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Affecting of Spastic Dystonia of the Hock in Upper Motoneuron Syndrome
VALIŠOVÁ, Alena
This bachelor thesis describes an issue of Spastic Dystonia of the Hock which appears as a result of upper motor neuron damage. Spastic dystonia is unphysiological of posture in motionlessness and can be seen at the first sight. Wrong posture of the limb limits the patient in his usual activities of daily living or in walk. So it is not just cosmetic problem but fault of function and movement limitation. Due to spastic dystonia the contracture and the pain appears which we are trying to lower with the right treatment as much as we can. The hock, the spastic dystonia and its causes and treatment are described in theoretical part of this work as well as physiotherapy intervention possibilities. It emphasizes the combination of treatment by botulotoxin injections and physiotherapy as of the main methods used to reduction of spastic dystonia. The course of the therapy itself is described in the practical part of this study. The last goal of this study was to find out the subjective patient's evaluation of the treatment for which the GAS scale was used. The sample of the patients in the trial is made of 10, 6 women and 4 men, with spastic dystonia of the hock in the age of 17 - 71 years old. The outcome of the tests which were made one month after application in time of the biggest effect of the botulinum toxin. The improvement of the patients here can be seen. But not at all of them in the same amount and not in all evaluated items.
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Standardized examinations of spasticity in physiotherapy
Špačková, Anežka ; Tichá, Monika (advisor) ; Jeníček, Jakub (referee)
Title: Standardized examinations of spasticity in physiotherapy Abstract: This bachelor's thesis is aimed at giving an overview of the most commonly used standardized examinations of spasticity in physiotherapy and their comparison. It deals mainly with the best known methods of examinations that are used in practice. The thesis is divided into two parts - theoretical and practical. In the theoretical part, muscle tone and its regulation and spasticity as one of the upper motor neurone syndrome symptoms are specified. Moreover, the methods of examination (Ashworth scale and its modifications, Tardieu scale and five-step clinical assessment of spastic paresis according to Gracies) are presented and described in detail there. The practical part contains two case reports of patients after a cerebrovascular accident. Examinations and evaluations of spasticity, including Modified Frenchay scale or walk tests, which are described in the theoretical part, are applied to patients. The main contribution of this thesis is to create a comprehensive comparison of standardized examinations of spasticity through studies and my personal experience. Key words: spasticity, upper motor neurone syndrome, examinations and evaluations of spasticity, rating scales, Modified Frenchay scale, walk tests, five-step clinical...
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Standardized examinations of spasticity in physiotherapy
Špačková, Anežka ; Tichá, Monika (advisor) ; Jeníček, Jakub (referee)
Title: Standardized examinations of spasticity in physiotherapy Abstract: This bachelor's thesis is aimed at giving an overview of the most commonly used standardized examinations of spasticity in physiotherapy and their comparison. It deals mainly with the best known methods of examinations that are used in practice. The thesis is divided into two parts - theoretical and practical. In the theoretical part, muscle tone and its regulation and spasticity as one of the upper motor neurone syndrome symptoms are specified. Moreover, the methods of examination (Ashworth scale and its modifications, Tardieu scale and five-step clinical assessment of spastic paresis according to Gracies) are presented and described in detail there. The practical part contains two case reports of patients after a cerebrovascular accident. Examinations and evaluations of spasticity, including Modified Frenchay scale or walk tests, which are described in the theoretical part, are applied to patients. The main contribution of this thesis is to create a comprehensive comparison of standardized examinations of spasticity through studies and my personal experience. Key words: spasticity, upper motor neurone syndrome, examinations and evaluations of spasticity, rating scales, Modified Frenchay scale, walk tests, five-step clinical...
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Prevention and therapy of spasticity in patients after cerabral apoplexy
TÁBORSKÁ, Žaneta
Spasticity is a manifestation of many neurological diseases, for example an infantile cerebral palsy, a traumatic injury of brain and spinal cord, a multiple sclerosis and a stroke. A genesis of the spasticity is not yet completely clarified and many definitions try to explain it. The spasticity can deepen a disability of patients even with a minimal paresis. The spasticity has a different clinical picture at various diseases of the central nervous system, but even at different patients with the same diagnosis, it also varies in the course of time at one and the same patient. The biggest problem in the treatment of the spasticity is the fact that the treatment, efficient at one patient, can completely fail at the other. A goal of this thesis was to give an overview of current options in a treatment of the spasticity. Therapeutic approaches to reduce the spasticity are usually a part of special kinesio-therapeutic methodologies, which are for example an anti-spastic positioning, a volitionary relaxation, passive movements, an anti-spastic placing (Bobath´s conception), relaxation techniques (PNF), an application of splints, a long-term effect of the heat, an icing and others. On the contrary, it is intensified by pain, pressure sores, a sub-luxation position most often of the shoulder joint, a psychical stress, urinary tract infections etc. In the theoretical part I focused on a control of the muscle tone, pathophysiology, clinical symptomatology, diagnostics and especially prevention and the treatment of the spasticity. In the practical part I investigated an effectiveness of an anti-spastic therapy through the qualitative research. For the data collection it was used an anamnesis, observations (kinesiological analysis), case reports and a secondary data analysis. The research was made at two probands with a brain damage on the vascular basis. I was finding out an effectiveness of selected therapies for individual probands {--} and at the same time its suitable combination. I focused on the area of the upper extremity. At the first patient there was a success, by a suitable combination of individual methods, to positively affect the spasticity and an active momentum of the upper extremity. At the second patient in a chronic stage of spasticity it was managed to influence it always only for a short term and results varied considerably in the course of time. The treatment of the spasticity must be preceded by a thorough knowledge of pathophysiological mechanisms, a neurophysiology and above all a complex kinesiological analysis. The therapeutic approach should be always individual, to respond appropriately to changes in the clinical picture and to use suitable combinations of therapeutic approaches. If the treatment of the spasticity is successful, it positively affects the motor deficit and reduces the patient's disability.
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