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Case report of therapeutic care patient with lateral humeral epicondylitis
Kieslingová, Anna ; Křížková, Štěpánka (advisor) ; Reckziegelová, Petra (referee)
1 Summary Title: Case report of therapeutic care patient with lateral humeral epicondylitis Object of paper: The primary aim of this work is to demonstrate both theoretical and practical information to the subject of lateral humeral epincondylitis on the grounds of a case report of a patient with this diagnosis, which was established during a hospital university-internship. Abstract: The general part of this work includes theoretical information about lateral humeral epicondylitis, or generally known as enthesopathies, their diagnostic and possibilities of treatment. Where as the specific part of this bachelor dissertation shows a case report of a patient with lateral humeral epicondylitis. The materials and foundation of this bachelor dissertation were gathered during an university-internship at regional hospital Kladno. Key words: Tenis-elbow, overuse, conservative therapy, prevention
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Aspects of the tretment of idiopathic scoliosis
Mundilová, Věra ; Černý, Pavel (advisor) ; Půlpán, Rudolf (referee)
Title: Aspects of the tretment of idiopathic scoliosis. Objectives: The aim of this bachelor thesis is complete the form to submit basic information about the ways and possibilities of treatment of idiopathic scoliosis with a focus on conservative treatment with orthoses fuselage. To capture the issue of disease, not only in terms of diagnosis, but also bring aspects of adoption and then handicap orthotic aids patient. Methods: For creation of thesis was used qualitative research method of data collection and analysis of secondary data from scientific articles, magazines and publications. This information was subsequently reviewed and consulted with an expert in the field of orthotics. Results: Indications night hypercorection orthoses for patients in many ways more acceptable and complies with the prescribed mode applications than the 23-hours braces. Keywords: scoliosis, idiopathic, orthotics, body brace, corset, conservative therapy, surgery, spine, vertebrae
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Case study of patient with diagnosis of lumbar and other intervertebral discs disease with radiculopathy
Hrdlička, Vít ; Malá, Jitka (advisor) ; Hlavičková, Růžena (referee)
Bachelor thesis title: Case study of patient with diagnosis of lumbar and other intervertebral discs disease with radiculopathy. Objectives: Objective of this thesis is to describe physioterapeutic procedures used to treat the patient diagnosed with lumbar and other intervertebral discs disease with radiculopathy. General section of this thesis is focused on background theory reserach. The disease definition, etiology, clinical picture, diagnostics and conservative therapy used to treat said condition are all covered in this section. Spondylolisthesis classification and various imaging methods are further discussed. Special section of this thesis covers the casuistry of the patient with said diagnosis. Twelve various therapies are descibed in this section. All of them were conducted in Central Military Hospital Prague, Ward unit of Department of Physical Medicine and Rehabilitation. The whole therapy effect evaluation is covered in the thesis conclusion section. Methods: Methods developed by Janda, Véle, Lewit, Pavlů and Kolář were used during the examination and therapy. Results: Loosening of the postoperative scar as well as of the right m. triceps surae soleus was achieved. Breathing stereotype was adjusted, abdominal muscles activated and the ribs positioning during inspiration was lowered....
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Physiotherapy for patients with thoracic spine injury (without spinal cord injury) in the early period after injury
KREJČÍŘOVÁ, Hana
This bachelor thesis deals with traumatic spinal cord injury (no lesion of the spinal cord) with a focus on the thoracic area. Fractures of the thoracic vertebrae occurs most frequently in traffic and bicycle accidents or falls from a height. Great influence also has osteoporosis (especially in postmenopausal women). Doctor´s assessment is followed by conservative or operative treatment and rehabilitation. The theoretical part consists of the sum of knowledge concerning this issue. There are explained the basic anatomical structures, the stability of the spine, definitions and divisions of injuries and fractures, fracture diagnosis and types of treatment. Also the effects of fracture healing are discussed. Subsequently it is focused on physiotherapy methods, which can be used in the treatment of fractures of the thoracic vertebrae. Effective physiotherapy is in place and might include practicing good posture, physiological respiration, restoration of movement stereotypes, briefing care scar, autorelaxation or motorization of the thoracic area. For the practical part of the thesis has been used qualitative research method. Physiotherapy in three patients with fractures of the thoracic vertebrae is described there. The first meeting included the history-taking in the form of a structured interview followed by entrance kinesiologic examination. It consisted of static testing of all respondents with aspection front, back and side, breathing wave dynamic tests and walk test. In addition, a measurement of distances on the spine was made. Another examination was testing of postural stabilization and postural reactibility for which they were selected three tests - diaphragmatic test, trunk flexion and extension test by Prof. Pavel Kolář. The therapy lasted eight weeks and individually at each patient's home. The aim was to map the possibilities of physiotherapy techniques used in patients with spinal thoracic spine (without damage to the spinal cord). Furthermore, the design and implementation of short-term treatment plan for individual patients and comparing their status at the beginning and at the end of research in relation to their degree of affinity to the active physical exercise. The therapy was finished with output kinesiological analysis. The probands were also subjected to an unstructured interview, in which each told their subjective evaluation of the progress of the research. This bachelor thesis could serve as study material for students and health professionals and to raise awareness of the general public about the impact of physiotherapy for pain relief and increasing range of motion in patients with fractures of the thoracic vertebrae. Equally essential purpose is to raise awareness of patients about their treatment options.
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Physiotherapy in patients with Femoral neck fractures
PRINCOVÁ, Pavlína
This bachelor thesis focuses on physiotherapy for patients with fracture of the femur bone in the neck of the femur. The femur is the strongest and longest bone in the human body, securing the stability of the latter. A femoral neck fracture is a fracture in the narrowest place of the bone, where the long femur bone goes over to the head of femur, connecting the femur bone with the acetabulum. Considering the influence of high energetic effects on the bone, the most often during sports or accidents, fractures might occur with younger individuals. However, the fractures are more frequent with older individuals: especially women are more prone to these, in context with influence of postmenopausal osteoporosis. In the Czech Republic, according to statistics, approximately 10.000 individuals per year suffer from this injury, with a clear predominance of women. For 20% of all Czech women aged 60-65 years, there is a strong probability of falling at least once a year. With women aged 80-84 years, this probability increases to one third (Trča, Kudrna, Hořejší, 2008). The theoretical part of this work describes the anatomy of the femur and the pelvic bone building up a hip joint. Further on, biomechanics of the hip joint, including etiology, classification and diagnosis of the femur together with the possibility of operative or conservative medical treatment, are considered. The practical part is based on qualitative research, using observation and interviews. Out of observation methods, the following were chosen: aspection, palpation, goniometrical and anthropometrical examination, examination of walking, muscle shortening and muscle strength that are observed at the beginning, during and at the end of the therapy. Patients of Traumatologic Department of the Hospital of Ceske Budejovice a.s. were chosen for this research.Two groups of patients are being observed: The first group consists of a man treated in conservative way and a woman with 1.5 year old femur fracture, originally treated by osteosythesis, indicated for total endoprosthesis out of a reason of a necrosis. These both patients were being observed for 6 weeks. The second group - a woman treated by osteosynthesis ? proximal femoral nail and a man with total endoprosthesis - were being observed for 8 days of therapy treatment in an early stage after the surgical intervention. Prior to starting the therapy, all patients were informed about the methods and targets of the therapy.The aim of the work is to map physiotherapeutic methods used for treatment of patients after femoral neck fracture, including a short term and a long term plan. The short term plan is especially focused on retreat of swelling and pain, restoring the muscular strength and movement and on training of walking with two crutches. The long term plan goal is approaching the same quality of life preceding the injury, especially by securing a better stability as prevention of falling down.All studied patients show a relatively quick improvement of the swelling and of the pain, especially these patients treated operatively. Verticalization of the patient is another important element, which is allowed by the classical treatment not earlier than after six weeks being confined to bed. Compared with this method, the operative method is more advantageous, allowing an earlier descend of the bed, helping avoiding such complications as thromboembolic disease, pneumonia or forming decubitus.The main objective of this bachelor thesis is not to evaluate a better and more efficient treatment method for the corresponding case - the sample of patients being not representative enough for such a purpose, but to remind and sum up the different used methods and means of physiotherapy.
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Compensatory therapy in patients with hallux valgus
DUŠKOVÁ, Šárka
This bachelor thesis is focused on the most common issue of foot acquired deformities, hallux valgus. This condition is characterized by the valgus positioning of the hallux with metatarsophalangeal joint rotation, varus and prominence of the first metatarsal head. The etiology of hallux valgus is multifactorial although risk factors for the developt of valgoid position of halluxes are divided in hereditary factors, direct and indirect effects. Deformity is often associated with longitudinal and transverse flatfoot. Deformity causes considerable difficulties to the patients, particularly in the form of post-exercise pain, calluses and blisters. Developing deformities may likewise create hammer fingers on the other toes. Last but not least, deformity and its complication significantly limit the selection of appropriate footwear. The main objective of this bachelor thesis is to summarize the available information concerning risk factors in the development of hallux valgus, the contemporary approaches in physiotherapy for the treatment of this deformity as well as the aplication of complex therapies and its effectiveness evaluation. In modern kinesiology, hallux valgus is not regarded as a foot problem only as it is rather a complex movement disorder. Therapy was applied symptomatologically on all body, using a movement compensation reaction system. An appropriate therapy compilation for this issue is also included. In the theoretical part, the basic terminology regarding hallux valgus is explained, breaching the subjects of foot kinesiology, phylogenetic and ontogenetic development. It also describes diseases and deformites caused by intermetatarsal angle calcification. The largest part of this section is devoted to risk factors in the development of hallux valgus and its conservative therapy. Conservative therapy was based on the thorough obtention of anamnestic data and kinesiological analysis; the selection and application of physiotherapy procedures was determined by the present symptomatology. Therapy was carried out individually according to the current status, age and overall condition of the patients when seeking to correct muscle imbalance, posture, stereotype walking practice, education and regime measures. A quantitative research method was approached, performed by studying 3 patients? case reports with hallux valgus and who had not yet underwent surgery. Every case report contains anamnestic data, kinesiology analysis, description of therapy and long term draft planning for physiotherapy. The patients come from the Private Practice Olga Poláková in Jihlava. At the start of the study, the patients were acquainted with the process and aims of the therapy. Therapy results are evaluated in discussion and conclusion sections. All patients showed improvement in foot pain and overall foot kinesiology improvement. Experimental results demonstrate that the therapy was chosen accurately thereby accomplishing the aim of the present study. This bachelor thesis can be useful in raising awareness regarding the conservative treatment of hallux valgus and in the clinical practice of physiotherapy.
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Physiotherapy for patients with LCA rupture during surgical and conservative therapy
PÍCHA, Radek
The bachelor thesis deals with the issue of an anterior cruciate ligament (ligamnetum cruciatum anterius ? LCA) trauma. The anterior cruciate ligament is an important stabilizer of the knee joint. During the LCA lesion serious biomechanical changes occur. The LCA trauma most frequently happens due to forced hyperextension or rotation of the knee joint. Nowadays this injury is quite frequent, in the sports medicine it occurs in the incidence of 1 / 1750 inhabitants. The therapy of the injured LCA has been very efficient recently mainly due to modern approaches both in the medicine and the following rehabilitation. The thesis contains the analysis of the anatomy and biomechanics of the knee joint, the next part describes LCA trauma mechanisms, methods of its examination and possibilities of the successive therapy. One part of the thesis is focused on the comparison of the conservative and the surgical therapy, there are described the circumstances under which it is decided which one of these therapies will be chosen. It is necessary to mention that the most important criterions for the proper therapy choice are the individual needs of the patient. The basic aim of the thesis is the comparison of the efficiency of therapeutic procedures for particular patients and the assembly of the short-term and the long-term treatment plans. The practical part of the thesis is processed by the qualitative research method. Three probands after the surgical therapy and two probands after the conservative therapy were examined. The observation and the therapy for surgically treated patients were carried out between the second and the sixth post-operative week, the examination for conservatively treated patients was carried out for six weeks. Patients were predominantly athletes in the age of 18 ? 24 years. They passed the initial and the final kineziologic examinations and the rehabilitation therapy; the treatment efficiency was rated by the Lysholm score. The initial Lysholm score for surgically treated patients varied between 32 and 34 points and after the therapy it increased to 48 ? 75 points. For conservatively treated patients the initial score varied between 73 and 76 points and the final score was 76 ? 81 points. There is one more important detail in the thesis ? the anthropometry results. The quadriceps femoris perimeter increase was around 1,5cm and the triceps surae perimeter increase was around 1cm. The final examination showed that the majority of the patients is missing minimally 1cm in the quadriceps femoris perimeter compared to the healthy leg. The similar indicator has been found also for the muscular strength testing. The examination was focused mainly on the knee joint extensors and flexors testing. All patients proved the increase of the muscular strength; surgically treated patients reached muscular strength maximally 4+. The short-time rehabilitation plan is initially based on the edema and pain elimination. Subsequent rehabilitation step is the training of the walking with the help of French canes and the knee joint motion range recovery and its stabilization. The aim of the long-term rehabilitation plan is the gradual return to social and sport activities. The basic factor of the long-term rehabilitation plan is good muscular training. In the conclusion it is important to mention that it is not possible to state which therapy (surgical or conservative) is more suitable or efficient, during the decision making process it is necessary to consider individual needs of a particular patient. The thesis may be utilized in the clinical practice of physiotherapists for the improvement of the care of the patient who is diagnosed with rpt. LCA.
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Therapy with corset in patients with scoliosis
ČERMÁKOVÁ, Michaela
For my bachelor thesis I selected the topic "Brace Treatment for Scoliosis Patients". Scoliosis is defined as a three-dimensional deformity of the spine with side curvatures in the frontal, sagittal and transverse planes at the same time. A scoliotic curvature is accompanied by deformations of vertebras, changes in ribs and spatulas and changes in the position of crista iliaca. One of the conservative scoliosis treatment options is brace treatment. Brace treatment aims at generating a positive effect on the curvature and, most of all, at preventing its further development in the period of an individual's growth. Brace treatment is a controversial method to a certain extent, considering a large number of diverse opinions of doctors, orthopaedists and physiotherapists concerning the treatment with torso orthoses. The theoretical part summarizes the findings relating to scoliosis, including anatomical structures influenced in scoliosis. It contains information on basic terminology, scoliosis classification, diagnostics and treatment options. The thesis is focused particularly on conservative treatments but also provides information on possible surgical treatments. Introduction into the issue of brace treatment is addressed in more detail. The history, kinds of braces, manufacture, and the principles of the effect of torso orthoses are outlined there. The practical part of the thesis includes objectives, description of the method, characteristics of the set and particularly the processed results presented in the form of case histories. The data were obtained in a qualitative research. The research involved two patients suffering from idiopathic scoliosis with indicated brace treatment in the Rehabilitation Department of the Hospital of České Budějovice. The girls were selected on the basis of their diagnosis and brace indication. The medical history of the probands was gained and the initial and final kinesiological analyses were performed. The analyses consisted of a visual static and dynamical examination, palpation examination, evaluation with a plumb line, and examination of hypermobility, gait and breathing mechanism. Both patients had the length of their lower limbs measured. The three-month research was aimed at creating a physiotherapeutic procedure for individual patients and outlining the effect of brace treatment on the overall effectiveness of the treatment. The research has confirmed the necessity of an individual approach to each patient suffering from scoliosis. Seemingly similar curvatures may show a completely different development and require a different therapeutic approach. It follows from the research that the best results may be achieved in patients if a combination of several various methods is used. Particularly auto-correction in front of a mirror, Vojta's reflex locomotion and de-rotational breathing proved successful in my research. Auto-correction in front of a mirror before and after the treatment was found particularly beneficial because the patients themselves could observe the changes of their posture during the treatment. In my experience, the use of Vojta's reflex locomotion always served as an excellent preparation for the following exercises because the abdominal wall, autochthonous muscles and ribs become activated and the breath wave is rearranged. Since both patients suffer from scoliosis with a considerable rotation element, the application of de-rotational breathing showed to be suitable because it brought visible results in each treatment for each patient. The brace treatment influences the effectiveness of the entire treatment particularly by not allowing the patient to keep a pathological posture all day long. This fact makes the work with a patient easier and has an effect on the patient's auto-correction. The bachelor thesis may be used in clinical practice of physiotherapists. The thesis may also be used as an educational material for patients.
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The nutrition specifics of patients with chronic renal failure in pre-haemodialysis and haemodialysis programmes.
PAVLÍKOVÁ, Andrea
Chronic renal insufficiency tends to worsen gradually until it gets to the stage of kidney failure, often despite the prescribed adequate treatment. The duration of this period of nephrology dispensarization may differ. Kidneys lose their cleaning ability within ten years, which leads to accumulation of metabolism waste products in the body. If the primary renal disease graduates to the final stage the patient depends on substitute kidney therapy in the form of haemodialysis, peritoneal dialysis or transplantation. Kidney failure treatment depends on the stage of renal function impairment. Modification of eating habits is also closely related to this fact. In the first stage of insufficiency the diet does not substantially differ from normal healthy nourishment principles. Only later gradual limitation of intake of the individual nutrients is necessary. The aim of the bachelor thesis was to map specific requirements for nourishment of patients suffering from chronic kidney failure that have not been included in a dialysis programme yet, contrary to individuals who already visit a dialysis centre and regularly undertake blood cleaning process. A lot of professional literature had to be studied to obtain necessary information for preparation of adequate diet regimen. Scientific bibliographic publications by Czech as well as foreign authors were used as the source on the one hand and the latest findings resulting from randomized multicentric studies had to be found in journals specialized in kidney diseases and nourishment on the other hand. Nourishment recommendations for patients with chronic kidney failure, which are divided into low-protein diet in conservative therapy and limitation of nutrient intake in patients included in the haemodialysis programme, were elaborated upon the obtained information.
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Differences in nursing care of patients after operations of fractures of the pelvis and in the conservative treatment after a pelvic injury.
ADAMČÍKOVÁ, Hana
The thesis is divided into the theoretical and practical parts. The theoretical part deals with fractures of the pelvis, which may be treated in the conservative manner, i.e. by the ligamentum of the pelvis. The ligamentum of the pelvis may be a temporary solution, or it is left until the fracture heals up, or by an operation. Further, nursing care is analysed here, ranging from the admission of the client to the department to his/her discharge. It points out differences in the care of clients in the conservative treatment and in the operational therapy. The research investigation was conducted in the hospitals in České Budějovice and Prachatice. The quantitative research was used for the bachelor thesis, in the form of an anonymous questionnaire, and additionally the qualitative research was conducted in the form of observation. The questionnaire was made up for nurses and contained 32 questions. The observation took place in the intensive care unit, where I had the opportunity to observe 6 nurses at work, and thus check up on the results of the graphs.
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