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SPECIFICS OF PHYSIOTHERAPY OF PATIENTS TRANSFERRED AFTER ORTHOPEDIC OPERATIONS DIRECTLY ON THE SO-CALLED SPA BUNK
JOHANUSOVÁ, Lucie
This bachelor thesis addresses the specificity of physiotherapy of patients, transferred to a so-called spa bed, after orthopedic surgery. Among the most performed orthopedic surgeries are the total hip replacement and the total knee replacement. Arthrosis is the most common reason for the implantation of joint replacements. It is a painful and life-aggravating disease which has a tremendous impact on the patient's quality of life. In order to lower the risk of the patient having to take a revision surgery of joints, a promptly initiated rehabilitation is necessary. It has to be intensive and professionally conducted. The present time-tested trend of rehabilitation treatment is a prompt comprehensive care, which takes place in a spa resort in the form of a direct transfer "from one bed to another", i.e. the patient is transported directly from the hospital to a spa resort. Often, patients would get to a spa resort with delay, while already having intercurrent problems like vertebrogenic and other problems. This thesis is divided into a theoretical part and a practical part. The theoretical part includes the anatomy of the hip joint and the knee joint, the description of the joint replacements including the indications and the contraindications, the specifications of particular types of hip and knee joint replacements and possible complications after surgery. The most important topics of the theoretical part are stated in the last chapters. The individual therapeutic rehabilitation methods, which have a positive impact on the health status of the patient after surgery, spa therapy and physical therapy included, are discussed and described in those chapters in detail. A qualitative research strategy and a personal case study technique (case history), with the use of a secondary data analysis, were used in the practical part. This strategy was carried out on three chosen patients, who after being discharged from a hospital after surgery had continued their treatment in a spa resort, i.e. a so-called direct transfer from a hospital bed to a spa. The research was conducted in Berta's spa resort in Třeboň, where the patients were transferred on the tenth day after surgery. On their first therapy session, all patients had their personal history taken and data from their medical documents was added. The practical part also includes a pre-therapy and a post-therapy kinesiologic analysis which included visual inspection, palpation, goniometric and anthropometric examination of the knee and hip joint area. Furthermore, a muscle test and an examination of shortened muscle groups related to the knees and hip joints, created by Janda, were conducted. The gait, stereotypes and neurologic functions were also examined. Following the evaluation of the pre-therapy data, the patients were introduced to the short-term therapeutic plan. The results were acquired by comparing the pre-therapy data and the data which was obtained during the last therapy session from the post-therapy kinesiologic analysis. The rehabilitation in the spa resort consisted of different treatment procedures each day and the patients were getting medical attention and care from doctors, nurses and physiotherapists. In each therapy, we focused on removing the problems at hand and only after that we moved to correcting other imperfections. After the completion of the therapy, the patients stated a decline of pain and an improved balance of the extremity and the whole body. The data of the chosen patients shows improvement of muscle strength, decreasing of swelling and widening of range of motion. These results were achieved thanks to a comprehensive rehabilitation and a positive attitude of the patients.
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The effect of "Propriofoot method" on knee joint stabilization in women professional softball
HOŠTIČKOVÁ, Barbora
This thesis is focused on knee joint instability. This issue is the most discussed theme in professional sport in context of knee injuries. The claims on knee biomechanics are enlarging natures and it leads in knee injuries and all structures of it. Knee joint is considered as the most difficult joint in human body. Knee joint consist of three bones femur, tibia and patella. Their surfaces creates femur - tibial and femur patellar joints. This bachelor thesis is aimed on knee injuries problematic, especially on knee instability, which is common in women softball players in extraleague. Theoretical part describes the history of softball, its specific nature, predilection places and different reasons of softball injuries. The thesis shows the amount of demands in stabilization of knee joint during the spin movements of whole knee joint and subsequent ballast of whole body affecting knee joint. The main task of this thesis was to create a specific list of strengthening and stabilizing exercises. The exercises was given to two groups of woman softball players. First group was orientated on strengthening muscles of knee joint with special aid from "Propriofoot Concept". The second group was working with aid called "čočka". Special exercises (SSC) was part of common training during winter set up before the season and particulary in three months period (January to March). The next aim was to compare the effectivity of methods of both groups. Practical part was utilized by quantitative method. The researched set of extraleague softball players was between 18 22 years old. For a good quality output was accomplished my supervision during one exercise. Women have to practise three times a week. I made a supervisor during the exercise for once a week. SSC had about 15 - 20 minutes. This bachelor thesis can be used as a material for coaches, fitness trainers, physiotherapist and for players also. This work can be used also for baseball players because of lots of similarities.
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Stabilization of knee joint in Female football players while respecting their menstrual cycle without the use of hormonal contraceptives
VOCEDÁLKOVÁ, Simona
The issue of the knee joint and its structures is nowadays in the field of sport very current. It has to do with the increasing demands that are placed on the muscular and ligamentous apparatus. The knee joint is a complex functional unit, which consists of many bones and intraarticular services. Tibia, femur and among themselves to create articulation femorotibiall and femoropatellar. Both of these joints form one jointknee anatomy. In connection with its specific structure allows this complex anatomical element of two seemingly incompatible features-stability and mobility. The stable position of the knee from the energy point of view, it is economical. On both of the functions involved in dynamic and static stabilizers. The first group consists of the active support and is represented by the muscles. The second group provides passive support joint and this includes ligaments, menisci, joint capsule, and the shape of the joint surfaces. In the women's football are the most traumatized by the lower limb especially the ankles and knees. According to Engebretsena and Steffena (2006) make up 26% of all knee injuries in women's football. In the world of football is more than men's soccer players to injury knee ligament-mainly anterior cruciate ligament. 70% of this ligament is injured uncontact mechanism. In the LCA is the receptor of sex hormones-estrogen and progesterone. These hormones have a direct effect on the structure of the LCA. The menstrual cycle (MC) is increeasing laxity of the knee joint during ovulation and the luteal phase (15. day of the MC-the end of the MC). In this period, the female knee is the most susceptible to injury. This thesis deals with the issue of just the knee joint in the world of football. It also discusses the regular fluctuations in endogenous female hormones and their effects on the ligament laxity . The theoretical part is focused on football, the differences between women and men and predilection places in the women's football injuries. Special chapter then describes the specifics of the female knee. The end of the theoretical part is devoted to the physiology of the menstrual cycle, the female sex hormones and their effects on ligaments. The main task of this work was to build a specific system of exercises for the world of football. The SSC is focused mainly on strengthening muscles involved in the movement in the knee joint and to stabilise this joint. The SSC should serve as a complement to the classical training and was included in the training units for a period of two months. Another aim was to compare the effectiveness of SSC groups A and B. Members of the group A trained in the different phases of the menstrual cycle for exercise, which should positively affect the stability of the knee joint in relation to increased or decreased ligament laxity, due to the action of female hormones. The group B then didn´t take account of the MC physiology. In the practical part of the thesis was used the method of qualitative research. Four players in one of the South Bohemian football team were examined. Research file is moved between the ages of 19 to 26 years of age. The girls did not use hormonal contraception at the time of reserch. For the refinement of the input and output of measurement results, I investigated the players between 5.-6. on the day of their MC with the opening two months. Objectification of the results I achieved by using four specific tests. One of these tests was to score one of the Functional movement screen. Input rating in the FMS range 22-25 points. When the output rating rose to 27-30 points. My work is probably the first of this focus. Its contribution could be a reduction in the number of injuries of the knee joint in the world of football. I consider the work of the information material for trainers, implementation teams and the female football players. In the future, can become a catalyst for further research into the issue.
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The importance of regular fitness activities before planned orthopedic surgery
KOTLABOVÁ, Sandra
The bachelor thesis deals with the influence of regular fitness activities before the scheduled orthopedic surgery. The thesis discusses the use of special methods of physiotherapy and physical therapy to help patients prepare for their surgery and post-operative rehabilitation. The most common scheduled orthopedic surgery in the Czech Republic is a total hip joint prosthesis, it is applied up to 10 000 refunds anually. The total hip joint prosthesis is followed by a less frequent knee joint prosthesis. Implementation of any suitably chosen fitness activity before the surgery may be very useful and desirable for the patient.The current knowledge of the anatomy and biomechanics of bearing joints of the lower limb - knee and hip is summarized in the theoretical part of the thesis. This part also describes the joint compensation in detail. After that, there is mentioned the development of compensations in the course of history, as well as the different types of prosthesis and inserted components. Last but not least, there are described surgical approaches of implantation of the compensation. The theoretical part also includes appropriate physiotherapeutic procedures and methods of physical therapy that can be applied in a pre-operative period. The aim of this thesis is to explore whether regular fitness activities applied before the surgery have an impact on the course of post-operative rehabilitation. The qualitative research method was used to achieve the objectives in the practical part. The collect the data there were used case reports, interview, observation and photographic documentation. Three patients participated in the research, all diagnosed with osteoarthritis of the joint, two of them of the hip joint and one of them of the knee joint. Not a single one of those patients was cured by the conservative treatment, so they all were recommended for surgical treatment consisting of the replacement of the damaged joint. At the first meeting the medical history and the kinesiological analysis were taken. After evaluating the input data, patients were acquainted with therapeutic method. The therapy continued for one month, three times a week. After ending the therapy, the output kinesiology analysis was taken. Each of the patients told her subjective opinion about the course of the therapy and the changes experienced after treatment. All data were recorded and subsequently evaluated. During the therapy local findings were threated at the first place. Specifically the limited joint mobility, swelling of soft tissues around the joints and shortened or weakened muscles. They were used sensomotor techniques that are suitable for correction of flat foot or hallux valgus. The stabilization techniques PNF and activation HSS were used to strengthen the entire trunk and to restore the stabilizing function of the diaphragm. This was followed by the strengthening of the upper limbs to prepare them for future walking on crutches. The last point after the treatment of local findings was the setting of the joint in proper movement stereotype. When the therapy was finished, patients reported a mild pain relief and greater stability of their limb and the entire body. The collected data show also an improvement of the muscle strength of damaged joints for at least half a degree The indicator of the progress is the comparison of the goniometric examination before and after the therapy. The joint mobility was incresed. Surgical procedures were carried out without any complications and subsequent rehabilitation was with no problem for our patiens.
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Physiotherapy for patients with LCA rupture during surgical and conservative therapy
PÍCHA, Radek
The bachelor thesis deals with the issue of an anterior cruciate ligament (ligamnetum cruciatum anterius ? LCA) trauma. The anterior cruciate ligament is an important stabilizer of the knee joint. During the LCA lesion serious biomechanical changes occur. The LCA trauma most frequently happens due to forced hyperextension or rotation of the knee joint. Nowadays this injury is quite frequent, in the sports medicine it occurs in the incidence of 1 / 1750 inhabitants. The therapy of the injured LCA has been very efficient recently mainly due to modern approaches both in the medicine and the following rehabilitation. The thesis contains the analysis of the anatomy and biomechanics of the knee joint, the next part describes LCA trauma mechanisms, methods of its examination and possibilities of the successive therapy. One part of the thesis is focused on the comparison of the conservative and the surgical therapy, there are described the circumstances under which it is decided which one of these therapies will be chosen. It is necessary to mention that the most important criterions for the proper therapy choice are the individual needs of the patient. The basic aim of the thesis is the comparison of the efficiency of therapeutic procedures for particular patients and the assembly of the short-term and the long-term treatment plans. The practical part of the thesis is processed by the qualitative research method. Three probands after the surgical therapy and two probands after the conservative therapy were examined. The observation and the therapy for surgically treated patients were carried out between the second and the sixth post-operative week, the examination for conservatively treated patients was carried out for six weeks. Patients were predominantly athletes in the age of 18 ? 24 years. They passed the initial and the final kineziologic examinations and the rehabilitation therapy; the treatment efficiency was rated by the Lysholm score. The initial Lysholm score for surgically treated patients varied between 32 and 34 points and after the therapy it increased to 48 ? 75 points. For conservatively treated patients the initial score varied between 73 and 76 points and the final score was 76 ? 81 points. There is one more important detail in the thesis ? the anthropometry results. The quadriceps femoris perimeter increase was around 1,5cm and the triceps surae perimeter increase was around 1cm. The final examination showed that the majority of the patients is missing minimally 1cm in the quadriceps femoris perimeter compared to the healthy leg. The similar indicator has been found also for the muscular strength testing. The examination was focused mainly on the knee joint extensors and flexors testing. All patients proved the increase of the muscular strength; surgically treated patients reached muscular strength maximally 4+. The short-time rehabilitation plan is initially based on the edema and pain elimination. Subsequent rehabilitation step is the training of the walking with the help of French canes and the knee joint motion range recovery and its stabilization. The aim of the long-term rehabilitation plan is the gradual return to social and sport activities. The basic factor of the long-term rehabilitation plan is good muscular training. In the conclusion it is important to mention that it is not possible to state which therapy (surgical or conservative) is more suitable or efficient, during the decision making process it is necessary to consider individual needs of a particular patient. The thesis may be utilized in the clinical practice of physiotherapists for the improvement of the care of the patient who is diagnosed with rpt. LCA.
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Prevention of the knee joint soft-tissue injuries in Athletics
KRÁLOVÁ, Eva
This Bachelor Thesis deals with the problems of injury of knee joint soft tissue structure. Knee soft tissue injury belongs to the most frequent injuries in athletics. The anterior cruciate ligament is very often harmed. The injury occurrence may be prevented by means of suitably chosen physiotherapeutic procedures to prevent occurrence of pathokinesiological consequences in the knee joint area as well as the whole locomotor system. The first aim of my work was to monitor the problems related to soft knee injury in selected athletes. The second aim was to prepare and apply the therapy procedure itself upon the obtained findings and to find to what extent the therapy affected the examined athletes with knee injuries. The theoretical part of the Thesis summarises the basic knowledge of anatomy, kinesiology, it deals with the most frequently injured knee soft structures, the most important check-up methods, the therapy possibilities and prevention of the injury. A qualitative research method was chosen for the research itself. The sample consisted of four randomly selected athletes. Two athletes were chosen from a group of short-distance runners and two athletes were chosen from a group specialized in long-distance running. Four individual therapeutic plans were compiled after an anamnestic interview and an entry kinesiology analysis. The plans were focused on an increase of the movement extent, increase of muscle strength, renewal of static and dynamic stability of the knee joint and removal of disturbed movement stereotypes. Positive results of examination in all the patients confirm correct selection of the therapy elements and the therapeutic plan. The extent of improvement in the monitored patients was influenced by the individuality of the patients and their approach. Positive results of the therapy may also be expected in the future and existence of preventive action, particularly in the secondary prevention level may be attached to. I recommend extension of the practical part by instrumentation examination by means of electromyography, posturography or digital baropodometry for extension of the work and making the data related to the issues in question more objective.
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Prevention and Therapy of the knee injuries in Football
BENEŠOVÁ, Michaela
My Bachelor Thesis deals with the problem of knee-joint injuries. The chosen theme ``Prevention and Therapy of the knee injuries in Football{\crqq} introduces a large variety of possible injuries. The Thesis includes an analysis of the complicated anatomical structure and biomechanics of the knee. The part devoted to injuries describes the injury mechanism that gives the ground for the following examination, diagnosis determination and proposal of the subsequent therapy. Another important chapter, prevention of the knee injuries, describes the activities to prevent from such injuries. The aim of this Thesis is to assess the treatment effect of the anterior cruciate ligament rupture in two probands in relation to their return to sports activities, and furthermore to furnish theoretic information concerning primarily the anatomy and prevention of injuries. In respect of the quantitative research, we chose at random two footballers of a district league standard suffering from ligamentum cruciatum anterius rupture. The research proceeded during their therapy using the technique of uncontrolled dialogue, observation, casuistry and secondary analysis of data. The result brought the ascertainment of the success in the therapy effectiveness. After 3 months both patients, sportsmen, achieved such health condition which allowed them do light sports activities with no limitation, e.g. exercise biking, swimming, walking, running on flat surface and even cross-country; cycling is also suitable. It is very important to keep to the said recommended sports activities as the inadequate overloading of the knee can give rise to recurrence or even to injury of other structures of the knee joint.
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Physiotherapeutic methods for the damage of the soft tissues of the knee joint
JAKEŠOVÁ, Kateřina
Abstract I chose as the theme of my thesis the effectiveness of physiotherapy following knee injuries. The aim of this work was determine whether appropriate and timely preventive treatment can prevent acute knee injuries in chronically unstable knee. Specifially, is it possible to avoid reinjuring or causing trauma to chronically unstable knee during physiotherapy. Research was conducted using a qualitative method and case reports on two women who had problems with chronic knee instability. The first patient received therapy from 15.1. to 6.4. 2009, while the second patient received therapy from 24.1. to 14.4. 2009. Thus both patiant received approximately 3 mont of physiotherapy. In the course of rehabilitation, treatment focused on sensory motor stimulation therapy. This therapy took place at two different physiotherapy clinics, where I had the most effective monitoring instruments. Both patiant with chronic knee instability were of simile age and the therapy was conducted during approximately the same time period. The first patient, whose sports activities typically involve home exercise and training, is rapidly recovering from both her subjective and objekctive symptoms. Further gradual improvement in her condition can be reasonably assumed. For the second patient, the pain fluctuates depending upon the sport load placed upon the knee. The goal there was to eliminate the phenomenon of {\clq}qgiving way``. From an objective point of view, this problem was fully resolved. In connection with these findings the patints were properly advised of therapy, shown how they can continue the therapy by themselves in their homes, encouraged to regularly return to the clinic for follow- up exams, and advised to purchase {\clq}qunstable boards`` for their homes.
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Injuries of knee joint and consequential physiotherapy after crossed ligaments plastic
ŠKABROUD, Libor
This work deals with questions of injuries of the fibrous apparatus of the knee joint, especially with the injury of ligamentum cruciatum anterius (LCA). The theoretical part summarizes the basic information relating to the problems of injuries of the fibrous apparatus of the knee. In the following, it offers an abstract of recent methods of physiotherapy used while dealing with patients with LCA plastic. The evaluation of the research, which compares the efficiency of the physiotherapy between two patients with LCA plastic (one active sportsman and the other a non sportsman), discovered that the therapy was more effective in the sportsman case, especially in term of faster growth of muscles.
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Reliability of the SPECT examination in diagnosis of meniscal lesions of the knee joint
VYTOPILOVÁ, Helena
Menisci are located within the knee joint and therefore it is very difficult to diagnose the knee joint meniscus injuries. There are several examination methods, such as RTG, SONO and MRI to diagnose knee joint meniscus injuries. Attention is given to these examination techniques in a section of my thesis. The substantial part of my thesis is focused on the nuclear medicine {--} the ionizing radiation detection, imaging methods {--} but mainly on the non-invasive examination {--} bone scintigraphy and SPECT imaging. The SPECT method is a tomographic version of a common method of planar scintigraphy. The SPECT examination follows the three-phase scintigraphy which is a combination of a static and dynamic scintigraphy. Aother part of my thesis refers to the largely used invasive method, arthroscopy. Arthroscopy is an endoscopic technique enabling visual diagnostics from minimal distance and surgical procedures. The closing part of my thesis brings the comparison of results obtained in patients examined both by the SPECT method and by arthroscopy. The objective of my thesis is to publish the role of the SPECT method in knee joint meniscus injury diagnostics.
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