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Physiotherapy after surgical solutions of spastic dystonia of the upper limb in patients after brain damage
Marešová, Zuzana ; Angerová, Yvona (advisor) ; Sládková, Petra (referee)
Bachelor's Thesis Abstract Author's Name: Zuzana Marešová Thesis Supervisor: doc. MUDr. Yvona Angerová, Ph.D., MBA Thesis Title: Physiotherapy after surgery for upper limb spastic dystonia in patients after brain damage Abstract This bachelor's thesis overviews surgical treatment for upper limb spastic dystonia and subsequent post-operative physiotherapy. The thesis consists of two sections, theoretical and practical. Theoretical part describes upper motor neuron syndrome and definitions of two relevant symptoms, which are spasticity and spastic dystonia. This section also contains quantitative estimation methods for spasticity and spastic paresis. This is followed by description of surgical procedures classified based on different upper limb segments. Finally, physiotherapeutic techniques recommended after these surgical procedures are described. Practical section consists of description of two case reports, in which the brain injury led to spastic dystonia that was treated by surgery of upper limb. Each case contains past medical history, entrance and exit kinesiological analyses, functional examination of upper limb using modified Frenchay arm test and physiotherapeutic sessions reports. Based on the comparison of the entrance and exit exams the effect of post-operative physiotherapy was assessed. Key...
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Physiotherapy for patients with thoracic spine injury (without spinal cord injury) in the early period after injury
KREJČÍŘOVÁ, Hana
This bachelor thesis deals with traumatic spinal cord injury (no lesion of the spinal cord) with a focus on the thoracic area. Fractures of the thoracic vertebrae occurs most frequently in traffic and bicycle accidents or falls from a height. Great influence also has osteoporosis (especially in postmenopausal women). Doctor´s assessment is followed by conservative or operative treatment and rehabilitation. The theoretical part consists of the sum of knowledge concerning this issue. There are explained the basic anatomical structures, the stability of the spine, definitions and divisions of injuries and fractures, fracture diagnosis and types of treatment. Also the effects of fracture healing are discussed. Subsequently it is focused on physiotherapy methods, which can be used in the treatment of fractures of the thoracic vertebrae. Effective physiotherapy is in place and might include practicing good posture, physiological respiration, restoration of movement stereotypes, briefing care scar, autorelaxation or motorization of the thoracic area. For the practical part of the thesis has been used qualitative research method. Physiotherapy in three patients with fractures of the thoracic vertebrae is described there. The first meeting included the history-taking in the form of a structured interview followed by entrance kinesiologic examination. It consisted of static testing of all respondents with aspection front, back and side, breathing wave dynamic tests and walk test. In addition, a measurement of distances on the spine was made. Another examination was testing of postural stabilization and postural reactibility for which they were selected three tests - diaphragmatic test, trunk flexion and extension test by Prof. Pavel Kolář. The therapy lasted eight weeks and individually at each patient's home. The aim was to map the possibilities of physiotherapy techniques used in patients with spinal thoracic spine (without damage to the spinal cord). Furthermore, the design and implementation of short-term treatment plan for individual patients and comparing their status at the beginning and at the end of research in relation to their degree of affinity to the active physical exercise. The therapy was finished with output kinesiological analysis. The probands were also subjected to an unstructured interview, in which each told their subjective evaluation of the progress of the research. This bachelor thesis could serve as study material for students and health professionals and to raise awareness of the general public about the impact of physiotherapy for pain relief and increasing range of motion in patients with fractures of the thoracic vertebrae. Equally essential purpose is to raise awareness of patients about their treatment options.
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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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Differences in nursing care of patients after operations of fractures of the pelvis and in the conservative treatment after a pelvic injury.
ADAMČÍKOVÁ, Hana
The thesis is divided into the theoretical and practical parts. The theoretical part deals with fractures of the pelvis, which may be treated in the conservative manner, i.e. by the ligamentum of the pelvis. The ligamentum of the pelvis may be a temporary solution, or it is left until the fracture heals up, or by an operation. Further, nursing care is analysed here, ranging from the admission of the client to the department to his/her discharge. It points out differences in the care of clients in the conservative treatment and in the operational therapy. The research investigation was conducted in the hospitals in České Budějovice and Prachatice. The quantitative research was used for the bachelor thesis, in the form of an anonymous questionnaire, and additionally the qualitative research was conducted in the form of observation. The questionnaire was made up for nurses and contained 32 questions. The observation took place in the intensive care unit, where I had the opportunity to observe 6 nurses at work, and thus check up on the results of the graphs.
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