Capes / A tetraplegia é uma lesão na medula espinhal, que compromete o tronco, os membros superiores e inferiores e músculos respiratórios. Nas lesões completas, a função motora e sensorial abaixo do nível da lesão apresenta-se comprometida. Nas lesões incompletas ou parciais, ocorre a preservação da função motora e sensitiva, não havendo padrões definidos de recuperação. A estimulação elétrica já vem sendo utilizada para indução respiratória diafragmática. Neste trabalho, foram avaliados 10 indivíduos tetraplégicos, de ambos os sexos, na faixa etária de 18 á 48 anos, durante 10 sessões onde foram aplicados anamnese, avaliação inicial constando sinais vitais, cintometria, manovacuometria, oximetria, avaliação do nível da lesão, e a avaliação do déficit motor e respiratório. Aplicaram-se dois métodos utilizando o sistema de Eletroestimulação sincronizada: o primeiro com sincronização manual, FESSM (Estimulação Elétrica Funcional) e o segundo, usando o MD2, com sincronização automática. A função muscular do Diafragma foi avaliada antes e depois das aplicações de estimulação elétrica, cuja intenção era potencializar a ação, possibilitando um melhor recrutamento muscular e, conseqüentemente, uma melhor reeducação muscular respiratória. Quanto a análise comparativa entre os métodos, após a intervenção com equipamento I observou-se melhores resultados em relação aos parâmetros sinais vitais e manovacuômetria. Com a intervenção do equipamento II, observou-se melhores resultados nos parâmetros oximetria e grau de dispnéia. O equipamento I apresentou resultados satisfatórios em relação a função do sistema digestório, principalmente em pacientes com lesão medular incompleta. / The tetraplegia is an injury in the spinal cord that compromises the motor and sensitive systems commanded by the spinal cord below of that damage level. Respiratory muscles are compromises too. In complete injuries, motor and sensorial function completely damaged. In the incomplete or partial injuries, motor and sensitive function occurs, but no recovery pattern is known. The electric stimulation is used nowadays for respiratory induction. In this work, 10 tetraplegic patients had been evaluated, both gender, ages range from 18 to 48 years, during 10 sessions where anamneses were applied. Vital signals motor respiratory disfunction, and injury level were evaluated. The system of synchronized electrostimulation was applied using two methods: the first one with manual synchronization; FESSM; and the second one, using the MD2, with automatic synchronization. The muscular function of the Diaphragm was evaluated before and after the applications of electrostimulation. The comparative analysis between the two methods, had shown better results after the intervention with equipment I regarding the parameters and vital signs of manovacuometry. With the intervention of equipment II, it was observed better results in the pulse parameters and degree of dyspnea. The equipment I had shown satisfactory results for the function of the digestive system, especially in patients with incomplete spinal cord injury.

Many devices are available on the market for the evaluation and rehabilitation of patients suffering from muscular disorders. Most of them are small, low-cost, passive devices based on the use of springs and resistive elements and exhibit very limited (or even not any) evaluation capabilities; extended muscular force evaluation is only possible on stationary, expensive, multi-purpose devices, available only in hospitals, which offer many exercise modes (e.g. isokinetic mode) that are not available on other devices.<p><p>The objective of this thesis is to make the functionalities currently only implemented on bulky multi-purpose devices available at a lower cost and in a portable fashion, enabling their use by a large number of independent practitioners and patients, even at home (tele-medecine applications).<p><p>In order to achieve this goal, a portable rehabilitation device, using a magneto-rheological fluid brake as actuator, has been designed. This particular technology was selected for its high level of compactness, simple mechanical design, high controllability, smooth and safe operation. The first part of this thesis is devoted to the design of MR-fluid brakes and their experimental validation. The second part is dedicated to the design of the rehabilitation device and the comparison of its performances with a commercial multi-purpose device (CYBEX). / Doctorat en Sciences de l'ingénieur / info:eu-repo/semantics/nonPublished

This diploma thesis deals with co-ordinated rehabilitation and its use in retirement home specifically in the Center of social services Staroměstská in České Budějovice. It is important to use a co-ordinated rehabilitation concept for achievement of high service quality which means better life quality for pensioners. Co-operation within multidisciplinary team is essential during comprehensive rehabilitation for all persons. The goal of this diploma thesis was to found out how retirement home uses individual components of co-ordinated rehabilitation concept. The principal research question was: How much are employees of retirement home informed about co-ordinated rehabilitation concept? For research was chosen retirement home in the Center of social services Staroměstská in České Budějovice. There were eight employees of this institution participated in the research. It was used method of questioning and half-structured interview technique. Retirement home in the Center of social services Staroměstská uses all aspects of co-ordinated rehabilitation concept. Particularly they utilize medical rehabilitation and social rehabilitation. Most of workers is well-informed about co-ordinated rehabilitation concept. Some of them do not know certain terms. However after explaining of these terms they prove good knowledge of this issue. The employees have satisfactory overview not only about rehabilitation which is directly their scope of working activity but also about other components of co-ordinated rehabilitation. The workers are perfectly informed about medical rehabilitation. They are also mostly satisfied with co-operation in multidisciplinary team. This kind of co-operation takes place at any time of a need or during the meetings or at individual scheduling. The results of this diploma thesis may help to retirement home in the Center of social services Staroměstská in České Budějovice to evaluate the usage of co-ordinated rehabilitation during elderly care. It might also show the measure of co-operation of multidisciplinary team members. This diploma thesis may help to anybody who is interested in specific retirement home or in co-ordinated rehabilitation in general.