|
|
Influencing of spasticity by means of selective dorsal rhizotomy in patients infantile paralysis
Prajerová, Hana ; Kraus, Josef (advisor) ; Kobesová, Alena (referee)
A neurosurgical method of the selective posterior rhizotomy (SPR) is used for a treatment of spasticity. The aim of this study is to evaluate an effect of the SPR on the reduction of the spasticity and on functional abilities of patients with cerebral palsy. Five patients (four males and a female) aged from 12 to 21 years with a spastic quadruplegia were tested by an Ashworth scale, modified Ashworth scale, Peacock scale and Barthel index of ADL. An initial assessment was preformed one day before the SPR. First assessment of changes was conducted one week after the SPR. An repeated follow-up assessment was done three to four years after the SPR procedure. In one week after SPR assessment a reduction of spasticity of lower and upper limb muscles and reduction of clonus were seen. A last three-year assessment detected some return of spasticity on hip adductors, plantar and dorsal flexors muscles. However, the return of the hypertonus did not reach initial values of spasticity. Powered by TCPDF (www.tcpdf.org)
|
|
|
Effect of botulinum toxin use in muscle spasticity
Tintěrová, Alena ; Kraus, Josef (advisor) ; Smékal, David (referee)
This study has brought an overview of botulinum toxin and its influence on the human muscles, especially on spastic muscles. In the practical part is resumed experience with botulinum toxin A therapy in children with cerebral palsy. There were observed two groups. Group A (n=9) was measured before and after therapy. Patients in group B (n=24) filled out a table of the global spasticity scale, which they returned by mail. All the patients improved after the treatment. Powered by TCPDF (www.tcpdf.org)
|
|
|
Effect of Botulinum toxin on muscular hyperactivity and motor performance of the patients
Kratochvílová, Pavla ; Syslová, Jana (referee) ; Kraus, Josef (advisor)
This study deals with the effects of botulinum toxin A treatment on pathological muscular hyperactivity in a group of 53 children. The thesis objective was to evaluat eeffect of botulinum toxin on muscle tone, range of movement and motor performance of the patient. The theoretical part summarizes the knowledge about this theme, characterizes the term spasticity and an impact of botulinum toxin on abnormal muscular hyperactivity. The practical part evaluates the effect of botulinum toxin in two groups of patients. The first group consists of 14 children, who were tested before and at least one month after botulinum toxin application. Clinical assessment involved range of movement measurement, the evaluation of spasticity with Modified Ashworth scale, Global Assesment of Spasticity Scale (GSA), assessment of motor performance with the use of GMFM test and Functional Independence Meassure for children WeeFIM and summarized physical therapeutic methods used in treatment of patients before and after the application. The second group consists of 39 patients who administered the GSA survey forms within a period of one month. The results confirmed positive effect of botulinum toxin treatment on reduction of spasticity, increasing of range of movement and improvement of motor performance of children. Powered by...
|
|
|
The importance and possibilities of positioning of patients after stroke
PLOUHAROVÁ, Kamila
This bachelor thesis is about the importance and possibilities of positioning of patients after stroke. The thesis is divided into theoretical part and practical part. The theoretical part deals with a summary of theoretical knowledge about stroke and possibilities of positioning patients after stroke. There is a more detailed description of antispastic positions, which are based on the Bobath concept. The thesis also includes information about other ways of positioning, which are positioning based on the concept of basal stimulation, positioning using inflatable splints, canistherapy and the suitable supply of information to the patient. The aim of the practical part of the thesis is to evaluate the importance of positioning of patients after stroke by comparing the entry and exit examination and suggest short and long term rehabilitation plan for patients. In practical part was chosen qualitative research a case study that was performed with 5 patients after stroke. Patients were selected randomly during my practice in hospital in České Budějovice at the Neurological and Rehabilitation Department. Data collection was performed processing of case studies, which used the method of observation, interviewing patients and nursing staff and secondary data analysis. Each case report contains anamnesis, entry and exit examinations, proposal of short and long term rehabilitation plan and information about therapy, which patients participated. The results of the thesis show that physical conditions were improved by patients described in case studies 1, 2 and 3. Patients 1 and 3 also improved their psychological conditions. The patient described in the case study 2 did not have any psychological problem at the beginning of the research. The physical and psychological conditions were not improved by patients 4 and 5, but avoid the formation of pressure ulcers and to reduce passive range of motion. Improvement by patients 1, 2 and 3 can be caused by favourable prognosis early in the disease and also care of multidisciplinary team. Against to this by patients 4 and 5 was the prognosis unfavourable.
|
|
|
The effect of multiple sclerosis on psychical health of people suffering from multiple sclerosis
CHROUSTOVSKÁ, Petra
In my thesis, I focused on people with multiple sclerosis and their kin. I followed the issues how this disease affects the psychological perception of people with this disease and how to change the perception of their kin. Sclerosis comes from latin word "skleros" that means "stiff, tough" and multiple stands for the fact that lesions can be formed anywhere in the central nervous system. Multiple sclerosis is an autoimmune inflammatory disease. The cause of this disease is still unknown and there are currently no drugs that would be able to completely stop the disease and cure it. It is a disease of mainly young people between 20 - 40 years. The myelin sheaths disintegrate and the nerve impulses consequently interrupt or slow down in the organism. This process leads to progressive disability of such ill people. The work is divided into two parts, theoretical and practical. The theoretical part is mainly deals with the fundamental issues of multiple sclerosis. There are stated and described the symptoms of the disease and its treatment, diagnostics of disease and the impact on family, social or work life. The practical part is focused on qualitative research where I addressed two groups of people. The first group consists of people with multiple sclerosis disease. Data was collected by narrative interviews. The second group is formed by kin, where a semi standardized questionnaire was applied. Respondents were selected using the "snowball". The survey conducted among patients resulted in basic finding. For people with good family backgrounds the knowledge of their diagnosis caused decrease of their mental health and mild depression that was usually subsided after treatment with antidepressants and the patient was able to return to active life. For people with impaired family background mental and physical health deteriorated. Immediate family members understand the changes in life values of their loved ones and support them in every new activity. I chose this topic because the number of people with multiple sclerosis is increasing. In this work, I would like to contribute to greater awareness, both patients and company, also support patients and show that even with multiple sclerosis they can live a full life.
|
|
|
Physiotherapy for Stroke Patients in Chronic Stage Using the Methods of the Neurophysiological Basis
HANZALOVÁ, Jitka
The topic of the thesis is the physiotherapy based on neurophysiological methods for chronical stage stroke patients. The stroke is a lesion of a part of the brain tissue which develops suddenly from lack of blood perfusion in the area. The clinical manifestation of stroke can differ widely depending mainly on localization, extent, graveness and duration of the reduced blood perfusion or encephalorragia. This results in need of special rehabilitation programme made for each patient individually. The main principle of physiotherapy based on neurophysiological methods is prospering from plasticity of the neural tissue which is preserved in spite of severe injury of the brain. These methods influence control mechanisms in central nervous system by activation of various neural receptors. This therapy affects the patient complexly, it is not aimed at analytic muscle training. The purpose of this thesis was to prove and to evaluate the significance of the neurophysiological methods based physiotherapy for chronical stage stroke patients. The thesis consists of theoretical part and practical part. The theoretical part resumes information on the stroke, its risk factors, complications, consequences etc. The next part briefly describes some of the neurophysiological methods which can be used for the stroke rehabilitation. These particular methods were then utilized in the practical part during physiotherapy sessions with concrete patients. The theoretical part also informs about other means of complex rehabilitation which can be used for treating chronical stage stroke patients. The practical part records physiotherapeutical treatment with the patients. In the practical part of the thesis qualitative research method was used and following methodics: anamnesis, entering examination, special examination by Chedoke for hemiplegia scoring, the records of each therapy session and evaluating the effect of the therapy, which show that physiotherapy for stroke patients is meaningful in chronical stage as well and that the methods and concepts used are suitable. The thesis may serve as a source of information for healthcare professionals and other people taking part in care of the chronic stage stroke patient.
|
|
|
Physiotherapy for people with cerebral palsy from 15 to 30 years old
ŠKOPKOVÁ, Eva
For my bachelor thesis I chose topic Physiotherapy of Persons between fifteen and thirty Years of Age Suffering Cerebral Palsy. Number of patients with this disorder is still increasing, but since 50s of the 20th century neonatal care began to become better. Thanks to this improvement in medical care number of saved newborns, who would have earlier died because of the consequences of prematureness or diseases, is now higher. These children are often disabled by cerebral palsy. Cerebral palsy is an untreatable disease, whose displays can be influenced only by a well chosen therapy. Bachelor thesis has two basic parts. The first one is theoretical, which is divided into a general and special part. In the general part, I focused on the sum of theoretical knowledge about cerebral palsy, I paid attention to the characteristics of the disease, incidence, etiology, pathological anatomy and to the classification of cerebral palsy. Then I focused on the diseases associated with cerebral palsy. I describe physiotherapy of cerebral palsy patients with focus on reflexive locomotion in the special part of my bachelor thesis. The aim of my bachelor thesis is to summarize knowledge about cerebral palsy. Considering that one of the basic features of the treatment is physiotherapy, I devoted my attention to the most usually used methods in the treatment of cerebral palsy. The theoretical part is concerned with methods of reflex-locomotion (Vojtova metoda), of Redcord ? therapy and by the concept of Mr. and Mrs.Bobaths. In the practical part of my thesis I made a quality research, where I specified goals of my work, offered description of methodology, characteristics of a file, and I made three casuistries. A part of the casuistries were anamneistic data and making of preliminary and output exploration. These explorations included objective general assessment, establishing locomotive state according to professor Vojta, exploration of locomotive abilities and goniometric explorations too. All persons went through classification of spasticity according to Ashworth´s measures and exploration of shorten muscles was also done. Research was made in the ARPIDA centre in České Budějovice, it took three months (March, April and June/2013) ? investigation of one patient of all three took circa one month, in which 9 therapies were done. The aim of practical part is to bring physiotherapical plan for observed patients with cerebral palsy. Results show that short-termed treatment had positive effect on health state of all three observed patients. The most affected areas were stability, correction of axial organ, but hypertonus of muscles and empowerment of weakened muscles also became better. The bachelor thesis can be used as a source of information for orientation in the topic of cerebral palsy by students of physiotherapy, but can also serve as an educative material for patients between fifteen and thirty years of their age and by their parents. Thesis could also be an inspiration for physiotherapists, who could think about their own treatment therapies for patients with cerebral palsy with the usage of not so known method Redcord?.
|
|
|
Hippotherapy, a part of the medical treatment of children with cerebral palsy
MACHOVÁ, Eva
My bachelor's thesis called Hippotherapy, a Part of the Medical Treatment of Children with Cerebral Palsy focuses on the influence and effects of hippotherapy on the locomotive apparatus and emotional feelings of three children's patients. The research took place from January to March 2011 on the premises of the Sociotherapeutic Farm of the Mental Hospital Bohnice in Prague. Nowadays the awareness of hippotherapy is growing both among specialists and laymen. However, it is important to realize that hippotherapy does not only mean horse riding which make people feel emotionally good, but it is also a purposeful and efficient therapeutic method. In my bachelor's thesis I emphasize the positive impact of this therapy not only on the emotional state of mind, but also on the locomotive apparatus of clients and the muscle tone. My bachelor's thesis is divided in two parts ? theoretical and practical. The theoretical part is an overview of my knowledge of hippo-rehabilitation with focus on hippotherapy from professional books and other available sources. I also present my knowledge of children's cerebral palsy (DMO), possibilities of physiotherapy of cerebral palsy and types of muscle tone. The practical part focuses on the research regarding effects of hippotherapy on patients suffering from DMO. By using the hippotherapy evaluation test (Hollý, Hornáček, 2005) I evaluated the influence of hippotherapy on the locomotive apparatus of patients sitting on a horse, by measuring the distance of epicondylus lateralis femur of the right and left lower limbs in the maximum abduction (Drhovský, 2006) I evaluated the influence on spasticity of patient's lower limbs, by using a verbal scale of feelings of happiness (Hollý, Hornáček, 2005) I tried to find out whether horse riding makes children with DMO feel happy and based on the secondary analysis of data I tried to outline the effects of hippotherapy in the medical treatment of children with DMO. The objective of my bachelor's thesis is to provide new information on hippotherapy both to professionals and public and to emphasize its positive effects on humans.
|
|
|
Prevention and therapy of spasticity in patients after cerabral apoplexy
TÁBORSKÁ, Žaneta
Spasticity is a manifestation of many neurological diseases, for example an infantile cerebral palsy, a traumatic injury of brain and spinal cord, a multiple sclerosis and a stroke. A genesis of the spasticity is not yet completely clarified and many definitions try to explain it. The spasticity can deepen a disability of patients even with a minimal paresis. The spasticity has a different clinical picture at various diseases of the central nervous system, but even at different patients with the same diagnosis, it also varies in the course of time at one and the same patient. The biggest problem in the treatment of the spasticity is the fact that the treatment, efficient at one patient, can completely fail at the other. A goal of this thesis was to give an overview of current options in a treatment of the spasticity. Therapeutic approaches to reduce the spasticity are usually a part of special kinesio-therapeutic methodologies, which are for example an anti-spastic positioning, a volitionary relaxation, passive movements, an anti-spastic placing (Bobath´s conception), relaxation techniques (PNF), an application of splints, a long-term effect of the heat, an icing and others. On the contrary, it is intensified by pain, pressure sores, a sub-luxation position most often of the shoulder joint, a psychical stress, urinary tract infections etc. In the theoretical part I focused on a control of the muscle tone, pathophysiology, clinical symptomatology, diagnostics and especially prevention and the treatment of the spasticity. In the practical part I investigated an effectiveness of an anti-spastic therapy through the qualitative research. For the data collection it was used an anamnesis, observations (kinesiological analysis), case reports and a secondary data analysis. The research was made at two probands with a brain damage on the vascular basis. I was finding out an effectiveness of selected therapies for individual probands {--} and at the same time its suitable combination. I focused on the area of the upper extremity. At the first patient there was a success, by a suitable combination of individual methods, to positively affect the spasticity and an active momentum of the upper extremity. At the second patient in a chronic stage of spasticity it was managed to influence it always only for a short term and results varied considerably in the course of time. The treatment of the spasticity must be preceded by a thorough knowledge of pathophysiological mechanisms, a neurophysiology and above all a complex kinesiological analysis. The therapeutic approach should be always individual, to respond appropriately to changes in the clinical picture and to use suitable combinations of therapeutic approaches. If the treatment of the spasticity is successful, it positively affects the motor deficit and reduces the patient's disability.
|
|
|
Heterotopic ossification in humans with spinal lesions - sanitary-social impact -
BRYNYCHOVÁ, Lenka
The degree paper titled "Heterotopic ossification of patients with spinal lesio- helth-related and social impact" treats, in general, the issues of the spinal cord trauma. It summarizes all, known to us, health-related and social impacts of such trauma and, primarily, is dedicated in detail to the less familiar consequence of spinal cord trauma which is the formation of heterotopic ossifications. The objective of this paper is to map the occurrence of heterotopic ossifications in the patients with spinal lesion who underwent the rehabilitation programme in Centrum Paraple.
|
guest ::
