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Occupational Therapy practice guidelines in children with perinatal brachial plexus palsy.
Jurečková, Michala ; Dvořáková, Petra (advisor) ; Jelínková, Jana (referee)
Title: Occupational therapy practice guidelines in children with perinatal brachial plexus palsy Abstract: Neonatal brachial plexus palsy is a palsy of the upper limb caused by traction of the brachial plexus during birth. It affects about 1.5 cases per 1000 live births and requires complex treatment. The clinical picture depends on the severity of the nerve damage and the part of the plexus that is affected. An unified framework for the treatment and management of paresis improves communication and clinical decision making for further rehabilitation. Currently there is an absence of clinical guidelines on pediatric issues and to ensure the highest quality of care, there is a need to develop them and find the best solutions to the problem. Clinical guidelines improve the quality of healthcare and reduce the variety of procedures and methods in clinical practice. The aim of this thesis is to develop a scheme for a clinical guidelines for diagnosis and intervention in children with neonatal brachial plexus palsy from birth to 7 years of age. A sub-objective is to review diagnostic tools and occupational therapy methods or procedures that appear in studies dealing with brachial plexus paresis and that can be used in occupational therapy practice. The thesis presents the issues of perinatal brachial plexus...
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Case Study of physiotherapeutic care of a polytraumatic patient diagnosed with proximal humerus fracture
Lichnovská, Bára ; Neuwirthová, Svatava (advisor) ; Nový, Filip (referee)
Author: Bára Lichnovská Title: Case study of physiotherapeutic care of a polytraumatic patient diagnosed with proximal humerus fracture Head of the thesis: Mgr. Svatava Neuwirthová Aim: The main aim of this bachelor thesis is to outline the possibilities of physiotherapeutic care of a patient with polytrauma, whose main limitations result from the consequences of multiple fractures such as HKK and DKK. Introduction to the problem of fractures - classification, solution of the case study of physiotherapeutic care of a patient with a diagnosis of proximal humerus fracture. Methods: The theoretical part of the thesis is prepared in the form of a literature search. The knowledge of anatomy, kinesiology of the shoulder joint area, humerus is mentioned. It also describes the types of fractures and their division, treatment options - invasive or non- invasive, the course of bone healing and the procedure of subsequent rehabilitation after fractures. The special part includes a complete case report of the patient, initial kinesiological analysis, record of therapeutic units completed by the patient and then the output kinesiological analysis. In the final part I discuss the evaluation of the overall effect of the therapy. Keywords: case study, physiotherapy, brachial plexus, shoulder joint, humerus,...
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Anatomical possibilities of the suprascapular nerve reconstruction by dorsal approach
Krajcová, Aneta ; Kaiser, Radek (advisor) ; Kachlík, David (referee) ; Měšťák, Ondřej (referee)
The presented dissertation primarily investigates new possibilities of targeted reconstruction of the lower branch of the suprascapular nerve for the infraspinatus muscle in patients with palsy of external rotation of the arm. It arises either on the basis of the brachial plexus palsy or during fractures of the scapula. The aim of the first part of the thesis was to use a systematic review of the literature and a subsequent meta-analysis to define data on the epidemiology and etiopathogenesis of severe injuries to the brachial plexus, which are indicated for surgical treatment. The second part describes two experimental studies on the reconstruction of the lower branch of the suprascapular nerve using the spinal accessory and lower subscapular nerves. Determining the values of the frequency of different types of brachial plexus lesions and their dependence on gender and causal mechanisms can be used as a basic reference when informing patients and the professional public about these types of injuries. In the experiment, it was proven that both methods of the suprascapular nerve reconstruction can be used in the vast majority of cadavers. They are thus potentially usable in clinical practice depending on the type of injury.
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Possibilitties of physiotherapy in peripheral paresis of upper extremities
ŠANDA, Ondřej
The theme of this thesis is "Possibilities of physiotherapy in peripheral paresis of upper limbs" and its aim is to investigate the influence of physiotherapy on improvement of muscle strength and function of paretic upper limb by various methods. The theoretical part includes the field of anatomy, neurophysiology and pathophysiology related to the peripheral nerves of the upper limbs. Information on nerve cells, evaluation classifications, classification of polyneuropathies and mononeuropathies, brachial plexus, treatment options and foreign experience are available in individual subchapters. The practical part contains the methodology of qualitative research. The sample consists of 3 patients with peripheral upper limb paresis. The aim was to elaborate case reports of patients with this type of disease in detail and to propose a rehabilitation plan for these patients, which will include entry and exit examinations that will be compared after the rehabilitation. Each patient had a total of 8 therapies, over a maximum period of 6 weeks, aimed at improving muscle strength and overall function of the upper limbs in daily life activities. Based on the data obtained, it is clear that physiotherapy was beneficial for these patients. All patients experienced improvement in muscle strength and function of the upper limb and remission of paresthesias after treatment. This work can be used by professional public, physiotherapists, physiotherapy students, or even patients who will face this disease. It should also serve as information for obtaining basic orientation in the problems of peripheral paresis of upper limbs, its pathology and possible physiotherapeutic procedures.
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Surgical treatment of Brachial plexus birth palsy and possibilities of Physiotherapy
Šolcová, Monika ; Zounková, Irena (advisor) ; Horáček, Ondřej (referee)
Obstetrical palsy of upper limb results from a perinatal lesion of brachial plexus nervous bunch. The incidence of this disease ranges from 0.42 to 5.1 / 1,000 live births. If the palsy isn't diagnosed early and treated adequately, child will be threatened by major consequences later. This work provides the reader with the current view on the surgical treatment of patients with brachial plexus birth palsy. It gives a comprehensive overview on early neurosurgical intervention and secondary orthopaedic reconstruction. It submits opinions on indicating criteria. It describes the main charakteristic and results of operations. It refers to the fact that the choice of a surgical procedure can be essential in therapy. The aim of this work is also to characterize the fundamental aspects of postoperative physiotherapy, which simultaneously goes along with the process of intervention therapy. The practical part of this work includes a case of a patient after a neurosurgical performance. It describes the preoperative examinations, the performed surgery and the implementation of postoperative rehabilitation.
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Use of Electrical Stimulation in Physiotherapy of Perinatal Brachial Plexus Palsy
Přikrylová, Martina ; Dyrhonová, Olga (advisor) ; Demeková, Júlia (referee)
Perinatal brachial plexus palsy (PBPP) is the most common peripheral nerve injury for a newborn children. Theoretical part summarizes the following themes: brachial plexus anatomy, causes of a palsy, levels and types of peripheral nerve damage, treatment options and a summary of rehabilitation techniques that are used in a therapy. Practical part focuses on pathophysiology after a nerve injury and an indication of electrical stimulation (ES) of peripheral nerve palsies. A lot of studies regarding this topic have been published, nevertheless the question whether ES is safe and beneficial method that should be applied in a peripheral nerve palsies treatment still remains unanswered. According to the obtained results, electrical stimulation necessarily has to be divided into electrical muscle stimulation and electrical nerve stimulation, to add to this, we have to determine their apparent parameters. It seems like electrical muscle stimulation is not as beneficial as electrical nerve stimulation. On the other hand, a takeover in the treatment of peripheral nerve palsies may be an intraoperative electrical nerve stimulation. Thesis includes case report of a patient suffering from PBPP with an indication for an ES.
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Case Study on Physiotherapy Treatment of a Patient with an upper type brachial plexus palsy
Škripková, Aneta ; Neuwirthová, Svatava (advisor) ; Hamouzová, Dita (referee)
Title: Case Study on Physiotherapy Treatment of a Patient with an upper type brachial plexus palsy Objectives: The main aim of this bachelor thesis is to summarise the theoretical knowledge about the lesion of the peripheral nervous system, specifically brachial plexus palsies. Other two core objectives are to become oriented in the specialised literature about the given subject and the elaboration of a case study on the physiotherapy treatment of a patient with the above-mentioned diagnosis. Methods: The bachelor thesis is divided into two main parts: theoretical and special. The theoretical part is dedicated to summarising data about the stated problematics obtained from specialised literature available. The findings inform about the basics of the nervous system, with more emphasis on the peripheral nervous system and its possible damage, about brachial plexus palsy, and the options for treatment of this diagnosis. The special, or practical, part contains a detailed case study on the physiotherapy treatment of a patient with an upper type brachial plexus palsy, conducted in a continuous specialised practice. The case study includes the pre- and post-therapy kinesiological assessments, a description of all therapeutic sessions performed and, in conclusion, an evaluation of the effects of the...
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Brachial plexus birth palsy options of physiotherapy in school age
Kováčová, Soňa ; Klouček, Vít (advisor) ; Hvězdová, Jana (referee)
Author: Soňa Kováčová, DiS. Institution: Department of Rehabilitation Medicine, Faculty of Medicine in Hradec Kralove, Charles University in Prague Name of the Thesis: Brachial plexus birth palsy options of physiotherapy in school age Supervisor: Bc. Vít Klouček Number of Pages: 88 Year of the Defense: 2014 Key Words: birth palsy, brachial plexus, rehabilitation This thesis deals with the issue of obstetrical brachial plexus palsy and possibilities of physiotherapy for children of school age. It contains a theoretical and a case section. The theoretical section is thematically divided into a general and a special part. The first part deals with general obstetrical brachial plexus palsy, in the second part are mentioned possible methodologies that can be used in the treatment of children of school age with residual damage. In the case section there is described the treatment of two patients in order to show the possibility of affecting the function of the shoulder girdle with the concept of Basal postural programs.
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This case study of the physiotherapy care of a patient with multiple injuries of nerves in the shoulder and arm
Polák, Alois ; Satrapová, Lenka (advisor) ; Šánová, Milena (referee)
Title: This case study of the physiotherapy care of a patient with multiple injuries of nerves in the shoulder and arm Objectives: The main objective of this paper is to summarize the theoretical knowledge about the peripheral nerve lesions in the shoulder and arm, and the development of the case studies of care for patients with this diagnosis. Methods: This work is divided into two main parts. The first part is devoted to a general summary of theoretical knowledge concerning anatomical, kinesiological, physiological and pathophysiological aspects of this disease and there are outlined some options for its examination and its treatment. In the second practical part is a detailed case report of physiotherapy care of patients with a given diagnosis. This section has been prepared on the basis of practice in the hospital Nemocnice Na Bulovce in the period from 19 January to 13 February 2015. There are a detailed input and output kinesiology analysis, itemized individual therapeutic units and drafted the effect of therapy. Results: The patient improved active movement of the shoulder joint in all directions increased the strength of the relevant muscles and especially improved coordination skills and volitional motor activity of his upper limb. Keywords: peripheral palsy, brachial plexus, shoulder...
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