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Kinesiological study performed Frenchay Arm Test in patients with spastic hemiparesis
KOPECKÁ, Monika
This bachelor thesis is devoted to a kinesiological study of the Frenchay Arm Test in patients with spastic hemiparesis. It is a study focused on the kinesiological analysis of selected items in modified Frenchay Arm Test, which is supplemented with mapping of electrical activity of selected muscles by surface electromyography in patients with spastic hemiparesis before and after botulinum toxin application. The theoretical part describes the different manifestations and forms of spastic paresis. Clinical scales for the assessment of spasticity and treatment options are also presented. The last part is devoted to grip functions and selected tests assessing functional abilities of the hand. One of those listed is the Frenchay Arm Test and its modified version. It is a tool that assesses common activities of daily living. In the practical part, a qualitative research was used. The research sample consisted of two probands with spastic hemiparesis who were indicated for botulinum toxin treatment. Kinesiological analysis was performed on each before and after botulinum toxin application. It included medical history, aspect, palpation, examination of sensation, reflexes and muscle strength, goniometry, spasticity examination according to Gracies and modified Frenchay Arm Test (mFAT). Three items were selected from this test, kinesiologically described in the practical section, in which the activity of selected muscles was mapped by surface electromyography (SEMG). By comparing the results, it was possible to observe the changes in muscle activity that occurred as a result of rehabilitation, botulinum toxin application and the kinesiological performance itself. It has been documented that mFAT is a suitable test for monitoring the effects of therapy in patients with spastic hemiparesis. However, it is important that it is evaluated by experienced therapists and its accurate performance is maintained. SEMG is a suitable method for mapping muscle activity, although the results and their interpretation are limited by the methodology of performance and the processing of the recording.
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Possibilities of physiotherapy in the treatment of spastic form of cerebral palsy
PORUBSKÁ, Ivana
This bachelor thesis deals with the topic of spastic paresis in the context of cerebral palsy. It consists of a theoretical and a practical part. The theoretical part of the thesis is structured into several chapters, which are devoted to the topics of cerebral palsy, spasticity and the possibilities of physiotherapy in the treatment of spastic paresis. The practical part is consist of qualitative research, which includes case studies of 2 pediatric patients with spastic form of cerebral palsy. In the conclusion of the thesis the results of the research and the effect of the chosen therapy are analyzed.
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Changes in selected postural stability tests in hemiparetic patients after botulinum toxin application
ZEMANOVÁ, Lucie
The subject of this bachelor thesis is to compare changes in selected clinical and posturographic tests of postural stability, before and after application of botulinum toxin A to selected lower limb muscles in patients with spastic hemiparesis. The theoretical part deals with the introduction of general information related to posture, such as clinical tests of postural stability, their significance and use, as well as the issue of falls. The next part concerns spastic paresis, its origin, causes, consequences and also clinical scales that evaluate spasticity. The last theoretical part summarize the treatment options of spastic paresis. The practical part describes in detail the kinesiological analyzes of patients and the results of clinical and posturographic tests. Functional Reach Test, Timed Up and Go and Mini BESTest were selected from the clinical trials. Within the posturography, the Weight Bearing Squat test, Modified CTSIB and Limits of Stability were selected. The overall results of this research were not entirely clear, as the individual tests focus on different aspects of postural stability. Some tests were better after botulinum toxin application and some of them before botulinum toxin application. However, impairment of postural stability was in relation to the hemiparetic half of the body. Research has also shown that vision is a key aspect of postural stability in hemiparetic patients. This research could serve as inspiration in the treatment of postural stability not only in hemiparetics, but also in stability disorders in general.
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Changes in lower limb muscle aktivity during walking in hemiparetics after application of botulinum toxin
RICHTROVÁ, Eliška
This bachelor thesis deals with influence of botulinum toxin and for walking in hemiparetic patient (spastic hemiparesis after stroke). In the theoretical part, the problem of stroke an one of the very common diseases that cause central hemiparesis is approached from the beginning. Further, spasticity and its treatment are described here. The last part deals with the issue of hemiparetic gait and its rehabilitation. The main goal of the work was to record possible changes in gait parameters during the application of botulinum toxin A, which is applied every 3 months. The research involved 2 probands from regional spasticity center of the Hospital of Czech Budweis a.s., with central hemiparesis after stroke. They underwent entrance (2-3 weeks after application botulinum toxin) and exit examinations (1-2 weeks before application botulinum toxin), which consisted of kinesiological examination, examination of spastic paresis hip dysplasia according to the procedure J.M. Graciese, selected clinical gait tests (TUG, 2MWT), EMG examination and postural stability test (WBS). The whole measurements were performed to see, if any changes during the action of botulinum toxin could be objectifield, either clinically or by surface EMG. The obtained results were quite individual, bit despire a very small group of proband, it was possible to follow certain trends influence botulinum toxin. Surface electromyography has proven to be a suitable tool for monitoring muscle activity, but for future similar studies,will be need many more probands and repeat measurements to be include.
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Possibilities of physiotherapy in patients with spastic paresis after stroke
OŠMERA, Martin
This bachelor thesis deals with spastic paresis of the lower limb in patients after a stroke. The thesis describes the problem of spastic paresis and the possibilities of using physiotherapy. A number of physiotherapeutic methods can be used in clinical practice to treat spasticity. One such method is the Guided Self-rehabilitation Contract by J. M. Gracies, which combines static prolonged stretching with the possible application of botulinum toxin and strength training of repetitive active movements (RAP) with home autotherapy. The aim of this thesis is to describe various possibilities of physiotherapy and evaluate the effectiveness of the method according to Gracies in the target group of patients. The Theoretical part focuses on spastic paresis, its origin, description, and characteristics together with the upper motoneuron syndrome (UMN syndrome), in which spasticity is one of its components. The following are individual clinical manifestations and forms of spastic paresis with the possibility of evaluation by clinical scales. The work also mentions a stroke, as one of the possible causes of spasticity. At the end of the theoretical part, pharmacological treatment with selected physiotherapeutic approaches to therapy is presented. The Methodological part describes the process of research implementation. The Practical part is conducted in the form of qualitative research, namely case studies in two probands with spastic paresis of the lower limb after a stroke, in which therapy according to Gracies is indicated. Each proband was subjected to an input and output kinesiological analysis, which included anamnesis, aspect, anthropometry, goniometry, examination of muscle strength, gait tests, Berg Balance Scale and Five-step Clinical Assessment in Spastic Paresis. During the study which lasted more than 6 months, the course of therapy was monitored in each proband. Based on the comparison of kinesiological analyses, was possible to observe a positive effect of the therapy. Proband 1's results are indistinct, despite clear subjective improvement. It was possible to improve movement, condition, and postural stability. Conversely, in some of the monitored muscles, the rate of spasticity worsened. Proband 2's results are significantly improved, despite the chronicity of the condition.
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Case study of physiotherapeutic treatment of a patient with spastic quadriparesis and condition after subarachnoid hemorrhage
Válová, Karolína ; Vomáčková, Helena (advisor) ; Hlinovská, Jana (referee)
Author: Karolína Válová Title: Case study of physiotherapeutic treatment of a patient with spastic quadriparesis and condition after subarachnoid hemorrhage Objectives: The aim of this bachelor's theses was to summarize theoretical knowledge about diagnosis spastic paresis, issues associated with it and present practical case study of physiotherapeutic treatment of a patient with spastic quadriparesis and condition after subarachniod hemorrhage. Methods: This theses is devided into theoretical and special part. Under the theoretical part are described characteristics of the diagnosis, it's epidemiology, etiopathogenesis, clinical picture, possibilities of therapy and treatment, complications associated with spastic paresis, physiotherapeutic care, physical therapy and effect of chosen therapeutic interventions and methods. Special part includes case study of a patient with spastic quadriparesis and condition after subarachnoid hemorrhage. It includes anamnesis, detailed initial kinesiological analysis, short-term and long-term therapeutic plan, record of therapeutic units, outcome kinesiological analysis and evaluation of the effect of therapy. Results: During therapeutic units has been achieved improvement of self-sufficiency of the patient, his general ability to move, gait stereotype, level of...
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Use of the Modified Frenchay scale in stroke patients with spastic paresis
Heřmánková, Kristýna ; Krulová, Anna (advisor) ; Angerová, Yvona (referee)
The objective of this thesis is to describe the Modified Frenchay scale and its use in stroke patients with spastic paresis. The thesis is divided into two parts - theoretical and practical. In the theoretical part, the issue of spastic paresis in stroke patients is specified; and in addition to this the methods of examination and assessment of spasticity are presented and described in detail. A large part of the thesis deals with the history of Frenchay arm test and its modification - Modified Frenchay scale. The theoretical part also contains a description of the phases and types of grasp, some of which can be observed during the assessment with Modified Frenchay scale. The practical part consists of a questionnaire mapping the situation in the institutions in the Czech republic, that use the Modified Frenchay scale in their practice, and of two case reports of patients after stroke. Examinations and evaluations of spasticity, including Modified Frenchay scale, which are described in the theoretical part, are applied in these case reports. The practical part also contains an evaluation of inter-rater reliability of the Modified Frenchay scale. The main contribution of this thesis consists in creating a handbook for Modified Frenchay scale and in evaluating the inter-rater reliability. The handbook...
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The effect of prolonged stretching on spastic muscle contracture before and after Botulinum toxin A application
Miňová, Zuzana ; Hojková, Klára (advisor) ; Kövári, Martina (referee)
A large proportion of patients with central motoneuron lesions is at risk of spastic paresis and formation of contractures. One of the therapeutic techniques used in patients with spastic paresis is prolonged stretching. The theoretical part summarizes the knowledge regarding spastic paresis, its clinical evaluation, the development of contractures and therapeutic interventions, especially botulinum toxin (BTX) and stretching. The aim of this study was to compare the effectiveness of prolonged stretching on spastic muscle contracture before and after BTX application. In our retrospective comparative study there were included 30 patients divided into two groups. The first group consisted of 15 patients performing prolonged stretching of the m. rectus femoris (m. RF) for three months according to Guided Self-rehabilitation Contract of Professor J. M. Gracies. The second group (15 patients) performing the same procedure, but at the same time BTX was injected into the m. RF. We monitored the change in passive knee joint range of motion into flexion and the change in 10MWT time. Statistical evaluation showed that the difference in knee joint range of motion after three months of performing prolonged stretching was statistically insignificant (p=0.194). The difference in knee joint range of motion after...
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Effect of peroneal nerve functional electrical stimulation on gait in patients with stroke
Jeníček, Jakub ; Petr, Miroslav (advisor) ; Jeřábek, Jaroslav (referee) ; Kemlink, David (referee)
The Abstract The Title: Effect of Peroneal Nerve Functional Electrical Stimulation on Gait in Post-stroke Patients The Goal: The aim of this work was to compare two different ways of applying functional electrical stimulation of the peroneal nerve as to their impacts on the gait speed and performance and the spastic paresis of lower leg in adult patients suffering from chronic stages of stroke accompanied by foot drop. The Method: An open, randomized, controlled clinical pilot study combining elements of both controlled and pragmatic experiments in comparing two different clinical approaches to peroneal nerve functional electrical stimulation. With the first group of patients (group A, consisting of 14 subjects), the intervention was carried out as an outpatient, strictly controlled and intense training of gait with electrical stimulation over the period of four weeks, five times a week; the B-group patients (13 subjects) were all provided with their own stimulator which they applied continuously throughout all their daily routines at their homes and community over the equal period of time. The Results: The four-week intervention turned out to cause no statistically significant difference in our two groups in terms of its impact on any of the monitored parameters of the gait speed and performance as well as...
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Measurement of lower extremities spasticity in patients with cerebral palsy
Vavřinová, Dominika ; Říha, Michal (advisor) ; Pavlů, Dagmar (referee)
Title: Measurement of lower extremities spasticity in patients with cerebral palsy Objectives: The aim of the theoretical part of this thesis is to evaluate possibilities of lower extremities spasticity measurement in adult patients with cerebral palsy. The main focus was given to the concept of French professor J.-M. Gracies: Five-step clinical assessment in spastic paresis. This unique concept presents differentiation of three main factors of motor impairment that emerge as a result of a lesion to central motor pathways: stretch sensitive paresis, soft tissue contracture and muscle overactivity. Ability to distinguish these factors is crucial for specific treatment indication. Finding a correlation between the Five-step clinical assessment in spastic paresis and muscle activity in gait measured with sEMG was the main objective in the practical part of the thesis. Methodology: This thesis has a theoretical-empirical character. The theoretical part is in a form of a research on the topic of spasticity diagnosis, focused on cerebral palsy patients. The empirical part of the thesis has a form of pilot quantitative research, which was attended by 6 participants with cerebral palsy (4 men and 2 women; average age 29 years). There were 2 independent measurement made for each of them. Each measurement...
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