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Botulinum toxin A treatment strategy in cerebral palsy in Czech Republic
Šupíková, Kateřina ; Jevič, Filip (advisor) ; Dyrhonová, Olga (referee)
Botulinum toxin A is a standard treatment of spasticity in cerebral palsy. Rules for its use and subsequent rehabilitation differ in the Czech Republic. Currently, there are no published guidelines for this treatment in the Czech Republic. The principle aim of this thesis is to explore the different strategies for the clinical use of botulinum toxin in Czech Republic. First, the background of this thesis is covering up-to-date information about cerebral palsy, its treatment and its modalities with the main focus on botulinum toxin use and subsequent rehabilitation. Lastly, the background explores the published guidelines for the botulinum toxin treatment in children with cerebral palsy. This thesis is focusing on qualitative research with seven medical doctors in the Czech Republic from eight neurologists in total, who are actively administering botulinum toxin to their patients with cerebral palsy. We are researching their criteria for indication, the strategies they are using when administering BTX, dosing, and the frequent complications they encounter. We also focus on their recommendation of rehabilitation. The outcome of this thesis is a qualitative analysis of the botulinum toxin A treatment strategies uncovering differences in the localization techniques, clinical Another outcome of this...
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Effect of illusory movements physiotherapy on vital and metabolic functions of patients with large burns
Jelínková, Pavla ; Bakalář, Bohumil (advisor) ; Jevič, Filip (referee) ; Smetana, Jiří (referee)
Name and surname of the author: Bc. Pavla Jelínková Institution: Third Faculty of Medicine, Charles University Title: Effect of illusory movements physiotherapy on vital and metabolic functions of patients with large burns Supervisor: MUDr. Bohumil Bakalář Year of defense: 2022 Keywords: large burns; illusory movements; proprioceptive neuromuscular facilitation; vital functions; catabolism; intensive care unit-acquired weakness The aim of this thesis was to determine how the usage of functional proprioceptive stimulation (so-called illusory movements) influenced vital and metabolic functions of patients with extensive burns. In the first part of the thesis we focus on defining the issues we encounter in patients with extensive trauma. Extensive damage not only affects metabolic and vital functions, but the extent of the skin injury changes prognosis of the injured person and the length of hospitalization. The longer patients are hospitalized in intensive care units, the more we encounter acquired muscle weakness. One of the ways to prevent this phenomenon is effective rehabilitation, which is quite challenging in burn patients. As an alternative, the usage of proprioceptive stimulation is offered. It creates illusions instead of real movements in the cerebral cortex. However, there has been no...
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The role of rehabilitation in children idiopatic toe walking - literature review
Pazderníková, Nikola ; Jevič, Filip (advisor) ; Vosecká, Lucie (referee)
Idiopathic toe walking is one of the types of pathological walking. The patient, who is without a neurological deficit after the differential diagnosis, steps only on the toes and in his walking cycle there is an absence of the heel strike on the pad. It was formerly mistaken for the congenital shortening Tendo calcaneus. Due to the absence of a comprehensive summary of findings and results of studies, our main goal is to create a research bachelor's thesis on this topic and the secondary goal is to create a document that would be useful in the diagnosis and classification of this pathological gait. Methods: Studies and articles dealing with idiopathic toe walking in pediatric patients were searched in the PubMed and Cochrane medical databases. We selected only studies in the period 2008-2021, which met our criteria and contained appropriate information for this work. We have evaluated a total of 40 articles as relevant and suitable for use in this search - 37 from the PubMed database and 3 from the Cochrane database. The result of the work is a comprehensive summary of available information on etiopathogenesis, prevalence, conservative and surgical treatment, which we can use in clinical practice, as well as an examination protocols that will help us in diagnosis and classification. Conclusion:...
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Translation and pilot validation of three healthcare questionnaires
Pecka, Václav ; Kavka, Tomáš (advisor) ; Jevič, Filip (referee)
Self-reported questionnaires are method of choice for evaluation of relevant domains in low back pain population. Multiple questionnaires exist measuring significant number of potentially meaningful domains. The decision which ones to use should be based on an analysis of clinimetric properties reported in literature. An effort should also be made to translate existing outcome measures to Czech language. This thesis consists of research on methods and parameters designed to evaluate quality and usefulness of measuring methods and example of analysis of clinimetric properties is provided. The experimental section is devoted to reporting the translation process and field testing of three healthcare questionnaires concerning disability (the Patient Specific Functional Scale), self-efficacy (the Pain Self-efficacy Questionnaire) and global perceived effect (the Global Perceived Effect Scale). The questionnaires are comprehensible and ready to be used in clinical practice. There still needs to be a cross-cultural equivalence study performed for them to be eligible for research purposes and international collaboration. In the preliminary analysis, the scores also showed behavior corresponding to the properties reported in the literature.
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Pressure pain threshold evaluation in relation to the knee joint position - pilot study
Čechová, Tereza ; Čech, Zdeněk (advisor) ; Jevič, Filip (referee)
The diploma thesis deals with the relationship between the level of stress of soft tissues and their pressure pain sensitivity. It aims to find out whether the level of tension in soft tissues, given by the position of neighbouring joints, affects the pressure pain threshold. The thesis assumptions were verified on a model situation with the sensitivity of the tissues of the ventral and dorsal sides of the thigh depending on the angular adjustment of the knee joint flexion. The theoretical part deals with the findings about biomechanical properties of soft tissues in relation to mechanical load and in the sense of tensile and compressive forces. It describes the mechanisms of tissue nociceptor activation and afferent signal transmission for processing by neurvous system. It distinguishes between the concepts of nociception and pain and deals with methods of their quantification, especially pressure algometry. A group of 30 (15 men and 15 women) healthy probands of younger adult age participated in the research. The values of the pressure pain threshold were measured for each person with an algometer from the ventral and dorsal side of the thigh with angular settings of 0ř, 45ř and 90ř flexion of the knee joint, with a constant position of the hip joint. The data set's statistical analysis did not show...
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Joint configuration changes pressure pain threshold-centered and decentered position
Jevič, Filip ; Čech, Zdeněk (advisor) ; Vaculín, Šimon (referee)
The term "joint centration" is recently perceived primarily in its biomechanical context. This paper suggests a possible neurophysiological point of view and examines the effect of centered or decentered position on pressure pain treshold (PPT) of three muscles (m. temporalis, m. tibialis anterior, m. interosseus dorsalis I) in sitting and lying position, researched on healthy volunteers. PPT was measured in four randomly ordered positions with 49 people (21 women, 28 men). Significantly higher PPT was detected in all three muscles (p=0,001; 0,0016; 0,00009). In percent the PPT change resembles some of studies working with therapeutical techniques (mobilization, joint manipulation, exercise). Influence of higher postural position (sitting compared to lying down) on PPT was not proved. Cenetered joint position increases the PPT of healthy young adults compared to decentered position. This newly proved fact opens further possibilities of conceiving the key physiotherapeutical notion of "joint centration".
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Impact of glucocorticoid treatment on musculosceletal system of pediatric patients with acute lymphoblastic leukemia.
Petráčková, Karolína ; Jevič, Filip (advisor) ; Šrámková, Lucie (referee)
This bachelor thesis aims to provide a general overview of complications of musculoskeletal system in pediatric patients diagnosed with acute lymphoblastic leukemia (ALL) undergoing chemotherapy treatment involving high cumulative doses of glucocorticoids. Musculoskeletal complications include steroid myopathy, osteonecrosis and reduced bone mineral density. The first part describes their basic pathophysiological mechanisms and the risk factors of their origin. The second part presents the current possibilities of muscle strength assessment and available exercise programs. Furthermore, diagnosis of osteonecrosis and bone mineral density are presented together with current possibilities of therapeutic intervention. The thesis also covers characteristics of muscle strength measuring methods and exercise programs along with presentation of the results of individual studies. In the discussion part, there are broken down the limits, advantages and disadvantages of using the muscle strength measuring methods and exercise programs in clinical practice.
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