|
|
The effect of regular training in Locomat system changing the stereotype of gait of patient after cerebrovascular accident
Lang, Michal ; Malá, Jitka (advisor) ; Pavlů, Dagmar (referee)
Title: The effect of regular training in Locomat system changing the stereotype of gait of patients after the cerebrovascular accident Objectives: The purpose of this thesis is to evaluate whether it is appropriate to use the Locomat system in therapy of gait of patients after the cerebrovascular accident, what is the effect of regular training of these patients in the Locomat system on their stereotype of gait and whether the training in the Locomat system of patients after the cerebrovascular accident is more effective in comparison with other physiotherapeutic practices. Methods: The thesis was processed in the Kladruby Rehabilitation Centre on 14 probands, who were divided after the entrance examination in order to form two equivalent homogenous groups. The first group of seven members was experimental, the second one was control. At the beginning of the study the rate of gait disorder was specified at each proband using standardized method of Wisconsin Gait Scale, they also underwent 10 - Meter Walk Test and 6 - Minute Walk Test. Afterwards all the probands absolved a three-week lasting standard regime of rehabilitation. The probands of research groups absolved except the rehabilitation regime during this time period regularly 5x times a week fifteen 30-minute lasting therapy units in the...
|
|
|
Rehabilitation Nursing in CVE Patients in Home Care
CHALOUPKOVÁ, Veronika
The thesis deals with application of nursing rehabilitation in patients after stroke at home care. The thesis further describes cerebrovascular accidents, rehabilitation nursing and home care agencies (HCA). The research reveals correlations between nursing quality and additional education of HCA nurses.
|
|
|
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.
|
|
|
Physiotherapy of fine motor skills for patiens after cerebrovascular stroke
DAMBOROVÁ, Barbora
The theme of this bachelor thesis is "Physiotherapy of fine motor skills for patiens after cerebrovascular stroke". Stroke is a neurological disease that is caused by a vascular disorder with symptoms corresponding to the affected part of the brain. This disease is the most common and its occurrence can not be reduced despite a great awareness of the risk factors that anyone can affect. The main target of this work is mapping of this stroke issue and its influence on fine motor skills of affected individuals. Than this thesis describe suggestion, implementation and evaluation of therapeutic methods in three probands. Based on those targets a research question was set: What changes in kinesiological testing might occur after the implementation of the proposed therapeutic methods by patiens with impaired fine motor skills after a stroke? This thesis is devided into two main parts: the theoretical part and practical part. The theoretical part deals with the stroke issue and its manifestation by the affected part of the brain as well as its impact on a man. This part describes fine motor skills, manipulation, grasps and fine motor skills testing. The last chapter introduces the therapy from the perspective of physiotherapy, occupational therapy and therapy using the robotic technology Armeo Spring and Amadeo. The practical part is based on qualitative research, which includes a complete kinesiology and neurological testing and analysis functions of individuals grip. Short and long term rehabilitation plans have been done. Both are based on the testing results. The research was conducted for patients with subacute phase of stroke who were hospitalised on the Rehabilitation or Neurological Department of Hospital České Budějovice a.s. Physiotherapy lasted for two weeks in the hospital each probands at the department. During therapy fine motor skills at all probands have been improved. The research could be considered beneficial.
|
|
|
Strokes and the protocol of a stroke for Emergency Medical Services of the South Bohemian Region
SCHWARTZ, Kamila
The topic of this thesis are the Stroke and the Protocol of a Stroke for Emergency Medical Services of the South Bohemian Region. The teoretical part of this thesis includes basic anathomy and pathophysiology facts of brain necessary for understanding of a cerebrovascular accident. Afterwards the chapters are focused on the CVA itself. First of all are described the definition and a basic division of Strokes. In the next chapter are described possible high-risk factors leading to an inception of a cerebrovascular accident. The following topic is the Clinical Picture of Ischemic and Hemorrhaging CVA, diagnostic method used in a hospital facility. The important chapter is the therapy of a cerebrovascular accident in a preliminary medical care, there is also described the Protocol of a Stroke and potential patient's aiming to an acute medical treatment. The two last chapters are focused on a hospital medical treatement and after-care. The intention of this thesis is the maping of theoretical knowledge and differences in application of the Protocol of a Stroke aplicated by paramedics and nurses working in the Emergency Medical Service of the South Bohemian Region. We also wanted to evaulate a cooperation with Stroke Centers that can help to get the patient to undergo a medical performance as fast as it is possible which is essential for the patient and improves many times a future quality of life. Practical part tooks place by the method of a qualitative research. There were used semi-structured interviews with paramedics and nurses employed by Emergency Medical Services of the South Boheminan Region. The interviews included twelve questions concerning theoretical knowledge about the Cerebrovascular Accident, knowledge of the Stroke Protocol and filling in of of it, evaulation of co-operation and a telephonic consultation with Stroke Centers in the South Bohemian Region. Furthermore there was led a semi-structured interview with the doctor of the Complex Cerebrovascular Centre in České Budějovice and with the doctor of the Stroke Centre in Písek. The interviews consited of five questions concerning primarily a frequency of occurrence of the Stroke Protocol during the submittig of the patient and the evaulation of the consultation of patient's condition using the Stroke Telephone. Transcribed interviews are the component of practical part. The evaulated answers were catalogued into the charts for a better arrangement and orientation.
|
|
|
Nurses and physical therapist cooperation for clients after stroke
ŠOULOVÁ, Kateřina
Theoretical base: The brain stroke is one of the most frequented illness which affect our population and which belongs to the second place between reasons of the death. We can divide strokes by origin on ischemics and hemoragics. The biggest part of strokes is composed of ischemics brain strokes, approximately 85%. The rest of strokes are hemoragics brain strokes. When affect patient the brain stroke is necessary fast transport to the hospital, screening and institution of medical treatment. Important part of medical treatment is comprehensive health care which is arranged thanks for the good function multidisciplinary team. It is necessary cooperation of nurses and physiotherapist in the rehabilitation care too. Last not least it is necessary that the patient is the part of the care and the motivation to the cooperation trying to return him to his normal life. My bachelor work is divided into the theoretic part and empiric part. In theoretic part we talk about brain stroke, health care, rehabilitee care and cooperation between nurses and physiotherapist. In empiric part there are results of the research.The objective of the work: The object of empiric part was mapping the cooperation of nurses and physiotherapists with clients after brain stroke in the hospital. For realization of the objective were determinate two questions. In what consist the cooperation between nurses and physiotherapists with clients after the brain stroke? The second question was: What problems complicate the cooperation between nurses and physiotherapists? Methodology: For processing the bachelor work was used qualitative research. For collecting dates we used forms of hidden observation and half structured conversations. The research was realized with 7 nurses and 3 physiotherapists in the hospital in neurologic ward and after care ward. The collection of dates was realized by the approval of the main nurse and head nurses in wards which I named. For keeping the anonymity the agreement is not the part of the bachelor work but it is possible to see it at author of the bachelor work. The research was anonymous, observation and conversations were realized from 23.3.2015 to 17.4.2015. For realization of the research was used the form f hidden participating observation. Discovered dates were written into the diary of observations of sisters (annexe 5) and of physiotherapists (annexe 6) during the observation. Discovered information were rewritten and evaluated. For collecting dates was applicate half structured conversation. I put 35 questions to nurses (annexe 7) and 28 questions to physiotherapists (annexe 8) which were completed thanks for other questions. Conversations were realized with the group of observed nurses and physiotherapists. Answers were written and then rewritten (annexe 9). Obtained dates were analysed, evaluated and sorted into categorical groups. Solutions: Thanks for the research we could see the cooperation between nurses and physiotherapists. The cooperation between them is in the passing on information because awareness is key for giving care. We discovered that they cooperate in rehabilitee care like is setting into position, putting clients to sit down on another place, putting clients to sit down, half help and practise of daily activities. The deficiency was noticed in not cooperation of nurses with physiotherapists next to the bed of the client. From conversations we discovered that nurses are not informed from physiotherapists about correct setting into right position even it is in their competence. From results we can see that the cooperation between nurse and physiotherapist hardly the deficiency of time which we can see in passing information and two-way cooperation. Other factor is changing of physiotherapists in the ward and insufficient consultation in the care of the patient.
|
|
|
Nursing care of patients with stroke
BALGOVÁ, Veronika
This thesis is divided into a theoretical and an empirical part and it deals with nursing and patient care after a stroke. The theoretical part comprehensively summarized the issues related to stroke. It deals with the definition of the disease given, its causes, symptoms, diagnosis, complications and therapy. Very important part is the area of nursing care that due to the nature of the disease, carries many specifics and includes comprehensive care, which may include stroke centers. There were stated objectives for this bachelor thesis: 1. To identify the problematic areas when providing nursing care to the patient after a stroke. 2. To secure the patient´s satisfaction with nursing care. Based on these objectives there were asked two research questions: 1. What are the problematic areas in nursing care of patients after a stroke? 2. Are patients satisfied with nursing care? The empirical part of this bachelor thesis presents the results of a qualitative research. The form of a semi-structured interview and a hidden observation was used. The interview with five nurses working in the neurology department and with five respondents who have had a stroke was conducted on the basis of questions prepared in advance. When analyzing the results, the method of "paper and pencil" was used. The processed results were categorized and then split into subcategories. The hidden observation was focused on five nurses working in the neurology department. Observation results were recorded into an observation diary and eventually evaluated. All of the research questions asked were answered by realizing and processing the survey. The results of the survey point to a very good quality of nursing care provided in the neurology department. However, based on interviews and observations, some minor flaws occurred. One of them is the lack of respect for privacy and intimacy while providing nursing care and inadequate defecation reflex training. It was further found that nurses presented the rehabilitation as the most important part in providing nursing care, but they unfortunately did not take part in it. Another problem mentioned by nurses is the lack of time to be able to individually work on all interventions that have been chosen. As a great positive we can present big satisfaction of respondents with the approach of nurses in providing nursing care. Based on the result of this research an informative brochure was created. This booklet can serve to the nursing staff as a kind of summary of the principles needed to be held when giving nursing care about patients with the issues mentioned above. It can also be used as a teaching tool for students.
|
|
|
The issues of patient´s self-sufficient after cerebrovascular accident at ward of subsequent care
MACHKOVÁ, Marcela
Cerebrovascular accident is a serious destructive condition with suddenly formed infliciton of cerebral blood vessel. There might appear obstruction and taper of them or defect on wholeness of vascular wall which result into hemorrhage to brain tissue. Sings of this condition might be termporary with physical and psychical changes or fatal which end up with serious paralysis, unconsciousness or even death of individual. Cerebrovascular accident problematics is currently a big challenge for the entire society, because progressiveness of European society´s aging is likely to bring increase in total amount of this disease´s causes. The first important step in problematics of the disease is to reduce the risk of stroke by consistent prevention; general lifestyle changes; blood pressure controls and treatment; lipid, coagulation factor and heart disease observation and compensation. The second step, when speaking about already formed disease, is to start well-timed and complex therapy which provides the patient with distinctly higher chance of better final clinical status without permanent harm. After overcoming the acute phase in neurology department the patient carries on with another therapy acorrding to seriousness of his/her condition in rehabilitation or aftercare department. Therapeutic, nursing and rehabilitation care should be set to contain all aspects of lost self-sufficiency encouragement and should be oriented mainly on person who has, even after stroke, his/her own needs, motivations, leisure time activities and skills. The bachelor thesis starts with medical part which describes brain anatomy, deals with epidemiology and stroke history. More detailted stroke characteristics and disease itself are defined by etiology, clinical picture, diagnostics and treatment. This part is then ended up with stroke consequences, factors influecing patient´s recovery, patient´s needs and self-sufficiency after stroke. Multidisciplinary team and aftercare deparment create an independent chapter and after this starts a new chapter interested in the role of nurse and needed nursing interventions, evaluation techniques during basic needs saturation of patients after stroke. Therapeutic rehabilitation creates almost the last important part of the bachelor thesis, on which depend gradual recovery and patient´s future life quality after this desease. The recovery part includes physiotherapy, occupational therapy, speech-language pathology, neuropsychology, spa treatment and prosthetic security of patient. Then, the whole thesis is ended up with patient´s preparation on release into home environment. The first set aim is to find out patient´s needs to reach the maximal functional independence and self-sufficiency after stroke according to previously studied sources. The second aim is to find out the nurse´s role in the encouragement of patient´s self-sufficiency and the third aim is to find out nursing interventions in the encouragement of patient´s self-sufficiency after stroke according to previously studied sources. The whole bachelor thesis is mainly taken as theoretical. It tries to insight into problematics of all needs, self-sufficiency encouragement and patient´s maximal functional independence after stroke according to previsously studied sources and information obtained from consultants, physiotherapists and general nurses. Then, the thesis deals with the role of nurse and nursing interventions in patient´s self- sufficiency encouragement on aftercare department to satisfy his/her essential needs of life without someone else´s help after the disease. After a gradual improvement of functional disability, the whole life quality and the independence of patient, it is necessary to follow all nursing, medical and rehabilitation procedures very carefully without their neglect with a sufficient amount of medical staff and specialized doctors.
|
|
|
Hippotherapy as a supporting therapy in patients with stroke
ČERVENÁ, Kateřina
This bachelor thesis deals with hippotherapy as supportive therapy of patients with stroke. Our starting platform is from the practical experience of therapists hippotherapy's centers Pirouette and available literature. The work is traditionally divided into theoretical and practical. The theoretical part provides an overview of current knowledge and is divided into two chapters, which dealing with the issue of stroke and hippotherapy. There are explained basic concepts necessary for insight into the problems of work. As part of subchapter about of stroke describing its dividing, the causes, consequences, and treatment. In hippotherapy I deal with the principles of hippotherapy effect and its impact to humans, both physically and mentally. In the research part describes the objectives of the work and the research itself. For the purposes of work I chose the design of qualitative research - a case study, which was carried out on three probands after a stroke. The probands were selected from the "Centre of hippotherapy Pirouette" Havlíčkův Brod, where it was from the end of September 2014 to mind January 2015 performed a practical application of hippotherapy under the expert guidance of a certified therapist. Data collection was conducted three complex processing of case studies using the technique of observation (kinesiology analysis of motor skills), secondary data analysis and interview with probands. The aim of this thesis is to map the effect of hippotherapy for patients with stroke and the develop specific hippotherapy's procedures in these patients. The purpose why the work was created, is an effort to improve awareness about hippotherapy as supporting methods for patients after stroke and objectification many years of practical experience hippotherapy's center "Pirouette". The outputs of this work can also be further utilized as educational material for students of physiotherapy and hipoterapeuty alone or as a basis for further research in this area.
|
|
|
Cooperation between a Home Care Nursing Agency and Family Members in the Care for Patients after Cerebrovascular Accident
SILOVSKÁ, Petra
Cerebrovascular accident means acute vascular brain damage. It may have various causes. This includes either blocking of a vein with a blood clot, vasoconstriction or combination of the aforementioned causes. Frequent symptoms of CVA are paralysis, weakness, loss of sensitivity in face or on one side of a limb. Another symptom may be speech disturbance. Cerebrovascular accident may be identified as brain ischemia and hemorrhagic ictus. The thesis includes characteristics and symptoms of the aforementioned types. Furthermore, the thesis describes examination methods and treatment for CVA. Consequences of CVA may include some forms of paresis or plegia, which brings limitation of self-sufficiency for a client. Thus, it is necessary to start timely rehabilitation which shall engage the affected body parts. If the client suffers from speech disturbance as a consequence of CVA s/he should be treated by a speech specialist. If the client does not stay in hospital facilities the family may use service of a home care agency. If the client's health allows s/he may stay at his/her home and a nurse from the home care agency may come to his/her home regularly and helps the client's family. The nurse performs all the required activities and s/he also makes the family engaged in the care. Communication forms an inseparable part of the care. The thesis called Cooperation of nurses and family members within care for a patient who suffered from cerebrovascular accident used qualitative research. The interviews were taken with nurses from home care agency and with family members who take care for a patient who suffered from cerebrovascular accident. The survey was categorized and charted to make it more illustrative. The aim of the thesis was to identify the extent of cooperation between nurses from home care agency and family members taking care for a patient who suffered from cerebrovascular accident, and then to define in which activities the family members may be engaged, and finally to describe how the nurse from home care agency communicates with the family. The nurses' point of view has shown the same positive results and they were satisfied with family's engagement in care for the patient. The revealed results of the survey may be provided to the home care agency to allow assessment of the effect of nurses' work on the overall condition of the clients.
|
guest ::
