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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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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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