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Addiction in people with the spinal cord lesions Questionnaire survey
Egemová, Olga ; Svěcená, Kateřina (advisor) ; Kulhánek, Adam (referee)
Background: In Czech Republic, the use of addictive substances in the general population is regularly evaluated. In people with spinal cord lesions, the issue of substance abuse is not sufficiently mapped. Difficulty to get feedback can also play a role in this regard. There are many factors for possible risky behavior in people with spinal cord lesions. In Czech Republic, there are several aftercare facilities that comprehensively address clients with spinal cord lesions. In these facilities, obtaining feedback from this specific group of clients would help get better target interventions and set up other specific services for the monitored subpopulation. Objectives: The main goal of the research was to map the issue of dependence on legal and illegal addictive substances in a group of people with spinal cord injuries after injury or illness. A secondary goal was the feedback from the Centre's clients on whether and how they would use addictology counseling. Methods: Data for quantitative research were obtained by voluntary questionnaire survey. Questionnaires were gradually obtained from the centre's clients in person between the three waves of the covid epidemic between 2020 and 2021. The research sample consisted of a total of 106 respondents aged between 18 to 77 years. Anonymous...
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Gradually increasing maximum inspiratory resistance during respiratory muscle training and its effect on respiratory function in chronic tetraplegia
Šilhová, Vanda ; Laštůvková, Petra (advisor) ; Našincová, Zuzana (referee)
The theoretical part of the thesis describes basic mechanisms of spinal cord injuries, summarizes respiratory complications of spinal cord injuries and the use of respiratory physiotherapy with emphasis on breathing trainers. The practical part of the thesis focuses on the effect of 6 week long inspiratory muscle training using the Threshold IMT or Powerbreathe breathing trainer on respiratory functions in patients with chronic tetraplegia, as well as comparing the results of the study with available research exploring the same issue. The research included one experimental group consisting of 15 probands. All probands underwent measurement of spirometry parameters prior to the therapeutic intervention and again after six weeks of breathing training. A total of six respiratory parameters were evaluated (FVC, FEV1, PEF, PCF, MIP, MEP). From the results of the study, it can be concluded that breathing training showed positive effects on all of these parameters, but statistically significant difference was demonstrated only in the parameters evaluating the strength of the inspiratory (MIP) and expiratory (MEP) muscles.
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Effects of proprioceptive neuromuscular facilitation on the upper limb function of people with C4-C5 spinal cord injury
Halamová, Adéla ; Zvelebilová, Pavlína (advisor) ; Melicharová, Hana (referee)
Title: Effects of proprioceptive neuromuscular facilitation on the upper limb function of people with C4-C5 spinal cord injury The main objective: The aim of the work was to find out what effect the use of the proprioceptive neuromuscular facilitation method will have on the function, muscle volume and ranges of movements of the upper limb in people who are affected by a spinal cord lesion in the C4 and C5 region. Furthermore, the work dealt with the subjective feeling of the patients, whether the upper extremity improved after the therapy and if it was possible to involve it more in ADL activities. Methods: 5 probands took part in the study - all men with an average age of 41 years. A total of 3 measurements were performed for the study participants - approx. 2 months before the start of the intervention, before the start of the therapy and after the end. Values such as the volume of the arm muscles in contraction, the range of motion of abduction in the shoulder joint and flexion in the elbow joint were recorded. Another measured subject was the forearm endurance test. Participants also filled out the SCIM form before and after graduation. Probands practiced the method of proprioceptive neuromuscular facilitation of the 1st diagonal in addition to their regular therapy. They were also instructed...
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Energy needs and body composition in individuals with transverse spinal cord injury
Pavlíčková, Jana ; Sadílková, Aneta (advisor) ; Staňová, Alžběta (referee)
Introduction Spinal cord injury is associated with negative changes in body composition, glucose and lipid metabolism. This fact is responsible for a higher risk of metabolic complications in patients with a transverse spinal cord lesion (TML). Individuals tend to achieve a positive energy balance, which leads to an increase in adipose tissue, the development of overweight and obesity and other diseases, and last but not least, to the deterioration of self-sufficiency. Setting optimal energy intake is main key to maintain the patient's health and quality of life. Target The aim of this bachelor's thesis is to determine resting energy rate (RMR) in people after a transverse spinal cord injury. The subject of interest is also the comparison of the results with the prediction equation of Harris-Benedict with the indirect calorimetry (NK) method, to determine the body composition and determine the real energy intake of the diet. A control set of healthy individuals without the handicap of a transverse spinal cord lesion was chosen for the comparison of the obtained data. Methodology The research group consists of adults after a transverse spinal cord lesion. There were 26 people included, 11 women and 15 men, clients of the non-profit organization Centrum Paraple, o.p.s. The average age is 40.3 years...
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Functional independence measures in wheelchair rugby players
Moudrá, Kristýna ; Vařeková, Jitka (advisor) ; Pavlová, Ilona (referee)
Title: Functional independence measures in wheelchair rugby players Objectives: The aim of the thesis is to investigate the relationship between the sports activity of wheelchair rugby players and the degree of functional independence in daily activities in people with spinal cord injury. Methods: 20 male wheelchair rugby players aged between 20 and 51 years, in the range of spinal cord injury level C5 - Th8, were selected for the empirical mixed research using the purposive sampling method. The methods of data collection include an interview and a self-constructed questionnaire that elicits anamnestic data, subjective assessment of self- sufficiency and player's experiences with health complications associated with wheelchair rugby. Furthermore, an evaluation of the SCIM III functional degree of independence was carried out, the results of which were compared with the results of two previous studies (EMSCI and assumptions of Occupational Therapists from the Czech Republic). Results: The results confirm a positive relationship between the player's functional independence and the sports activity of wheelchair rugby players. Respondents at levels of complete spinal cord injury C6 and C7-8 with the SCIM III assessment demonstrated a higher functional independence rate compared to the overall average...
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CoughAssist in respiratory physiotherapy in patients with spinal cord lesion
Špačková, Tereza ; Babková, Lenka (advisor) ; Šedivá, Kristýna (referee)
The bachelor thesis ,,CoughAssist in espiratory physiotherapy in patients with spinal cord lesions'' will be a research about CoughAssist, which is a specific mechanical insufflation- exsufflation device used in respiratory physiotherapy in patients with spinal cord lesions. It will discuss spinal patients with introduction of clinical manifestations and classification in spinal lesions. It will more specifically describe respiratory issues in spinal patients, the effect of lesion level on the patient's respiratory function, and respiratory complications associated with spinal lesions. Methods of assessing the patient's condition in terms of respiratory physiotherapy will be presented, as well as techniques used in respiratory physiotherapy in spinal patients. Furthermore, the thesis will discuss expectoration disorders, the cough pattern in spinal patients and the possibilities of treating these disorders within the framework of respiratory physiotherapy, especially with the CaughAssist mechanical insufflator-exsufflator. The thesis will present its possible uses, effects and position within respiratory physiotherapy. Then, based on scientific studies, the thesis will evaluate the effectiveness and overall potential of the CaughAssist in spinal patients. The practical part will include one case...
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The role of the nurse in providing multidisciplinary care in spinal units
HARAZINOVÁ, Lucie
The aim of this master's thesis is to map the role of the nurse in the spinal unit, describe the collaboration of multidisciplinary team members in the spinal unit and describe the needs of the hospitalized patients. To meet these objectives, a total of five following research questions were set: "What is the role of the nurse in the care of patients in the spinal unit?", "What are the specifics of nursing care of patients in the spinal unit?", "What is the composition of the multidisciplinary team in the spinal unit?", "How does the cooperation between these workers take place?" and "What are the needs of patients hospitalized in the spinal unit?". The theoretical part of the thesis is designed to provide the reader with a comprehensive overview of the issue of spinal cord injury. At the very beginning, it defines the basic anatomical and physiological conditions of the nervous system, spine and spinal cord. Injury of these structures is the subject of other chapters, which discuss the causes, symptoms, diagnosis and treatment options in more detail. It also describes the development of spinal units in the Czech Republic and abroad. It defines a multidisciplinary team, whose work is an integral part of the care of a patient with a spinal cord injury. The nursing care chapter is devoted to areas that require a specific approach by nurses in patients with spinal cord injury. A qualitative research study was chosen for the empirical part of the thesis. Data collection took place using a semi-structured interview with thirteen nurses from selected spinal units. After finding out their personal information, they were asked a total of twenty-nine questions focused on the functioning of the spinal unit, characteristics of provided multidisciplinary care and the nurses' experience of the patients' condition and needs. The obtained information was subsequently transcribed and processed with the open coding method and colouring text. For easier orientation in the results of the interviews, four categories and seventeen subcategories were created, which clearly present the answers to the above research questions. It was found that the informants perceive their role in the spinal unit mainly as a nurse-caregiver. The cooperation of the multidisciplinary team is conditioned by various forms of verbal and non-verbal information exchange, for example during ward rounds, by change-of-shift handoff, operational meetings or information boards. Most of the nurses rate this cooperation as effective and mostly problem-free. The results also show that the needs of patients are closely related to mobility restrictions and long-term hospitalization. Most often, these are physiological needs and the need for contact with the society. This master's thesis points out the importance of a multidisciplinary and sensitive approach to patients with a spinal cord injury, who experience many worries and tense moments in their return to everyday life. The results may serve as educational material not just for students of healthcare professions, but also for the medical staff themselves. An output of the thesis is a manual for new nurses on spinal units, which aims to make them easier to integrate and prepare for the significant specifics about the nursing care for patients with spinal cord injury.
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Evaluation of wheelchair adjustments and their impact on proper propulsion pattern upper extremities and sitting posture in patients with spinal cord lesions
Dáňová, Petra ; Pfeiffer, Jan (advisor) ; Neuwirthová, Svatava (referee)
Title: Evaluation of wheelchair adjustments and their impact on proper propulsion pattern upper extremities and sitting posture in patients with spinal cord lesions. Objectives: The objective of this work was to evaluate the adjustments of wheelchair and to determine their impact on the work of the upper limbs and posture while sitting. This work was done on a group of patients with spinal lesions with their own wheelchairs. Another objective was to assess how education of proper propulsion pattern and form and type of a grip of handrim affects the correct propulsion pattern. Methods: In the group of 26 patients with spinal cord injuries in different levels of the spinal cord, I tested the adjusments of wheelchair, in particular the centre of gravity and maximum seat height from the ground. I also investigated what education on correct propulsion pattern the patients received, and observed any home-made adjustments to handrim, as well as patients' techniques of handrim grip. Finally, I examined how the subjects drove his/her wheelchair. During all the tests, I recorded video and photo documentation. The results were statistically evaluated using the Fisher test. Results: Despite the fact that only a small group was investigated, I showed the effect of wheelchair seatings on the correct posture. I...
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The possibilities of physical exercise in relation to the metabolism after spinal cord injury
Olišarová, Eva ; Hlinková, Zuzana (advisor) ; Kříž, Jiří (referee)
The goal of this bachelor thesis is to summarize the information about the possibilities of the physical exercise in individuals with the spinal cord injury. The work presents various types of the physical activity and describes their effect on metabolism and body composition. It also includes the information about the frequency, the duration and the intensity of exercise. The interruption of the somatomotor and somatosensory pathways in patients with spinal cord injury leads to the reduction of their physical activity. As a consequence of that, their metabolic profile and body composition get worse. Early after the injury, the patients suffer from the massive muscle atrophy and the rise of the amount of adipose tissue. These changes have a negative effect on metabolism of lipids and carbohydrates. It results in the development of dyslipidaemia and insulin resistance, sometimes even in type 2 diabetes mellitus. These secondary complications worsen the quality and the length of life of the patients with the spinal cord injury. Better understanding of these issues is necessary to improve the quality of health care for these people. The work includes a short questionnaire. Its goal is to describe the current situation of patients with the spinal cord injury in the Czech Republic. The questionnaire was...
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Evaluation of the short-term effect of physiotherapeutic techniques on spasticity in patients with spinal cord injury
Špačková, Anežka ; Hlinková, Zuzana (advisor) ; Kříž, Jiří (referee)
The subject of this thesis is spasticity in individuals with spinal lesions. The aim is to evaluate and compare a short-term effect of selected physio-therapeutic methods on spasticity of lower limbs in spinal patients. Two methods of comparison were chosen - passive stretching and the Vojta's reflex therapy. The work consists of two parts. The theoretical part describes the problems of spinal lesions, central motoneuron syndrome and spasticity, including its pathophysiology and investigation and therapeutic approaches. The practical part contains an attempt to verify and subsequently compare the immediate antispastic effect of the chosen methods, which is an important prerequisite for the following active exercises as an inseparable part of a physiotherapeutic exercise unit. Clinical evaluation scales are used to evaluate spasticity, namely Modified Ashworth Scale (MAS) and Muscle Excitability Scale (MES). The results are then compared with other studies and literature. Keywords spinal lesions, quadriplegia, Modified Ashworth Scale, Muscle Excitability Scale, Vojta's method, stretching
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