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Viscerovertebral relations focusing on GERD.
Švorcová, Barbora ; Pánek, David (advisor) ; Martínek, Milan (referee)
I Abstract Title: Viscerovertebral relations focusing on GERD Objectives: The thesis is focused on describing viscerovertebral relations focusing on GERD and physiotherapeutic possibilities of using these relations to influence this disease. It is divided into two parts - theoretical and research. The aim of the theoretical part is to summarize the current knowledge about GERD and mentioned viscerovertebral relations focusing on specific technique - stimulation of the Chapman points. The aim of the research part is to present the study to assess the effect of stimulation of the Chapman points in physiotherapy of patients with GERD. Methods: The study consists of the application of a physiotherapy intervention to probands randomly divided into two groups - control and experimental. The intervention consisted of individual physiotherapy lasting approximately 45 minutes, once a week for 4 weeks, and self-therapy at home based on instructions. The therapy of both groups differed by the inclusion of the Chapman points stimulation in the experimental group. As a method of testing the effect of therapy, two standardized questionnaires were used to assess the symptoms and quality of life of patients with GERD - "GERD-HRQL" and "Relux symptom index podle Belafského ", which were presented to the probands before the...
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Activity of lower oesophageal sphincter in healthy patients in various postural positions
Beranová, Kateřina ; Bitnar, Petr (advisor) ; Hlava, Štěpán (referee)
The aim of this thesis is to describe information about GERD, its etiology, anatomy, pathology, treatment options and rehabilitation in patients with GERD. Lower oesophageal sphincter and antireflux barrier. The study was approved by the ethics committee. 30 probands were included in the study and their health status was verified using the Health Related Quality of Life questionnaire. A manometric catheter was inserted, proband was instructed to maintain various postural positions. Lying supine with lower limbs elevated above the surface, lying supine with lower limbs elevated above the surface with head fixated manualy, sitting and standing position, load in the center of gravity 3/6/9 kg, load outside the center of gravity 3/6/9 kg, lifting of the office chair. It has been shown that LES pressure increases in all postural positions compared to resting pressure. The positions activate the diaphragm to demonstrate the postural function of the diaphragm. The most significant change in LES pressures was in the postural position of lying supine with lower limbs elevated above the surface, the LES resting pressure of 20.34mmHg changed to the pressure of LES 40.92mmHg. Clinical experience and studies have shown that patients with GERD have disposition for respiratory and / or vertebrogenic difficulties....
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Effect of breathing training and DNS on lower esophageal sphincter and back pain in patients with gastroesophageal reflux disease
Jandáková, Vladana ; Mádle, Kateřina (advisor) ; Babková, Lenka (referee)
This thesis focuses on lower esophageal sphincter and low back pain in patients with gastroesophageal reflux disease (GERD). Common etiological factor of both GERD and low back pain frequently present in GERD patients is diaphragm dysfunction. Diaphragm fulfils respiratory, postural and sphincter functions, all these functions are interrelated which we benefit from in therapy. Theoretical section presents anatomy of the esophagus, upper and lower esophageal sphincters, diaphragm, follows etiology, diagnostic methods and treatment of GERD and LBP as well as common therapeutical approach by means of postural and respiratory physiotherapy. Basic principles of Dynamic Neuromuscular Stabilization and Respiratory muscle training are presented and their use in the treatment of GERD and LBP. Practical section contains a case study of a patient diagnosed with GERD, kinesiological analysis, high resolution manometry of esophagus and therapy focused on diaphragm activation achieved by improving trunk stabilization and by optimising patient's breathing stereotype.
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Monitoring of postural stability of crural diaphragm in patients suffering from functional disorders of upper digestive system with the help of manometry
Sedláčková, Iveta ; Bitnar, Petr (advisor) ; Kodríková, Kateřina (referee)
The diploma thesis aims to describe the functional disorders of the upper gastrointestinal tract with an emphasis on gastroesophageal reflux disease. The theoretical part describes the anatomy, pathophysiology, etiology of GERD and treatment options. In the practical part is measured postural reactivity of the diaphragm in the selected 15 probands with GERD. We measured the postural reactivity of the diaphragm using high resolution manometry in various postural situations: lying on the back with flexion of lower limbs above the surface, standing and standing on the AIREX mat, for standing patients, we used weights of 3,6 and 9 kilos inside and outside the center of gravity. Patients also completed the GERD Health-Related Quality of Life questionnaire. The measurements confirmed an increase in resting pressure in all positions except standing, which correlated with the highest occurrence of reflux episodes in standing. The results were compared with a healthy control group. The activation of the crural part of the diaphragm was the same in both groups. We found in patients with GERD decreased coordination, delayed and influent activation of the crural diaphragm. The most significant increase in pressure in GERD patients occurred in the postural position of the flexed lower limbs and in standing...
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Effect of postural - respirative physiotherapeutic intervention during therapy of gastroesofageal reflux (GERD(
Zahrádková, Tereza ; Malá, Jitka (advisor) ; Stupková, Michaela (referee)
Title: Effect of postural-respiratory physiotherapeutic intervention in the treatment of gastroesophageal reflux disease (GERD) Objectives: The aim of the theoretical part of this thesis is to describe the problem and summarize the latest knowledge about gastroesophageal reflux and its current treatment approaches. Based on this theoretical knowledge, in the practical part to create a design and verify the functionality of a comprehensive therapeutic procedure and exercise set aimed at influencing the postural-respiratory function of the diaphragm and viscero- somatic manifestations of reflux disease of the oesophagus. Methods: The theoretical part of the work was processed in the form of literary research, based on information from book and electronic resources in Czech, English and German language. A total of 16 probands with a diagnosis of GERD were included in the research part, which were subsequently divided into two groups of 8 - experimental and control. Both groups were to undergo a series of 8 physiotherapies within one month as indicated by the physician. In addition, a set of yoga asanas and pranayama was added to the daily exercise sets of the experimental group, which were aimed at improving the postural-respiratory ability of the diaphragm, overall coactivation of myofascial chains...
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Activity of lower oesophageal sphincter in healthy patients in various postural positions
Beranová, Kateřina ; Bitnar, Petr (advisor) ; Hlava, Štěpán (referee)
The aim of this thesis is to describe information about GERD, its etiology, anatomy, pathology, treatment options and rehabilitation in patients with GERD. Lower oesophageal sphincter and antireflux barrier. The study was approved by the ethics committee. 30 probands were included in the study and their health status was verified using the Health Related Quality of Life questionnaire. A manometric catheter was inserted, proband was instructed to maintain various postural positions. Lying supine with lower limbs elevated above the surface, lying supine with lower limbs elevated above the surface with head fixated manualy, sitting and standing position, load in the center of gravity 3/6/9 kg, load outside the center of gravity 3/6/9 kg, lifting of the office chair. It has been shown that LES pressure increases in all postural positions compared to resting pressure. The positions activate the diaphragm to demonstrate the postural function of the diaphragm. The most significant change in LES pressures was in the postural position of lying supine with lower limbs elevated above the surface, the LES resting pressure of 20.34mmHg changed to the pressure of LES 40.92mmHg. Clinical experience and studies have shown that patients with GERD have disposition for respiratory and / or vertebrogenic difficulties....
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Diaphragm in the role of external esophageal sphincter - spirometric - manometric study
Veličková, Barbora ; Bitnar, Petr (advisor) ; Šnajdauf, Martin (referee)
The aim of this thesis is to present a complex information about the etiology, diagnosis and treatment of gastroesophageal reflux disease (GERD) and to further elucidate the function of the diaphragm as the external esophageal sphincter and as a part of the antireflux barrier in patients with GERD. The study included 87 patients with verified GERD. Patients were subjected to a set of postural and respiratory maneuvers - caudal position of chest, abdominal breathing and measuring of the maximal respiratory pressures, all performed on the basis of tolerance to position and maneuver. The high-resolution manometry (HRM) was chosen to record the changes in pressure in the lower esophageal sphincter and for the measurement of respiratory pressures was used the spirometric system MasterScope. It was found that postural and respiratory maneuvers, that activate the diaphragm, increase the pressure in the EGJ. The most significant increase occurred during the maximal inspiratory maneuver, which increased LES pressure up to 261.2 %. The results also show that patients with GERD have reduced the strength of respiratory muscles, especially inspirational muscles. Reaching only 66.5 % of predicted PImax. We have demonstrated that patients with GERD have significantly lower diaphragm muscle strength, what...
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