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Physiotherapeutic approaches for patients with flat-foot in different age categories
VANDOVÁ, Alena
Flat foot, pes planus, belongs to common diagnosis encountered by orthopaedic surgeons. It is described as the fall or loss of the medial longitudinal arch of the foot. Pes planus often occurs in children as well as adults. In the theoretical part of the thesis the foot anatomy is defined, along with the structure of the plantar vault and supporting tendons and ligaments. Furthermore, the development of the plantar vault with its relation to other parts of the body is outlined. The last chapter focuses on flat foot, its cause, impact and prevention. The aim of the thesis is to map the possibilities of therapeutic and physiotherapeutic influence of the plantar vault; describe and evaluate the findings of patients' therapy in different age categories. The information for the practical part was gathered on the basis of qualitative research, with the casuistic approach. Six male patients took part in the research, divided into three groups according to their ages. The therapy lasted for eight weeks. Before the start of the therapy I created a training unit, which was altered individually on the base of actual abilities of the patients. The unit included exercise with elements of sensomotoric stimulation, positions from dynamic neuromuscular stabilisation with the support of the correct foot positioning and exercise for the awareness of unwinding the sole of the foot. Improvement has been found in all patients' foot condition after the therapy. Better activation of the short feet muscles was recognised, as well as preferable overload of the toes. In some cases apparent correction of the longitudinal arch of the foot occurred. The therapy raised the patients' awareness of their own feet. This thesis could contribute to clinical practice of the physiotherapists or as a source of information for the general public.
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Affecting the flat foot in children with Down syndrome
NOVOTNÁ, Gabriela
This bachelor thesis deals with one of the most common problems, from which the people with Down syndrome suffer flat foot. Flat foot appears along with this illness more often than with healthy population. This fact is given by the presence of excessive amount of collagen type VI, also by generalised low muscle tone (hypotonia) and hypermobility. Human foot is a very important part of the musculoskeletal system and performs statical, as well as dynamical function. The sole is capable of kindly taking to the terrain on which it moves. The foot ensures the stability of the either standing or moving body, moreover it is source of proprioceptive information from minor planta. To perform these functions, it is necessary that arch of the foot is properly created, to centre stance of joints of the foot be set and no other deformations be present. Many information about the treatment of healthy children for flat foot can be found in professional literature, but unfortunately no information about the treatment of children with such genetical burden so far. Many opinions about the flat foot treatment occur among the professional community, next to starting active exercise it is often recommended to wait with the treatment till further age or use only passive orthopaedical tools. This thesis aims to bring closer the possibilities of the flat foot treatment of children with Down syndrome. In the theoretical part, the Down syndrome is described, its cause of creation and characteristics. Attention is given to signs of the disease on the musculoskeletal system. Moreover, the theoretical part discusses the human foot, its anatomy, kinesiology, its functions and most common deformity flat foot. The diagnostics of the flat foot is described as well the Chippaux - Šmiřák method. The practical part of the thesis is carried out by casuistries with the help of qualitative research. The research set consists of three children with Down syndrome, two girls aged 11 and 8 and one boy aged 5. The therapy was carried out during 5 months. Once in 14 days the children came with their parents to Centre Arpida in České Budějovice for the therapy lead by me, and the children should then exercise daily at home with the help of their parents. At the beginning of the therapy, an entering kinesiological examination was done, footprints were made, as well as examination of standing with the help of dynamical pavement Zebris at the Rehabilitation department of Hospital České Budějovice, a.s. At the end of the therapy, this examination was carried out again and the occurring changes were described.
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The variability of the distribution of pressure forces on the foot with coupling EMG
Semeráková, Nikola ; Kolářová, Jana (referee) ; Koťová, Markéta (advisor)
The bachelor work is focused on the distribution of pressure forces in the area of the foot with support from electromyography. Part of the work deals with the physiology of leg muscles and where the groups of muscles responsible for standing are defined. After that the thesis focuses on postural stability, the foot vault and biomechanical parameters. Additionally, there's the defining of the principles of electromyography and dynamic pavement. Furthermore, the thesis focused on describing how the data is processed, first from elektromyograph and then from dynamic pavement. Finally, there are outcomes from these devices, which are compared and evaluated,there are also partial parameters for electromyography and for the dynamic pavement.
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The variability of the distribution of pressure forces on the foot with coupling EMG
Semeráková, Nikola ; Kolářová, Jana (referee) ; Koťová, Markéta (advisor)
The bachelor work is focused on the distribution of pressure forces in the area of the foot with support from electromyography. Part of the work deals with the physiology of leg muscles and where the groups of muscles responsible for standing are defined. After that the thesis focuses on postural stability, the foot vault and biomechanical parameters. Additionally, there's the defining of the principles of electromyography and dynamic pavement. Furthermore, the thesis focused on describing how the data is processed, first from elektromyograph and then from dynamic pavement. Finally, there are outcomes from these devices, which are compared and evaluated,there are also partial parameters for electromyography and for the dynamic pavement.
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Possibilities of physiotherapy and problematics of flat foot focus on pupils of older school age
PODRACKÁ, Veronika
This thesis deals with the issue of flatfoot in older school-age children and physiotherapy methods effective for this condition. The human foot underwent considerable changes during its evolution once a limb adapted to climbing, it gradually developed into an organ which enables humans locomotion and upright stance. Flatfoot is a rather common condition described as minimal to non-existent arch of the foot. The aim of this thesis is to list the physiotherapy methods which can be used to treat the condition in older school-age children, to suggest an exercise to help improve both the foot flexibility and the arch position, and to describe the effects of exercising on a person´s posture. The theoretical part of this thesis includes the description of the foot anatomy, foot functions and its functional relationships with other parts of the body. This part of my thesis also describes the flatfoot condition and possible therapy methods focused on children of older school age. The practical part is based on a qualitative research. The focus group of my research were three school children two girls aged 12 and 13 and a boy, 12 years old. The physiotherapy treatment was applied for eight weeks, once a week under my supervision, and the patients were asked to do the required set of exercises daily. The data was gathered during the initial and the final kinesiology examination and photos providing documentary evidence were enclosed. The physical examination included 3D scan assessment. Respective casuistries and both short-term and long-term individual rehabilitation plans were based on the processed data. The set of exercises was created beforehand and then modified during the therapy according to each patient´s physical ability and their current condition. The last therapy session included each patient´s subjective feedback concerning the therapy and its results. Positive results and a distinct improvement of the foot arch position and the body posture were achieved in each case.
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Dynamic plantography
Grossmann, David ; Sekora, Jiří (referee) ; Balogh, Jaroslav (advisor)
This thesis contains introduction to the principles of dynamic plantography and it´s clinical application. Afterwards it is described feet anatomy, types of feet arch and human walking process. Next part describes principles of various types of tactile sensors and electrical platform Arduino. Most important part of this thesis is focused on teoretical design of device and it’s practical realization. The last part of diploma thesis is devoted to discussion of parameters of the device and to results of measuring of group of volunteers.
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The influence of sensorimotor stimulation induced by specialized tools and pshysioterapeutical techniques on the function of the foot of middle childhood aged children
VOTAVOVÁ, Eva
This bachelor thesis addresses the function issues of children's foot and the possible ways of influencing it by using sensomotoric stimulation. The foot is an important organ, which has multiple functions. Locomotion is one of the primary functions. The ability to adapt to different types of surfaces is one of the other functions. The gait on different terrains is natural for the foot. Alas, under the influence of the modern age, we the deviate from nature and lock our feet into misshapen footwear. Last but not least it is the sensitive component, which allows the motor system to respond appropriately to stimuli. The name of this phenomenon is sensorimotor coordination. Its base principle is the processing of data sent from the proprioceptors embedded in the body structures. The central nervous system processes the information and responds in an organism-specific way. It is an essential requirement for physiological gait. Basic information allowing the understanding of the given topic is stated in the theoretical part, for example the anatomy and structure of the locomotion system in the lower extremity area, biomechanics of gait included. A great deal of attention is paid to sensomotoric stimulation and its possible usage. The practical part was made in the form of a qualitative research. The research poll consists of four younger school-aged subjects, who took part in a 3-month therapy. The results were obtained by comparing the pre-therapy examination and post-therapy examination. The aim of the bachelor thesis was to conduct a survey about sensomotoric stimulation and to elaborate how it can impact functions of the foot. The results show, that it can have a positive impact on subjects with signs of flat feet. The muscles of flat feet are flaccid and therefore the sensomotoric stimulation is a suitable therapy for this condition. It activates the main leg joints stabilizers and the short muscles of the arches. The results are not as convincing in the case of a high arch, nevertheless even this condition has shown improvement. The muscles of a foot with a high arch have higher tension and in many cases, structural changes are present. These changes can be removed only by operation, e.g. pes cavus. Nonetheless if the therapy is undertaken at an early age and with a proper intensity, a positive effect can be achieved. Sensomotoric stimulation should be a part of natural development for the human body. It ensures the correct and efficient integrating of muscle units during locomotion.
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The influence of physioterapy in adult pacients with flatfoot and chronic vertebrogenic algic syndrome in cervical region
KUŽELOVÁ, Blanka
This thesis deals with problem of flat foot in adults with the occurrence of chronic pain responses vertebrogenic syndrome in the cervical spine. In the system of motion the foot is the most important part that primarily allows locomotion and provides support for upright posture. Due to the large number of proprioception we get information about the ground in which we are moving in. The foot is through muscular chain segments connected with higher incidence of musculoskeletal and its dysfunction can lead to chain malfunctions and subsequent formation of pain around the knee and hip joints as well as the entire spine, including the cervical section. Flat foot in the adult population is a frequent static deformity developed on the foot originally normal and can arise at any age. Most often it happens after a long-term abuse, such as prolonged standing, heavy lifting, and prevalence of overweight but in the first place it is caused by wearing inappropriate footwear. Above all, women are subject of fashion trends and wear tight pointy shoes, especially on high heels, which is the main cause of flat feet. It is most often accompanied with deformities such as bunions or hammer toes. As a result of flat feet it is reduced its flexibility, joints and spine are no longer protected against bumps. Lower limbs and the whole spine are under an abnormal loading. Vertebrogenic algic syndrome is due to sedentary lifestyle and are one of the most common cause of disability. There are signs of faulty posture and muscle imbalance in the cervical spine. The work includes theoretical and practical part. The theoretical part deals with problem of decrease foot arch, its connection to the cervical spine, therapy and prevention. There are also described muscle imbalances of the cervical spine, the anticipating and treatment options. In the practical part there was used a qualitative research method that involved four students with significant reductions in the instep and a pain in the cervical spine. The techniques of observation and subsequent processing of case studies were used, and that was accompanied with a questionnaire about the effectiveness of the treatment according to subjective feelings of patients. The meetings with patients were conducted every week for eight weeks of therapy. Each session lasted approximately 45 minutes during which the hypertonic muscles along with trigger points were unblocked and the foot was stimulated. Further exercises from the previous treatment were controlled and subsequently were given the new ones. The patients performed exercises 1-2 times daily for about 20 minutes. The aim of this work is to outline the relations between the dysfunction in the form of flat feet and cervical spine, and further to design and implement short-term rehabilitation plan, which cause a mitigating the effects of flat feet for specific patients. For each patient the exercise unit was compiled according to his needs individually, and new exercises were added every week. If the patient did not accomplish some of the exercises, these were included into the next treatment. And the final goal was to design a set of exercises that will serve as a precaution against the functional changes of the spine due to flat foot. The research shows an overall improvement of posture by all patients. There was a significant reduction of pain in the cervical spine and strengthen in the plantar arch. The therapy was also focused on the treatment of bad breath stereotype, which was manifested by upper respiratory type, and its consequence occurred the overloading of the cervical section. A great importance was also given onto strengthening lower shoulder blade fixators, which were by all patients really weakened. This work can serve not only for students and their study purposes. It can be an inspiration for physical therapists in clinical practice for the treatment and, finally, it can serve as a source of information for the general public.
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Physiotherapy procedures affecting flat foot and their another effect on posture in preschool children
BOČANOVÁ, Lucie
This thesis deals with the relationship between the flat foot and overall posture in preschool children. The foot is an important organ for the proper functioning of the entire musculoskeletal system. It mainly provides the standing and the human locomotion. Thanks to receptors ,stored in structures legs CNS (central nervous system) , it obtains information about the surrounding environment. If its function is impaired, occurs due to long muscle chains affecting other body segments. One of the most frequent deformity is flat foot, which is characterized by a reduction or disappearance of the longitudinal arch of the foot. The arches of the foot are essential for the proper function of the foot. It creates three footholds, into their centre of gravity falls man. The aim of this work is to use the stimulation of the soles and use exercises through which will improve the position of the foot arch in preschool children. The exercise unit was chosen individually for each patient. It contained mostly exercises with the element of games that children were able to hold their attention during therapy. The exercises I chose are not only on the soles, but also on the dynamic exercises, involving the participation of the entire musculoskeletal system. Another aim is to map the impact of flat feet in overall posture. The area of the leg is very important for the entire musculoskeletal system its links with higher tiers through the muscular chain. In the theoretical part of this work is presented information about the issue. The first part contains a discussion of foot anatomy and her kinesiology . There are also expressed basic functions of the legs. A significant section of the theoretical site composes arches of the foot and its dysfunction.The most common deformity which is defined here is a deformity of the foot arch, flat foot. The last topic of theoretical part deals with the relationship between flat feet and posture. The practical part was prepared by qualitative research in the form of case studies. The research group consisted of three patients - two boys aged 4 and 5 years, one girl aged 6 years. Therapy took place for 12 weeks where children practiced daily under supervised instructed parents. During the first and the last therapy I carried the input and output assessment, which includes an objective evaluation of the slab using fingerprints. The therapy I had set individually according to the needs of each patient. The results of this work can be assessed that the therapy of the flat foot we can affect the entire musculoskeletal system. In all patients after three months are visible changes not only in the slab, but also in the torso area. For this reason, the area of the feet should not be overlooked.
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The influence of flat feet onto the posture of children at school age
ŤUPOVÁ, Jana
The bachelor thesis is describing problems of the impact of flat feet on school age children´s posture. The foot is the organ that allows contact with the terrain. In case it´s functional component is changed pathologically to some extent, it fails to work properly and can change the whole posture of particular individual in pathological way. Flat feet is a condition of foot when the arch of the foot flattened partly or completely. Arch of the foot enables us flexible treading contact and is defined with three support points: calcaneus and the heads of the first and the fifth metatarsals. They develop and change during one´s lifetime. The appearance of flat feet during the first two years of life is considered as a physiological condition. The appearance of the flat feet later in childhood is viewed as a deformity and needs more examinations and some therapy. Some studies showed that early treatment of flat feet can prevent later unwanted manifestations, and that is why flat feet in children should not be underestimated. Flat feet in children is the most often cause for the visit at a doctor. Children´s flat feet is the topic that needs to be very often consulted at any level of the health care. It is not completely clear, when the foot is still considered as physiologically flat without any pathological cause and when it is considered as pathological flat feet. The purpose of the thesis was to describe links between flat feet and posture. The foot is the key area for motor system and that is why its disorder or malfunction can become the cause and also the consequence of chain functional disorders. That is the reason why the foot area should not be disregarded. Another goal was to suggest exercise units and search out appropriate exercises concerning described problems. Exercise unit was designed individually for each participant according to one´s needs. The first exercise unit has been modified gradually according to participants´ skills to master the exercise. The modification was however essential to keep children´s attention up during the therapy. The thesis consists of the theoretical and practical sections. The practical section contains information about the foot from anatomical, neurological, and kinesiological view and its pathology that is affecting posture. The therapy lasted 10 weeks, children have been exercising from ten to fifteen minutes a day with supervision of parents who were instructed about the exercise, and twice a week individually, under my supervision, and also in parents´ present. The investigation was carried out using interview with parents and children, and also using kinesiological analysis. There was carried out entry and exit assessments in children´s group. They were used to determine proper therapy at the start and also for the conclusion from results at the end. For each participant was designed proper therapy according to one´s needs. The goal of physiotherapy was determined as well as recommended certain type of exercise and proper exercise activity for all children in long time horizon. Our findings showed that proper therapy in children with flat feet can positively influence whole posture. When the entry and exit examinations were compared, we found that there was found greater range of ankle joint motion, positive change in flat feet condition, better body control, the change of breathing mechanics, and also participants´ personal view of better self body control. I have chosen the topic to bring closer problems of flat feet affecting body control in children. The foot area is an integral part of our body. When the arches of foot flatten, position of whole lower limb in joints and complete body posture is negatively affected.
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