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The Gait Analysis of People with the Multiple Sclerosis
Havlištová, Michaela ; Ježková, Martina (advisor) ; Káfuňková, Petra (referee)
The Multiple Sclerosis (MS) is one of the most frequent reason of disability of people in productive age. Fatiglle and motor impairment affect the qllality of patients' life. This bachelor thesis focllses on the gait assessment of people aftlicted with the MS. It describes differences of gait of people aftlicted with the MS in compare to healthy people. The thesis shows clinical tests and relevant functional scales which can be lused for the gait assessment in any clinical practice. Instrumental methods of gait assessment are not discussed. There is one casllistry of people affected with the MS in practice pati ofthe thesis and inf1l1ence of the Vojta's therapy on these gait tests (TUG, T25FW, 1 OMWT, DGI and 6MWT). Powered by TCPDF (www.tcpdf.org)
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Coordinated rehabilitation segments used in a selected group of individuals with DMO (combined disability) in center ARPIDA in České Budějovice
PYKALOVÁ, Jana
The thesis focuses on coordinated rehabilitation components, which are used at individuals with cerebral palsy (combined disability) in a concrete non state medical institution in České Budějovice. Cerebral palsy is the most frequent neurodevelopmental disease, wherein the health disability may occur in one or more fields. We can find crucial factor in care of individuals with handicap in coordinated rehabilitation, which is currently perceived as an interdisciplinary field seeking the fastest and widest participation of personal with disabilities in all usual activies of society with the use of medical, educational, social and labour resources. A prerequisite for success is a multidisciplinary team (circular support), which consists of experts and parents of individuals with disabilities. The thesis contains theoretical background, where health disbility, coordinated rehabilitation and cerebral palsy is mentioned, at which the occurrence, forms, associated disorders and treatment are described. A separate chapter is devoted to families of individuals with health disability, where I mentioned the reaction of parents on the birth of a child with a disability, the impact of disability on the family and family support. Furthermore I focus on social services for handicapped people and to ARPIDA centre, where my research took place. In the research section there is defined the aim of the thesis, which was to chart a coordinated rehabilitation components, which are used at individuals with cerebral palsy (combined disability) in ARPIDA centre in České Budějovice. The partial target of my thesis was also to compare the usage of coordinated rehabilitation components at individuals under 15 years of age and at individuals over 15 years. According to target of the work there were developed three hypotheses. Thesis research was conducted through quantitative research. To obtain the data, I used the method of questioning. The sample was comprised of individuals with cerebral palsy (combined disability), who attend the centre ARPIDA, while the questionnaires were filled out by their parents. The research undertaken within the thesis, which was supported by rehearsed literature, confirmed the third hypothesis of more often usuage of Vojta reflex locomotion method at individuals with cerebral palsy in the centre ARPIDA compared to individual therapeutic physical training. The remaining two hypotheses were disproved. Statistical survey also shows that care for people with cerebral palsy is a long-term care, where interconnection of services within the coordinated rehabilitation is needed. In the group of individuals under 15 years of age and over 15 years it has been used different coordinated rehabilitation components, this is associated with cerebral palsy, disorders, age and other factors. Problematic remains the job placement of individuals with disabilities, who remain at home without further stimulation possibility. Care and services in the centre ARPIDA were assessed positively. The results and conclusions of the thesis will be used as a feedback centre ARPIDA to map the coordinated rehabilitation components and further to the clearing of needs of single coordinated rehabilitation components in a group of individuals under 15 years of age and over 15 years.
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The effect of an early Reflex locomotion therapy according prof. Vojta in children with postpartum paresis of Brachial plexus and its social influence from the view of parents
PLACHÁ, Milena
The thesis topic is "The influence of the early therapy by reflex locomotion according to Vojta on children with brachial plexus palsy postpartum and its social impact from the perspective of their parents."The brachial plexus (BP) consists of nerve bundles based on radicular segments C5-Th1. Innervate muscles girdle blades, shoulder, arm and hand. When BP is damaged the mobility may be impaired (paresis to plegia of muscles), sensation (hypoesthesia to anesthesia, paresthesia, pain) and vegetative symptoms can appear (discoloration and skin temperature changes, changes in hair, nail brittleness). Types of BP palsy are classified according to clinical and anatomic course. Paresis of upper type (Erb-Duchene) is the most common and has the best prognosis, clinically manifest by the adduction and internal rotation of the upper limb, the elbow in extension, the wrist in flexion,the limb is poor, the gripping reflex present. During the paralysis of the lower type (Déjerine-Klumpke) the wrist flexion is not possible and the hand grip is poor or absent, and when there is a disruption of the cervical sympathetic the Horner's syndrome appears. An isolated paresis of the secondary trunk with disabilities muscles innervated n. Radialis is rare. During the complete lesion BP the whole limb is plegic with anesthesia all dermatomes excluding the inner arm. The complete lesion BP has the worst prognosis. BP perinatal injury arises in connection with childbirth. Despite the knowledge of risk factors we fail to prevent these injuries. With all children with postnatal paresis BP the initiation of conservative treatment is indicated, some children require neurosurgery. With some children a residual limb dysfunction remains after the treatment. Among the consequences we include permanent residual paresis, postural abnormalities, limb bone deformities, contractures of joints, shortened arm. Delays in mental development and cognitive impairment are related to motor disorders. The early and quality diagnosis and the immediate initiation of therapy is the prerequisite for successful treatment. The therapy should prevent the development of pathological patterns of movement and evoke and restore optimum momentum. The main aim is the restoration of innervation and hand function and the second one is the elbow flexion and the third is the arm abduction. Vojta method of reflex locomotion is one of the methods used for conservative treatment of peripheral paresis. In therapy, congenital partial patterns of forward movement global models, which is reflective crawling and reflective rotation, are activated. These patterns are inborn but with children with locomotor disorders these are blocked. By repeated targeted activation we can achieve the correct fixation of the correct models and thus enable their use in spontaneous motor fluctuations and pathological compensatory movements are displaced. Reflex locomotion favorably influences other functions such as posture and its management, neurological status, the development of mental and autonomic functions, and oculomotoric and disproportionate growth. The goal of the treatment is to reduce the disability degree and to minimize the future disability and handicap. Improving the quality of the child´s life leads to improvement of the life quality for the entire family. The theoretical part is devoted to BP palsy therapy and reflex locomotion according to Vojta. First, the function of peripheral nervous system is characterised, the other part is devoted to BP injury - mechanisms of injury, diagnosis, treatment options, BP perinatal injuries and rehabilitation of patients with spinal BP. The chapter dealing with Vojta describes the basic principles of Vojta method - reflexive crawling and reflexive rotation. The final chapter deals with the birth of a handicapped child, the need to support families and individuals affected especially in the psychological and sociological levels.
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Coordinated care for children with cerebral palsy in the Budweis
KOLESÁROVÁ, Petra
This bachelor thesis is: "Coordinated care for children with cerebral palsy in Ceske Budejovice". Thesis is composed from two parts when first theoretical part is focused on cerebral palsy as multi handicap and follow possibilities of treatment for individuals. Furthermore I am going to emphasize an importance and irreplaceability of coherent system of rehabilitation as an instrument of coordinated care. Theoretical part will be fluently followed by practical part dealing with coordinated care in the frame of Ceske Budejovice. The thesis aims to find out current state of coordinated care for children with cerebral palsy in Ceske Budejovice. In order to reach the goal of the thesis research question has been determinate by following: "How is in Ceske Budejovice complex coordinated care for children with cerebral palsy realized?" For purposes of this thesis additional questions have been determinate which importance came from research part of the thesis. Additional questions have been determinate as following: "How parents of children with cerebral palsy perceive informations from specialists regarding treatment therapy of their children?" "How parents of children with cerebral palsy evaluate coordinated care in frame of Ceske Budejovice and how do they perceive cooperation among specialists?" Part of the second part of the thesis was realization of research together with quantitative methods. Research itself was realized based on semi-standardized deep dive with parents of children with cerebral palsy. Question in semi-standardized conversation have been aligned to circles that allowed to flexibly change interpretation of specific questions based on actual needs. Child for purposes of this research has been defined as an individual between 1 to 15 year old. Considering needs to gain valid informations has the method of semi-standardized conversation been supplemented by analysis of scientific documentation of specific children. Parents with children with diagnosis of cerebral palsy have been chosen as a sample of this research. The result of this thesis are casuistries of specific children and based on that there is scheme created for better readability regarding coordinated care in frame of Ceske Budejovice. According research is coordinated care in Ceske Budejovice realized "freely" which means that it is not driven by any institution. According research second form of coordinated care is institutional. That means child is in care of some institution that provides complex coordinated care aligned with coherent system of rehabilitation. Main advantage of those institutions is their complexity. All researched children are currently in care of Arpida center despite it that this is not only one center focused on cooperated care for individual with multi handicap in Ceske Budejovice. Based on that we can say that Arpida center in Ceske Budejovice is most searched and often visited center by parents witch children with cerebral palsy. The part of results of this thesis is also evaluation of coordinated care in frame of Ceske Budejovice. At the end of this thesis I pointed out that despite the most coordinated most complex care all the time cares on individual level of disability and many other factors that directly determine how the development of an individual will be affected. Undoubtedly we can coordinated care take as imaginary index that guides an individual with this kind of disability right direction.
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Influence of the reflexive locomotion according Vojta to children with Down´s syndrome.
PLACHÁ, Milena
The topic of the thesis is "Effects of reflex locomotion according to Vojta for children with Down?s syndrome" from the perspective of parents. Down?s syndrome (DS) is a congenital syndrome which is caused by the presence of a third copy of chromosome 21. A common feature for children with DS is a mild to moderate mental retardation. A very common feature of children with DS is muscular hypotonia and the relaxation of ligaments and tendons. This is the cause of posture disorder, slow motor development accompanied by the emergence of abnormal patterns of movement. Method that may be used in physical therapy for these children is the Vojta reflex locomotion method. In this therapy, we use partial patterns of global models of reflexive forward movement - reflex creeping and reflex rolling. In the treatment of children with abnormal motor function, we activate normal patterns of movement which can be then used in volitional motor skills. Reflex also positively affects other functions, such as fine motor skills in the orofacial region, peristalsis, respiration, urinary bladder muscle and development of the mental function. If the therapy results in an improvement of motor skills, then the life quality of the child and its family is improved too and there are better conditions for the social and vocational integration of the child. The theoretical part describes the characteristics of DS and the Vojta method of reflex therapy. First specified is DS, its history, classification of different types of DS and its heredity. The following describes the possibilities of diagnosis, symptoms and health problems of children and adults with DS. Last but not least should be mentioned the possibilities of education of children with DS and forms of support to families for a child with DS. In the chapters dealing with the Vojta reflex locomotion method, there is also the briefly mentioned personality Vaclav Vojta, who developed this therapy. It further describes the diagnostic possibilities of motor disabilities of children, two basic principles in Vojta reflex locomotion ? reflex creeping and reflex rolling and their possible use within the therapy. This theoretical part is followed by a research part. The research represents a qualitative narrative interview method. This method uses the recording and subsequent transcription of the interview in which the interviewee describes his life story. When processing, the interview is firstly literally converted into a written form and subsequently analyzed. Individual interviews are presented in stages. The first stage describes the situation in the family before the childbirth. The second stage describes the situation in the family after finding out about the diagnoses of DS. The third stage describes the current situation within the family, development of the child. The fourth stage focuses on planning for the future. The fifth stage is super analysis. In interviews, I search for patterns that are common to all narrations. Parents of five preschool aged children with DS, who undergo the therapy of Vojta reflex locomotion in the Vojta centre in Ceske Budejovice, were included in this research. Interviews were held with all the mothers, two fathers did not participate in the research. From the analysis of all five narrations, it was clear that the influence of the Vojta reflex locomotion method was positive with those children involved in the research. Parents noticed an improvement in body posture, improved motor skills of the tongue and also speech in older children. They consider the contribution of the Vojta reflex locomotion methods positive, both in the areas of motor skills and in the psychosocial area. For all the children involved in the research, this therapy is still being used.
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