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Stress incontinence and the possibilities of targeted rehabilitation
VYHLÍDALOVÁ, Denisa
The topic of my bachelor thesis is stress incontinence and options of targeted physiotherapy. The first section contains theoretical background concerning mentioned problems. The theoretical section summarizes anatomical and physiological facts about urinary system and pelvic floor, and the theory of incontinence. There are described types of urinary incontinence and their causes. As next, there are mentioned the options of diagnostics and treatment especially of stress incontinence. Incontinence, i.e. involuntary leakage of urine, is one of the most widespread female inconveniences of recent years. It brings many problems, not only physical ones but also mental, and so that it has negative impact on quality of the life. This involuntary leakage of urine is not an illness to all intents and purposes but symptom with various causes. The most common cause are weakened muscles of pelvic floor, which belong to the deep stability system. They significantly support the whole stability system of the trunk. These muscles and fasciae of pelvic floor provide proper stabilization of urinary bladder, urethral closure, and urethra in proper position and by this they assure continence, especially when intra abdominal pressure increases. The muscles of pelvic floor and diaphragm participate together in breathing. The frequency of incidence of urinary incontinence increases depending upon the age. One of the incontinence types is stress incontinence. Urine leakage is always related to physical activity. Urine leakage happens when intra abdominal pressure increases and happens without contraction of detrusor. Unlike against other disorders, it is possible to fight successfully against incontinence not using only drugs and operative surgery. The treatment of incontinence is in recent years relatively successful and with the help of proper and regular exercise it is possible to prevent it. According to some recommendations, when treating stress incontinence, physiotherapy should be chosen as a primary treatment. The goal of physiotherapy is the effort to help patient to be able to activate muscles of pelvic floor in situations when the leakage of urine is expected. There was used the method of qualitative research in practical section of the thesis, using case studies of 2 patients suffering from stress incontinence. The thesis contains entry and final kinesiologic analysis completed with the query CONTILIFE, the plan with adequate exercises and measures, and the final success rate of the treatment. The goal of the thesis was to point out significant role of physiotherapy in the treatment of patient with stress incontinence, then outline the available rehabilitation methods and propose complex of appropriate exercises and measures. There was created a booklet with the list of exercises for each patient. Patients have exercised using these single exercises being previously instructed about them for eight weeks, and they were simultaneously controlled on regular basis. Patients were observed in a complex manner so that the individual therapy was made for each of them according to individual problems, revealed in entry kinesiologic analysis. Final results of this study showed that the chosen therapy was successful and patients mention not only subjective feeling of improvement of their incontinence problems during the day, but also an improvement of their physical condition and relief from the pain of the cervical and lumbar spine due to a complex approach and individual therapy.
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The effectiveness of exercise on unstable surfaces for physiotherapy students at the University of South Bohemia
ČEJKOVÁ, Veronika
The topic of my thesis is ?Effectiveness of exercising on shaky planes with students of physiotherapy?. Shaky planes and exercising on them positively influences our organism, especially our deep stabilization system. The deep stabilization system is imporatnt for the right body posture. The deep stabilization system is formed by the muscle coordination of the diaphragm, muscles of the abdominal wall, basinal bottom and mm. multifidi. The muscles of the deep stabilization system influence the stabilization of the backbone. If there´s not the right muscle coordination, the backbones is unprotected. The dysfunction of the stabilization of the backbone causes pains of the musculosceletal system, after a longer time degenerative ilnesses emerge. To avoid these problems we have to strengthen the muscles of the deep stabilization system and for this we can use exercising on shaky planes. In me thesis the tested people are using the Bosu ball. The study has been made on the basis of a qualitative survey. The case study has been used. The examination of the tested people has been made on the basis of investigating the biggest possible amount of inforamation. An anamnesis of every tested person has been made and also an aspect and palpation examination has been made. Next a breath stereotype of every tested person has been made, walk and the deep stabilization system. The examination was made before the therapy, as an entry examination. After 4 weeks of exercising, a final examination was made. The final examination consists of the same tests as the entry examination. The final examinatiuon also contains an interview with every tested person, in which I was trying to find out how each tested person was feeling during the exercising and how the exercising influenced each tested person and wheather they want to continue exercising. Exercising lasted for 4 weeks and every tested person worked out 3 times a week. There were two groups of three tested people. The first group used the Bosu ball. All tested people did the same kinds of exercises. There were ten kinds of exercises for every week. When first trying each kind of exercise, the people were checked and I explained them how to do it correctly. Next week there were new kinds of exercises and the old ones were checked again. In the second group of tested people, every person chose their kind of exercise according their concerns. They tried pilates, swimming or going to the gym. After 4 week the results were checked and the effectiveness of the exercises on the deep stabilization system of the backbone. The theoretical part of the thesis describes the anatomy of the deep stabilization system, its examination, function. The therapy and aids that can be used for influencing the deep stabilization system are decribed in the theoretical part. Also the history and the development of the topic of human perceptual and motor skills in the Czech Republic and in other countries has been described. In the practical part the aimes of the thesis are described, the research tasks and the methods used. The most important part is the case interpretation of the tested people with the results of the research. In the attachment there are photographs of the tested people made at the time of the entry and final examinations. There is also a brochure containing a list of exercises which were used. From the results we got from every tested person, it is obvious that their deep stabilization system was positively influenced. The other tested people showed a total or partial pain elimination, but the deep stabilization system was not influenced except the case of pilates. The results of this thesis can be used by other physiotherapists for the need of instruction or for other research. There is also a brochure added containing a list of exercises, which can be used by physiotherapists exercising on the Bosu ball or by the public.
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Effect of jumping training on the postural functions of the spine
KEPKOVÁ, Jana
For my bachelor thesis I chose the theme ?The Effect of Jumping Exercise on Postural Functions of the Spine.? Jumping is safe and gentle aerobic exercise on mini trampolines, which has beneficial effect on virtually all systems of the human body. Speaking about the deep stabilization system, we mean muscle interplay mm.multifidi, diaphragm, pelvic floor and abdominal muscles, which together regulate intra-abdominal pressure. This muscular interplay which ensures stabilization of the spine is activated throughout all movements. Its dysfunction is one of the most significant factors causing back pain. The jumping exercise strengthens these important muscles and improves the overall stability of the body. The objective of the research was to assess the deep stabilization system with respect to kinesiology and kinesiotherapy and to find out whether and how the jumping exercise influences the postural functions of the spine. The data for the thesis were collected by means of qualitative research, by the method of case study and the technique of personal case study. The examination of probands includes a brief history, palpation and visual examination, the examination of deep stabilizing system by functional tests and then also the testing by L.A.S.A.R posture device. Based on the comparison of the initial examination and the final examination, which followed after 10 weeks of jumping exercise, a previously set research question was answered. The thesis involves the theoretical part, which describes the jumping exercise, anatomy, examination of the deep stabilization system and its importance for our body. The practical part involves objectives of the thesis, research questions, the description of methodology, discussions with the authors from which I drew information and primarily, processed results in the form of case reports. The research results show that there were clear positive effects of the deep stabilization system and other structures in all probands. On the jumping lessons the probands were regularly forced to activate the muscles of the deep stabilization system, which resulted in reduction of back pains, in reduction of knee pain in one case and the overall stability of the body improved. The results of the thesis could be used in therapeutic procedures of physiotherapists, for the purposes of further research, in teaching and also in the implementation of more efficient jumping lesson, etc.
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Importance of foot for exercises of deep stabilizing muscles
TURKOVÁ, Alena
The issue of deep stabilization system is still topical at present as its dysfunction causes vertebrogenic problems, one of the most frequent causes of disability to work. The deep stabilization system represents a functional stabilization unit including particularly diaphragm, mm. multifidi, abdominal wall muscles and pelvic bottom muscles. Balanced interaction between muscles is important as this system participates in backbone stabilization and is involved in all moves. A foot is an important part of stabilization system as stabilization of vertically standing body starts in the foot inner muscles. Qualitative research, the method of case study was applied on the data collection. The research was performed for 9 to 12 weeks on a sample of 4 probands who suffered from vertebrogenic problems. The examination of probands consisted of anamnesis, static and dynamic check-up of aspections, palpation examination, examination of the deep stabilization system by functional test and examination of feet. The aim of the thesis was to outline how the use of the foot affects the deep stabilization system and to propose a set of exercises and aids for its correct activation. The theoretical part of the thesis describes foot anatomy and function and the most important part of the deep stabilization system, its examination and therapeutic possibilities including proper use of aids. The practical part presents the aims of the research, describes the methodology and results of the research elaborated in the form of case studies. The Annex also contains a set of exercises affecting the deep stabilization system with application of balance aids. The research results show that body posture has improved in all the probands, all the patients were capable of isolated contraction of the individual DSS parts and functional involvement of the whole system. Influencing of the feet and the whole system led to better stability and graphesthesia on the foot sole, backache has subsided. This thesis may be used in physiotherapeutic clinical practice or as educational material for patients.
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Rehabilitation of patients with asthma bronchiale
NOVÁK, Lukáš
The topic of my thesis is the recovery of patients suffering from bronchial asthma. Asthma Bronchial (next asthma) is one of the most frequented civilisation diseases the prevalence of which has been increasing dramatically in the last 20 years. It is a chronic inflammatory disease of respiratory tract, which may appear at any age. The four major symptoms of asthma are whistling breath, shortness of breath, cough and tightness in the chest. Physiotherapy enables considerably a complex treatment of patients suffering from asthma. The complex treatment program takes into consideration the breathing and moving abilities of the patient, primarily the current state of his or her deep stabilisation system. The theoretical part of my thesis is focussed on a general description of asthma and its possible treatments, in terms of physiotherapy. The main aim of my thesis is to set up and practise a physiotherapeutic program in order to mitigate the asthma symptoms. The particular set-ups are focused on the respiratory and motion physiotherapy respecting their individual needs. The practical part of my thesis is based on a quantitative survey made by a semi-structured interview focussed on revealing the patient history, direct observation (examining the patient and realising the rehabilitation program). The survey was made within a group of three patients of a different sex and age undergoing the treatment in Luhačovice Spa, as well as one patient of a pre-school age treated in her home environment. The premises of a successful treatment following the rehabilitation scheme reflect an individual attitude to patients and their active participation in the recommended exercising and physiotherapeutic activities in their free time. My thesis can be used as a brief asthma bronchial outline for the public and for study purposes of future physiotherapists.
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DEEP STABILIZING MUSCLES
ŘEHŮŘKOVÁ, Markéta
The topic of this bachelor thesis is a deep stabilization system. The system consists of muscles which stabilize the backbone while at rest or in motion. A dysfunction of the deep stabilization system is one of many potential causes of vertebrogenic disorders and a targeted affecting of the deep stabilization system of the backbone is a fundamental therapeutic method in treatment of back pain. The purpose of the first part of this thesis was to process information available in literature about this issue. The theoretical part of this thesis contains information about the anatomy, function, examination options and some principles and methods of therapeutic affecting of the deep stabilization system. The purpose of the research part of this thesis was to select suitable clients for effective treatment of the deep stabilization system and practical verification of the individual examination and therapeutic methods used in physiotherapy to treat vertebrogenic disorders. The practical part of this bachelor thesis uses methods of qualitative research and case studies. The research was conducted in an outpatient department of the rehabilitation ward of the hospital in Blansko. The tested group consisted of three female patients with vertebrogenic disorders who were monitored for several months. The results have been processed in form of case reports. After their deep stabilization systems were affected all the patients have reported improvement of the disorder and reduction of pain; the patients learned to breathe correctly and to activate their deep stabilization muscles, including strengthening and relaxation of the pelvic bottom and autotherapy exercises. The treatment was completed with a final examination which demonstrated that the care of the patients´ deep stabilization systems effectively reduced their symptoms, which means that the purpose of the research part of this thesis has been fulfilled. This bachelor thesis may be used in clinical physiotherapeutic practice.
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Clinical importance of pelvic floor problems in patology of motoric system and its therapy
KRÁSENSKÁ, Radmila
Pelvic floor fulfils the postural function and influences the erect carriage of body significantly. The pelvic floor muscles support the body and the pelvic together with other components of the deep stabilization system (Skalka, 2002). The Thesis is aimed at collection of basic information on the above mentioned problems and at application of such information in the practice as part of diagnostics and therapy of patients with vertebrogenous difficulties. The theoretical part deals with pelvic area anatomy and kinesiology, deep stabilization system, pelvic floor and vertebrogenous disorders and their causes and symptoms. A list of possibilities of physiotherapeutic treatment includes basic practices used in the therapy of the pelvic floor and the whole deep stabilization system. The actual proposal for the therapy includes soft tissue mobilization techniques, postisometric relaxation, facilitation techniques, deep breathing and exercises for pelvic floor and the deep stabilization system. The therapy led particularly to reduction of tonus of hypertonic muscles, relieving of overstrained ligament, optimization of breathing stereotype and involvement of the deep stabilization system. The clients mentioned subjectively relief of back pain. The discussion and the summary intend to be a complex review. With respect to the achieved results, I think that the therapy was the right choice. However, the therapy must be continued in order to remedy the disorders completely.
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Effect of pelvic floor muscles in the deep stabilization system
KOTALÍKOVÁ, Kateřina
The bachelor thesis deals with back pain issues from the viewpoint of function. Backbone is an articulated axial organ and its stability, in addition to passive structures, is secured with long multi-articular muscles but their stabilization function is not sufficient. The stability is further improved with other muscular groups called a deep stabilization system (DSS). DSS in the trunk is made up on the dorsal side with short musculi multifidi, cranially with the diaphragm, ventrally with musculus transversus abdominis and caudally with the pelvic floor. The objective of the theoretical part has been to map the existing methods which affect the deep stabilization system with involvement of pelvic floor. The theoretical part contains an anatomic description of individual components of DSS, available methods of examination and particularly methodical procedures focusing on affecting of the system, mainly by involvement of pelvic floor. The objective of the practical part was to find out whether the pelvic floor has any influence on activation of the deep stabilization system and also what is the effect of gender on the involvement of pelvic floor in the course of performed physiotherapeutic procedures. The thesis has used the method of qualitative research. The research was conducted on 4 probands from my environs, who suffered from occasional pain in the backbone area and who were in the entry examination diagnosed with a disorder of frontal stability of the backbone. The monitoring lasted for ca. 2 months. The deep stabilization system was involved in all the probands. The first impulse for it, however, was the activation of pelvic floor. The therapy was concluded with a final examination which has shown that it was important to involve pelvic floor in order to activate the deep stabilization system (DSS). This has also contributed to the fulfillment of the objective in the research part. The results have been processed in the form of case studies. The bachelor thesis can be used in clinical practice of physiotherapists and some parts of it can be used as an educational material for patients.
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Využití balančních ploch ve fyzioterapii
KROČÁKOVÁ, Lada
Since the childhood, i.e. the period that the human organism is developing, even the slightest bad habit is reflected in the overall body construction in the future life. The body works as one unit, and that is why one component influences the other. Weakening one group is reflected in the other, which resulsts in forming an incorrect body posture. This weakening concerns not only larger muscule groups, on the contrary, very often the deep stabilisation system is also affected, and abdominal muscules, muscules of the pelvic bottom and other body stabilisation components are badly conected. One of the possibilites of teh therapy of the incorrect body posture is to exercise on balancing areas.
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Measurement and evaluation force paraxial ray muscles in the area lumbar spine and muscles sinuses coeliac.\\
ŠEBESTA, Karel
The aim of the work was to measure and evaluate the strength of deep stabilizing system (DSS) in connection with correct body posture and, subsequently, to asses the efficiency of the existing known exercise of the lumbar spine area as well as drawing comparison to the exercise recently introduced by doc. PaedDr. Pavel Kolář. The research was carried out on two sample groups of sixth form boys attending elementary school. It was necessary in the first place to detect, test and document correct body posture and, above all, the functionality of the DSS in members of the respected groups. This was followed by six weeks of active exercise according to exercise programme focusing primarily on the lumber spine area. The control group of ten boys carried out exercises based mainly on general principles of correct exercise whereas the experimental group totalling the same number of boys did exercises of DSS and lumbar spine area according to doc. PaedDr. Pavel Kolář. A muscle dynamometer was used to objectify and check the DSM in lumbar spine area. The measuring was than documented, processed and evaluated by means of charts and graphs. The work also comprises an overview of basic principles of lumbar spine stability as well as a questionnaire designed to assess health and lifestyle.\\
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