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Possibilities of physiotherapy methods of psoriatic arthritis
DROBNÁ, Martina
This bachelor thesis deals with the problems of psoriatic arthritis, which has chronic evolution among most cases and can lead to articular deformities in patients. This disease has an unclear pathogenesis conditioned by genetic, external and immunologic factors. It affects above all patients with type I psoriasis with emerging symptoms such as swellings with articular pains, morning stiffness and overall fatigue. PsA often shows positive antigen HLA B27, without presence of rheumatoid nodules and negative rheumatoid factor (Štolfa, 2012). PsA causes both physical handicap in patients and substantial disturbance of their social and psychical life. The thesis is divided into theoretical and practical part. The theoretical part briefly outlines the anatomy of skin as well as structure and function of joints. Onward it describes psoriasis, its forms and methods of treatment. The next chapter explains the term arthritis and presents RA as an example. It is followed by detailed description of PsA, definition of the disease, its causes and occurrence, clinical picture and some therapy possibilities. In the practical part, the method of qualitative research was used, with participation of three female patients suffering from PsA. Therapy was initiated by input kinesiologic analysis, including specific examinations such as goniometric examinations of joints, grasp examinations, muscle palpation examinations and others. Patient appointments were held regularly each week for a period of eight-week therapy. On each appointment, previously applied therapy was consulted, exercises were repeated, possibly uncertainties were clarified. Each therapy lasted about 45 minutes, during which hypertonic muscles along with trigger points were relaxed according to specific patient issues. In the last session, output kinesiologic analysis was done and patients were informed about the importance of adhering to regimen measures. The results of the research clearly show overall posture improvement in all patients. A very substantial indicator of therapy success is noticeable reduction of swellings and pain, and hand function improvement. The therapy also focused on adjustment of faulty breathing stereotype manifesting itself with upper type, thereby causing overexertion of cervical spine muscles and frequent headaches. Strong emphasis was also put on activation of the transverse arch, which was collapsed in all patients. This bachelor thesis can be used in clinical practice of physiotherapists or as an educational material for patients.
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