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Clinical evaluation of postural balance functions in patients with chronic obstructive pulmonary disease
Hrdý, Tomáš ; Smolíková, Libuše (advisor) ; Špaňhelová, Šárka (referee)
Introduction: Chronic obstructive pulmonary disease (COPD) is one of the most common chronic respiratory diseases. Impairments in exercise capacity, kinesiology and skeletal muscle function are well established in these patients. Recently presented data also suggests impairments in postural balance and increased risk of falls in patients with COPD. The aim of this study is to examine postural balance functions in a group of patients and compare the results with a control group. Methods: Twelve patients (the average age 65,6 ± 7,1, 5 women, 7 men) with COPD hospitalized at the Pulmonary Clinic at the Faculty Hospital, Prague Motol and 10 healthy control subjects (the average age 58,6 ± 5,2, 7 women, 3 men) participated in this study. Participants were measured by The Activities-specific Balance Confidence Scale (ABC) and The Balance Evaluation Systems Test (BESTest). Results: COPD patients scored significantly worse (0,0099, p < 0,05) on the ABC scale total score compared to healthy controls, 78,38 ± 21,14 for COPD versus 97,78 ± 3,88 for controls. The total score and the six subsystem categories score of the BESTest were lower in COPD patients, but not significantly, compared to controls. Conclusion: Patients with COPD showed a lower degree of balance confidence and postural balance functions....
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Use of computer based exercise therapy in patients with Parkinson's disease. Comparation effectiveness of computer based exercise therapy and conventional therapy in parkinsonian patients with postural instability-pilot study
Otta, Jiří ; Hoskovcová, Martina (advisor) ; Kobesová, Alena (referee)
Author's first name and surname: Jiří Otta, BA Title of the master thesis: Use of computer based exercise therapy in patients with Parkinson's disease. Comparation effectiveness of computer based exercise therapy and conventional therapy in parkinsonian pacients with postural instability-pilot study. Department: Department of Neurology 1st Faculty of Medicine and General teaching Hospital Supervisor: As. MUDr. Martina Hoskovcová Consultant: Mgr. Ondřej Čakrt, Ph.D. The year of presentation: 2013 Abstract Introduction: Stability and walking disorder is an important part of clinical image of Parkinson's disease (further only as PD) and another neurodegenerative diseases with Parkinson-syndrome aspects (further only as PS). Above all in the late PD - phases stability and walking disorders and falls resulting from them responsible for serious functional restrictions and they can lead up to a self - sufficiency decreasing. In the clinical application for patients with PD are so far ordinarily accepted as a standard the guidelines Clinical Practice Guidelines - KNGF (Koninklijk Nederlands Genootschap voor Fysiotherapie - Royal Hollandian Physiotherapeutical Societies). In these days there are appearing new, unconvenional methods in rehabilitation (further only as RHB) of stability disorder and falls in patients...
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Evaluation of rationality and risks of pharmacotherapyin older patients in long-term care facilities
Lukačišinová, Anna ; Fialová, Daniela (advisor) ; Alušík, Štefan (referee) ; Paluch, Zoltán (referee)
Objectives Main objectives of this doctoral thesis were to review available information on pharmacological properties of benzodiazepines and their age-related changes; to evaluate the prevalence of benzodiazepine use in older patients residing in long term care facilities; to investigate the association between use of benzodiazepines and occurrence of falls in acutely hospitalized older patients; and to describe utilization of benzodiazepines in the Czech Republic. Methods A narrative review of literature focused on pharmacokinetics, pharmacodynamics, adverse effects and association of benzodiazepines with falls in older population was conducted. The evaluation of benzodiazepine use in long term care facilities was analysed in a retrospective cross-sectional study using data from the EC 7th Framework Program SHELTER project (Service and Health in the Elderly in Long Term Care). A prospective cohort study data of acutely hospitalized patients in Australia were used to evaluate association between benzodiazepines and falls. To describe utilization of benzodiazepines in the Czech Republic, data from the State Institute for Drug Control and from databases of General Health Insurance Fund were used. This dissertation thesis is a summary of published articles from above stated works and analyses. Results...
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Effects of vestibular rehabilitation in elderly people with balance disorders
Benešová, Klára ; Slámová, Adéla (advisor) ; Jeřábek, Jaroslav (referee)
BACHELOR THESIS ABSTRACT Author: Klára Benešová Supervisor: Ing. Bc. Adéla Slámová Title: Effects of vestibular rehabilitation in elderly people with balance disorders Abstract: The bachelor's thesis deals with the influence of the vestibular rehabilitation on the postural stability of seniors who have balance disorders. Vestibular rehabilitation has an unmissable place in this issue, as it is able to ensure the preservation of the quality of life of the elderly without the need for subsequent hospitalization. This statement is based on the fact that vestibular rehabilitation serves as a prevention against falls and increases the overall fitness of the elderly. The practical part of the bachelor's thesis deals with case studies of three patients and the application of vestibular training to these patients. The main components of this training are elements of visual motor skills, eye-hand coordination, movement planning and balance training. The main methods of data collection are the PhysioSensing Stability Platform, the 10 Meter Walk Test and the Timed Up and Go Test. The aim of the bachelor's thesis focuses on several areas. First goal is to create a design for the examination. Furthermore, the aim of the thesis is to create an exercise unit which includes elements of vestibular training and to apply this...
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Evaluation of rationality and risks of pharmacotherapy in older patients in long-term care facilities
Lukačišinová, Anna ; Fialová, Daniela (advisor) ; Alušík, Štefan (referee) ; Paluch, Zoltán (referee)
Objectives Main objectives of this doctoral thesis were to review available information on pharmacological properties of benzodiazepines and their age-related changes; to evaluate the prevalence of benzodiazepine use in older patients residing in long term care facilities; to investigate the association between use of benzodiazepines and occurrence of falls in acutely hospitalized older patients; and to describe utilization of benzodiazepines in the Czech Republic. Methods A narrative review of literature focused on pharmacokinetics, pharmacodynamics, adverse effects and association of benzodiazepines with falls in older population was conducted. The evaluation of benzodiazepine use in long term care facilities was analysed in a retrospective cross-sectional study using data from the EC 7th Framework Program SHELTER project (Service and Health in the Elderly in Long Term Care). A prospective cohort study data of acutely hospitalized patients in Australia were used to evaluate association between benzodiazepines and falls. To describe utilization of benzodiazepines in the Czech Republic, data from the State Institute for Drug Control and from databases of General Health Insurance Fund were used. This dissertation thesis is a summary of published articles from above stated works and analyses. Results...
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Cognitive Impairment in Parkinson's Disease
Bezdíček, Ondřej ; Růžička, Evžen (advisor) ; Papežová, Hana (referee) ; Hort, Jakub (referee)
Cognitive impairment is considered as essential feature of non-motor symptoms in Parkinson's disease (PD). It is a result of underlying pathological processes in the brain of PD patients and it leads to decreased quality of life. In this thesis an analysis of the structure and profile of cognitive impairment is presented with special emphasis on executive functions and memory. We take diagnostic entities developed for the description of PD cognitive spectrum such as mild cognitive impairment (PD-MCI) and dementia (PD-D) as examples of heterogeneity and different severity of cognitive impairment in PD. However, neuropsychological methods in Czech version that would measure these diagnotic units were not adequatly validated. In the experimental part we test a hypothesis, if gait disorder with falls in PD is interconnected with cognitive impairment, and if PD-fallers have more severe cognitive deficit than PD-non-fallers. On the basis of nine validity or normative data studies we show psychometric properties and clinical utility of several basic neuropsychological methods in the Czech population for memory (Rey Auditory Verbal Learning Test, California Verbal Learning Test, Second Edition, Memory For Intentions Screening Test and Enhanced Cued Recall Test), sustained attention and executive functions...
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The issue of falls in special-purpose homes
RESŐOVÁ, Žaneta
This bachelor thesis is focused on the falls and their problems in special-purpose homes. The aim was to map out the interventions and measures that are applied to prevent falls of patients/clients in special-purpose homes. Another aim was to find out the most frequent causes and circumstances of patients/clients falls and the opinion of nursing staff on the issue of falls and their solution in special-purpose homes. The work was divided into two parts. The first, theoretical part, describes the basic concepts of gerontology, geriatrics and the comprehensive geriatric assessment. Furthermore, there is a detailed description of falls, which includes the instability syndrome with falls, the phenomenology and etiology of the fall, the fall prevention, the fall complications and the nursing care after the fall. The next chapter describes special-purpose homes, their specifics and the principles of nursing care for people with dementia. The second part of this work is the empirical part. The research was carried out by qualitative research, by questioning and observation. In view of the objectives, 13 questions were created for the semi-structured interview. Ten nurses and four carers from five special-purpose homes attended the interviews. The obtained data were then processed using open coding, by the metod pencil and paper. Seven categorization groups from interviews and four categorization groups from observation were created. The results of the research show that the most common preventive measures in all facilities are compensatory aids, monitoring health status and the modified environment in special-purpose homes. The most frequent cause of falls of patients/clients in special-purpose homes is the state of health of the elderly, poor estimation of physical possibilities, confusion and restlessness. The opinion of nursing staff on the issue of falls in special-purpose homes is that dementia has a great impact on the falls and the individuality of each patient/client is important. Overall, research has shown that falls occur despite all the measures and may be related to the frequent cognitive disease that the pacients/clients often suffer from. It would also be appropriate to raise the awareness of all staff about the problematics.
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Evaluation of rationality and risks of pharmacotherapyin older patients in long-term care facilities
Lukačišinová, Anna ; Fialová, Daniela (advisor) ; Alušík, Štefan (referee) ; Paluch, Zoltán (referee)
Objectives Main objectives of this doctoral thesis were to review available information on pharmacological properties of benzodiazepines and their age-related changes; to evaluate the prevalence of benzodiazepine use in older patients residing in long term care facilities; to investigate the association between use of benzodiazepines and occurrence of falls in acutely hospitalized older patients; and to describe utilization of benzodiazepines in the Czech Republic. Methods A narrative review of literature focused on pharmacokinetics, pharmacodynamics, adverse effects and association of benzodiazepines with falls in older population was conducted. The evaluation of benzodiazepine use in long term care facilities was analysed in a retrospective cross-sectional study using data from the EC 7th Framework Program SHELTER project (Service and Health in the Elderly in Long Term Care). A prospective cohort study data of acutely hospitalized patients in Australia were used to evaluate association between benzodiazepines and falls. To describe utilization of benzodiazepines in the Czech Republic, data from the State Institute for Drug Control and from databases of General Health Insurance Fund were used. This dissertation thesis is a summary of published articles from above stated works and analyses. Results...
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The quality of nursing care at selected department subsequent care
KRATOCHVÍLOVÁ, Eva
Current state: The goal of nursing is a quality of nursing healthcare. Each department has its own specific features and therefore has its own quality indicator. This work focuses on two quality indicators related to healthcare, specifically on patients with MRSA infection and their falls. Methodology: In the research were applied three methods of data collection: 1) statistical data from the hospital system; 2) intentional structured observation; 3) structured interviews. Research file: In order to evaluate the incidence of falls and cause of falls, were examined a total of 85 patients and a total of 98 patients for evaluation of decolonized patients with MRSA infection. The investigated group of people for observation and in-depth interviews were ONP nurses from the 6th floor of České Budějovice Hospital, plc. Results: The hypothesis that the most common cause of the fall is leaving the bed without any accompaniment has not been confirmed and the incidence of falls at the patients throughtout the observation period of the year 2015 dropped down significantly in comparison with the year 2014. The most common source of MRSA infection was a wound. Also, has not been confirmed the hypothesis that the number of decolonized patients with MRSA infection who were observing in the year 2015 will be statistically higher than in the year 2014. Most nurses know the cause of MRSA infection, but the problems they have are the precise definitions. By observing the practical activities and skills of nurses during the treatment of patients with MRSA infection were revealed certain shortages, especially the improper use of protective equipment and the improper disinfection of aids after their use. Conclusion: The results of the research show the need for more nursing education in this subject. Adverse events are a serious complication of the nursing process. The number of falls as well as the number of decolonized patients with MRSA infection is not successful significantly decrease in comparison year-on-year. The research also found inadequate theoretical preparedness of the nurses in the area of infectious diseases and a certain discrepancy between verbally presented experiences and the results of observation real activities.
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