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Enthesopathy - Etiology and Therapy (review and case study)
Ševčík, Vladislav ; Hojková, Klára (advisor) ; Čakrt, Ondřej (referee)
Background: Enthesopathies affect entheses, highly specialized connetive tissue, connecting tendon to bone. Enthesis and adjacent structures form a functional unit. It is prone to degenerative and inflammatory tissue damage caused by enthesis overuse or diffuse inflammatory disease. Methods: First task is to compose a narrative review concerning enthesopathies with emphasis on disease etiology, its phases, and efficacious therapies. Second task is to suplement the narative study with a case study of a patient suffering chronic elbow enthesopathy, in accordance with the department requirements. This paper takes a form of narrative study. Results: One patient has been treated for lateral epikondyl enthesopathy. Namely FSWT, RPW and eccentric contractions therapy were used. The patient has improved. A narrative review has been completed attempting to offer a more comprehensive perspective on entheses. Conclusions: Not enough up-to-date information about ethesopathies and treatment options is available in Czech publications. There are still some inefficient therapies being currently used, and there is lack of awareness of entheses complexities and various causes of enthesopathies. At the same time new therapeutic approaches are not being used, partially for the lack of high quality RCTs producing...
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Vestibular rehabilitation efect of patients with postural stability impairment
Ševčík, Marek ; Kučerová, Klára (advisor) ; Čakrt, Ondřej (referee)
Disorders of postural stability seriously impair the quality of life. Falls are more common in the elderly, where they can have very serious consequences. However, this issue does not always concern only seniors. These disorders can be caused by a number of reasons. The diploma thesis is devoted to postural stability in patients with vestibular disorders. The aim of the theoretical part of the work is to present comprehensive information on the control of postural stability, its disruption and the integration of sensory systems needed for its maintenance. Further chapters describe postural control assessment and rehabilitation options. The aim of the experimental part was to determine the effect of vestibular rehabilitation on postural control. The evaluation was carried out with the help of a static stabilometric platform Kistler®. 9 patients with postural stability disorder in the chronic stage participated in the research part. A total of 5 men and 4 women, aged from 35 to 78 years, on average 59 with SD ± 16 years, with peripheral (4), central (4) or combined (1) vestibular disorders were exposed to a 3- month rehabilitation program. Before starting the vestibular rehabilitation program, patients were examined for static stabilometry using the CTSIB and SLST tests. Every month, the...
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Influence of temporomandibular dysfunction on head position
Veselá, Nikola ; Čakrt, Ondřej (advisor) ; Kučerová, Klára (referee)
Dysfunction in the temporomandibular joint appears to varying extents, depending on the chosen criteria, in at least half of the world's population. Altered afferentation from the orofacial area (for example due to dysfunction in the temporomandibular joint) can, according to research, have an effect on the position of the head, cervical spine and postural stability. However, the issue of the influence of temporomandibular dysfunction on head position or postural stability is still not sufficiently explored and conflicting opinions appear in the literature. The aim of this thesis is to reveal the correlation between dysfunction in the temporomandibular region and changes in postural stability, head position and subjective visual vertical. In the theoretical part, the current knowledge of the influence of the temporomandibular region on the surrounding structures and body posture will be presented using research. The aim of the practical part will be to investigate to what extent and in what time modulated afferentation from the orofacial area will affect the posture, head position and possibly also the subjective perception of the vertical. Measurements will take place on a stabilometric platform, using the Bucket method and further using QR codes and a computer program. The results will be...
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Subjective visual vertical in patient with BPPV
Svobodová, Klára ; Čakrt, Ondřej (advisor) ; Kučerová, Klára (referee)
The perception of verticality may be affected by a disorder of the vestibular system. One of the causes of vestibular system pathology is benign paroxysmal positional vertigo (BPPV). Our study investigates the changes in the perception of verticality in patients with BPPV compared to the healthy population. Therapeutic positional maneuvers are used to treat BPPV. Using the positional maneuver, the otoconia are relocated from the semicircular canals back to the utricle. This thesis investigates the effect of therapeutic maneuver on the change in the perception of verticality. The theoretical part discusses the perception of verticality, types of verticality, pathology in the perception of verticality and the possibilities of its measurement. Most of the focus is on the description of subjective visual verticality (SVV). It also describes the vestibular system and discusses the BPPV. In the practical part, a set of ten patients and a control group are presented. Using statistical data processing, the result is to answer the hypotheses whether there is a difference in the perception of verticality between patients with BPPV and healthy subjects. It also addresses the question of whether the therapeutic maneuver will affect the perception of verticality in patients with BPPV. Verticality was measured...
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Otolithic system disorders in patients with positional vertigo.
Jendrichovská, Lucia ; Čakrt, Ondřej (advisor) ; Kučerová, Klára (referee)
One of the functions of the equilibrium system is to detect direction and action of the gravitional vector. The dysfunction of the equilibrium system is expressed by a change in the perception of the vertical axis. The aim of this work is to evaluate the function of the otolithic system by examining the subjective visual vertical (SVV) in patients with benign paroxysmal positional vertigo (BPPV). The theoretical part of the study deals with the anatomy and physiology of the inner ear, with focus on the etiopathogenesis, clinical presentation, evaluation and treatment of BPPV. Practical part of the study examined 5 patients who were diagnosed with BPPV. All patients had objective examination of the SVV by digital device. The optokinematic rotation of the enviroment in static and dynamic contidtions were monitored. After examination and input data recording, treatment was performed with an Epley repositioning maneuver. Re-evaluation of the SVV values were performed immediately after treatment maneuver. Measurements after the repositioning maneuver confirmed improvement of the SVV values in all subjects with BPPV.
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Vestibular Function in Cochlear Implant Patients
Matějková, Michaela ; Čakrt, Ondřej (advisor) ; Koutná, Sára (referee)
Hearing loss is the most common sensory impairment. More than 5 % of the world's population suffers from disabling hearing loss, which affects approximately one third of people over the age of 65. In those cases where hearing aids are not a sufficient solution to these difficulties, cochlear implantation is the standard treatment. It replaces, at least in part, the function of the hair cells that are no longer able to stimulate the primary auditory neurons. However, there are concerns about the potential risk of impaired vestibular function and the development or worsening of non-vestibular problems such as tinnitus, vertigo and orofacial disorders. Aims: To provide a theoretical summary of fundamental information on the vestibular system and cochlear implantation and to assess vestibular and non-vestibular function after cochlear implantation and the impact of any abnormalities on patients' quality of life. Methods: All of the participants underwent subjective visual vertical examination, platform posturography and completed five questionnaires - Dizziness Handicap Inventory, Tinnitus Handicap Inventory, Facial Disability Index, Beck's Anxiety Inventory and Beck's Depression Inventory. Overall and partial results from platform posturography examinations were compared with a control group of...
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The Effect of Vestibular Rehabilitation in Patients with Peripheral Vestibular Disease
Kačerová, Veronika ; Kučerová, Klára (advisor) ; Čakrt, Ondřej (referee)
Dizziness is one of the most common reasons for visiting a doctor. Their common cause is a peripheral vestibular lesion. Recently, more and more evidence is emerging regarding the effect of vestibular rehabilitation in these patients. The aim of the theoretical part of this thesis was to provide a comprehensive review of information on peripheral vestibular lesions with an emphasis on the possibilities of physiotherapeutic intervention. Individual peripheral vestibular lesions, vestibular rehabilitation, principles of its functioning and mechanisms of vestibular function repair were described in detail. The main aim of the experimental part of the study was to evaluate the effect of vestibular rehabilitation in patients with peripheral vestibular lesions. Stance and gait stability and the patient's subjective perception of difficulties were evaluated. A total of 31 patients (22 women and 9 men) were included in the study. The age range of the patients was 60 years (SD ± 13 years). The mean duration of the difficulties was 30 months (SD ± 52 months). For objectification, the modified Clinical Test of Sensory Inter-action on Balance (mCTSIB), Dynamic Gait Index (DGI) and Vestibular Rehabilitation Be-nefit Questionnaire (VRBQ) were performed. Measurements were taken before and after the rehabilitation...
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The interindividual variability in examination by Balance Master
Oršulíková, Radka ; Kobesová, Alena (advisor) ; Čakrt, Ondřej (referee)
This thesis "The interindividual variability in the investigation by Balance Master® System" resolves the problem of postural stability in the context of age and incidence of external factors as day-time, physical activity or stress in tested individuals. The aim of the work was to summarize knowledge about the postural stability, mechanisms of processing, holding and testing postural stability. The target of the research was to verify if there are any differences in quality of postural stability between the group of healthy young individuals and the group of healthy elderly by Balance Master® measurements, and if the quality of postural stability is affected by the day-time, fatigue and stress. It was investigated 6 tests: Weight Bearing/Squat (WBS), Modified Clinical Test of Sensory Interaction on Balance (mCTSIB), Limits of Stability (LOS), Rhytmic Weight Shift (RWS), Step Up/Over (SUO) a Forward Lunge (FL). Powered by TCPDF (www.tcpdf.org)
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The use of biofeedback for stability training in patients with degenerative cerebellar disease
Stránská, Lenka ; Čakrt, Ondřej (advisor) ; Jeřábek, Jaroslav (referee)
The graduation thesis deals with the issue of balance disorders due to a cerebellar damage. It deals in detail with the treatment of patients suffering from degenerative cerebellar ataxia and with the use of biofeedback technologies as means of postural stability treatment. The aim of practical part of this work was to investigate the effectiveness of therapy using biofeedback for patients suffering from progressive ataxia due to cerebellar neurodegeneration. The research sample consisted of 8 patients. The patients underwent a total of 18 therapy sessions within a twelve-day rehabilitative program. The therapy contained a training of stability in various positions with the elimination of visual control. A device provided an additive information about head sways for the patients via a tongue electrotactile stimulation. The effects were assessed by means of posturography, functional clinical tests (BESTest, Dynamic Gait Index) and questionnaires (Activities-specific Balance Confidence Scale, Dizziness Handicap Inventory). Three assessments were performed: immediately before, immediately after, and 30 days after the rehabilitative program. A statistical analysis of the data showed significant improvement in all observed parameters. In addition, there was no loss of the benefits in the interval of 30...
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