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A Case Study of Physiotherapy Treatment of a Patient After Total Knee Replacement
Schwarzová, Eva ; Dvořáčková, Dominika (advisor) ; Vrbický, David (referee)
Author: Eva Schwarzová Title: A Case Study of Physiotherapy Treatment of a Patient After Total Knee Replacement Goals: The aim of the theoretical part is to look into the issue of arthrosis of the knee joint based on scientific literature. The practical part presents a case study of a physiotherapy treatment after a total knee replacement. Method: This thesis consists of a theoretical and a practical part. The theoretical part describes the scientific findings on the subject of the knee joint from an anatomical and kinesiological perspective. Furthermore, this part deals with the gonarthrosis, the total knee replacement, and the physiotherapy treatment. The practical part shows the physiotherapy treatment of a female patient after a total knee replacement. The case study took place during an internship at the Military University Hospital (ÚVN). It contains a kinesiological analysis, a short - and a long-term physiotherapy schedule, a description of the therapy sessions as well as a final evaluation of the effects of the therapy. Results: During the hospitalization, patient underwent eight therapy sessions which led to an increased mobility of the left knee joint, a reduction of the pain as well as a decreasing of the swelling. Furthermore, due to the therapy the strength of certain muscles was...
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A case study of physiotherapeutic care of a patient with total knee replacement
Valovičová, Andrea ; Dvořáčková, Dominika (advisor) ; Sohrová, Jana (referee)
Author: Andrea Valovičová Title: A case study of physiotherapeutic care of a patient with total knee replacement Objectives: The aim of the theoretical part of the thesis is to introduce the problematics of total knee replacement based on literature research. The objective of the practical part is to introduce a case report of a patient after total knee replacement. Methods: The thesis is divided into two parts - theoretical and special (practical). The theoretical part provides basic knowledge of anatomy and kinesiology of the knee joint, gonarthrosis, total knee replacement and the subsequent rehabilitation care. The special part contains a case study of a patient after total knee replacement. The study was executed during continuous professional practice in CLPA s.r.o. The special part consists of the kinesiological analysis, the proposition of the short-time and long-time therapy, the description of individual therapeutic units and the outcome of the kinesiological analysis and evaluation of the effect of the therapy. Results: The patient has completed 8 therapeutic units during which there was an observable improvement in the range of motion of the left knee, strengthening of the weakened muscles and reduction of the joint swelling and pain. Furthermore, joint play was restored on the left...
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The case study of physiotherapeutical treatment of a patient after total hip replacement
Kroiherová, Tereza ; Říha, Michal (advisor) ; Hankovcová, Eva (referee)
Title of bachelor's thesis: The case study of physiotherapeutical treatment of a patient after total hip replacement. Summary: The aim of this thesis is a comprehensive treatment of the theoretical and practical knowledge in a patient after total hip arthroplasty and subsequent rehabilitation. The thesis is divided into two parts. The general part is focused on the theoretical treatment certain diagnoses, drawn from literature. A special part contains a case report of a patient after total hip arthroplasty implanted l.dx. Key words: Hip joint, koxarthrosis, total replacement, arthroplasty, physiotherapy, case study
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Specificities of physioterapy care after the convetional implantation of a total knee-joint in relation to its different surgical solutions
ŠMITMAJER, Jakub
The main aim of this bachelor study is concentrated on an after- total- knee- joint endoprosthesis physiotherapy from the surgical solution point of view. The total endoprosthesis is used as the very last possible option of an invasive means of therapy that is possible to take an advantage of when there is extensive damage of biomechanics of a knee joint. When speaking about the frequency of this operation, it is very high, and it is becoming a more and more common way of surgery that is nowadays being practised. The only more frequent orthopaedic surgery these days is a total hip endoprosthesis implantation. As a result of longer durability of the endoprostheses as well as better joint stability and owing to the great technological development it is possible to use various materials for making endoprostheses. However, there are appropriate demands on both the competence of the operational and consequently the rehabilitative staff working with a complicated structure of the prostheses. The study is divided into the theoretical and practical part. First, in the theoretical part there you can find analysed anatomy and biomechanics of a knee joint. Secondly, there are described indications and contra- indications of the total endoprosthesis implantation, types of total endoprostheses as well as the possibility of consequent physiotherapy. In addition, a method of qualitative research was used in the practical part of the study. There were two groups of patients under the reseach- including two women aged between 61 and 70 in each group.A different means of surgery for the total endoprosthesis of the knee joint was applied in each of the groups. There was also the same amount of time for the research of both groups. An entry kinesiological analysis was taken the sixth day after the surgery. Consequently the output kinesiological analysis was done after the second orthopaedical check- up (approximately the third month after the surgery), when a hundred per cent tread on the operated limb was permitted. The research itself took place in a hospital, afterwards it continued in domestic surrounding at home using available aids. Providing anamneses of all patients a goniometrical, anthropometrical and palpational check- ups of the knee joint were done. Furthermore, according to Janda, a muscle test and a check- up of shortened muscle groups related to the knee- joint were done as well. A functional check- up of a knee- joint muscles and an endoprosthesis itself was included in the output kinesiological analysis. All the patients were offered the same exercise unit to make better evaluation of the research. The frequency of regular exercise was set to a four-time period per week. An anthropometric check up showed that a post surgical swelling was more significant with the patients after the lateral parapatelar cut, that slows down patients' active joining the short- period kinesiotherapeutic schedule. The range of the movement in the operated knee joint was one of the main observing aspects that much differed already at the entry kinesiological check- up. The aim of the therapy was to achieve the minimum of 90 degree- active flexion of the knee joint at the end of the research. Both the patients after the medial parapatelar cut achieved the given point a few days earlier because the patients after the lateral parapatelar cut were provided with a motorial splint. This motorial splint enabled the patients to extend the range of movement in the joint. The power of muscles did not fundamentally differ comparing the output check- ups of both the groups, however the patients after the medial parapatelar cut achieved the muscle power degree 5. In addition, after the third month from the surgery, permitting 100 per cent tread on the operated limb, a functional check- up of muscles and the endoprosthesis of the operated knee joint was taken. It revealed stronger stability of the patients after the lateral parapatelar cut
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The doctor and nurse cooperation in the center for patients undergoing a principal joint aloplasty
RAZIMOVÁ, Lada
Motoric system diseases belong to the most frequent ones in the present days. All age categories are affected. Congenital defects are included and also injuries, inflammations, degenerative illnesses and others. In the Czech republic are many centers gathering patients with the same diseases. However the centers for orthopedic patients are missing. The dissertation is divided into a theoretic and empiric parts. The theoretic one is focused generally on problems with joint replacements, rehabilitation and relation between a medic and a patient. The dissertation was targeted on: 1. To verify if the informing about the subsequent postop nursing care provided in the center for patients undergoing aloplasty comes up to a patient?s expectations and fulfils their needs. 2. To find out if hospital nurses perceive the difference in the patient engagement in the nursing care according to if he had visited the center before or not. 3. To reveal potential problems in the center running from the patient, nurse and doctor point of view. The research part of the dissertation was implemented with a combination of both qualitative and quantitative survey. For quantitative survey was chosen a method of questioning with a form technique for patients (after a hip or a knee aloplasty) in the Czech republic and Austria and also for nurses working in the orthopedic department and intensive care unit in the Pelhřimov hospital. Three hypotheses were established. 1. The given nursing care informations provided in the center for patients undergoing aloplasties fulfil the patient?s needs. 2. The hospital nurses assess a significant difference in the patient?s collaboration between those who had visited the center before and who had not. 3. In the center for patients waiting for aloplasty daily running there exist problems from the nurse?s point of view. As for the qualitative part of survey a method of questioning with the technique of a semistructured dialog with open questions was used. The research file was created by patients after principal joints aloplasties. In this part we have tried to answer three main questions. 1. What is the relationship between both hospital and the center nurse activities and the patient?s contentment in the sphere of his needs? 2. What sorts of informations for the patients in the center are missing? 3. The patients evaluate the informations provided in the center as orientational or as significant for easier postop care managing? The results of the research survey were analysed and taken in schemes. Patients suffer from disturbing their both physical and psychological needs and so the goal of collaboration is a satisfied and fully informed patient. From the results it is apparent that a nurse in the center closely cooperates with a hospital nurse. The survey revealed that the patients in the center are missing no informations. The patients are prepared for the operation, orient themselves in the related problems know what comes with the rehabilitation as an important part of the postop care. To be concluded: patients are prepared for easier postop care managing. On the basis of analysis of respondent?s answers it was found that the patients undergoing a principal joint aloplasty are sufficiently informed. Although hospital nurses and doctors sense the difference between a patient who had visited the center before and who had not the stimulus for subsequent survey could be how the patients perceive the differentness of info provided within the center and out of it. The survey results could be a stimulus for establishing new centers not only within Vysočina but also in Austria. In the relation with the dissertation results and on the basis of info provided in the center when the patients assessed the info as sufficient for them an informing prospectus was created. The dissertation could serve as an informational material for students not only in the nursing profession.
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