therefore not possible to say unequivocally whether a dysphagic diet is a prevention of the risk of malnutrition in the elderly, but if the variety of the diet is maintained and the principles of technological preparation are followed, it could be.
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Stimulation of swallowing within PNF concept in patients with acquired brain injury
Matys, Václav ; Slámová, Adéla (advisor) ; Fabičovic, Klaudia (referee)
BACHELOR THESIS ABSTRACT Name, surname: Václav Matys Supervisor: Ing. Adéla Slámová Consultant: Ing. Mgr. Jana Horynová Title: Stimulation of swallowing within PNF concept in pacient with acquired brain injury A swallowing disorder often occurs as a complication in acquired brain injury diagnosis. In more serious cases it can constitute even life-threatening condition, primarily due to the risk of aspiration and possilbe subsequent development of an inflammatory lung disease. This thesis deals with a possibility of therapeutic influencing of neurogenic dysphagia with utilization of elements of the concept of proprioceptive neuromuscular facilitation - PNF. Contrary to the fact that exercise on the PNF basis to influence dysphagia isn't used frequently in clinical practice, it represents highly effective and for the therapist easily managable method of therapy. The practical part contains a case history of patients with dysphagia, to whom the therapy on the PNF basis was applied. The goal of the bachelor thesis is to create an educative material for a community of experts, particularly physiotherapist as well as speech pathologists or occupational therapists, and thus support interdisciplinary cooperation in the care of dysphagia patients. The result of the thesis is a formation of the therapeutic procedure...
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Use of myofunctional therapy in people with communication disability
Janečková, Sandra ; Komorná, Marie (advisor) ; Mlčková, Marie (referee)
The topic of this thesis is discussion of usage of myofunctional therapy on persons with communicative disorders. The main goal is to map the extent and possibilities of this therapy in speech therapy practice. The theoretical part deals with physiology and patophysiology of breathing, sucking, swallowing and the orofacial system. Further, in connection with myofunctional therapy it discusses its historical development, methodical approaches, utilities, therapeutical benefits and possibilities of education on this field. The empirical part contains a quantitative investigation, which analyses the extent and usage possibilities of this therapy by speech-language pathologists in the Czech Republic. Based on the data obtained by a questionnaire distributed to speech-language pathologists it can be stated, that about 20 % of the respondents do not use the myofunctional therapy in practice, while those (with one exception) never took part on an expert training. The offer of the trainings is rated as insufficient. The myofunctional therapy can be used on persons with orofacial disorders regardless of age or communicative disorder. KEYWORDS: myofunctional therapy, communicative disorder, swallowing, dysphagia, bite disorders, orofacial area
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Dysphagia failure of the upper esophageal sphincter in patients after stroke
Gregová, Daniela ; Bitnar, Petr (advisor) ; Smolíková, Libuše (referee)
Stroke is one of the most frequent causes of dysphagia, a serious symptom triggered by affected coordination of the swallowing muscles or limited sensation. This bachelor thesis focuses on providing a compendium of literature concerned with dysphagia and demonstrating how the symptom occurs after cerebrovascular accident. The first part discusses the swallowing process and stroke from anatomical, physiological and neurophysiological standpoint. Second part presents a closer view of the upper sphincter of esophagus, additional healt problems caused by dysphagia and possibilities of alimentation and brings up a set of the most frequently used diagnostic methods. From chapter 4 and 5 on, the thesis describes methods and technics that can be involved in the treatment of patient with swallowing difficulties and casuistry of a patient suffering from serious dysphagia caused by cerebrovascular accident.
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The intervention of physiotherapy in the treatment of dysarthria after stroke
Nováková, Kateřina ; Bitnar, Petr (advisor) ; Roubíčková, Lenka (referee)
Stroke is the most comman cause of the speech disorders in adults. Dysarthria, as a motor speech disorder, is one of them. The treatement is based not only on vocal and articulatory exercices, but it requires the complex rehabilitation treatement. The benefit of the physiotherapeutic intervention beside speech therapy might be large. The treatement of the muskuloskeletal system allows to see the orofacial disorders in the context of the posture of the whole body. This work wants to make a view on the process of speech production and to describe relationship of the musculoskeletal system and speech. This work also summarises the basic informations about pathogenesis of dysarthria and particularly about the treatement. The swallowing disorders are also very comman complication of the stroke and occur very often with dysarthria. The aim of this work is to describe the specific role of the physiotherapy in the treatement of dysarthria and look for some possibility of the cooperation between physiotherapist and clinical speech therapiste. The form of the work is the research with case history. Powered by TCPDF (www.tcpdf.org)
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Nutritional support in patients with neurological disease
Laštovička, Petr ; Jambor, Daniel (advisor) ; Cempírek, Ondřej (referee)
This diploma thesis deals with the topic of nutritional support in patients with neurological diseases (stroke and Critical-Illness-Polyneuropathy). The aim of this thesis is to find out, how implemented unified system of nutritional support affects the well-being of patients at neuro-rehabilitation clinic Asklepios Schlossberg Klinik in Bad König. There were observed 55 patients (30 men and 25 women) for 8 weeks. The theoretical part of this thesis describes basic components of nutrition, energy expenditure and needs, selected neurological diseases, dysphagia, malnutrition. The emphasis is put on nutrition in intensive neurological care. The practical part of the thesis analyses data obtained by the observation. There are observed changes of body weight, BMI and laboratory values of total protein, albumin and glycaemia in serum. These data are divided by sex, age, type of disease and initial BMI values. The observed patients had mainly overweight and obesity, which have lost a part of their excess weight due to catabolism. At the beginning of the observation 13 patient had normal BMI value, this number of patients rose to 24 after eight weeks. At the end of the observation the reduction of BMI value was on the average 2.45 units. Based on the results, it was found that although patients due to...
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Nutritional support in patients with neurological disease
Laštovička, Petr ; Jambor, Daniel (advisor) ; Cempírek, Ondřej (referee)
This diploma thesis deals with the topic of nutritional support in patients with neurological diseases (stroke, craniocerebral trauma, critical-illness-polyneuropathy. The aim of this thesis is to find out, how implemented unified system of nutritional support affects the well-being of patients at neuro-rehabilitation clinic Asklepios Schlossberg Klinikum in Bad König. There were observed 58 patients (33 men and 25 women) during 8 weeks. The theoretical part of this thesis describes basic components of nutrition, energy expenditure and needs, selected neurological diseases, dysphagia, malnutrition and nutrition in intensive neurological care. The practical part of the thesis analyses data obtained by the observation. There are observed changes of body weight, BMI and laboratory values of total protein and albumin in serum. These data are divided by sex, age and type of disease. Based on the results, it was found that although patients due to uniform tube feeding do not have sufficient protein intake, serum total protein and albumin levels increased. This can be caused by eating a uniform diet that contains good quality protein in patients, which suffered from hypoalbunemia at the outset of observation, also by reducing the effect of stress reactions with gradual improvement of the state and...
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