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Robotic systems in neurorehabilitation specialized in the upper extremity by patients after stroke
Pokorná, Barbora ; Senohrábková, Eva (advisor) ; Muchová, Zuzana (referee)
OF BACHELOR THESIS Title of bachelors thesis: Robotic systems in neurorehabilitation specialized in the upper extremity by patients after stroke Abstract: This bachelors research describes robotic systems application in neurorehabilitation of the upper extremity in stroke patients. Acquired paresis of the upper extremity as a result of stroke is very frequent impairment what stimulates developing of new treatment possibilities of higher effectivity. The robotic therapy is one of them. Are the robotic systems really effective in treatment of upper arm impairment in stroke patients? This is the principal question of this bachelor's work. It consists of two parts. The first , theoretic, is based mainly on forein articles and researches regarding robotic systems. There were compared advantages and disadvantages of robotic systems, described different characteristics, and discussed economics and the effectivity rate, as it's the most controversial point, in chosed articles. And the second part, practical, is made of two case history where the robotic system Armeo®Spring was used as a treatment approach. The answer to the principal question was established according to results of this work. The robotic systems are effective in neurorehabilition of upper arms impairment in stroke patients. Key words:...
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Use of Forced-Use Therapy in stroke patients
Slavíková, Radka ; Senohrábková, Eva (advisor) ; Drábová, Zuzana (referee)
Title of bachelors thesis: Use of Forced-Use Therapy in stroke patients Abstract: This bachelor thesis deals with Forced-use therapy, which is used in neurorehabilitation of the upper extremity in stroke patients. The most common symptoms of stroke included upper limb paresis, therefore in neurorehabilitation are alway looking for new methods, which include the FUT. The basis of this therapy is restraint healthy limb, which is achieved by use of the paretic extremity. The basic question this work is whether is FUT effective upper limb in neurorehabilitation of patients after stroke and whether improvements persist after termination of therapy. Bachelor thesis consists of theoretical part and practical part. The theoretical part is conceived as a research drawing particularly from foreign studies. This section contains an overview of studies that discuss the effectiveness of FUT. The practical part contains two case reports documenting the examination and treatment of patients after stroke through FUT. Key words: forced-use therapy, constraint-induced movement therapy, neurorehabilitation, neuroplasticity, stroke
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Neurorehabilitation of patients after brain injury at the Day Care Center of The Department of Rehabilitation Medicine
Stepanova, Kristina ; Angerová, Yvona (advisor) ; Matolínová, Vendula (referee)
Title: Neurorehabilitation of patients after brain injury at the Day Care Center of The Department of Rehabilitation Medicine Abstract: Neurorehabilitation represents a complex approach to the patient carried out by an interprofessional rehabilitation team. Neurorehabilitation is particularly important for brain-injury patients suffering not only from motor dysfunction, but also cognitive- communication disorders. The aim of this thesis is to explore and analyze the methods and options of rehabilitation in improving the functional outcome of persons following a brain injury at the Day Care Center of The Department of Rehabilitation Medicine (DS KRL). Within the framework of the practical part of my thesis, the research was carried out using content analysis of the medical records of 37 patients who visited DS KRL from November 2010 until March 2012. In most cases, they were persons after a vascular brain injury. Acquired data were evaluated by percentages and displayed graphically. Examination of input and output data of the FIM test exposed a relationship between the degree of improvement in FIM and the age of patients, where the percentage improvement of people of younger ages were higher than those of older age. It was also observed that the biggest improvement occurred in patients with a delay between...
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Clinical application of the Fugl-Meyer assessment in occupational therapy
Pivoňková, Zuzana ; Sládková, Petra (advisor) ; Svěcená, Kateřina (referee)
The goal of this BA thesis is to translate and to create a manual of so called Fugl-Meyer assessment concept that can be used within the Czech population and its following clinic application for the patients with the brain damage. The theoretical part focuses on patient's issues after the brain damage, on the details and specifics of neuro-rehabilitation and the possibility of a usage of ICF. It also focuses on test scales and it describes Fugl-Meyer assessment. The last part focuses on inter-professional team and the role of Occupational therapist within the team. The practical part defines the problem, the goal of the thesis and deals with the methodology of the thesis. It brings the results of the research, it deals with the characteristics and the evaluation process, it deals with the tools, time demands and scoring. In the very end there is an answer to the basic question of the whole thesis: Is the Fugl-Meyer assessment applicable for the patients after the brain damage? Key words: Fugl-Meyer Assessment brain damage functional assessment in occupational therapy occupational therapy neurorehabilitation
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Neurorehabilitation after brain injury. Therapeutic possibilities.
Angerová, Yvona ; Lippertová-Grünerová, Marcela (advisor) ; Jeřábek, Jaroslav (referee) ; Kozler, Petr (referee)
Neurorehabilitation is a multidisciplinary rehabilitation process used in patients with neurological diseases. These patients have not only movement disorders but also cognitive and neurobehavioral problems as well as aphasias. Their rehabilitation is a long term process and the results are often unsatisfactory. Neuroplasticity - physiological basis for neurorehabilitation induces functional restitution or recovery after secondary brain damage. Various neuroprotective substances (e.g. erythropoietin - EPO) are tested to empower mechanisms of plasticity after brain injury. Preclinical studies testing efficacy of those substances in animal brain damage models are essential to prepare clinical trials. The aim of the study was to reveal the influence of EPO combined with rehabilitation on functional outcomes after global cerebral hypoxia. FIM (Functional independence measure) test was used for functional evaluation and Meilli test for visual memory of the patients who attended special program for rehabilitation in clinical part. Patients who came earlier had better prognosis than patients who came later. In experimental part three-months old male Wistar albino rats were exposed to hypobaric hypoxia for 60 minutes in an experimental chamber, simulating an altitude of 8000 m. Half of the animals received...
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Application of inertial sensors in physiotherapy
Doležalová, Eva ; Sládková, Petra (advisor) ; Oborná, Pavlína (referee)
OF BACHELOR THESIS: Author's first name and surname: Eva Doležalová Bachelor thesis supervizor: MUDr. Bc. Petra Sládková Bachelor thesis consultant: Mgr. Štěpánka Kozlerová Oponent: Title of bachelor thesis: Application of inertial sensors in physiotherapy Key words: inertial sensors, fyzioterapie, accelerometr, gyroskop, functional independence measures, neurorehabilitation Abstract: Inertial sensors are devices that allow monitoring of the movement. They are used also in physiotherapy, where they are applied to analyze walking and to detect falls. My bachelor thesis is focused on the possibility of using inertial sensors for monitoring patients affected by upper extremity. The theoretical part contains an outline of chosen foreign studies that deal with this issue. The second part is about theoretical neurorehabilitation, which is an important part of treatment for patients after brain damage. The practical part is processed in the form of quantitative research. The aim was to obtain and correlate the values obtained before and after the rehabilitation process. It was a total daily activity of upper limbs, which was measured by inertial sensors and the results of functional independence measures (FIM).
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Experimental model of rats neurorehabilitation
Panas, Maria ; Angerová, Yvona (advisor) ; Matolínová, Vendula (referee)
Modern neurorehabilitation improves the quality of life for people with brain injury. An important role of modern physiotherapy is to apply all latest findings of brain neuroplasticity and to support and strengthen it. The theoretical part of my work focuses on the physiology and pathophysiology of the central nervous system, the definitions of neuroplasticity, its mechanisms and the possible uses in rehabilitation, and it looks at different types of neurorehabilitation and its foundation. My work also reviews various substances that can influence neuroplasticity. The practical part of my work describes a neurorehabilitation experimental model of laboratory rats and the resulting experimental outcomes.
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The importance and possibilities of positioning of patients after stroke
PLOUHAROVÁ, Kamila
This bachelor thesis is about the importance and possibilities of positioning of patients after stroke. The thesis is divided into theoretical part and practical part. The theoretical part deals with a summary of theoretical knowledge about stroke and possibilities of positioning patients after stroke. There is a more detailed description of antispastic positions, which are based on the Bobath concept. The thesis also includes information about other ways of positioning, which are positioning based on the concept of basal stimulation, positioning using inflatable splints, canistherapy and the suitable supply of information to the patient. The aim of the practical part of the thesis is to evaluate the importance of positioning of patients after stroke by comparing the entry and exit examination and suggest short and long term rehabilitation plan for patients. In practical part was chosen qualitative research a case study that was performed with 5 patients after stroke. Patients were selected randomly during my practice in hospital in České Budějovice at the Neurological and Rehabilitation Department. Data collection was performed processing of case studies, which used the method of observation, interviewing patients and nursing staff and secondary data analysis. Each case report contains anamnesis, entry and exit examinations, proposal of short and long term rehabilitation plan and information about therapy, which patients participated. The results of the thesis show that physical conditions were improved by patients described in case studies 1, 2 and 3. Patients 1 and 3 also improved their psychological conditions. The patient described in the case study 2 did not have any psychological problem at the beginning of the research. The physical and psychological conditions were not improved by patients 4 and 5, but avoid the formation of pressure ulcers and to reduce passive range of motion. Improvement by patients 1, 2 and 3 can be caused by favourable prognosis early in the disease and also care of multidisciplinary team. Against to this by patients 4 and 5 was the prognosis unfavourable.
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Physiotherapy for patients with acute disseminated encephalomyelitis
JINDROVÁ, Kateřina
ADEM is the inflammatory demyelinating disease of central nervous system which affects mainly white matter cerebrospinal. This bachelor thesis deal with problems of the acute disseminated encephalomyelitis and appropriate approaches of the physiotherapy approaches. For the purpose of this diagnosis is to give a comprehensive view about the disease. Question of acute disseminated encephalomyelitis is nowadays increasingly topical because the incidence of this disease increases every year not only in the world, but also in the Czech Republic. The issue of children is described in detail and subsequently divided. The main stated aim of my thesis is to explore the issue of acute disseminated encephalomyelitis, physiotherapy and process approaches at selected patients with this diagnosis realize defined physiotherapy processes. The theoretical part focuses on the incidence of acute disseminated encephalomyelitis in the Czech Republic and in the world, disease characteristics, causes of its formation, progression, diagnosis and prognosis, and not least the many options in the treatment of diseases such as neurorehabilitation, pharmacological, spa treatment etc. Methodological part is processed using qualitative research. Data collection is carried out observation, interview, analysis of medical records, kinesiology and as neurological examinations is used video and photographic documentation of individual respondents. The research sample includes 2 respondents from Arpida Centers in Ceske Budejovice. Examination and treatment was carried out for 5 months in Arpida areas. To evaluate changes in the patient after treatment is performed input and output kinesiology and neurological examination. One kinesiology examination is completed by testing for posturograf from Copany Neurocom that the patient has received at the beginning of therapy and after its completion. The main research question was determinated in accordance with the objective and qualitative research. The research question was: What are the changes in kinesiological examination occurs after physical therapy in patients with acute disseminated encephalomyelitis? Physiotherapy primarily affected the stereotype of breathing, better stability of scapulas, improved walking stereotypes and generally improved postural stability in stance. Physiotherapy as itself may well affect some degrees of clinical symptoms of acute disseminated encephalomyelitis. It helps improve the quality of life, physical or mental state of a person, helping to improve self-care and improve its team-integration.
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Case study of physiotherapy treatment of a patient with the diagnosis of Multiple Sclerosis
BÁRTOVÁ, Adéla
The thema of this bachelor thesis is "Case study of physiotherapy treatment of a patient with the diagnosis of Multiple Sclerosis". The severity of multiple sclerosis incrementaly increases as the incidency of this disease - globaly and in the Czech Republic as well - rapidly grows year by year. Multiple sclerosis -as an autoaggressive chronic disease - is still incurable, however, plenty of changes in the diagnosis and the therapy have emerged during last years. This illness afflicts mostly persons during the productive period of their lifes. The patient is often without clinical symptoms during the first few years, which, until recently, misled to an idea that there is no urgent need to apply a long-term medical treatment. Today it is evident that only early executed diagnosis and early started therapy afterwards can prevent from the permanent neurologic impairment of the patient. Besides the pharmacological treatment, there is also physiotherapy which helps patients to live an active and valuable life. The point of this paper is to illustrate a complex view of this problem. The first, theoretical part deals with multiple sclerosis as a whole, with the goal to summarize the latest knowledge and findings about this disease. It describes the potential causes of the origin of the disease, its occurrence, particular symptoms, development of the disease, different types of the disease and the possible diagnosis together with the differential diagnosis. The ending of the theoretical part informs about the therapy comprising the pharmacological treatment and the complications it may bear, and the rehabilitation treatment summarizing therapy of all symptoms, which can appear. Nowadays, it is possible to find different approaches in the rehabilitation of multiple sclerosis. But according to many physiotherapy studies those methodologies, which are based on the neurophysiological fundamentals, were already very positively aplied on the patients. It is an objective of the practical part of my thesis to introduce one of these methodologies. The impact of an aplication of the individual physiotherapy, which utilizes the neurophysiological findings, can be evaluated by comparing the results from the entering and exit. This work is conceived as a case study in the form of casuistry. Qualitative research based on the data collection was chosen to verify the efficiency of the aplied physiotherapy. Data was obtained by interviews, observation, analyses of medical records and kinesiology testing. An entering and exit examination, comprised from the set of tests, were performed after the six months therapy to assess changes in the clinical conditions of the patient. These tests allows the therapist to comprehensively evaluate the effect of the rehabilitation on the patients with the central disabilities, particularly on the patients with multiple sclerosis. Tests were selected regarding the clinical signs of the disease. There were examinations done to test the balance, dysmetria, dysdiadochokinesia, scales of postural reactions, walking, muscle strength and spasticity. The test of grabbing ability was done to examinate the light motor skills and goniometry was aplied to determine the joint's range of mobility. The results of the research proven, that the individual physiotherapy employing findings in neurophysiology together with aerobic therapy and other techniques appropriately selected with the respect to the actual complications of the patient has a positive effect on the overall condition of the patient. This bachelor thesis can serve as a theoretical basis for the teaching needs or as an informational source for all, who are interested in the multiple sclerosis disease issue. It can also be an inspiration for physiotherapists on how to proceed in the rehabilitation of patients with multiple sclerosis.
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