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The effect of an early Reflex locomotion therapy according prof. Vojta in children with postpartum paresis of Brachial plexus and its social influence from the view of parents
PLACHÁ, Milena
The thesis topic is "The influence of the early therapy by reflex locomotion according to Vojta on children with brachial plexus palsy postpartum and its social impact from the perspective of their parents."The brachial plexus (BP) consists of nerve bundles based on radicular segments C5-Th1. Innervate muscles girdle blades, shoulder, arm and hand. When BP is damaged the mobility may be impaired (paresis to plegia of muscles), sensation (hypoesthesia to anesthesia, paresthesia, pain) and vegetative symptoms can appear (discoloration and skin temperature changes, changes in hair, nail brittleness). Types of BP palsy are classified according to clinical and anatomic course. Paresis of upper type (Erb-Duchene) is the most common and has the best prognosis, clinically manifest by the adduction and internal rotation of the upper limb, the elbow in extension, the wrist in flexion,the limb is poor, the gripping reflex present. During the paralysis of the lower type (Déjerine-Klumpke) the wrist flexion is not possible and the hand grip is poor or absent, and when there is a disruption of the cervical sympathetic the Horner's syndrome appears. An isolated paresis of the secondary trunk with disabilities muscles innervated n. Radialis is rare. During the complete lesion BP the whole limb is plegic with anesthesia all dermatomes excluding the inner arm. The complete lesion BP has the worst prognosis. BP perinatal injury arises in connection with childbirth. Despite the knowledge of risk factors we fail to prevent these injuries. With all children with postnatal paresis BP the initiation of conservative treatment is indicated, some children require neurosurgery. With some children a residual limb dysfunction remains after the treatment. Among the consequences we include permanent residual paresis, postural abnormalities, limb bone deformities, contractures of joints, shortened arm. Delays in mental development and cognitive impairment are related to motor disorders. The early and quality diagnosis and the immediate initiation of therapy is the prerequisite for successful treatment. The therapy should prevent the development of pathological patterns of movement and evoke and restore optimum momentum. The main aim is the restoration of innervation and hand function and the second one is the elbow flexion and the third is the arm abduction. Vojta method of reflex locomotion is one of the methods used for conservative treatment of peripheral paresis. In therapy, congenital partial patterns of forward movement global models, which is reflective crawling and reflective rotation, are activated. These patterns are inborn but with children with locomotor disorders these are blocked. By repeated targeted activation we can achieve the correct fixation of the correct models and thus enable their use in spontaneous motor fluctuations and pathological compensatory movements are displaced. Reflex locomotion favorably influences other functions such as posture and its management, neurological status, the development of mental and autonomic functions, and oculomotoric and disproportionate growth. The goal of the treatment is to reduce the disability degree and to minimize the future disability and handicap. Improving the quality of the child´s life leads to improvement of the life quality for the entire family. The theoretical part is devoted to BP palsy therapy and reflex locomotion according to Vojta. First, the function of peripheral nervous system is characterised, the other part is devoted to BP injury - mechanisms of injury, diagnosis, treatment options, BP perinatal injuries and rehabilitation of patients with spinal BP. The chapter dealing with Vojta describes the basic principles of Vojta method - reflexive crawling and reflexive rotation. The final chapter deals with the birth of a handicapped child, the need to support families and individuals affected especially in the psychological and sociological levels.
Influence of the reflexive locomotion according Vojta to children with Down´s syndrome.
PLACHÁ, Milena
The topic of the thesis is "Effects of reflex locomotion according to Vojta for children with Down?s syndrome" from the perspective of parents. Down?s syndrome (DS) is a congenital syndrome which is caused by the presence of a third copy of chromosome 21. A common feature for children with DS is a mild to moderate mental retardation. A very common feature of children with DS is muscular hypotonia and the relaxation of ligaments and tendons. This is the cause of posture disorder, slow motor development accompanied by the emergence of abnormal patterns of movement. Method that may be used in physical therapy for these children is the Vojta reflex locomotion method. In this therapy, we use partial patterns of global models of reflexive forward movement - reflex creeping and reflex rolling. In the treatment of children with abnormal motor function, we activate normal patterns of movement which can be then used in volitional motor skills. Reflex also positively affects other functions, such as fine motor skills in the orofacial region, peristalsis, respiration, urinary bladder muscle and development of the mental function. If the therapy results in an improvement of motor skills, then the life quality of the child and its family is improved too and there are better conditions for the social and vocational integration of the child. The theoretical part describes the characteristics of DS and the Vojta method of reflex therapy. First specified is DS, its history, classification of different types of DS and its heredity. The following describes the possibilities of diagnosis, symptoms and health problems of children and adults with DS. Last but not least should be mentioned the possibilities of education of children with DS and forms of support to families for a child with DS. In the chapters dealing with the Vojta reflex locomotion method, there is also the briefly mentioned personality Vaclav Vojta, who developed this therapy. It further describes the diagnostic possibilities of motor disabilities of children, two basic principles in Vojta reflex locomotion ? reflex creeping and reflex rolling and their possible use within the therapy. This theoretical part is followed by a research part. The research represents a qualitative narrative interview method. This method uses the recording and subsequent transcription of the interview in which the interviewee describes his life story. When processing, the interview is firstly literally converted into a written form and subsequently analyzed. Individual interviews are presented in stages. The first stage describes the situation in the family before the childbirth. The second stage describes the situation in the family after finding out about the diagnoses of DS. The third stage describes the current situation within the family, development of the child. The fourth stage focuses on planning for the future. The fifth stage is super analysis. In interviews, I search for patterns that are common to all narrations. Parents of five preschool aged children with DS, who undergo the therapy of Vojta reflex locomotion in the Vojta centre in Ceske Budejovice, were included in this research. Interviews were held with all the mothers, two fathers did not participate in the research. From the analysis of all five narrations, it was clear that the influence of the Vojta reflex locomotion method was positive with those children involved in the research. Parents noticed an improvement in body posture, improved motor skills of the tongue and also speech in older children. They consider the contribution of the Vojta reflex locomotion methods positive, both in the areas of motor skills and in the psychosocial area. For all the children involved in the research, this therapy is still being used.

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