KRATKY, Jakub. Monitoring the activation of selected muscle groups of clients with spinal cord injuries. Prague: Charles University, Faculty of Physical Education and Sport, 2013. 82 pages. Supervisor Doc. PaedDr. Karel Jelen, CSc The aim of this thesis is to monitor the activation of selected muscle groups (musculus deltoideus pars anterior, musculus deltoideus pars posterior, musculus triceps brachii caput laterale and musculus trapezius pars descendus) during double poling ergometry. Nine subjects with different spinal cord lesions volunteered to participate in the study. The surface electromyography is used to detect the musculus activation. The monitoring of four muscle groups is devided into three phases. Firstly, all the participants double-poled for one minute at moderate intensity according to the Borg scale. Each participant underwent a 10-minute intervention to correct the posture. In the last phase the volunteers exercised again for one minute at moderate intensity. The aim of the intervention is to decrease muscle activation of musculus deltoideus pars anterior and musculus trapezius pars descendus (muscles with a tendency to hypertonia during wheelchair propulsion and activity of daily living) and to increase muscle activation of musculus deltoideus pars posterior and musculus triceps...

The aim of the study: The aim of this work is to find out the possibilities to influence the clinical state of the patients suffering with incomplete spinal cord lesion syndrome with the help of a therapeutic video played through a virtual reality helmet. Methods: The research was conducted with 22 probands (15 males and 7 females) aged between 27 and 76 years (the average age of 55±14 years) from the client of Rehabilitation Centre Kladruby. The probands were divided into two homogenised groups with the same number of members. The control group received a standard rehabilitation programme set by the Rehabilitation Centre. The research group followed the same plan but in addition to this, they were given helmets, and a video with virtual reality was played daily on the total of 30 occasions. The clinical state before conducting the research and after was evaluated using the standard test ASIA impairment scale where the observed transformation was the total of motoric points for the lower limbs. Initial and final examination was conducted by professional and highly trained staff at Kladruby, always doctors. The variance between the initial and the final examination results and the length of stay at the centre were used to set the relative transformation of the clinical state in comparison with the...

A dor é uma das consequências da lesão medular, somada às disfunções miccional e intestinal, à manutenção da integridade da pele, alterações na sexualidade e na reprodução, às questões sociais e familiares. Conhecer a dor e a interferência na qualidade de vida faz com que o profissional que assiste ao paciente, consiga seguir o caminho mais adequado e conjugar modalidades para o controle da dor neuropática. Neste estudo objetivou-se conhecer as implicações da dor neuropática na qualidade de vida de indivíduos com lesão medular traumática. Trata-se de uma pesquisa de abordagem quantitativa, do tipo transversal, exploratória, descritiva e comparativa. Os dados foram coletados pela propria pesquisadora. A coleta incluiu entrevista com os pacientes, aplicando Escala de Avaliação da Dor de McGill, uma escala analógica de avaliação da intensidade da dor e a Escala WHOQOL-brief, versão abreviada do WHOQOL-100. Os pacientes participantes da pesquisa foram em sua maioria do sexo masculino, com idade entre 30 e 49 anos, casados, aposentados, com ensino médio, lesao medular causada por queda, paraplegicos com lesao incompleta, entre um e cinco anos de lesao. As implicações dos pacientes com dor neuropática e qualidade de vida mostram que pacientes que referiram maior intensidade de dor, têm um pior resultado em relação à qualidade de vida, no fator social, que aborda relações pessoais, vida sexual e apoio que recebe dos amigos. Verificou-se que a qualidade de vida é melhor em pacientes com diagnóstico de lesão medular completa, do que em pacientes com lesão medular incompleta. E é melhor também em pacientes que tiveram o ferimento por arma de fogo como causa da lesão medular. Os pacientes com incontinência fecal referiram pior qualidade de vida no aspecto físico, assim como na questão que afirma que a dor atrapalha sua vida. Em relação a sexo, idade, estado civil, tipo de lesão, escolaridade, tempo de lesão, espasticidade, incontinência urinaria e úlcera por pressão, os resultados mostram que essas variáveis não aumentam ou diminuem a ação da dor na qualidade de vida. Nao se pode ignorar a dificuldade na discussao dos dados desta pesquisa, visto que a maior delas esteve relacionada a impossibilidade de comparar os dados encontrados com resultados previos, porque a literatura e muito restrita em relaçao a dor e qualidade de vida apos lesao medular / Pain is one of the consequences of spinal cord lesion, besides in addition to bladder and bowel dysfunction, maintenance of skin integrity, changes on sexuality and reproduction, and social and family issues. Knowing the pain and how it interferes on the quality of life enables the health professional assisting the patient to identify the best treatment and how to combine methods to control neuropathic pain. This study aimed at learning the implications of neuropathic pain for the quality of life of individuals with traumatic spinal cord injuries. Its approach is quantitative, cross-sectional, exploratory, descriptive, and comparative. The data was collected by the researches herself. Collection of data included interviews with the patients by applying McGills Pain Questionnaire, an analogic pain intensity assessment scale, and the WHOQOL-Brief Scale which is an abridged version of WHOQOL-100. The majority of the studied subjects is male, ages 30 to 49, married, retired, high school graduates, paraplegic with incomplete lesions, and whose injury to the spinal cord occurred between one to five years and has been caused by fall. The study of the implications for patients with neuropathic pain shows that the patients who report a more intense pain have the lowest quality of life in relation to social matters, which encompass personal relations, sexual life, and support from friends. It has been identified that patients with complete spinal cord lesion have better quality of life than those with incomplete lesion; also, patients whose injury was caused by gunshot have been proved to have better quality of life. Patients with fecal incontinence have reported worse quality of life from a physical perspective, being those who report more frequently that the pain interferes with their lives. In regards to sex, age, marital status, type of lesion, education level, age of lesion, spasticity, urinary incontinence, and pressure ulcer, results indicate that those variables do not increase or decrease the influence of pain in the quality of life. It is worth highlighting the difficulty to discuss the data gathered by this study, especially the impossibility to compare the collected data with previous results due to the scarceness of literature on pain and quality of life after spinal cord injury

A dor é uma das consequências da lesão medular, somada às disfunções miccional e intestinal, à manutenção da integridade da pele, alterações na sexualidade e na reprodução, às questões sociais e familiares. Conhecer a dor e a interferência na qualidade de vida faz com que o profissional que assiste ao paciente, consiga seguir o caminho mais adequado e conjugar modalidades para o controle da dor neuropática. Neste estudo objetivou-se conhecer as implicações da dor neuropática na qualidade de vida de indivíduos com lesão medular traumática. Trata-se de uma pesquisa de abordagem quantitativa, do tipo transversal, exploratória, descritiva e comparativa. Os dados foram coletados pela propria pesquisadora. A coleta incluiu entrevista com os pacientes, aplicando Escala de Avaliação da Dor de McGill, uma escala analógica de avaliação da intensidade da dor e a Escala WHOQOL-brief, versão abreviada do WHOQOL-100. Os pacientes participantes da pesquisa foram em sua maioria do sexo masculino, com idade entre 30 e 49 anos, casados, aposentados, com ensino médio, lesao medular causada por queda, paraplegicos com lesao incompleta, entre um e cinco anos de lesao. As implicações dos pacientes com dor neuropática e qualidade de vida mostram que pacientes que referiram maior intensidade de dor, têm um pior resultado em relação à qualidade de vida, no fator social, que aborda relações pessoais, vida sexual e apoio que recebe dos amigos. Verificou-se que a qualidade de vida é melhor em pacientes com diagnóstico de lesão medular completa, do que em pacientes com lesão medular incompleta. E é melhor também em pacientes que tiveram o ferimento por arma de fogo como causa da lesão medular. Os pacientes com incontinência fecal referiram pior qualidade de vida no aspecto físico, assim como na questão que afirma que a dor atrapalha sua vida. Em relação a sexo, idade, estado civil, tipo de lesão, escolaridade, tempo de lesão, espasticidade, incontinência urinaria e úlcera por pressão, os resultados mostram que essas variáveis não aumentam ou diminuem a ação da dor na qualidade de vida. Nao se pode ignorar a dificuldade na discussao dos dados desta pesquisa, visto que a maior delas esteve relacionada a impossibilidade de comparar os dados encontrados com resultados previos, porque a literatura e muito restrita em relaçao a dor e qualidade de vida apos lesao medular / Pain is one of the consequences of spinal cord lesion, besides in addition to bladder and bowel dysfunction, maintenance of skin integrity, changes on sexuality and reproduction, and social and family issues. Knowing the pain and how it interferes on the quality of life enables the health professional assisting the patient to identify the best treatment and how to combine methods to control neuropathic pain. This study aimed at learning the implications of neuropathic pain for the quality of life of individuals with traumatic spinal cord injuries. Its approach is quantitative, cross-sectional, exploratory, descriptive, and comparative. The data was collected by the researches herself. Collection of data included interviews with the patients by applying McGills Pain Questionnaire, an analogic pain intensity assessment scale, and the WHOQOL-Brief Scale which is an abridged version of WHOQOL-100. The majority of the studied subjects is male, ages 30 to 49, married, retired, high school graduates, paraplegic with incomplete lesions, and whose injury to the spinal cord occurred between one to five years and has been caused by fall. The study of the implications for patients with neuropathic pain shows that the patients who report a more intense pain have the lowest quality of life in relation to social matters, which encompass personal relations, sexual life, and support from friends. It has been identified that patients with complete spinal cord lesion have better quality of life than those with incomplete lesion; also, patients whose injury was caused by gunshot have been proved to have better quality of life. Patients with fecal incontinence have reported worse quality of life from a physical perspective, being those who report more frequently that the pain interferes with their lives. In regards to sex, age, marital status, type of lesion, education level, age of lesion, spasticity, urinary incontinence, and pressure ulcer, results indicate that those variables do not increase or decrease the influence of pain in the quality of life. It is worth highlighting the difficulty to discuss the data gathered by this study, especially the impossibility to compare the collected data with previous results due to the scarceness of literature on pain and quality of life after spinal cord injury

Traumatic damage to the cervical spinal cord has a dramatic impact on determinants affecting cardiovascular fitness. In tetraplegia, in addition to diminished skeletal muscle function, impaired sympathetic cardiovascular innervation together with a dysfunction of catecholamine release is typically present. Individuals with tetraplegia are at a high risk of long-term inactivity, which increasingly contributes to the development of common civilization diseases. The aim of the current dissertation project is to investigate the cardiovascular fitness in males with cervical spinal cord injury (n=20) as compared to able- bodied males (n=27). Both groups completed exercise testing on an arm-crank ergometer. Arterial blood pressure response to exercise, peak oxygen consumption and peak heart rate were the primary outcome variables. In the first part of the study, a graded maximal arm- crank ergometer test to the subjective exhaustion was performed for the inter-group peak exercise comparison. The peak power dramatically differs between the groups and could be an important confounding factor limiting the evaluation of a physiologic response related to the equivalent physical loading. Therefore, in the second part of the study, individuals of the control group completed a second graded arm-crank ergometer...

Traumatic damage to the cervical spinal cord has a dramatic impact on determinants affecting cardiovascular fitness. In tetraplegia, in addition to diminished skeletal muscle function, impaired sympathetic cardiovascular innervation together with a dysfunction of catecholamine release is typically present. Individuals with tetraplegia are at a high risk of long-term inactivity, which increasingly contributes to the development of common civilization diseases. The aim of the current dissertation project is to investigate the cardiovascular fitness in males with cervical spinal cord injury (n=20) as compared to able- bodied males (n=27). Both groups completed exercise testing on an arm-crank ergometer. Arterial blood pressure response to exercise, peak oxygen consumption and peak heart rate were the primary outcome variables. In the first part of the study, a graded maximal arm- crank ergometer test to the subjective exhaustion was performed for the inter-group peak exercise comparison. The peak power dramatically differs between the groups and could be an important confounding factor limiting the evaluation of a physiologic response related to the equivalent physical loading. Therefore, in the second part of the study, individuals of the control group completed a second graded arm-crank ergometer...

The aim of this work is to find out whether the people after spinal cord injury are motivated enough to get work and whether emplozers accept their demand of part-time working hours because of their health condition. The method of this work was research, the form of questionnaire. The research was carried out in Prague, The Union of Paraplegics in the Center Paraple. 82 out of 95 asked respondents took part in the survey. The thesis consists of two parts. The first part is theoretical. It presents brief anatomics description of spine and central nerve system, the change of health condition after spinal cord injury as well as the psychosocial trauma of people wirh spinal cord lesion. Next, the teoretical part deals with komplex rehabilitation-medical, social, pedagogical and working one. The thesis focuses especially on the working rehabilitation, referring to one elementary human rights-the right for work. It deals with the problem of the handicapped people unemployment and its characteristics. Next the chapter of working rehabilitation deals with the legislation of handicapped people unemployment, especially the new unemployment law n. 435/2004 Sb. Nowadays we can no longer ignore international documents concerning the employment of handicapped people, mentioned in the final chapter of the theoretical part. The second part of thesis is practical. It includes the resultsof both, the survey and the questioning by phone. The data are processed percentualy and graphically. every graph has its own description. Then the results are discussed. People after spinal cord injury are motivated to work. Yet, there are many obstacles to the employment of these people, which may result in their desillusion and demotivation to work. One of such obstacles is e.g. the fact that potential employers do not accept their demand of shorter working hours. The final part of the thesis includes the conclusion, the list of sources and supplement.

The impact on health, mental state and quality of life in people after spinal cord injury is enormous. Significant impairment occurs not only of sensorimotor functions. The autonomic nervous system is also disturbed to some extent, which is very closely related to the management of cardiovascular functions (and heart rate). The aim of this study is to evaluate the effect of different physical activities on heart rate in people after spinal cord injury. The study included 30 people in the chronic stage after spinal cord injury, which were divided into 3 groups according to the neurological level of the spinal cord lesion in tetraplegics (lesion C1-C8), paraplegics with high thoracic lesion (T1-T6), and paraplegics with lesion from T6 below. Each proband completed 4 exercise tests on sports simulators (rowing, kayaking and cross-country trainer and Rotren) and peak heart rate values (SFpeak) were measured after reaching the subjective maximum load (according to the Borg RPE scale). The values of SFpeak were then statistically processed, evaluated and compared - within groups between sports simulators and between groups. The results of the statistical processing show that the sports simulators are not different in terms of reaching the top SFpeak. Although differences between peak heart rate values...