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Pain in patients with multiple sclerosis
Paulů, Kateřina ; Novotná, Klára (advisor) ; Grosserová, Barbora (referee)
The bachelor thesis deals with the topic of pain in patients with multiple sclerosis. The aim of the thesis is to map the prevalence of pain among patients with multiple sclerosis, its localization, time course, triggering factors, type, character, intensity and some other aspects pain through a shortened Czech form of the standardized questionnaire of McGill University. The thesis consists of theoretical and practical part. The theoretical part deals with the issue of pain in general, but also focuses on the individual types of pain that are characteristic of multiple sclerosis. The practical part relies on data collection by means of a questionnaire survey that focuses on mapping the prevalence of pain, its location, haracter, duration, intensity and other possible related factors. To collect data, I used a shorter form of the Czech version of the standardized McGill University questionnaire. The questionnaire survey was carried out with patients of the Centre for Demyelinating Diseases, Department of Neurology 1. LF UK and VFN in Prague, who were given a paper questionnaire. The information I obtained was processed into graphs and tables. The results showed that pain is present in 60 % of respondents with multiple sclerosis, most often localized in the spine and lower limbs. The intensity of...
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Use of electrostimulation according to Jantsche and Hufschmidt to influence triceps surae muscle spasticity and walking speed in patients with multiple sclerosis
Tichá, Simona ; Demeková, Júlia (advisor) ; Hojková, Klára (referee)
This thesis focuses on comparing the effectiveness of two types of electrostimulations, specifically electrostimulation according to Hufschmidt and Jantsche, in reducing m. triceps surae spasticity and influencing walking speed in patients with multiple sclerosis (MS). The aim of the thesis is to determine which type of electrostimulation is more suitable for patients with MS. The topic was chosen based on two previous theses that examined the effects of these electrostimulations individually. The theoretical part provides basic information about MS, explains the pathophysiology of spasticity and the possible influence of spinal mechanisms on it, describes the examination of spastic patients, and summarizes the possibilities of electrotherapy treatment. The practical part compares the effects of both types of electrostimulations in patients with MS who were partially randomly divided into two groups of three and evaluates short-term and long-term results using the "Five step clinical assessment in spastic paresis" examination and the subjective perception of walking questionnaire MSWS-12 (Multiple Sclerosis Walking Scale). The results of the thesis do not show significant differences in the effects of both electrostimulations. The most significant improvements in both groups were observed in the...
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Multiple sclerosis: correlation of gene expression and response to immunomodulatory therapy
Kleinová, Pavlína ; Kubala Havrdová, Eva (advisor) ; Taláb, Radomír (referee) ; Musil, Zdeněk (referee)
KLEINOVÁ, Pavlína. Roztroušená skleróza mozkomíšní: korelace genové exprese a odpovědi na imunomodulační léčbu [Multiple sclerosis: correlation of gene expression and response to immunomodulatory therapy]. Praha, 2023. 107 s., 3 přílohy. Disertační práce. 1. lékařská fakulta Univerzity Karlovy v Praze. Vedoucí práce Eva Kubala Havrdová. Abstract Multiple sclerosis is a chronic autoimmune disease of the central nervous system with a genetic component, modifiable with immunomodulatory therapy. It is assumed that genetic factors influence the course of the disease and the therapeutic response. The thesis presents the results of two studies investigating the genetic background of multiple sclerosis. In the first study, the influence of the (GT)n polymorphism of the promoter of the HMOX1 gene for heme oxygenase 1 affecting its expression was investigated in people with multiple sclerosis. No effect of this polymorphism on the course of the disease was observed. We confirmed the effect of immunomodulatory therapy on delaying disease progression. The second study, called the Genotype/Phenotype Project, is a multicentre international genome-wide association study aimed at detecting single nucleotide polymorphisms associated with severity of multiple sclerosis. It has been shown that common genetic variants with...
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Hand training in people with multiple sclerosis in home enviroment
Boudová, Alžběta ; Novotná, Klára (advisor) ; Klimošová, Sylva (referee)
BACHELOR THESIS ABSTRACT Name, Surname: Alžběta Boudová Supervisor: Mgr. Klára Novotná, Ph.D. Consultant: Mgr. Eliška Rotbartová Title: The practice of a hand functioning in patients suffering from multiple sclerosis at their home environment Abstract: The bachelor thesis focuses on the training of hand function in patients with multiple sclerosis in the home environment. Multiple sclerosis is an autoimmune disease leading to demyelination of nerve fibres and their subsequent loss. The aim of the bachelor thesis is to compare the feasibility and effect of different types of therapies aimed at improving upper limb function in people with multiple sclerosis. The types of therapy include conventional outpatient occupational therapy intervention, outpatient intervention with elements of music therapy, telerehabilitation occupational therapy intervention, telerehabilitation intervention with elements of music therapy. The bachelor thesis contains a practical part and a theoretical part. The theoretical part describes the disease multiple sclerosis, risk factors, clinical picture, forms of the disease and treatment options. It also deals with the function of the upper limb and the possibilities of assessment, the possibilities of training hand function are mentioned. Methods of telerehabilitation and music...
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The Independency Training in Person with Multiple Sclerosis in Home Environment
Fabriková, Anna ; Novotná, Klára (advisor) ; Rodová, Zuzana (referee)
BACHELOR THESIS ABSTRACT Name, Surname: Anna Fabriková Supervisor: Mgr. Klára Novotná, Ph.D. Consultant: Mgr. Eliška Rotbartová Title: The Independency Training in Person with Multiple Sclerosis in Home Environment Abstract: This theoretical and practical bachelor thesis deals with the possibilities of occupational therapy for increasing or maintaining self-sufficiency in patients with multiple sclerosis (MS) with higher degree of neurological disability (i.e., patients with EDSS>7). The MS disease, issues of self-sufficiency, palliative care, and some options for social benefits, are described in the theoretical part. The practical part includes 3 case reports of patients of the Centre for Demyelinating Diseases of the Neurological Clinic of the 1st Faculty of Medicine of the Charles University in Prague. All patients completed 6 individual occupational therapy sessions in their home environment. The therapy effect was evaluated by the Barthel Index, modified Frenchay scale and by the Canadian Occupational Performance Measure (COPM). Key words: multiple sclerosis, occupational therapy, rehabilitation, independency, activities of daily living, home environment
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Role of glial cells in pathophysiology of demyelinating diseases of the nervous system
Holásek, Michal ; Kriška, Ján (advisor) ; Pivoňková, Helena (referee)
Glial cells, such as oligodendrocytes, Schwann cells, NG2 glia, astrocytes, and microglia, play a major role in the homeostasis of the nervous system, including the myelin sheath maintenance. Enveloping myelin sheaths produced by oligodendrocytes and Schwann cells, provide a mechanical, isolating, and trophic support to the axons. Importantly, a disruption of a certain component or a dysregulation of a specific process may lead to the collapse and the loss of the myelin sheath, known as demyelination. Axonal demyelination is a pathological condition characteristic of different neurological diseases, such as multiple sclerosis, acute disseminated encephalomyelitis, Charcot-Marie- Toth disease, or Lyme neuroborreliosis. Since, demyelinating diseases are still more prevalent in the population, a suitable and effective treatment is crucial for the patients. However, treatment is not available, which results from an insufficient understanding of pathological mechanisms, low permeability through the blood-brain barrier, and a limited regenerative capacity of the nervous system. Therefore, further research in the field of demyelinating diseases is necessary. Key words: oligodendrocyte precursor cell, oligodendrocyte, Schwann cell, myelination, acute disseminated encephalomyelitis, multiple sclerosis,...
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Longitudinal observation of parameters of dymanic postural stability on patients with sclerosis multiplex in terms of biological treatment
Krčíková, Barbora ; Vomáčková, Helena (advisor) ; Maršáková, Kateřina (referee)
Author: Bc. Barbora Krčíková Supervisor: PhDr. Helena Vomáčková, Ph.D. Title: Longitudinal observation of parameters of dymanic postural stability on patients with sclerosis multiplex in terms of biological treatment Objectives: The aim of this thesis is to describe the postural movement behaviour (independent of therapeutic intervention) in patients with multiple sclerosis referred for biological treatment. Methods: The study used longitudinal monitoring of fatigue and quality of walking in probands (n=2, female, ages 24 and 52) using the Multiple Fatigue Impact Scale (MFIS) and the Multiple Sclerosis Walking Scale-12 (MSWS-12) questionnaires, Longitudinal follow-up of changes in selected parameters of dynamic postural stability obtained on the NeuroCom SMART EquiTest System (Limits of Stability) and longitudinal follow-up of mobility tests using the T25FW (Timed 25 Foot Walk), 6MWT (6-minute Walk Test) and 5STS (5-repetition sit-to-stand test). Testing was conducted in the Applied Kinesiology Laboratory of the Department of Physiotherapy, UK FTVS. Each proband was asked to complete subjective questionnaires at each measurement, after which measurements were performed on the NeuroCom SMART EquiTest System using 7 protocols - Sensory Organization Test, Motor Control Test, Adaptation Test, Weight...
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Principles of complex physiotherapy in a patient with multiple sclerosis in the context of the clinical course of the disease
HODÁČOVÁ, Barbora
The topic of the bachelor's thesis is the principles of complex physiotherapy of a patient with multiple sclerosis in the context of the clinical course of the disease. The aim of the thesis was to provide a comprehensive view of the given disease, from diagnosis to treatment, where I focused on the possibilities of therapy on a neurophysiological basis. Multiple sclerosis is a chronic autoimmune disease for which there is currently still no causal treatment. As patients are often without clinical symptoms in the first years after diagnosis, they have the idea that they do not need to rush into long-term treatment. However, it has been proven that the only prevention of permanent neurological impairment is early diagnosis and almost immediate initiation of treatment, an integral part of which is physiotherapy. Together with pharmacotherapy and regimen measures, they give patients the opportunity to maintain a quality life. The practical part of this work was processed as qualitative research in the form of three case studies. More than one method of obtaining purposeful data has been used, the first was an analysis of the entire medical documentation, followed by an interview with the patient and taking a complete medical history, and finally a kinesiological examination was carried out. To evaluate the results of the four-month therapy an output kinesiology analysis was performed, which was compared with the input. From the results of the research, it was evident that therapies based on neurophysiology have the greatest impact in rehabilitation care. Since all three patients had difficulty with standing titubation, the therapy was partly directed at balance training using sensorimotor stimulation. Patients rated subjectively this concept as the most beneficial. Since the therapy was focused on all clinical symptoms comprehensively, the patients took away not only the possibilities of new exercise, but they got also educated about the correct movement stereotypes during normal daily activities in order to improve the overall state of health. The bachelor's thesis can serve as an inspiration for physiotherapists, what can be used in patients with multiple sclerosis and how to proceed in rehabilitation.
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Prognostic markers of disease course in early stages of multiple sclerosis
Petržalka, Marko ; Marusič, Petr (advisor) ; Taláb, Radomír (referee) ; Lízrová, Jana (referee)
Prognostic markers of disease course in early stages of multiple sclerosis ABSTRACT This thesis analyzes the biomarkers of unfavorable prognosis assessed at early stages of multiple sclerosis. Because specific biomarkers often providerather complex information,the theoretical part provides a summary of biomarkers used not only in prognosis assessment, but also in diagnostics and therapy monitoring. In the empirical part, we have investigatedthe prognostic value of intrathecal synthesis of class M immunoglobulins, serum and cerebrospinal fluid concentrations of interleukin 2, interleukin 6, interleukin 10, chitinase 3-like 2 protein and neurofilament heavy chains, assessed from samples acquired during diagnostic procedures. 58 patients early after the first manifestation of multiple sclerosis were included. All patients initiated therapy with glatiramer acetate, teriflunomide, or interferon beta. To assess the evolution of the disease, we followed the patients clinically and with MRI for two years. Interleukin 2 to interleukin 6 ratio of cerebrospinal fluidvalues ˂0.48 (p=0.0028), interleukin 2 in cerebrospinal fluid ≥1.23 (p=0.0260), chitinase 3-like 2 in cerebrospinal fluid ≥7900 (p=0.0330), age at clinical onset ˂22 years (p=0.0312) and baseline Expanded Disability Status Scale ≥1.5 (p=0.0481), proved to...
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