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Physiotherapy of scar in prevention and treatment of functional disorders
HRDÝ, Tomáš
The topic of the thesis is "Scar physiotherapy in the prevention and treatment of functional disorders." A scar is an inferior connective tissue resulting by the healing process, in various depths of soft tissues of various etiologies. A scar can never reach the original rheological properties of the given tissue, it is a regeneration product, replacing the original damaged tissue. A scar is physiologically healed into a thin, pale hair line, which does not affect local shunt and protraction abilities of soft tissues moving in accordance with the osteoarticular apparatus. If the healing process does not happen physiologically, a pathological scar is created, that scar can often become active, having a negative impact not only on its immediate vicinity, but also reflexively on the whole postural-locomotor system of the individual. The thesis is a comprehensive view on the scar as another "organ ", the activity of which can manifest itself in postural and movement patterns of the person. In the study the connection of a scar and its neurophysiological chaining are discussed, where an active scar may cause local changes in the muscle tone, skin sensitivity, it can lead to dysfunctions of internal organs and a limited mobility of the locomotive segment with the afferent link to the central level of motor control. Overlooking a scar as a possible provoking segment of a pathogenetic chain can lead to the failure of therapy and the relapse of symptoms. The method of this study was qualitative research based on a deliberate (purpose) data collection. The data were obtained by the method of observation, interview, document analysis and kinesiologic examination. The research group consisted of 4 probands, in which an activity of a scar at different levels of soft tissues linked to postural-locomotor system was found by examination. On the basis of continuous and a final examinations of the probands, the research questions were answered. The results show that appropriately selected techniques of physiotherapy had a positive effect on the health condition of a given patient. Using continuous and meaningful therapy including manual medicine techniques, physical therapy, balneology and pharmacology, the activity of the scar tissue with all its consequences was mitigated or completely stopped. The outcomes of the study can be used by physiotherapists as well as other members of the medical staff, and may also serve to physicians in differential-diagnostic considerations.
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Case study of Physiotherapy Care of patient with diagnosis Multiple injuries of soft tissues of knee joints with following rigidity.
Poláková, Eliška ; Žáková, Hana (advisor) ; Kozáková, Alena (referee)
Title: Case study of Physioterapy care of patient with diagnosis Multiple injuries of soft tissues of knee joints with following rigidity Author: Eliška Poláková Aim: Treatment proposal to the pacient with diagnosis multiple injuries of soft tissues of knee joints with following rigidity Methods and abstract: This work was developed as a research case study in professional practice, which took place from 23rd January 2012 do 17th February 2012 in Regional Hospital Kladno. The work is divided into a theoretical part and special part. The theoretical part deals with theoretical knowledge in terms of anatomy, kinesiology and injury mechanisms. It also includes the possibility of treatment in the matter, the possibility of investigative techniques and physiotherapy practices in the postoperative period. Related special section describes a case report of a patient with multiple disabilities posttraumatic soft tissue knee followed by rigidity, behavior therapy and evaluate the effect of therapy. Results: Status of patient is different at the beginning and end of therapy. Mainly to improve range of motion in L knee, increase muscle strength and improve walking stereotype. Key words: knee joint, menscus, posterior cruciate ligament, instability, medial collateral ligament, physioterapy
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The use of a shock wave in the physiotherapy
NOVÁK, Jan
Except a few scientific studies there is not yet enough available literature, written in Czech language, which would summarize theoretical information on the effects of shock wave therapy. In my thesis I tried to clarify physical conditions associated with emergence and specific spread of shock waves in various media and other physical principles which explain behavior and effects of shock waves passing through different types of tissues. From the results of expert studies and articles I made a survey of the most common possibilities of use of shock waves in medicine - especially in physiotherapy. In the practical part I evaluate the effects and course of shockwave therapy in three randomly selected patients diagnosed with epicondylitis radialis humeri (tennis elbow). Patients were treated by a series of applications of radial shock waves, when one session amounted to 1500 - 2000 shocks of varying frequency of 4-21 Hz and the pneumatic pressure of 2 - 3.2 bar. The results show that the patient may respond differently to shockwave therapy. Due to the fact that in a relatively small research sample quite disparate results have been recorded - the first patient significantly improved, the second improved slightly and the third got worse on the contrary - we can better understand the diversity of opinions of the professional public on the meaningfulness of the shock waves use in orthopedic diagnoses. For the practical part the method of qualitative research was chosen. Interview techniques, observations, case reports, data analysis and research were used. The research was conducted in the rehabilitation centre OLMA R + in České Budějovice and Rehabilitation Department of Polyclinic South MEDIPONT Ltd. in the time period from January to April 2012.
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Physiotherapy of functional disorders resulting from the prolonged sitting at a computer- focusing on neck pain
RYBECKÁ, Pavla
The topic of this Bachelor thesis looks at the issue of ?Physiotherapy of functional movement disorder originating from sitting in front of a computer for long periods ? aimed at pain in the cervical spine?. Many people with long-term sitting jobs often complain about pain in the cervical spine. The theoretical part focuses especially on ergonomics while sitting and the proper poise or postures of sitting. The second part of the aforesaid theoretical part describes the cervical spine anatomy, as well as causes of the origin of pain in the cervical spine and its symptoms. Finally, the theoretical part introduces various possibilities for therapy dealing with functional movement disorder of the cervical spine. The aim of the thesis is to specify the functional disorder of the limbs movement system, appoint and implement an individual plan and assess the resulting effect of therapy. Qualitative research focused on data collection was used as the main method by using different practices, such as direct anamnesis, input and output medical examination, nursing observation, document analysis, project and execution of a physiotherapeutic schedule. The survey was carried out on 2 men and 1 woman who have jobs which require long-term sitting. Their working tasks require sitting in front of a computer for at least an 8-hour period a day. All three people submitting the given survey suffered from pain in the cervical spine. The kinesiological examination described faulty body poises and related findings on soft tissues of the given testing group. The main problem was also caused by a faulty poise while sitting in front of a computer. The objective of the aforesaid therapy concentrated on releasing the overload of stressed muscle groups and on their integration according to the optimal kinetic formula. Functional movement disorders of the spine are prevented by implementing ergonomics of sitting in front of a computer. The results of the given survey demonstrate that the cervical spine subsided. Furthermore, the practical part of the thesis reveals that the positive effect of the targeted physiotherapy dealing with functional disorder and changes of the stereotype of our postures and poises was considerable. The main problem causing pain was incorrect poise while sitting at the desk. The essential point of therapy was to release the overload of muscle groups and their integration into a new poise. The results of the given survey demonstrate that pain in the cervical spine has been alleviated. Based on the results introduced in the practical part, it may be stated that functional movement disorder can be positively influenced by targeted physiotherapy and changes made in the routine of body movements. The results specified in the submitted thesis shall be used in practice for the needs of other surveys to follow, during lessons or by companies furnishing their offices.
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CT and MR using for diagnostics and therapy controle of scaphoid fracture
HEGEROVÁ, Jindřiška
In the opening part of this thesis I focused on the description of wrist anatomy and os scaphoideum, carpo kinetics, mechanism of injury origin, types of fractures and their classification. Next part contains the description of particular examination techniques that are ordered from the most basic to those that are technically more demanding. These techniques are ordered according to present examination algorithm. Following part deals with therapeutic processes. There is a list of therapeutic processes. Type of treatment depends on the type of fracture and influences the length of wrist fixation and physiotherapy. I mention the basic principle of a particular technique in all diagnostic methods and I advert to elaborate examination protocols used in our department. I also mention advantages and disadvantages of the most modern display methods (CT and MR). In the closing part I introduce results that I obtained by data gathering during the particular time period (form of retrospective study). From these data I have an impression that although the X-ray is the basis, it is no longer the golden standard because of various reasons such as longer time spent on acquiring a quality X-ray picture, problems with cooperation with patients and deletion or summation of body structure details in an X-ray picture. CT contribution consists in a definite fracture confirmation or exclusion. It has a crucial importance when determining the type of treatment and assessing fracture consol MR is used especially for diagnosis of soft tissues and it is also recommended for diagnosis of subsequent consequences. But for its financial expensiveness it is not used in our department for urgent diagnosis of fractures os scaphodeum.
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Physiotherapy in patients after fracture of the ankle joint
ROKŮSKOVÁ, Pavla
This Bachelor?s thesis deals with the theme of physiotherapy of patiens with a fractured ankle joints. An injury of ankle joint is one of many kinds of musculoskeletal injuries. As a result of an injury in this area appears a pathological situation for human organism which results in changes of local and distant parts of human body. Among important local problems of the physiotherapy treatment belong pain, swelling, limited mobility of the surrounding tissue and malfunction of muscles. The main role of physiotherapy is an elimination of local problems and a restoration of the proper function of ankle joints. Then the techniques of physiotherapy aim to the reeducation of walking and to avoid any incorrect movement streotypes and compensatory mechanisms. Therefore this therapy does not focused only on the ankle joint itself, but contains whole postural function of muscles in the whole human body. In the theoretical part of this thesis I describe the anatomy of human feet and ankle joints, the kinesiology of ankle joint and the biomechanism of human walking. Then etiology, diagnostics , treatment and complications of traumas of the ankle joint are mentioned. As an individual chapter there are therapeutic guidelines used at the time during healing, and of course, after healing of the fractures. In the research part of this thesis the qualitative method of research was used. This chapter was prepared as a list of case reports, which contain case history, initial examination, design and description of the therapy, final examination and long term physiotherapeutic plan. The utilized techniques for collecting data were interview and observation. The researched group consisted of two patients with diagnosed fracture of the ankle joint. These patients were selected from two ambulatory departments. One of the department is part of the Nemocnice Ceske Budejovice, a.s., and the other is part of Centrum lecebne rehabilitace Marie Kotrbove, s.r.o. Total duration of therapy was four weeks in both cases. At the beginning of therapy these patients were informed about the procedure the goal of therapy. The goal of this thesis was using theoretical and practical knowledge gained during studying of physiotherapy for the most effective treatment of patients. The first goal was to introduce complete knowledge of kinesiology and physiotherapy of the fractures of ankle joints. This part was achieved in the theoretical chapter of my thesis. The second goal was describing the possibilities of the therapeutic care and the following practical effectinevess. At the beginning of the study the question was set: Are the recommended methods of physiotherapy of patiens with fractured ankle joints effective?. The progress and outcome of therapy was judged in conservative treated cases as well as surgical treated cases of fractured ankle joints. In the conservative treated fracture the terapy was effective, swelling has been gone, the muscle strenght increased and the motion range extended. In the surgical treated case terapeutic progress was slowed down. But even there after the complex physiotherapy treatment success was achieved. Maximum level of all functions will be matter of further therapy. The results of research part has shown, the proper terapeutic methods were chosen. The results of this thesis will be provided to the whole physioterapic community. Benefit in clinical practice is in present processing and pointing out all possibilities of local and complex therapy of fractures in the area of ankle joint.
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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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Physiotherapy and treatment of elbow enthesopathy
MRÁZKOVÁ, Lucie
The topic of my work with the name ?Physiotherapy and Treatment of Enthesopathy in the Ulnar Joint? is very current at present. A large part of the population suffers from it, in the consequence of excessive loading. Very often the first symptoms, which could prevent the problems, are not taken into account. It often starts after single hard work (computer typing, wood chopping, etc.), and that acute form very often changes into a chronic form. The treatment of such problems is usually very protracted. The choice of the treatment is difficult as well and no method of a correct procedure of therapy has been described yet, because each individual reacts in a different way. It is not possible to estimate how long it will take, before the everyday activities could be resumed. As the aim in the theoretical part of my work I chose to study and apply the current available information from various resources and thus create an educational material about the application of suitable treatment. The basic anatomy of ulnar joint, kinesiology, the most often factors and reasons of the origin are described there. Further there were special methods of examination and a clinical picture, therapy and prevention against the problems. For the practical part I chose a method of a qualitative research. Three cases of patients, who were treated by MUDr. Kunovsky in Tabor and who underwent physiotherapy there, have been studied and dealt with. The research was carried out by means of observation, anamnesis and discussions during the treatment, the documentation of the patients and special examination methods. The treatment methods I have focused on were mobilization, technique of soft tissues, pro-prioceptive neuromuscular facilitation, physiotherapy and taping technique. Some forms of applications had a positive effect on the patients and brought improvement, the others showed no changes. In my opinion the individual elements should be combined and applied for a longer period of time and the anamnesis of the patient should be thoroughly discussed, to find out the main reasons of the origin. The patients learned a procedure during the therapy how to face correctly the origin of that problem and how to apply efficiently the preventive measures to avoid the recurrence of the problems. My work could be used for the purpose of studies of future physiotherapists, for the patients, or a source of information for public.
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Physiotherapy after soft tissue injuries of the ankle joint
Weissová, Marie ; Muchová, Renáta (advisor) ; Nováková, Petra (referee)
My bachelor thesis focuses on physiotherapy after soft tissue injuries of the ankle joint. This type of injury can affect both athletes as well as regular population during their daily activities. In the theoretical part of my thesis I discuss the anatomy of the ankle joint, specifically, its soft tissue; ligaments and muscles. Furthermore, I discuss kinesiology of the ankle joint and traumatology of the ankle joint's soft tissue. I particularly focus on the mechanisms of emergency of the injuries and majority of the injured structures. Included as well is a section on the instability of the ankle joint which is the focus of the practical part of my thesis. The practical part of my thesis contains two case studies where physiotherapy was applied, in particular, sensomotoric stimulation and spiral dynamic which are techniques suited to treatment of this type of injury. I explore their effectiveness. I have also included a description of these methods as well as tests examining the instability of the ankle joint. Both case studies examine patients who were injured more than two months ago and struggle with ankle joint instability, which is typical for this type of injury. The objective assesment of my therapy should be the measures on footscan. Key words: ankle joint, instability of the ankle joint,...
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