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New Approaches in Physiotherapy of Patients with Bronchial Asthma
Výtisková, Klára ; Kejhová, Eva (advisor) ; Kulich, Václav (referee)
BACHELOR THESIS ABSTRACT First name, surname: Klára Výtisková Supervisor: Ing. Eva Kejhová Title: New Approaches in Physiotherapy of Patients with Bronchial Asthma Abstract: This bachelor thesis deals with the physiotherapeutic influence of bronchial asthma and methods of physiotherapy, which are currently the most applied in the treatment of asthma. The thesis consists of theoretical and practical part. The theoretical part describes bronchial asthma, its diagnosis, classification, clinical manifestation of the disease, pharmacological treatment and methods of physiotherapy, which are currently the most modern and most used in the treatment of asthma bronchiale. This section is the key part of my bachelor thesis. The contents of the therapies of the practical part are based on the knowledge from this chapter. The practical part includes case reports of two patients. The target group were patients aged 20-30 years with diagnosed bronchial asthma, which is currently in a stable state, and in whom there is no regular application of bronchodilators. Each patient underwent a ten - week physiotherapy intervention. Respiratory amplitude measurements and spirometry were used to objectively assess the results of the intervention. The therapies were also evaluated subjectively by the patients, focusing on the...
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Využití respirační fyzioterapie u pacientů po prodělání onemocnění Covid-19
BÍLKOVÁ, Klára
Covid-19 disease is caused by a new type of coronavirus, technically called SARS-CoV-2, which had not been identified in humans before December 2019. It is a droplet- and aerosolborne infectious disease mainly affecting the nasopharynx and lungs. Nowadays, numerous people suffer from the after-effects of having contracted Covid-19, the so-called post-covid syndrome. This is a set of different symptoms that can provide in essence the whole body. The most common complaints include shortness of breath and a persistent cough, deconditioning, headaches, back and chest pain to varying degrees, weakness and fatigue, as well as psychological problems such as anxiety and depression, concentration disorders and insomnia. From a physiotherapy perspective, these symptoms can be modified to varying degrees. For example, directly respiratory difficulties - influencing lung function, respiratory muscles, restoring the correct breathing stereotype. However, we can also influence posturalarticular functions and posture. The aim of the bachelor's thesis is to describe the most common health problems of patients after Covid-19 infection and to suggest appropriate physiotherapy approaches for the identified difficulties. In particular, the thesis focuses on breathing difficulties and the possibility of influencing them with respiratory physiotherapy techniques. A qualitative research strategy was chosen, the research population consisted of five adult patients, and during the course of the research the number was reduced to four probands. The condition for inclusion in the research was a history of SARS-CoV-2 infection, after which patients continued to experience some persistent health problems. Physiotherapy interventions were targeted to optimize respiratory function using selected respiratory physiotherapy techniques. The results were processed by comparing the input and output kinesiological analysis, measuring inspiratory and expiratory mouth pressures using the MicroRPM device and measuring the patient's lung function using spirometry. Improvements were achieved in walking ability, postural-respiratory diaphragmatic function, chest mobility, respiratory pressure values and subjective perception of health status. Some improvement in lung function was also noted by spirometry.
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Influence of respiratory rehabilitation on lung function in patients after COVID-19 pneumonia.
Světová, Barbora ; Benediktová, Květa (advisor) ; Irving, Anna (referee)
This diploma thesis focuses on the comparison of the measured values of selected spirometric parameters (FVC, FEV1, PEF) and the results of quality of life questionnaires (Karnofsky score and Jones shortbreathness score) in two groups, one of which had a prescribed rehabilitation program and the other was a control group. The theoretical part summarizes knowledge about the disease COVID-19 and its immediate and long-term impact, especially on the respiratory system. It also deals with the use of specific methods of respiratory rehabilitation in patients who have experienced the disease of COVID-19. The main goal of the practical part is to verify the effect of respiratory rehabilitation - a prescribed rehabilitation program on lung functions in patients after pneumonia caused by the disease COVID-19. Methodology: A total of 20 patients (average age 60±11,04 years) after pneumonia caused by the disease COVID-19 were included in the research, of which 10 followed the prescribed rehabilitation program. On the day of the end of hospitalization and a second time with an interval of 2-3 months, the spirometric parametres of the probands of both groups were measured and the quality of life was determined using questionnaires. The S-Index and chest amplitude were also measured in the experimental group...
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Dechová rehabilitace u pacientů operovaných pro spontánní pneumothorax
DOLANSKÝ, Petr
This bachelor thesis deals with the issue of respiratory therapy after surgical treatment of spontaneous pneumothorax. Pneumothorax is defined as the presence of air or other gas in the pleural cavity. Patients experience high dyspnea, soreness, decreased respiratory parameters and changes in posture. The aim of the work was to map the possibility of respiratory rehabilitation in patients operated for spontaneous pneumothorax and to propose a procedure for respiratory rehabilitation in these patients. The theoretical part briefly describes the anatomy of the chest, describes the primary and auxiliary inspiratory and expiratory muscles. Furthermore, the problem of pneumothorax, its division, diagnosis, symptomatology, conservative and surgical treatment are described. At the end, the breathing rehabilitation techniques and other physiotherapeutic concepts, that can be used in patients after spontaneous pneumothorax surgery, are discussed. The practical part had been done in the form of qualitative research, in which three patients that were operated for spontaneous pneumothorax participated. Kinesiological examination took place the first day after the surgery. It consisted of the muscle test according to Janda, goniometric measurement of active range of motion in shoulder joint, anthropometric measurment of chest development, measurement of maximum inspiratory pressures using a Micro RPM, Borg's CR10 scale and measurement of hemoglobin oxygen saturation. In the following days, the therapy itself took place, ending with a final kinesiological examination. The measured values were compared with each other. Improvements were achieved in all probands, so it can be argued that the therapy had a positive effect.
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Possibilities of pulmonary rehabilitation for oncological patients after lung resections
ŠVEC, Martin
The lung carcinom is one of the most common types of cancer in male population of the Czech Republic. The usual signs are chest pain, stuffiness, hoarseness and coughing. Lobectomy is usually done to the patients with smaller tumors. It is important to ensure the right preoperative education of the excercises. The priority after the operation is pain therapy, removal of the increased amount of phlegm, support of expectoration, improvement of the ventilation parameters and prevention of post-operative complications. The selected objective of this thesis was to map the problematics of pulmonary rehabilitation of oncological patients after lung resections and also to suggest an approach to the pulmonary rehabilitation of oncological patients after lung resections. The theoretical part describes the anatomy of primary and auxiliary respiratory muscles, the characteristics of the lung carcinoma and its chirurgical therapy and the techniques of pulmonary rehabilitations including different physiotherapeutic concepts like soft and mobilization techniques, the Brügger concept, proprioceptive neuromuscular facilitation and kinesiotaping. The practical part is consisted of qualiative research in which three oncological patients after the lung resetions participated. The research includes trigonometric and anthropometric examinations, muscle test, measurement of maximal exhaling and maximal inhaling pressure, the Borg's scale of percieved exertion and saturation of hemoglobin from oxygen. The therapy began the day before operation and ended before discharge on the seventh to eighth day. The results went back to previous values before the operation in some of the parameters and there were no negative effects of the therapy. It is safe to say that the therapy had a positive effect on the patients without any complications.
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Oxygen therapy after cardiothoracic surgery from the point of view of nurses and patients
VRCHOTOVÁ, Klára
Cardiac surgeries are very serious surgical procedures with considerable specific features. This bachelor thesis focuses on oxygen therapy from the viewpoints of nurses and patients. Its theoretical part describes physiology of breathing and the oxygen therapy as such. It describes individual sources of oxygen and indications for oxygen administration. It also describes principles to be observed during oxygen administration. Specific aids are used for oxygen administration, particularly oxygen masks or oxygen goggles. Quality pulmonary rehabilitation is also necessary to make oxygen therapy more effective. Pulmonary rehabilitation is particularly important for patients after a cardiac surgery and it should be practiced even before the surgery. This approach is critical because in the post-surgery period the therapy makes it possible for the patient to breathe and to expectorate properly. Pulmonary rehabilitation is practiced with patients by general nurses at the cardio surgery ward, as well as by physiotherapists. There are various techniques available to determine efficiency of oxygen therapy and pulmonary rehabilitation. The techniques may be classified as invasive and non-invasive; the most frequently used non-invasive method is pulse oxymetry and the most frequently used invasive technique is blood collection for ABR. Two objectives were set for the thesis. The first objective was to map knowledge of nurses about how to provide care to patients treated with oxygen therapy. The second objective was to determine how the patients feel after a cardiac surgery. Two hypotheses and two research questions were formulated. The first hypotheses were: Nurses working at the resuscitation care station have more knowledge about oxygen therapy than nurses working at the intermediate care station. The second hypothesis was: Nurses working at the resuscitation care station have more knowledge about pulmonary rehabilitation than nurses working at the intermediate care station. The first research question was: How do the patients feel during oxygen therapy and pulmonary rehabilitation? The second research question was: How are the patients after a cardiac surgery informed about oxygen therapy and pulmonary rehabilitation? In the research part of the bachelor thesis I have used both quantitative and qualitative research methods. Quantitative processing of data was used for questionnaires filled out by nurses working in the hospitals Nemocnice České Budějovice a.s., Nemocnice na Homolce in Prague and in the faculty hospital Královské Vinohrady in Prague. The method was used for evaluation and assessment of knowledge of nurses working at the resuscitation and intermediate care wards. Quantitative methods were used for processing of data obtained through semi-structured interviews with patients after a cardiac surgery. The data were transcribed and coded using a pencil and paper method. The data were categorized based on the identified codes. Two categories were created: oxygen therapy and pulmonary rehabilitation. Each of the categories was further divided into three sub-categories. Two categories were created for the research oxygen therapy and pulmonary therapy. Three sub-categories were subsequently created for the oxygen therapy and the pulmonary therapy. The quantitative research has shown that the knowledge of nurses about oxygen therapy is higher among the nurses working at the resuscitation care ward. However, the situation is different in case of their knowledge about pulmonary rehabilitation. In this case the knowledge of nurses working at the intermediate care ward was higher. The processed data from the qualitative research have shown that patients do have sufficient information about post-surgery oxygen therapy, as well as about pulmonary rehabilitation. For all patients in the post-surgery period after a cardiac surgery the frequency of pulmonary rehabilitation was higher than 1 per day.
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Nursing care for patients with a chest trauma.
HORÁKOVÁ, Magdaléna
Injuries to the chest together with damage to the chest organs are among the most frequent injuries in common life. These traumas are often combined with another injury, or they are classified as polytraumas. Care for such patients is provided mainly by trauma centres due to the necessary complex, multi-stage treatment. In the event of an injury to the chest, the chest wall or internal organs in the ribcage may also be injured. These include especially the heart, lungs, main blood vessels, bronchi and throat. A chest injury may endanger the client?s life due to an immediate or potential risk of cardiopulmonary failure. The mechanisms of injury include contusion, compression and deceleration. Injuries may be isolated, multiple or classified as polytraumas. Treatment may be conservative as well as surgical. In most cases, the injuries are non-penetrating. Injuries may be caused by direct force (for example collision with a steering wheel, collision with the ground during a fall, a received blow) or indirect force (deceleration). Chest drainage is an often applied solution. During this medical operation, the drain is inserted into the pleural sac to remove pathologic content. This diploma thesis has been elaborated using the questionnaire method. Data were collected in selected trauma centres of the Czech Republic. 182 questionnaires were processed. Results of the research are processed in the form of graphs and contingency tables. Three hypotheses were defined to achieve the objectives. Hypothesis 1: Nurses have knowledge of the principles of care for patients with active chest breathing. Hypothesis 2: Nurses have knowledge of the principles of care for patients with passive chest breathing. Hypothesis 3: Nurses cooperate with rehabilitation therapists. We have managed to confirm all the hypotheses in our research investigation and thus meet the defined objectives. The research shows that nurses have knowledge of the principles of care for patients with active and passive chest breathing, and that they cooperate with physiotherapists. A nursing standard was created for nurses who focus on patients with applied chest drainage. This thesis may also serve as study material.
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