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Skiascopic and skiagraphic examination of the spine with a focus on scoliosis
DOSTÁL, Martin
The spine is the body's support system and a supporting pole to the whole skeleton, therefore it is important to take good care of it to prevent its deformities, such as scoliosis. Scoliosis is a serious illness which can appear at a really young age. Nowadays, it's timely detection and early treatment is achieved through not only expert orthopaedic check-up, but mainly through radiological examination, mostly skiagraphy. In my bachelor thesis named "Skiascopic and skiagraphic examination of the spine with a focus on scoliosis" I deal with skiagraphic and fluoroscopic options of examining the spine, the issues of scoliosis in general and with specific statistical analysis of incidents of scoliotic changes recorded at the Radiological clinic of the University hospital Brno, at the department of adult medicine. In the introduction, I explain the basic anatomy of the spine including the movement possibilities of individual spinal parts, such as tilting or rotation. The differences between cervical, thoracic and lumbar part of the spine, and their individual vertebrae, are described. In the next part, I focus on the basic principles of skiagraphy and fluoroscopy. It's important to realise what these examination techniques involve, how they work and why are they indispensable parts of examination process of scoliosis. The origin of x-rays and its types are explicated. I also devote a little subchapter to digitalisation, because in modern medicine, it's gradually replacing original technology of recording on film screens, and its use requires minor adjustements of the skiagraphy procedure. The third part of the bachelor thesis focuses on individual skiascopic and skiagraphic examinations of the spine. I describe procedures of skiagraphy of the cervical, thoracic and lumbar part of the spine including the projection of the sacrum. I mention special skiagraphic methods performed in the process of intentional detection or observation of scoliotic changes, including telemetric pictures composed into the long format. From the skiscopic examinations, I marginally chose myelography and discography, application of which is currently almost none thanks to modern examination methods such as computed tomography and magnetic resonance imaging. In the next chapter, I'm finnaly dealing with the topic of scoliosis itself. The basic classification according to aetiology is shown, I also explain the difference between idiopathic, congenial and neuromuscular scoliosis. Also, I clarify by what reference is the scoliosis' curvature measured and what terms are used to describe scoliosis. The chapter concludes by brief explanation of therapy used for scoliosis. The second part of the thesis includes my research. I present the goals of the work and anticipated hypothesis. I explain where and in what conditions the data collection took place, including description of the process of telemetrical screening at the forementioned workplace in Brno. I also present outcome achieved by statistical processing of data, including my commentary based on hypothesis and acquired experience. In the discussion, I compared incidents of scoliosis today according to my research with professional literature focused on scoliosis. Furthermore, I mentioned options of spinal issues prevention, including related illnesses. I also enclose suggestion of utilization of my work in practice, which, as I hope, will be a usefull addition to clinical research for University hospital Brno. In the last part of my dissertation, I summarize all my findings from the thesis and enclose, along with the list of used literature and internet links, attachments in the form of expertly described radiographs of scoliotical spines, which I obtained, with the consent of the staff, also ati the University hospital Brno.
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Nursing care of Pacients after spine surgery
TAKÁCSOVÁ, Alena
The title of my thesis is Nursing care after spinal surgery. The number of patients with problems of different parts of the spine is growing as well as indications to operational solutions. This is due to society trends and a greater load on the body. Therefore operational procedures requiring specific nursing procedures for treatment in the early post-operative period increase. The thesis highlights the issue of specific nursing care for patients with various diseases and parts of spine. It points out that there is no universal measurement of nursing care for different types of operations on the same section of the spine and it is necessary to choose the right procedure in specific nursing care along with subsequent rehabilitation care. The number of people with diseases of the spine indicated for surgery continues to increase. Research mentions modern days numbers compared with the time 20 years ago and I dare say the numbers are disastrous. There is nothing to wonder about. Disproportionate load does not decrease, a sedentary way of life either at work or at home also adds to the risk of developing these diseases. These have resulted in discomfort mainly in personal life of a human, but also threaten their working and social role and disrupt the economic security, which we cannot do without nowadays. In our thesis we deal with already incurred pathological manifestations indicated for a surgery. In other words, what happens to the patient, if they are recommended by our outpatient physician - neurosurgeon for a surgery. The lack of nursing literature on this specific issue was the reason for us to choose this theme. In the theoretical part we will discuss the general structure - spine anatomy and physiology, basic terms related to the basic movements, and curvature of the spine. Since our thesis is focused on nursing care after a surgical treatment of diseases of various sections of the spine at the department of Neurosurgery, Traumatology and the Infectious department in České Budějovice, the theoretical part includes basic theoretical outlines of the most important surgical procedures performed at these departments in the hospital of České Budějovice a.s.. Furthermore, we will get to the specifics of nursing care after these surgeries related to early rehabilitation care and close cooperation with physiotherapists. It should be emphasized that teamwork is the cornerstone in the care of patients after spinal surgery, whose subsequent rehabilitation and education in self-care after being discharged from the hospital care is one of the basic prerequisites for a successful recovery and return to their working and social role. The research part focuses on the following objectives: Aim 1: To determine whether nurses know the correct procedures for early rehabilitation of patients after spinal surgery Aim 2: Find out what is the level of collaboration between nurses and physiotherapists in the specifics of patients after spinal surgery Aim 3: To determine whether the nurse´s education and length of practice has an impact on the provision of specific nursing care for patients after spinal surgery Furthermore, using the research questions related to this issue: Research 1: How do nurses and physiotherapists cooperate in a patient´s care after spinal surgery? Research 2: Is a nurse´s length of practise connected with higher expertise in providing specific nursing care to the patient after a spinal surgery? Research 3: Does the education of nurses affect the knowledge of the specifics of the nursing care to the pacients after a spinal surgery? Research 4: How do nurses extend their knowledge in specifics nursing care for pacients after spinal surgery?
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The issue of mentoring patients with degenerative diseases of the spine for autotherapy for long-term kinezioterapeutical plan
KADERA, Jan
This bachelor thesis focuses on instructing the patients with a degenerative disease of the spine for autotherapy from the kinesiotherapeutic long-term plan point of view. The right instruction for autotherapy is one of the most fundamental elements not only due to its correct understanding, but most importantly for the right home exercising. Unless the exercises are done correctly, a patient's conditions may worsen, which we need to avoid. In the theoretical part individual anatomic structures of the axial system are described, including vertebrae and their interconnection and of course the spinal muscular components, greatly contributing to both the static and dynamic stability necessary for all forms of motion. Then, there are the most frequently occurring degenerative diseases of the spine and their diagnosis possibilities mentioned here. In the next part different ways of treatment are described. The main treatment for the degenerative diseases of the spine is a conservative treatment involving variety of methods and concepts in terms of physiotherapy. In case this treatment is not successful, a surgical treatment comes into effect, which does not yet guarantee a 100% positive result beforehand. In that case we are talking about the so-called failed back surgery syndrom caused by a number of factors, and thus the treatment is not clearly defined. Apart from its therapy the main aim of the thesis is to evaluate the efficiency of the variety of ways of instructing patients because there are many approaches through which it is possible to instruct patients on dong exercises at home. For my thesis I chose three options, which are a verbal instruction, an instruction according to pictures and a video instruction. To achieve the aim, the qualitative method of data collection was used. The sample group consists of three patients with a generative disease of the spine. In the practical part based on the initial kinesiology examination I, besides the therapy, deal with the patients instructions on autotherapy and I assess their efficiency. During the therapy each patient was informed about a few possibilities of the instructions which they should subsequently follow when exercising at home. During the first visit an initial kinesiology analysis was conducted. The second visit included the therapy and an oral instruction on how to do the exercises. These instructions and exercises were the same at the third visit. The fourth as well as the fifth session was finished with the instructions for autotherapy through pictures. The sixth and the seventh session involved video instructions. At the end of each session every patient demonstrated the assigned exercises which were being corrected at the same time. During the final therapy session the output kinesiology analysis was performed and the success of the therapy was assessed. Simultaneously an uninstructed interview was conducted with each patient in which the patients expressed their subjective opinion on the executed therapy and the ways of the instructions. All the patients state the most appropriate instruction was the audio instruction because of its simplicity and clarity.
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The influence of physiotherapy for patients with ankylosing spondylitis treated in outpatient facilities and spa resorts
HRADILOVÁ, Ivana
This Bachelor´s thesis is concerned with influence of physiotherapy at patients with Bechterew´s disease, out of them one group of research sample undergoes therapy in outpatient facilities and the second one undergoes all-embracing balneotherapy. In theoretical part is briefly described the stability of backbone, functional anatomy and kinezilogy of axial system. Next part is concerned to a detailed description of Bechterew´s disease, concerned with its categorization to the group of serum-negative spondylartritid, with definition and classification of the disease, its occurrence, genesis and progress, prognosis and clinical picture of the disease. The main aim of this thesis is to evaluate the effects of physiotherapy on patients with Bechterew´s disease who were treated in outpatient facilities and spa sanatorium. To achieve the goal was used the qualitative research, in which four participants took part, out of them two were treated outpatiently, namely in Rehabilitation and regenerative Borovany and in Outpatient clinic Medipont, s.r.o. Next two participants attended complex curative therapy in Berta´s spa Třeboň. The patients had different stadium of the disease in the range between II. V. stage of disability. During the introductory meeting was executed preliminary kinesiological examination, next they were asked to fill up the informed agreement and Functional index BASFI (The Bath Ankylosing Spondylitis Functional Index), which is used to considering the patient´s functional abilities to solve common daily activities and which reflects impact of the disease to the quality of patient´s life. After therapy´s ending it was executed final kinesiological analysis together with repeated filling out the Index, in order to evaluate success rate of the treatment in range of theirs functional skills. With participants were as well executed not structured interview, in which they communicate their subjective evaluation to the realized research and compared outpatient and spa therapy from their pont of view to their contribution to themselves. The results of preliminary and final researches and physiotherapy course are placed upon record in practical part of Bachelor´s thesis. The Bachelor´s thesis can be used as study material for students, medics and non-professional public as well to improve knowledge about influence of the physiotherapy at patients with Bechterew´s disease, as well to teach patients about possibilities of their treatment.
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Public education on the preventive options in medical rehabilitation
SEGEŠ, Patrik
This bachelor?s thesis focuses on the topic of public education concerning the possibilities of the prevention in the context of medical rehabilitation. The thesis consists of two major parts, a theoretical and a practical one. The primary focus is the prevention of vertebrogenic disorders as a large percentage of the patients visit the rehabilitation centre because of these particular syndromes. In the theoretical part I elaborate on the anatomy and kinesiology of the vertebral column, the muscle system as well as prevention in the context of medical rehabilitation, pathophysiology of formation of vertebrogenic dysfunctions, motion stereotypes and pain. The main goal of this part is to specify the meaning of the prevention in terms of physiotherapy. In the second part of my bachelor?s work I examine in depth the methods which were used for the therapy and prevention of three patients suffering vertebrogenic dysfunctions. These constituted the research sample for practical part of this thesis. The aim of the research is to suggest particular therapeutic solutions and changes in motion stereotypes of patients as well as their further education concerning the possibilities of prevention within the field of medical rehabilitation and evaluate the effects of such therapy.
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Back pain prevention nurses.
BERANOVÁ, Kristýna
The thesis: Backache Prevention in General Nurses, examines whether general nurses practice backache occurrence prevention. The following goals were set for the quantitative research: Goal 1: To find out whether general nurses are sufficiently informed on backache prevention in performance of their job. Goal 2: To find out whether nurses have an opportunity to participate in preventive programmes focused on backache prevention in the organizations they work for. The following hypotheses were set: Hypothesis 1: Backache, as a symptom of overload is a frequent health problem among general nurses. Hypothesis 2: Nurses practice backache prevention. Hypothesis 3: Nurses regularly keep fit. Hypothesis 4: Nurses that attend seminars or training sessions aimed at backache prevention are sufficiently informed on these problems. Hypothesis 5: Organizations where nurses work provide them with some preventive programme aimed at backache prevention. The method of anonymous questionnaire focused on general nurses working in a hospital was used for confirmation of the hypotheses. After assessment of the quantitative research results we discovered, that the first hypothesis in the quantitative research was confirmed. Hypotheses 2 and 3 were not confirmed by the research. Hypothesis 4 was conformed, nevertheless not many nurses participate in seminars or courses aimed at this issue. Hypothesis 5 was confirmed with the comment that an employer should do more for health of nurses. The research has shown that general nurses are actually aware of how to prevent backache occurrence, however not many of them use that. Neither the employer contributes remarkably to prevention of the fact that healthcare is the profession where backache occurs most frequently of all. I am convinced that thorough training of new healthcare staff should be sufficient for remarkable reduction of backache occurrence. A brochure that will be the output of this thesis may serve this purpose, as well as continuous training by a qualified physiotherapist or a physician together with provision of an all-hospital seminar.
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Physiotherapy at treatment of chronic pain
VAŇKOVÁ, Denisa
The title of my bachelor thesis is "Physiotherapy at Chronic Pain Treatment". In my thesis I have focused on chronic back pain. Ambulatory practice indicates the above by general diagnosis as vertebral algic syndrome (VAS). First part of my work consists of processing of theoretical basis related to the problem. Main sections focus on pain, function of the spine, vertebral algic syndrome, spine examination methods, physiotherapeutic procedures and prevention of VAS origination. The research part of my work includes two case reports with diagnosis of chronic vertebral algic syndrome. The objective of the theoretical part of the work was to focus from the physiotherapist's view on most common causes of chronic pain, namely vertebral etiology. This part is also aimed at analyzing basic causes of VAS, processing of current information for diagnostic, therapeutic and preventive procedures related to VAS. The objective of practical part of the work was to find out, based on the case reports, whether the physiotherapy relieves the patient from pain. In the practical part of the thesis I applied the method of qualitative research, case study. The research was carried out in Malvazinky Rehabilitation Center and in Medicentrum Chodov. The tested set consisted of two probands diganosed with chronic vertebral algic syndrome. The diagnoses were given by the doctor treating the probands. Results have been prepared in the form of case reports. Both monitored patients showed a relief from pain and rehabilitation objectives set in advance have been met. Providing that the patients shall practise self-therapy and pay attention to measures preventing origination of problems. The thesis may serve as a theoretical document for medical science students. For physiotherapists it may serve as an inspiration when preparing rehabilitation plans for chronic back pain treatment.
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Training of the back at vertebrogenous patients
ZEISKOVÁ, Kateřina
The world statistics state that 80% of the population encounter pains in the back. These problems were accelerated by modern times, that thanks, to the technical comfort, brought to many people health troubles resulting from the lack of exercise. I chose the subject {\clqq} Training of the back`` because I work as physiotherapist and the people feeling pains in the back belong to my profession every day. I occupy myself with the given problems. Considering the present state of the given problems, I concentrated on the most important connection concerning the training of the back. First, I described the backbone as a part of the locomotory system. Another guideline that was interconnection of muscular groups of the back, chest, abdomen and of the pelvis, that build the muscular corset. I described locomotory stereotypes and disorders there of in particular relations. Integral part of the present state that is the origin of the pain, its cause, diagnosis and therapy. In the theoretical part I dealt with general principles as to the training of the back and with the importance of this training for the therapy of vertebrogenous patients. The aim of the work and of the research was to discover whether a change in locomotory stereotypes before and after therapy took place at patients with pains in lumbosacral part of the backbone and to propose for three different professions the therapy inclusive of necessary regiment measures. The hypothesis was proclaimed that the therapy including also the training of the back will bring about the change locomotory habits of the patients. Secondary analysis of data from health documentation in combination with directly watching the patents were used as technology of the research. The last form of the research is the questionnaire interviewing of the patients suffering from pains in the lumbosacral part of the backbone. It concerns an integral research with prevailing technologies of quantitative research. The basic check group, that are clients of the physiotherapeutical clinic, who suffer from back pains in the lumbosacral part of the backbone. 100 patients altogether underwent the therapy. They were given the same number of questionnaires. All of them were returned. Theoretical questionnaire investigation was under way from October 2007 to March 2008. I used diagrams in processing the collected data and show the results in percentages. I chose three different professions in the course of therapy, and that secretary, forester and student doing sport and I proposed for them the therapy of back pain, that included also the training of their backs and regimen measures as pain prevention. The proclaimed hypothesis was confirmed in connection with the aim of the work. The research work, I carried out, present analysis of particular locomotory stereotypes. The results showed that locomotory habits had been improved after the therapy in direction to psychology. If the patients observe the stereotypes, they learnt and continue the physiotherapy, I chose, and the part of which is also the training of the back, helped not only the patients themselves, but that it brought benefit for the whole physiotherapeutical clinic. The work will be exploited for organization of seminars on the given place of work.
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