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Gait impairment in movement disorders.
Poláková, Kamila ; Brožová, Hana (advisor) ; Čakrt, Ondřej (referee) ; Baláž, Marek (referee)
Summary: Movement disorders are caused by impairment of the basal ganglia and extrapyramidal connections. The most common is Parkinson's disease (PD), characterised by hypokinesia together with resting tremor and / or rigidity, which may be influenced by dopaminergic therapy or invasive methods, including deep brain stimulation (DBS). Gait and balance disorders are part of the Parkinson's syndrome, progress during the disease course and limit daily activities, quality of life, may lead to falls and contribute to higher mortality of the patients in the late stages. Therapy is difficult. Gait disorders and parkinsonism may occur also in other diseases, including intoxications which may also lead to basal ganglia impairment. The theoretical part include the physiology of gait, gait disorders and examination. The section devoted to movement disorders focuses on Parkinson's disease and methanol intoxication. The practical part consists of 3 studies evaluating gait disorder in patients with advanced PD and possibilities of the treatment, the 4th study documents gait disorder in survivors after mass methanol poisoning with outbreak between 2012 and 2014 in the Czech Republic. The result confirm the effect of DBS in step length prolongation and gait speed increment in patients with PD. Compensation strategies using...
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Pathophysiology and clinical aspects of eye movements in basal ganglia disorders.
Hanuška, Jaromír ; Růžička, Evžen (advisor) ; Vymazal, Josef (referee) ; Jeřábek, Jaroslav (referee)
This dissertation is a collection of a total of seven publications that deal with eye movement disorders in patients with basal ganglia disorders. We obtained normative data for videooculography in healthy individuals. We have described the eye movement evolution during a human life such as the increase of latency, movements become hypometric and antisaccadic error rate increases. We have shown that sex and education do not affect the eye movements. Our study highlighted the asymmetry in the eye movement performance. As the first, we studied the vergence in patients with Parkinson's disease (PN) using videooculography (VOG). We devised and defined a paradigm for this examination and saw that in patients with PN there is a prolonged latency and hypometry of divergence. In patients with ephedrone induced parkinsonism (EP), we were the first who examined eye movements and found that it was possible to identify between this toxic Parkinson's syndrome and PN on the basis of a videooculography. In EP patients, we described velocity decsrease and hypometry in horizontal saccades, prolonged latency in horizontal saccades, and higher error rate in the antisacadic task. Behavioral disorder in REM sleep (RBD) as a prodromal stage of PN leads to impaired eye movement. In the evaluation with PN patients, we...
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The "integrated" rehabilitation in extrapyramidal diseases
KREMZOVÁ, Adéla
In my bachelor thesis I focus on the issues of the "integrated" rehabilitation in extrapyramidal disease. Due to large spectrum of extrapyramidal diseases and syndromes I mostly focused in my work on the clients afflicted with the Parkinson{\crq}s disease. In the theoretical part I first define the notion of extrapyramidal diseases, further I am describing the issues connected with the Parkinson{\crq}s disease from the health and social point of view. The last chapter of the theoretical part is devoted to the "integrated rehabilitation{\crq}q and the sequence of its individual components. I also mentioned the International Classification of Functioning, Disability and Health. In the practical part I focused on ascertaining of the scope, means and the resulting effect of the "integrated" rehabilitation from the perspective of the clients afflicted with Parkinson{\crq}s disease. Therefore, it was suitable to use qualitative research. I used the method of questioning and the technique of semi-standardized interview. Further to that the secondary data analysis as well as case studies {--} casuistry were used. The clients for this research were chosen among the patients with the Parkinson{\crq}s disease, who are registered with the Center of extrapyramidal disorders of the General Teaching Hospital in Prague. The aim of my work was to answer the following questions: 1. Whether the clients ever underwent some of the components of the ``integrated{\crq}q rehabilitation described in the theoretical part of this thesis. 2. How were they satisfied with the performance of the rehabilitation. 3. Whether they missed some of the said rehabilitation components. The client{\crq}s answers to the above questions are stated in the explanation. The case studies show that the patients underwent mostly the treatment component of rehabilitation. In the majority of cases, they were satisfied with the way it was performed. Some of them, however, experienced lack of information on the social assistance within the framework of social rehabilitation. The work could help to those people, who are interested in the issues in question, especially in order to get an overview of the sequence of individual components of the "integrated" rehabilitation in the Parkinson{\crq}s disease. It could be further instrumental to the patients and their families and last but not least for study purposes of workers in helping professions.
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