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Lymphotherapy as part of physiotherapy in patients after the ablation of breast in outpatient care
Jarotková, Eva ; Horká, Bohumila (advisor) ; Vondráková, Ivana (referee)
Author: Eva Jarotková Institution: Department of Rehabilitation Medicine, Faculty of Medicine in Hradec Králové Title of the thesis: Lymphotherapy as part of physiotherapy in patients after the ablation of breast in outpatient care Supervisor: Mgr. Bohumila Horká Number of pages: 97 Year: 2014 Key words: lymphatic system, secondary lymphedema, breast cancer, Complex Decongestive Therapy, quality of life This bachelor's thesis deals with lymphotherapy - Complex Decongestive Therapy, which makes an important part of physiotherapy in patients after the treatment of breast cancer. Information about anatomy, physiology and pathophysiology of the lymphatic system is covered within the theoretical part. It also brings forward the whole issue of breast cancer with its diagnosis, prevention and treatment and mainly focuses on its complication, secondary lymphedema of the upper extremity. The end of the theoretical part describes the basis of Complex Decongestive Therapy. The empirical part shows how Complex Decongestive Therapy is used in two patients after the ablation of breast, diagnosed with the secondary lymphedema of the upper extremity. The goal of this part is to prove how significantly Complex Decongestive Therapy contributes to cure lymphedema and how greatly it affects the quality of patient's...
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Therapeutic importance of manual lymphatic drainage for lymphedema of limbs
VOTRUBOVÁ, Eva
The importance of lymphatic drainage and other techniques used to cure lymphedema was known as early as around the year 3,000 BC. In the Czech Republic it became quite common after 1992, when the Czech Society of Lymphology was founded. Since the number of professionals in this area has been increasing and so has the number of patients, which makes the cure of lymphedema a very topical question. The first chapter of the theoretical part of my thesis is devoted to the history of the anatomy of lymphatic system, lymphedema and manual lymphatic drainage. There are also chapters on the definition of lymphedema and its classification according the mechanism of its creation and pathophysiology which triggers this problem. The differences between primary and secondary lymphedema are described in detail. I also sum up the knowledge about the etiology of lymphedema, its clinical picture, its differential diagnosis and stages of development. Apart from surgical, pharmacological and spa treatment I deal with decongestive treatment, which includes instrumental lymphatic drainage, banding, regime measurements, special exercise and manual lymphatic drainage. The chapter on manual lymphatic drainage deals both with effect and indications and contraindications of this method. The basic aim of my thesis is to map the contribution of manual lymphatic drainage to the cure of the lymphedema of limbs with special attention to the span of motion of joints and circumference of the limb before and after the therapy. The method of quantitative research was used for the practical part. The research was done on 3 respondents, who went through the entry examination. It contained the taking of thorough anamnesis including the personal data and family, social, professional etc. anamnesis. I also did a kinesiology analysis, which contained the aspection from the front, from the side and from the back and the values which were of the highest importance to me: circumference of the limbs and goniometric measuring of the span of motion of joints of the afflicted limb in comparison to the healthy one. The first research question is: What is the influence of the manual lymphatic drainage on circumference of the afflicted limb? The second question is: What is the influence of the manual lymphatic drainage on the span of motion of joints of the afflicted limb? During my internship in the rehabilitation centre in Borovany I had consultations with Jana Poláková, BA, who is a graduate of a certified course of manual lymphatic drainage. We discussed the choice of suitable patients, possible therapy and short-term and long-term plans. After every first or second massage I conducted a check measurement with all probands. Al in all conducted 5 measurements with each proband. The aim of my thesis was to map the contribution of the lymphatic drainage to the rehabilitation and its positive influence on the overall improvement of the patient´s health. The research was conducted in the rehabilitation centre in Borovany through an interview, retrospective data analysis, measurements of the circumference of the limbs and the span of motion of joints and observation and examining of the afflicted limbs. Subjectively all the patients find manual lymphatic drainage useful in the treatment of lymphedema. They mention improvements in the visible decrease in circumference of the limbs and the span of motion of joints as well as the overall perception of the limbs, their posture and motoric. Objectively the decrease of centimetres in circumference of the limbs and increase in the span of motion of joints was observed with all the patients.
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Obesity of gynoid type and its effect on diet.
ZADRAŽILOVÁ, Františka
This thesis deals with the obesity of gynoid type and the effect of a diet on it. The introduction of my thesis is focused on the definition of the gynoid obesity, its characterization, emergence and complication. Furthermore metabolic syndrome Y, complex decongestive therapy and the diet are also characterized. The practical part talks about modifying eating habits and how the restriction of carbohydrates can change the physique. The group of examined women underwent an antropometric measurement before and after the intervention. Based on the obtained data, a presentation of the results was prepared to target the effectivity of the diet.
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The Subjective Evaluation of a Patient´s Overall Health State at the End of the Reduction Phase of Lymphedema Treatment
PLACATKOVÁ, Petra
The graduation thesis is focused on Lymphedema patientś problems. It addresses how the patient values his or her own health state. The differences between a patientś health state before therapy and after finishing its reduction phase have been compared. The following aspect have been valued: limited movement, pain and mental stress. All of them were improved after the reduction phase. Thus Hypothesis 1 has been confirmed: "At the end of the Reduction Phase of Lymphedema therapy the overal health state of the patient is improved." Out of above meditioned three aspect, the mental stress improved at a lowest rate. Differences between patients with and without good social background were demonstrated. Patients with bad social background valued mental stress caused by Lymphedema before and after the therapy as significantly higher then patients with good social background. Thus Hypothesis 2 was also confirmed: "Patients with good social background cope with their disease in a better way." In order to test the hypotheses the quantitative research was done. The technique was standardised integration.
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