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Possibilities of physiotherapy in patients with spastic paresis after stroke
OŠMERA, Martin
This bachelor thesis deals with spastic paresis of the lower limb in patients after a stroke. The thesis describes the problem of spastic paresis and the possibilities of using physiotherapy. A number of physiotherapeutic methods can be used in clinical practice to treat spasticity. One such method is the Guided Self-rehabilitation Contract by J. M. Gracies, which combines static prolonged stretching with the possible application of botulinum toxin and strength training of repetitive active movements (RAP) with home autotherapy. The aim of this thesis is to describe various possibilities of physiotherapy and evaluate the effectiveness of the method according to Gracies in the target group of patients. The Theoretical part focuses on spastic paresis, its origin, description, and characteristics together with the upper motoneuron syndrome (UMN syndrome), in which spasticity is one of its components. The following are individual clinical manifestations and forms of spastic paresis with the possibility of evaluation by clinical scales. The work also mentions a stroke, as one of the possible causes of spasticity. At the end of the theoretical part, pharmacological treatment with selected physiotherapeutic approaches to therapy is presented. The Methodological part describes the process of research implementation. The Practical part is conducted in the form of qualitative research, namely case studies in two probands with spastic paresis of the lower limb after a stroke, in which therapy according to Gracies is indicated. Each proband was subjected to an input and output kinesiological analysis, which included anamnesis, aspect, anthropometry, goniometry, examination of muscle strength, gait tests, Berg Balance Scale and Five-step Clinical Assessment in Spastic Paresis. During the study which lasted more than 6 months, the course of therapy was monitored in each proband. Based on the comparison of kinesiological analyses, was possible to observe a positive effect of the therapy. Proband 1's results are indistinct, despite clear subjective improvement. It was possible to improve movement, condition, and postural stability. Conversely, in some of the monitored muscles, the rate of spasticity worsened. Proband 2's results are significantly improved, despite the chronicity of the condition.
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Measurement of lower extremities spasticity in patients with cerebral palsy
Vavřinová, Dominika ; Říha, Michal (advisor) ; Pavlů, Dagmar (referee)
Title: Measurement of lower extremities spasticity in patients with cerebral palsy Objectives: The aim of the theoretical part of this thesis is to evaluate possibilities of lower extremities spasticity measurement in adult patients with cerebral palsy. The main focus was given to the concept of French professor J.-M. Gracies: Five-step clinical assessment in spastic paresis. This unique concept presents differentiation of three main factors of motor impairment that emerge as a result of a lesion to central motor pathways: stretch sensitive paresis, soft tissue contracture and muscle overactivity. Ability to distinguish these factors is crucial for specific treatment indication. Finding a correlation between the Five-step clinical assessment in spastic paresis and muscle activity in gait measured with sEMG was the main objective in the practical part of the thesis. Methodology: This thesis has a theoretical-empirical character. The theoretical part is in a form of a research on the topic of spasticity diagnosis, focused on cerebral palsy patients. The empirical part of the thesis has a form of pilot quantitative research, which was attended by 6 participants with cerebral palsy (4 men and 2 women; average age 29 years). There were 2 independent measurement made for each of them. Each measurement...
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Measurement of lower extremities spasticity in patients with cerebral palsy
Vavřinová, Dominika ; Říha, Michal (advisor) ; Pavlů, Dagmar (referee)
Title: Measurement of lower extremities spasticity in patients with cerebral palsy Objectives: The aim of the theoretical part of this thesis is to evaluate possibilities of lower extremities spasticity measurement in adult patients with cerebral palsy. The main focus was given to the concept of French professor J.-M. Gracies: Five- step clinical assessment in spastic paresis. This unique concept presents differentiation of three main factors of motor impairment that emerge as a result of a lesion to central motor pathways: stretch sensitive paresis, soft tissue contracture and muscle overactivity. Ability to distinguish these factors is crucial for specific treatment indication. Finding a correlation between the Five-step clinical assessment in spastic paresis and muscle activity in gait measured with polyEMG was the main objective in the practical part of the thesis. Methodology: This thesis has a theoretical-empirical character. The theoretical part is in a form of a research on the topic of spasticity diagnosis, focused on cerebral palsy patients. The empirical part of the thesis has a form of pilot quantitative research, which was attended by 6 participants with cerebral palsy (4 men and 2 women; average age 29 years). There were 2 independent measurement made for each of them. Each...
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