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Respiratory physiotherapy - part of a comprehensive treatment of Duchenne muscular dystrophy patients
Vargová, Zuzana ; Smolíková, Libuše (advisor) ; Slováčková, Lenka (referee)
Duchenne muscular dystrophy is a progressive muscular disease. This serious disease attacks not only the musculoskeletal system, but also the respiratory system. Respiratory system is one of the most influenced systems. The risks of respiratory problems increase with deteriorating condition of the patient due to muscle weakness. This work is focused on treatment of respiratory system. The aim of treatment is early prevention and solving of complications. These complications include not only scoliosis and cardial problems, but mainly inefficient cough, night hypoventilation, irregular night breathing and failure of respiratory system even during the day. The aim of the respiratory physiotherapy is to keep the right functionality of lungs for the longest time and to choose the correct method of the rehabilitation following the patient's condition deteriorating. Interventions suitable for the patients with the DMD are techniques that leads to increasing lung volume, manual and mechanical techniques of assisted coughing, and noninvasive ventilation. NIV is one of the preferred methods of treating nowadays. Another method is continual invasive ventilation and ventilation with tracheostomy. This treatment includes keeping hygiene of the airways, which is the basis for their throughput. The work also includes...
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PHYSIOTHERAPY OF PREGNANCY AND PUERPERIUM
PITNEROVÁ, Alžběta
The bachelor thesis is focused on physiotherapy during the time of pregnancy and puerperium. Both pregnancy and birth have a significant influence on the expectant mother. During the nine months, woman undergoes a great amount of changes both from the physical and the mental side. This bachelor thesis deals foremost with changes that affect the physical side of the expectant mother. They include changes on genital organs, on cardiovascular, blood and respiratory system, gastrointestinal tract, skin and last but not least on the locomotory system. With exercise in gravidity, we try to influence these changes and, therefore, avoid any occurrence of eventual difficulties. Exercising during gravidity has not only a great importance to prevention but also to the preparation of an expectant mother to the delivery and for acceleration of return of the mother into the shape before conception. The expectant mother should be careful when choosing a suitable sport and she should always consult her attending gynaecologist. Recommended sports and methodologies include gravid yoga, pilates, belly dance, Moses method, exercise on a big ball, Alexander's technique, hydrokinesiotherapy and gynaecological gymnastics. The theoretical part includes a description of anatomy of genital organs and pelvis, creation of an individual, description of physical changes during pregnancy and puerperium and also characteristics and selection of individual suitable sport activities and methodologies. The goal of this bachelor thesis was to find such suitable physiotherapeutic procedures and methods, apply them to particular expectant mothers and verify their effects. For the practical part of research, the method of qualitative research and personal cases studies were used. Three pregnant women participated in the research. Therapy took place once per week for the period of several months. While having free conversation with the clients during the said period, I obtained the information I have incorporated into the individual casuistries. The therapy was completed by the final examination, which proved a positive effect of the exercise not only on the health conditions of expectant mothers, but also on their mental well-being, which was especially important for mothers.
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Rehabilitation of patients with asthma bronchiale
NOVÁK, Lukáš
The topic of my thesis is the recovery of patients suffering from bronchial asthma. Asthma Bronchial (next asthma) is one of the most frequented civilisation diseases the prevalence of which has been increasing dramatically in the last 20 years. It is a chronic inflammatory disease of respiratory tract, which may appear at any age. The four major symptoms of asthma are whistling breath, shortness of breath, cough and tightness in the chest. Physiotherapy enables considerably a complex treatment of patients suffering from asthma. The complex treatment program takes into consideration the breathing and moving abilities of the patient, primarily the current state of his or her deep stabilisation system. The theoretical part of my thesis is focussed on a general description of asthma and its possible treatments, in terms of physiotherapy. The main aim of my thesis is to set up and practise a physiotherapeutic program in order to mitigate the asthma symptoms. The particular set-ups are focused on the respiratory and motion physiotherapy respecting their individual needs. The practical part of my thesis is based on a quantitative survey made by a semi-structured interview focussed on revealing the patient history, direct observation (examining the patient and realising the rehabilitation program). The survey was made within a group of three patients of a different sex and age undergoing the treatment in Luhačovice Spa, as well as one patient of a pre-school age treated in her home environment. The premises of a successful treatment following the rehabilitation scheme reflect an individual attitude to patients and their active participation in the recommended exercising and physiotherapeutic activities in their free time. My thesis can be used as a brief asthma bronchial outline for the public and for study purposes of future physiotherapists.
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Respiratory physiotherapy affects the quality of life of children with spinal muscular atrophy - How, when and why?
Havlištová, Michaela ; Smolíková, Libuše (advisor) ; Zounková, Irena (referee)
Bibliographic identification HAVLIŠTOVÁ, Michaela. Respiratory physiotherapy affects the quality of life of children with SMA - how, when and why? Prague: Charles University, 2nd Faculty of Medicine, Department of rehabilitation and sport medicine, 2012. 81 p. Supervisor Doc. PaedDr. Libuše Smolíková, Ph. D. Annotation This thesis deals with the influence respiratory function in children with spinal muscular atrophy (SMA). The theoretical part provides an overview of respiratory physiotherapy techniques that can be used in the care of the airways in people with SMA. The practical part deals with the question whether it is possible using the selected techniques of respiratory physiotherapy after six weeks of training to affect ventilatory parameters in children with SMA. The group of six probands with SMA I. - III. type in the range of the age from 3.5 to 12 years participated in this study. To objectively assess changes was performed spirometry efore the beginning of the therapy and after its conclusion. The main therapy was daily training with inspiratory breath simulator CliniFlo. After the finishing of therapy there was a positive change in all measured parameters except for vital capacity (VC) and maximal expiratory flow at 75% of FVC (MEF75), where the values didn't change. Statistically significant...
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Kinesiotherapy in the third trimester of pregnancy and childbirth preparation
HANZALOVÁ, Edita
The bachelor thesis deals with kinesiotherapy in the 3rd trimester of pregnancy and subsequent preparation for birth. Pregnancy is a physiological state when the body nourishes two organisms. Because of the baby nourishment pregnancy is certain strain for pregnant woman?s organism. Kinesiotherapy at the final stage of pregnancy is very important. The theoretical part describes physiological changes in female organism during pregnancy. Changes particularly occur in the respiratory system, circulatory system, musculoskeletal system and in body weight. From physiotherapeutic point of view particularly the changes in the postural system and selected muscles are described. Sudden weight growth affects the overall body posture and the structure of pregnant woman?s foot arch. The theoretical part also describes physiological birth, its phases and their length. The last chapter of the thesis theoretical part focuses on the most frequently applied kinesiotherapy methods. These are Ludmila Mojzisová method, Pilates method and gravidyoga. Outline of further kinesiotherapy methods then follows. The bachelor thesis has two aims and one research question set. The first aim is to introduce motion therapy among women in the 3rd semester of pregnancy. The second aim is to prepare pregnant women for the birth by means of kinesiotherapy. The research question deals with finding whether kinesiotherapy has positive influence on the birth progress. Quantitative research method in the form of elaboration of case studies from three respondents was applied to meeting the goals in the practical part. The respondents attended pregnancy exercise and birth preparation classes. Case history was taken from of each pregnant woman to get the necessary data. The interview included information on accidents, operations, painful states, sport activities both before and during pregnancy. Static and dynamic check-up of aspections was then performed. The static check-up focused on overall body posture in back, side, and front views and was documented. The dynamic check-up monitored backbone development and hypermobility test. The practical part then describes individual therapies. An individual kinesiotherapeutic plan is described for all three respondents. The practical part is concluded in an output kinesiological analysis several days after the birth. The output examination also includes an interview on the birth progress and mental state of the respondents. The research confirmed that kinesiotherapy was beneficial for pregnant respondents in the 3rd trimester of pregnancy. The locomotor system problems caused by pregnancy changes in female organism were reduced or eliminated. The clients describe mental well-being during motion activities as well as between the visits. Birth preparation in the form of breathing in the individual birth phases and training of relief position was included into the therapy near the end of pregnancy. The women used the relief position on the big ball in the first birth period and as well as breathing specific for the individual birth phases. The research did not confirm whether kinesiotherapy influences the birth progress. Two of the three respondents delivered without significant complications. The delivery of the woman No. 1 was on the due date. The woman No. 3 delivered less than 3 weeks before the due date. The delivery was without serious complications in both the women. However there were complications in the respondent No. 3 caused by wrong position of the child. Caesarean section in epidural anaesthesia followed. The woman had no problems after the anaesthesia and was transported to the postpartum ward the next day after the intervention. This bachelor thesis may be used as educational material for students and graduates in physiotherapy. It is also suitable for the public, particularly for women in
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Physiotherapy in patients after injuries of the spine and spinal cord
HAJNÁ, Petra
In connection with our lifestyle every year in our country but also abroad there is a growing number of people with spinal cord injuries. The spinal cord injury usually occurs while a spinal injury, where the spinal canal is compressed by luxated vertebra or bone fragments. Affected are more often young people, especially men. The most common causes are falls from height, accidents and sports injuries. A person with this condition not only has limitations in terms of loss of movement or sensitivity but is often threatened by various health complications. Therefore a complex care and intensive rehabilitation is very important, which is in the Czech Republic secured by the spinal program lasting 6-9 months. Rehabilitation is needed not only in the acute period after injury, but has a unique place in the chronic stage of spinal cord injury as well. The aim of this thesis was to explore issues of trauma and spinal cord injury from the perspective of physiotherapy. Based on the defined targets following research questions have been determined. What kinds of physiotherapy procedures may be used onpatients in the subacute stage and what procedures in the chronic stage of spinal cord lesion. A qualitative research in the form of case reports has been executed. Data was obtained from interviews, observation, document analysis and kinesiological analysis. Standard tests related to the spinal lesion were performed, only the most relevant tests and the results that were found during therapy in case reports were entered. The sample included four patients. Two patients in the subacute and two patients in the chronic stage of spinal cord injury lesion etiology. The research was conducted at the Spinal Unit Department of Traumatic Surgery, University Hospital Brno and at the Rehabilitation and restoration center Borovany. Physiotherapy in subacute phase of spinal cord injury is directed at the prevention of pressure sores, contractures, pain, maintaining optimal mobility of joints, focusing on respiratory rehabilitation, maintenance and strengthening of preserved motor potential, activation of the motor transient spinal cord lesion with efforts to activate the motor skills in the most distally way, improving the overall physical condition. The aim is to use and support functional ability of the patient to the fullest extent and quality with the subsequent effort to develop alternative mechanisms.Of the special methods the ones on the neurophysiological basis are the most commonly used treatment methods. An important part is the gradual verticalization of the patient, training equilibrium reactions such as training seat, support for upper limb, keeping in certain positions and functional training, thus the mobility on the bed, self-care, transfers, training wheel chair control, practicing functional replacement grip. Patients return to life with a big handicap, are often dependent on the assistance of others, learn to use a wheelchair and other aids. They have years of life ahead in which they have to cope with the conditions subsequent their injury. In the chronic period, it is important to maintain physical fitness, preventpossible complications, especially pressure sores and joint contractures. Physiotherapist addresses the consequences of overloading the exposed muscles, monitors the vertebral problems, joint pain or muscle imbalance. During this period, patients can attend ambulant physiotherapy or use maintenance stays in rehabilitation centers. The purpose of the study was to mention the basic and the most important areas in the care of spinal patients and to highlight the importance of physiotherapy comprehensive care not only within the spinal program, but also from the perspective of the long-term care of these patients as the rehabilitation should accompany the patient's whole life.
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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 as prevention of painful childbirth and stretch recovery of second mother-to-be
CHRÁSTKOVÁ, Veronika
My Bachelor Work deals with the problem of influence of kineziotherapy, exactly by the activation of pelvic diaphragm on the birth and time of convalescence at second time mother.The pregnancy appears as very difficult period because the woman body provides nutrition for two organisms - the baby and the expectant mother. In theoretical part I´ve presented anatomy of bony and muscular structures of pelvic diaphragm. As well as I´ve descibed all changes of the body during the period of pregnancy, especially the changes of reproductive organs, cardiovascular and respiratory system and increasing of weight.From fyziotherapy aspect I´ve described the change of postrural system when rapid increasing of weight impacts uprising of the body. I´ve also noticed the process of the birth, including its phases. In the last chapter I´ve mentioned the most frequently used methods of pelvic diaphragm activation, ball excercise according Ludmila Mojžíšová and Feldenkrais Method. Each of above mentioned is descibed, explained and presented on some examples.This Bachelor Work solves one important question and it has one aim. Experimental part solves if pelvic diaphragm activation affects the time of birth and convalence at second time mother. The main question is if fyziotheraphy infuences the process of the birth.I´ve asked four pregnant women who attended special course for pregnant. For getting all needed information I took anamnesis. The dialogs concerned their present problems, injuries, operations, previous birth and their physical activities before and during pregnancy. As next step, palpable checkup according Tichý was done, Trendelenbug - Duchenn exam and goniometry of hip joints followed. I´ve also descibed the therapies of respondents. Research includes the final kinezitologhy analysis and dialogs few days after birth.
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