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The Effect of Vestibular Rehabilitation in Patients with Peripheral Vestibular Disease
Kačerová, Veronika ; Kučerová, Klára (advisor) ; Čakrt, Ondřej (referee)
Dizziness is one of the most common reasons for visiting a doctor. Their common cause is a peripheral vestibular lesion. Recently, more and more evidence is emerging regarding the effect of vestibular rehabilitation in these patients. The aim of the theoretical part of this thesis was to provide a comprehensive review of information on peripheral vestibular lesions with an emphasis on the possibilities of physiotherapeutic intervention. Individual peripheral vestibular lesions, vestibular rehabilitation, principles of its functioning and mechanisms of vestibular function repair were described in detail. The main aim of the experimental part of the study was to evaluate the effect of vestibular rehabilitation in patients with peripheral vestibular lesions. Stance and gait stability and the patient's subjective perception of difficulties were evaluated. A total of 31 patients (22 women and 9 men) were included in the study. The age range of the patients was 60 years (SD ± 13 years). The mean duration of the difficulties was 30 months (SD ± 52 months). For objectification, the modified Clinical Test of Sensory Inter-action on Balance (mCTSIB), Dynamic Gait Index (DGI) and Vestibular Rehabilitation Be-nefit Questionnaire (VRBQ) were performed. Measurements were taken before and after the rehabilitation...
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Occupational therapy intervention in patients after vestibular schwannoma surgery
Havlíková, Darina ; Táborská, Silvie (advisor) ; Jeřábek, Jaroslav (referee)
Title: Occupational therapy intervention in patients after vestibular schwannoma surgery Abstract: Vestibular schwannoma is a benign tumor of the vestibulocochlear nerve and contains about 8-10% of all intracranial tumors. With an incidence of approximately 1 new case per 100,000 population, it is a rare disease that, although we can now successfully treat, can without an early diagnosis and treatment have debilitating consequences. The main manifestations of schwannomas include hearing loss, tinnitus, vetigo, balance disorders and significantly reduced quality of life. This thesis mainly focuses on the rehabilitation of patients after VS resection. These patients most commonly visit rehabilitation facilities for balance impairment, postoperative paresis n. facialis or deteriorated orientation. Attention is also specifically paid to occupational therapy intervention. The theoretical part approaches the issue of vestibular schwannomas generally, it describes the symptoms and options of treatment. A large part is also devoted to rehabilitation. This work founds a basis for the creation of a clinical practice guideline focused on the rehabilitation of patients after resection of VS. The last section then contains a summary of the intervention for occupational therapy. This paper responds to the absence of...
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Occupational therapy intervention in patients after vestibular schwannoma surgery
Havlíková, Darina ; Táborská, Silvie (advisor) ; Jeřábek, Jaroslav (referee)
Title: Occupational therapy intervention in patients after vestibular schwannoma surgery Abstract: Vestibular schwannoma is a benign tumor of the vestibulocochlear nerve and contains about 8-10% of all intracranial tumors. With an incidence of approximately 1 new case per 100,000 population, it is a rare disease that, although we can now successfully treat, can without an early diagnosis and treatment have debilitating consequences. The main manifestations of schwannomas include hearing loss, tinnitus, vetigo, balance disorders and significantly reduced quality of life. This thesis mainly focuses on the rehabilitation of patients after VS resection. These patients most commonly visit rehabilitation facilities for balance impairment, postoperative paresis n. facialis or deteriorated orientation. Attention is also specifically paid to occupational therapy intervention. The theoretical part approaches the issue of vestibular schwannomas generally, it describes the symptoms and options of treatment. A large part is also devoted to rehabilitation. This work founds a basis for the creation of a clinical practice guideline focused on the rehabilitation of patients after resection of VS. The last section then contains a summary of the intervention for occupational therapy. This paper responds to the absence of...
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The evaluation of vestibulospinal and vestibuloocular reflex in patients during early postoperative period after vestibular schwannoma resection
Markvartová, Anna ; Čakrt, Ondřej (advisor) ; Chovanec, Martin (referee)
The thesis deals with the issues of balance disorders in patients after vestibular schwannoma surgery. The aim of this thesis is to evaluate the effect of targeted rehabilitation with biofeedback on balance disorders and subjective visual vertical compensation. During the period of one year, a group of 20 vestibular schwannoma patients were examined and treated in University Hospital Motol. The compensation of vestbuloocular refex was assessed by a tilt of subjective visual vertical. The level of vestibulospinal compensation was determined according to score of the Activities-Specific Balance Confidence Scale. Patients were examined before the surgery, after the surgery and after the rehabilitation. The Homebalance system, developed by Support center for application outputs and spin-off companies at the 1st Faculty of Medicine, Charles University in Prague, branch office in Kladno, was used for the therapy with visual biofeedback. Another aim of this thesis was to monitor the effect of vestibular prehabituation with ototoxic gentamicin application two months before surgery. The statistical analysis of data proved in the case of subjective visual vertical tilt a significant increase of deviation after surgery and a decrease after rehabilitation. According to the ABC questionnaire the confidence of...
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Factors affecting vestibular compensation in patients after vestibular schwannoma surgery.
Balatková, Zuzana ; Čada, Zdeněk (advisor) ; Salzman, Richard (referee) ; Šlapák, Ivo (referee)
Vestibular schwannoma surgery causes in majority of patients the unilateral peripheral or combined vestibular lesion due to surgical interruption of both branches of vestibular nerve. It manifests postoperatively with postural instability, vertigo, oscilopsia and even with vegetative symptoms. Central compensation, in which cerebellum plays dominant role, influences duration of the symptoms. Factors affecting compensation may be divided into several groups (general health status of a patient, the tumor itself, actual state of function of vestibular system, external factors induced by a therapeutist). Therapeutic aim is to induce compensatory mechanisms as soon as possible and to reduce overall duration of the compensation. The aim of this study is to consider predictive factors influencing central vestibular compensation and to influence the vestibular compensation itself. Early operated vestibular rehabilitation is a basic procedure. It leads to faster recovery in majority of patients. Even with maximal effort the full compensation is not always achieved. It results in permanent deficit of vestibular function manifested with postural instability. However in some patients it is difficult to achieve full compensation despite maximum effort of a physiotherapeutist and that results in permanent...
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Quality of life in patients after vestibular Schwannoma surgery
Hajná, Barbora ; Čakrt, Ondřej (advisor) ; Chovanec, Martin (referee)
TVestibular schwannoma is a benign tumor that arises from the Schwann cells of the vestibular nerve. Unilateral hearing loss, tinnitus, facial and trigeminal dysfunction and vertigo are the most common symptoms. Surgical removal of the tumor is one of the treatment modalities of this disease. Surgical excision usually involves the complete vestibular nerve resection and there is also a risk of cochlear and facial nerve lesion. This thesis deals with changes in quality of life in patients after vestibular schwannoma sugery, which are associated with balance deficits, tinnitus and facial palsy.
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The influence of unilateral vestibular dysfunction on spatial orientation in patients after vestibular schwannoma surgery
Šponarová, Lenka ; Čakrt, Ondřej (advisor) ; Chovanec, Martin (referee)
The aim of this diploma thesis is to evaluate spatial orientation in the patients after vestibular schwannoma surgery. In the theoretical part, there are summarized the facts about vestibular system; there is described the clinical picture of unilateral vestibular dysfunction and the field of vestibular schwannoma and spatial orientation in general. In the practical part, we performed the investigation of the spatial orientation using the Blue Velvet Arena System and posturography using the platform Balance Master® System. The purpose of the practical part was to find out, whether unilateral vestibular dysfunction in patients after vestibular schwannoma surgery has the impact on spatial orientation and to what extent is the postural stability influenced in patients identified for surgery and in patients after vestibular schwannoma surgery. Powered by TCPDF (www.tcpdf.org)
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Factors affecting vestibular compensation in patients after vestibular schwannoma surgery.
Balatková, Zuzana ; Čada, Zdeněk (advisor) ; Salzman, Richard (referee) ; Šlapák, Ivo (referee)
Vestibular schwannoma surgery causes in majority of patients the unilateral peripheral or combined vestibular lesion due to surgical interruption of both branches of vestibular nerve. It manifests postoperatively with postural instability, vertigo, oscilopsia and even with vegetative symptoms. Central compensation, in which cerebellum plays dominant role, influences duration of the symptoms. Factors affecting compensation may be divided into several groups (general health status of a patient, the tumor itself, actual state of function of vestibular system, external factors induced by a therapeutist). Therapeutic aim is to induce compensatory mechanisms as soon as possible and to reduce overall duration of the compensation. The aim of this study is to consider predictive factors influencing central vestibular compensation and to influence the vestibular compensation itself. Early operated vestibular rehabilitation is a basic procedure. It leads to faster recovery in majority of patients. Even with maximal effort the full compensation is not always achieved. It results in permanent deficit of vestibular function manifested with postural instability. However in some patients it is difficult to achieve full compensation despite maximum effort of a physiotherapeutist and that results in permanent...
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The evaluation of adaptation of the vestibulo-ocular reflex in patients after vestibular schwannoma surgery
Hladíková, Veronika ; Čakrt, Ondřej (advisor) ; Jeřábek, Jaroslav (referee)
This thesis deals with the evaluation of the vestibulo-ocular reflex in patients indicated for neurosurgical resection of vestibular schwannoma, executed at the Motol University Hospital. To evaluate the function of the vestibulo-ocular reflex, three types of clinical examinations were used. In periods before the surgery, early after the surgery and before leaving the hospital we monitored the patients' ability to perceive subjective visual vertical, which reflects tonic function of otolith organs. Before the surgery we also tested relative dynamic visual acuity during passive isolated head movements in the transversal plane, whose impairment is related to dysfunction of lateral semicircular canals. Furthermore, we obtained patients' preoperative values achieved in caloric reflex test. In the early postoperative period, bordered by the first day after the vestibular schwannoma surgery and the last day of the hospitalization, patients underwent specialized vestibular rehabilitation. Based on statistical analysis of acquired data, we found out that in some patients there was a lesion of the vestibulo-ocular reflex already before the surgery and moreover, there was a correlation between dysfunction of translational and rotational parts of the vestibulo-ocular reflex. Although variance of subjective...
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