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Prevalence of neurodegenerative disorders in patients with esophageal achalasia
Jerie, Martin ; Vojtěch, Zdeněk (advisor) ; Šonka, Karel (referee) ; Bronský, Jiří (referee)
Introduction: Achalasia is a primary motility disorder of the esophagus due to degeneration neurons in myenteric plexus. Although the exact pathogenesis is unknown, autoimmune and neurodegenerative processes seem to be involved. We thus hypothesized that the prevalence of neurodegenerative and/or neuroinflammatory disorders (NDD) with autoimmune component could be higher among patients with achalasia and vice versa as the background pathogenetic mechanisms might be similar. Methods: This was a prospective, observational, comparative questionnaire-based study. Patients with achalasia from a gastroenterology center and patients with NDD from neurology centers in the Czech Republic were enrolled. Patients from achalasia group were then examined by neurologist and neurological patients by gastroenterologist, including further testing to confirm or rule out either NDD and achalasia, respectively. We assessed the prevalence of both achalasia and NDD and compared them with prevalences in general population. Results: A total of 150 patients with achalasia and 112 patients with NDD were enrolled. We observed an increased prevalence of NDD among patients with achalasia (6.0 % (9/150) as compared to the estimated 2.0 % prevalence of NDD in general population, p=0.003). In the NDD group, 32 out of 112 patients...
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The effect of dysphagic diet on the prevencion of malnutrition risk in the elderly
ZEMANOVÁ, Adéla
This thesis, entitled "Effect of dysphagic diet on the prevention of malnutrition risk in the elderly", deals with the dysphagic diet, which is a diet for swallowing disorders. Swallowing disorders are most commonly seen after stroke, in neurodegenerative diseases, head, neck and oesophageal tumours, and in critically ill patients or the elderly. For this thesis, I chose to conduct both quantitative and qualitative research involving two hospitals and one social service facility for the elderly. I divided the practical part into two subchapters. In the first, I discuss the processing of the observational data. Here I describe what kind of diet is served to patients with dysphagia in a particular facility, what technological procedures are used in its preparation and what meals are most frequently served in the facility. In the second part, the five-day menus of each facility are evaluated and compared with the values from the facility's dietary system. The research showed that if the patient consumed all the food given to him, he would not be at risk of malnutrition, as it is energetically sufficient and covers the needs of the elderly. However, in only two facilities did the patients receive a varied diet, and in one facility the meals or individual foods were more often repeated. The aesthetics of the food in none of the facilities corresponded to my idea of an attractive appearance of the prepared food, nor did the technological preparation of the food in any of the facilities correspond to the requirements of a textured diet - pureed. Therefore, it is likely that patients will not tolerate the diet because of the low variety, poor technological preparation, or the way it is served, because, as they say, we eat with our eyes. The intake would then be insufficient and could lead to a risk of malnutrition. It is therefore not possible to say unequivocally whether a dysphagic diet is a prevention of the risk of malnutrition in the elderly, but if the variety of the diet is maintained and the principles of technological preparation are followed, it could be.
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Stimulation of swallowing within PNF concept in patients with acquired brain injury
Matys, Václav ; Slámová, Adéla (advisor) ; Fabičovic, Klaudia (referee)
BACHELOR THESIS ABSTRACT Name, surname: Václav Matys Supervisor: Ing. Adéla Slámová Consultant: Ing. Mgr. Jana Horynová Title: Stimulation of swallowing within PNF concept in pacient with acquired brain injury A swallowing disorder often occurs as a complication in acquired brain injury diagnosis. In more serious cases it can constitute even life-threatening condition, primarily due to the risk of aspiration and possilbe subsequent development of an inflammatory lung disease. This thesis deals with a possibility of therapeutic influencing of neurogenic dysphagia with utilization of elements of the concept of proprioceptive neuromuscular facilitation - PNF. Contrary to the fact that exercise on the PNF basis to influence dysphagia isn't used frequently in clinical practice, it represents highly effective and for the therapist easily managable method of therapy. The practical part contains a case history of patients with dysphagia, to whom the therapy on the PNF basis was applied. The goal of the bachelor thesis is to create an educative material for a community of experts, particularly physiotherapist as well as speech pathologists or occupational therapists, and thus support interdisciplinary cooperation in the care of dysphagia patients. The result of the thesis is a formation of the therapeutic procedure...
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Use of myofunctional therapy in people with communication disability
Janečková, Sandra ; Komorná, Marie (advisor) ; Mlčková, Marie (referee)
The topic of this thesis is discussion of usage of myofunctional therapy on persons with communicative disorders. The main goal is to map the extent and possibilities of this therapy in speech therapy practice. The theoretical part deals with physiology and patophysiology of breathing, sucking, swallowing and the orofacial system. Further, in connection with myofunctional therapy it discusses its historical development, methodical approaches, utilities, therapeutical benefits and possibilities of education on this field. The empirical part contains a quantitative investigation, which analyses the extent and usage possibilities of this therapy by speech-language pathologists in the Czech Republic. Based on the data obtained by a questionnaire distributed to speech-language pathologists it can be stated, that about 20 % of the respondents do not use the myofunctional therapy in practice, while those (with one exception) never took part on an expert training. The offer of the trainings is rated as insufficient. The myofunctional therapy can be used on persons with orofacial disorders regardless of age or communicative disorder. KEYWORDS: myofunctional therapy, communicative disorder, swallowing, dysphagia, bite disorders, orofacial area
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The intervention of physiotherapy in the treatment of dysarthria after stroke
Nováková, Kateřina ; Bitnar, Petr (advisor) ; Roubíčková, Lenka (referee)
Stroke is the most comman cause of the speech disorders in adults. Dysarthria, as a motor speech disorder, is one of them. The treatement is based not only on vocal and articulatory exercices, but it requires the complex rehabilitation treatement. The benefit of the physiotherapeutic intervention beside speech therapy might be large. The treatement of the muskuloskeletal system allows to see the orofacial disorders in the context of the posture of the whole body. This work wants to make a view on the process of speech production and to describe relationship of the musculoskeletal system and speech. This work also summarises the basic informations about pathogenesis of dysarthria and particularly about the treatement. The swallowing disorders are also very comman complication of the stroke and occur very often with dysarthria. The aim of this work is to describe the specific role of the physiotherapy in the treatement of dysarthria and look for some possibility of the cooperation between physiotherapist and clinical speech therapiste. The form of the work is the research with case history. Powered by TCPDF (www.tcpdf.org)
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Nutritional support in patients with neurological disease
Laštovička, Petr ; Jambor, Daniel (advisor) ; Cempírek, Ondřej (referee)
This diploma thesis deals with the topic of nutritional support in patients with neurological diseases (stroke and Critical-Illness-Polyneuropathy). The aim of this thesis is to find out, how implemented unified system of nutritional support affects the well-being of patients at neuro-rehabilitation clinic Asklepios Schlossberg Klinik in Bad König. There were observed 55 patients (30 men and 25 women) for 8 weeks. The theoretical part of this thesis describes basic components of nutrition, energy expenditure and needs, selected neurological diseases, dysphagia, malnutrition. The emphasis is put on nutrition in intensive neurological care. The practical part of the thesis analyses data obtained by the observation. There are observed changes of body weight, BMI and laboratory values of total protein, albumin and glycaemia in serum. These data are divided by sex, age, type of disease and initial BMI values. The observed patients had mainly overweight and obesity, which have lost a part of their excess weight due to catabolism. At the beginning of the observation 13 patient had normal BMI value, this number of patients rose to 24 after eight weeks. At the end of the observation the reduction of BMI value was on the average 2.45 units. Based on the results, it was found that although patients due to...
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Nutritional support in patients with neurological disease
Laštovička, Petr ; Jambor, Daniel (advisor) ; Cempírek, Ondřej (referee)
This diploma thesis deals with the topic of nutritional support in patients with neurological diseases (stroke, craniocerebral trauma, critical-illness-polyneuropathy. The aim of this thesis is to find out, how implemented unified system of nutritional support affects the well-being of patients at neuro-rehabilitation clinic Asklepios Schlossberg Klinikum in Bad König. There were observed 58 patients (33 men and 25 women) during 8 weeks. The theoretical part of this thesis describes basic components of nutrition, energy expenditure and needs, selected neurological diseases, dysphagia, malnutrition and nutrition in intensive neurological care. The practical part of the thesis analyses data obtained by the observation. There are observed changes of body weight, BMI and laboratory values of total protein and albumin in serum. These data are divided by sex, age and type of disease. Based on the results, it was found that although patients due to uniform tube feeding do not have sufficient protein intake, serum total protein and albumin levels increased. This can be caused by eating a uniform diet that contains good quality protein in patients, which suffered from hypoalbunemia at the outset of observation, also by reducing the effect of stress reactions with gradual improvement of the state and...
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Mmultidisciplinary care with the focus on speech and swallowing disorders provided to patients with amyotrophic lateral sclerosis
Černá, Adéla ; Klenková, Jiřina (advisor) ; Horynová, Jana (referee)
The diploma thesis is focused on the issue of acquired dysarthric and swallowing disorders in amyotrophic lateral sclerosis and on multidisciplinary care provided to patients with this disease. Theoretical part of the thesis is divided into three chapters. The introductory chapter presents a summary of current knowledge about amyotrophic lateral sclerosis (ALS). The following two chapters are dedicated to dysarthria and dysphagia and their specifics in ALS. The practical part of the diploma thesis is represented by the fourth chapter which incorporates a research survey focused on multidisciplinary care provided to patients with ALS. The primary aim of the research is to evaluate the multidisciplinary care provided to two selected patients with ALS with a focus on speech and swallowing disorders. The secondary objectives of the research relate to the evaluation of the extent of acquired dysarthric and swallowing disorders of these patients, providing a comprehensive overview of the course and content of the provided care and gathering information to create information brochure for patients with ALS and caregivers. The research approach to achieve the determined objectives of the research survey is creation of case studies using qualitative methods of data collection, which is a structured interview...
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Speech and Language Therapy Field Care for People with Dysphagia
Poláchová, Denisa ; Horynová, Jana (advisor) ; Klenková, Jiřina (referee)
The diploma thesis deals with the topic of field language and speech therapy for people with dysphagia. The work is divided into four chapters, while the first three define the theoretical framework of the work, the fourth chapter is empirical. The introductory chapter provides an insight into the physiology of swallowing and the anatomy of the orofacial area. The following chapter is devoted to the issue of dysphagia. The final theoretical chapter offers an insight into speech therapy intervention in patients with dysphagia. The fourth chapter presents a mixed design of a research survey focusing on the provision of field speech therapy care for people with dysphagia in the Czech Republic. The main goal of the research survey was to analyze the provision of this care in our country. This was followed by setting partial goals of the work and research questions. Within them, the work tries to analyze the specifics and barriers to the provision of field speech and language therapy care for patients with dysphagia. A questionnaire survey among clinical speech therapists and interviews with some of them was developed. The conclusion of the work is a summary of the results of the research survey supplemented by recommendations for speech therapy practice. The appendix contains a list of contacts of...
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Evaluation of Nutrition of Patiens Suffering from Dysphagia
ŠMÍDOVÁ, Radka
The bachelor thesis is focused on nourishment of dysphagic patients in a particular medical facility. The theoretical part serves to explain the problems of swallowing disorders, it deals with anatomy, swallowing physics and nutrition of dysphagic patients. The research focuses on anamnesis of individual patients, description and evaluation of their menus. The aim of this thesis was to make sure that the selected patients are saturated with the necessary amount of nutrients, and to find out what technological and special processes are being used to prepare the meals for these patients. The objectives have been achieved through qualitative research. I used the information mainly from medical documentation and from nutritional therapists, eventually from nursing staff. In exceptional cases, it was possible to talk to the patient or his / her family. The menus, which were subsequently evaluated in Nutriservis Professional nutrition software, were received from nutritional therapists. I noticed the total daily energy intake, the amount of proteins, carbohydrates and fats, and the technology used. Nutrition for patients suffering from dysphagia should be seen as a problem that can occur in both health and social facilities of all kinds. Many patients live with swallowing difficulties on a long-term basis at home. However, appropriate handling of swallowing problems can significantly contribute to the overall improvement of the patient's condition. The bachelor thesis can be used as an information material for professional public, medical staff or patients suffering from dysphagia and their relatives.
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