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Use of Mobile Applications in Vestibular Rehabilitation
Batelková, Barbora ; Kučerová, Klára (advisor) ; Bárta, Martin (referee)
The bachelor's thesis focuses on the use of mobile apps in vestibular rehabilitation. The main purpose of this thesis is to provide market research of mobile apps currently available at Google Play Store. Additional goal is to provide an overview of current literature relating to the use of the mobile apps in vestibular rehabilitation. Theoretical section summarizes knowledge of the anatomy and physiology of the vestibular system, vestibular compensation mechanisms and vestibular rehabilitation practice. It also provides a brief information about mHealth apps and rehabilitation apps. Following topic is a retrieval of the literature scoping mobile apps in vestibular rehabilitation and a search of mobile applications available on the Google Play Store, that are or may be intended for use in vestibular rehabilitation. Experimental section consists of two case reports of patients with vestibular hypofunction using mobile app for 4-week therapy. Patients underwent 3 measurements (before, during and after the therapy) including Clinical Test of Sensory Interaction and Balance (CTSIB), Functional Gait Assessment (FGA), and Dynamic Visual Acuity Test (DVA). Also, a standardized questionnaire The European Evaluation of Vertigo scale was used and finally, patients were asked about satisfaction with the...
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The evaluation of vestibulospinal and vestibuloocular reflex in patients during early postoperative period after vestibular schwannoma resection
Markvartová, Anna ; Čakrt, Ondřej (advisor) ; Chovanec, Martin (referee)
The thesis deals with the issues of balance disorders in patients after vestibular schwannoma surgery. The aim of this thesis is to evaluate the effect of targeted rehabilitation with biofeedback on balance disorders and subjective visual vertical compensation. During the period of one year, a group of 20 vestibular schwannoma patients were examined and treated in University Hospital Motol. The compensation of vestbuloocular refex was assessed by a tilt of subjective visual vertical. The level of vestibulospinal compensation was determined according to score of the Activities-Specific Balance Confidence Scale. Patients were examined before the surgery, after the surgery and after the rehabilitation. The Homebalance system, developed by Support center for application outputs and spin-off companies at the 1st Faculty of Medicine, Charles University in Prague, branch office in Kladno, was used for the therapy with visual biofeedback. Another aim of this thesis was to monitor the effect of vestibular prehabituation with ototoxic gentamicin application two months before surgery. The statistical analysis of data proved in the case of subjective visual vertical tilt a significant increase of deviation after surgery and a decrease after rehabilitation. According to the ABC questionnaire the confidence of...
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Factors affecting vestibular compensation in patients after vestibular schwannoma surgery.
Balatková, Zuzana ; Čada, Zdeněk (advisor) ; Salzman, Richard (referee) ; Šlapák, Ivo (referee)
Vestibular schwannoma surgery causes in majority of patients the unilateral peripheral or combined vestibular lesion due to surgical interruption of both branches of vestibular nerve. It manifests postoperatively with postural instability, vertigo, oscilopsia and even with vegetative symptoms. Central compensation, in which cerebellum plays dominant role, influences duration of the symptoms. Factors affecting compensation may be divided into several groups (general health status of a patient, the tumor itself, actual state of function of vestibular system, external factors induced by a therapeutist). Therapeutic aim is to induce compensatory mechanisms as soon as possible and to reduce overall duration of the compensation. The aim of this study is to consider predictive factors influencing central vestibular compensation and to influence the vestibular compensation itself. Early operated vestibular rehabilitation is a basic procedure. It leads to faster recovery in majority of patients. Even with maximal effort the full compensation is not always achieved. It results in permanent deficit of vestibular function manifested with postural instability. However in some patients it is difficult to achieve full compensation despite maximum effort of a physiotherapeutist and that results in permanent...
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Factors affecting vestibular compensation in patients after vestibular schwannoma surgery.
Balatková, Zuzana ; Čada, Zdeněk (advisor) ; Salzman, Richard (referee) ; Šlapák, Ivo (referee)
Vestibular schwannoma surgery causes in majority of patients the unilateral peripheral or combined vestibular lesion due to surgical interruption of both branches of vestibular nerve. It manifests postoperatively with postural instability, vertigo, oscilopsia and even with vegetative symptoms. Central compensation, in which cerebellum plays dominant role, influences duration of the symptoms. Factors affecting compensation may be divided into several groups (general health status of a patient, the tumor itself, actual state of function of vestibular system, external factors induced by a therapeutist). Therapeutic aim is to induce compensatory mechanisms as soon as possible and to reduce overall duration of the compensation. The aim of this study is to consider predictive factors influencing central vestibular compensation and to influence the vestibular compensation itself. Early operated vestibular rehabilitation is a basic procedure. It leads to faster recovery in majority of patients. Even with maximal effort the full compensation is not always achieved. It results in permanent deficit of vestibular function manifested with postural instability. However in some patients it is difficult to achieve full compensation despite maximum effort of a physiotherapeutist and that results in permanent...
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The evaluation of adaptation of the vestibulo-ocular reflex in patients after vestibular schwannoma surgery
Hladíková, Veronika ; Čakrt, Ondřej (advisor) ; Jeřábek, Jaroslav (referee)
This thesis deals with the evaluation of the vestibulo-ocular reflex in patients indicated for neurosurgical resection of vestibular schwannoma, executed at the Motol University Hospital. To evaluate the function of the vestibulo-ocular reflex, three types of clinical examinations were used. In periods before the surgery, early after the surgery and before leaving the hospital we monitored the patients' ability to perceive subjective visual vertical, which reflects tonic function of otolith organs. Before the surgery we also tested relative dynamic visual acuity during passive isolated head movements in the transversal plane, whose impairment is related to dysfunction of lateral semicircular canals. Furthermore, we obtained patients' preoperative values achieved in caloric reflex test. In the early postoperative period, bordered by the first day after the vestibular schwannoma surgery and the last day of the hospitalization, patients underwent specialized vestibular rehabilitation. Based on statistical analysis of acquired data, we found out that in some patients there was a lesion of the vestibulo-ocular reflex already before the surgery and moreover, there was a correlation between dysfunction of translational and rotational parts of the vestibulo-ocular reflex. Although variance of subjective...
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The dynamic of vestibular compensation in patients after vestibular schwannoma surgery
Kletenská, Markéta ; Čakrt, Ondřej (advisor) ; Čada, Zdeněk (referee)
The thesis deals with the issue of vestibular compensation in patiens after vestibular schwannoma surgery. The aim of this thesis was to objectively evaluate the dynamics of vestibular compensation in the early postoperative period and to determine whether the application of gentamicin impacts the dynamics of equilibrium functions. 32 patients participated in the study (20 women and 12 men) ranging from 28 to 73 years of age. Patients underwent a rehabilitation program with visual feedback using the interactive rehabilitation system, Homebalance. This rehabilitation program was carried out daily from the 5th postoperative day until hospital discharge. Patients were examined preoperatively, postoperatively and after rehabilitation. To assess the vestibular compensation, static posturography, the Synapsys Posturography System, and the Activities-Specific Balance Confidence Scale were used. The statistical analysis showed a significant increase in mean values of measured COP parameters (the length of the COP trajectory and COP confidence elipse area) postoperatively. After completing the rehabilitation program no significant reduction of measured COP parameters was found. The total score from the Activities- Specific Balance Confidence Scale showed a statistically significant decrease in postoperative...
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The effect of targeted rehabilitation on vestibular compensation in patients after vestibular schwannoma resection.
Holá, Irena ; Čakrt, Ondřej (advisor) ; Čada, Zdeněk (referee)
The thesis deals with the evaluation of the impact of preoperative application of gentamicin on vestibular compensations of patient after vestibular schwannoma surgery. The trial involved 32 patients with diagnosed vestibular schwannoma and hospitalized with the indicated for neurosurgical resection at the University Hospital Motol. Ototoxic gentamicin was transtympanically applied to ten of these patients two months before their surgery. After the surgery the patients underwent a rehabilitation program based on the visual biofeedback using the Homebalance system. To evaluate the vestibular compensation the subjective visual vertical measurement and the Dynamic Gait Index standardized walking test were used. In total, each patient performed three examinations: before the surgery, after the surgery and before the end of hospitalization. Statistical analysis of the measured data showed the statistically significant increase tilt of subjective visual vertical and the decrease in the overall score of Dynamic Gait Index after surgery. Reduction in the subjective visual vertical tilt and the overall score of Dynamic Gait Index after rehabilitation has not been proven to be statistically significant. Any statistically significant difference was found between the group of patients treated by gentamicin and...
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The evaluation of vestibulospinal and vestibuloocular reflex in patients during early postoperative period after vestibular schwannoma resection
Markvartová, Anna ; Čakrt, Ondřej (advisor) ; Chovanec, Martin (referee)
The thesis deals with the issues of balance disorders in patients after vestibular schwannoma surgery. The aim of this thesis is to evaluate the effect of targeted rehabilitation with biofeedback on balance disorders and subjective visual vertical compensation. During the period of one year, a group of 20 vestibular schwannoma patients were examined and treated in University Hospital Motol. The compensation of vestbuloocular refex was assessed by a tilt of subjective visual vertical. The level of vestibulospinal compensation was determined according to score of the Activities-Specific Balance Confidence Scale. Patients were examined before the surgery, after the surgery and after the rehabilitation. The Homebalance system, developed by Support center for application outputs and spin-off companies at the 1st Faculty of Medicine, Charles University in Prague, branch office in Kladno, was used for the therapy with visual biofeedback. Another aim of this thesis was to monitor the effect of vestibular prehabituation with ototoxic gentamicin application two months before surgery. The statistical analysis of data proved in the case of subjective visual vertical tilt a significant increase of deviation after surgery and a decrease after rehabilitation. According to the ABC questionnaire the confidence of...
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Compensation of balance disoder in time in patients after vestibular schwannana resection
Hajná, Barbora ; Čakrt, Ondřej (advisor) ; Chovanec, Martin (referee)
Introduction: Disorders of balance and dizziness are characteristic symptoms in patients after vestibular schwannoma surgery and often have a negative impact on their quality of life. This thesis deals with impairment of postural stability particularly in patients at the long time period after surgery. The aim of this study is to observe the longitudinal development of vestibular compensation from acute postoperative period to time of several years after surgery. Another aim is to evaluate the short-term effect of vestibular rehabilitation in a long time period after surgical treatment, and to compare the results of measuring the subjective visual vertical, posturography, score of the Dizziness Handicap Inventory questionnaire, age and tumor size in these patients. Methods: Examined group consisted of 10 patients after resection of vestibular schwannoma (mean age 41.4 ± 12.1 years; 2 women and 8 men). All patients underwent intensive rehabilitation program in the acute phase after surgery. 7 patients did exercise with visual feedback, and 3 patients had conventional rehabilitation without visual feedback. In long time period after surgery all patients underwent one exercise unit with visual feedback. Patients underwent computerized posturography examination using force platform Balance Master® in...
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Evaluation of the effect of rehabilitation using visual biofeedback for patients after vestibular schwannoma resection
Jandová, Nikola ; Čakrt, Ondřej (advisor) ; Chovanec, Martin (referee)
The aim of this thesis was to evaluate the effect of rehabilitation with visual biofeedback at acute stage after vestibular schwannoma surgery and to evaluate if preoperative intratympanic aplication of gentamicin has influence on vestibular compensation of standing stability. The study was attended by 20 patients (12 women and 8 men) in the age from 28 to 63 years. Eight patients had vestibular schwannoma diagnosed in their left side, twelve in the right side. Rehabilitation program using interactive rehabilitation system Homebalance took place from the 5th postoperative day until hospital discharge, daily 15 to 20 min. To evaluate of therapeutic intervention objectively the device Synapsys Posturography System was used. Stabilometric examination was done before operation of vestibular schwannoma, after operation and after termination of rehabilitation with visual biofeedback. Statistic analysis showed significant increase of mean values of measured parameters CoP (sway velocity CoP, length of trajectory of CoP, area of the confidence ellipse CoP) postoperatively compared to preoperative values. After termination of therapeutic intervention there was any significant decrease of values of parameters CoP compared to postoperative status. Between group of patients with preoperative aplication of...
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