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Background innate reflex locomotion patterns of movement and ventilation in children patients with chronic respiratory diseases
Plešková, Jana ; Pohunek, Petr (advisor) ; Sedlák, Vratislav (referee) ; Homola, Lukáš (referee)
Reflex locomotion according to Professor Vojta (VRL) is based on the activation of complex motor patterns from certain defined positions with stimulation of the so-called trigger zones, located on the human's body. It is primarily used in patients with neurological deficits; however, it is currently also being used in internal medicine. It has been reported that VRL can indirectly affect breathing, however its use in paediatric patients with chronic respiratory disease has not yet been investigated. As part of this theses, a randomized controlled single-centre intervention study was conducted. Its aim was to evaluate the short-term effects of VRL on lung function in paediatric patients with cystic fibrosis (CF) with normal baseline spirometry. The effect of a 30minute VRL intervention was compared in a crossover design with the effect of positioning (without stimulation of trigger zones). The primary outcome was the change in global ventilation inhomogeneity, assessed by lung clearance index (LCI2.5) derived from nitrogen multiple breath washout test. Secondary outcomes included changes in regional ventilation inhomogeneity (indices of acinar [Sacin*Vt] and conductive airways [Scond*Vt] inhomogeneity) and spirometric parameters (inspiratory capacity, forced vital capacity, and forced expiratory...
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Impact of Minimally Invasive Approach on Pulmonary Function in Patients Undergoing Aortic Valve Replacement
Gofus, Ján ; Pojar, Marek (advisor) ; Rohn, Vilém (referee) ; Šantavý, Petr (referee)
of the dissertation Impact of minimally invasive approach on pulmonary function in patients undergoing aortic valve replacement MUDr. Ján Gofus The most common minimally invasive approach to aortic valve replacement is upper hemisternotomy, which has been implemented at our department, as well. Preserving the lower half of thoracic cage could lead to lower postoperative drop of pulmonary function, apart from other benefits. Nevertheless, publications on this topic are insufficient and controversial. Our aim was to perform a prospective randomized trial comparing upper hemisternotomy with standard (median) sternotomy in terms of pulmonary function changes perioperatively. We also added a novel exercise tolerance test, one-minute sit-to-stand test, and a quality of life evaluation to the study. We included patients indicated for elective isolated aortic valve replacement with bioprosthesis who were older than 65 years, signed informed consent, and in which both surgical approaches were technically feasible. Exclusion criteria were re-do surgery and concomitant cardiac surgery. Patients were randomized to minimally invasive and standard group in 1:1 ratio. On the day of admission, on the 7th postoperative day and 3 months postoperatively, the patients underwent pulmonary function testing and one-minute...
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