Title: The effect of analytic and synthetic methods in patients with muscular dystrophy Objectives: Two main objectives are set in my thesis. The first objective is to summarize the theoretical knowledge concerning problems of muscular dystrophy, its classification, hereditary predispositions, diagnostic procedures, subsequent care and to present international grant projects, and the muscular dystrophy world organization and registry. The second objective is to assess the effect of the six months lasting physiotherapeutic intervention on the self-sufficiency and self-reliance of given probands - the individuals suffering from the muscular dystrophy at the age from 40 to 66 years, and to assess the extent of muscular shortening according to Janda in the experimental group Methods: This thesis is of an exploratory nature. It is an experimental study focused on the assessment of the effect of the physiotherapeutic intervention in the individuals suffering from the muscular dystrophy. To assess the extent of the improvement I used the information collected during the kinesiologic analyses (entry, final, follow up) that included goniometric assessment according to Janda, the examination of shortened muscles according to Janda, the examination of joint play according to Lewit and Rychlíková, the examination of...

Student Number : 0414012 - MSc dissertation - School of Therapeutic Sciences - Faculty of Health Sciences / Aim: The aim of this study was to quantify the level of ability and in particular walking ability of a group of stroke survivors resident in Soweto, between 3-6 months post incident. Design: Descriptive study in which comfortable walking speed over ten metres is correlated with the distance covered in six minutes and two minutes. Subjects: Forty one subjects after stroke divided into two groups. Twenty six with a Barthel Index initial score of ≤60 and fifteen with a score >60. Main Outcome Measures: Walking speed and two and six minute distance were compared between groups. In addition actual distance walked in six minutes was compared with the distance predicted by the ten-metre walking speed test and the distance predicted by normative reference equations. Heart rate was measured during the six minute walking test. Functional ability was compared using the Barthel Index within ten days post stroke and three to six months. Results: Of those who survived 90% of subjects were able to walk independently after stroke. The mean walking speed of 0.55 m/s demonstrated a strong correlation with the distance walked in six minutes (R2=0.816). However it underestimated the distance walked in six minutes by 7.4%. There were no significant differences between groups for the walking tests. The two minute walking test distance accurately predicted the results of the six minute walking test distance (R2=0.97). The average distance walked in six minutes by subjects after stroke was 40% of the distance predicted for healthy adults. For the functional walk test 95.5% of subjects had a heart rate within normal recommended limits. The functional walk test together with a measure of exertion (heart rate) may indicate an individual's ability to sustain submaximal activity. Subjects had minimal rehabilitation training. Lower limb pain did not significantly lower the walking speed (p=0.18) or distance walked in six minutes (p=0.17). Mean Barthel Index score at three to six months was 85.78 indicative of independence with minimal assistance. Although the mortality rate for the Barthel Index group with a score less than 60 is 30.7%, the prognosis of survivors was not uniformly poor. Conclusion: This study demonstrates that though a high percentage of subjects recovered independent walking after stroke in the Soweto community with minimal rehabilitation, their walking speed and distance walked are indicative of limited walking capacity. Walking speed and the two minute walking test could be used to predict functional walk test performance. Pain in the paretic lower limb though commonly reported did not appear to affect walking speed or distance walked. The use of the Barthel Index to predict activities and/or survival merits further investigation.

Title: Possibilities of functional Evaluation of Patients after acute cerebral Palsy in Czech Republic Objectives: The main objective of this study was to describe the problems of functional assessment of patiens after stroke. Another objektive was to determine and compare the properties ofthe most commonly used functional measures designed for stroke,in our country. Methods: This work is theoretical - research work, which is the theoretical part of the period from September 2012 to June 2013 when retrieving data from literature sources using advanced targeted keywords and thein hotkey in databases based on EBM. The practical part of the study consisted of a questionnaire, which was using the questionnaire survey gathered data needed to evaluace the clinical utility, in the period from May 2013 to July 2013. After obtaining the necessary data from both theoretical and practical part of this data was evaluated and analyzed according to the standard metodology for the evaluation of functional measures for spinal patiens (Chapman, J.R. et al, 2007) and the results of the individual measures were mutually compared. Results: In the theoretical part of the available resources found high objectivity of the free evaluated measures, the measure Barthel Index and the Functional independence measure received...

Quantitative pharmacokinetic-pharmacodynamic and disease progression models are the core of the science of pharmacometrics which has been identified as one of the strategies that can make drug development more effective. To adequately develop and utilize these models one needs to carefully consider the nature of the data, choice of appropriate estimation methods, model evaluation strategies, and, most importantly, the intended use of the model. The general aim of this thesis was to investigate how the use of pharmacometric models can improve the design and analysis of clinical trials within drug development. The development of pharmacometric models for clinical assessment scales in stroke and graded severity events, in this thesis, show the benefit of describing data as close to its true nature as possible, as it increases the predictive abilities and allows for mechanistic interpretations of the models. Performance of three estimation methods implemented in the mixed-effects modeling software NONMEM; 1) Laplace, 2) SAEM, and 3) Importance sampling, applied when modeling repeated time-to-event data, was investigated. The two latter methods are to be preferred if less than approximately half of the individuals experience events. In addition, predictive performance of two validation procedures, internal and external validation, was explored, with internal validation being preferred in most cases. Model-based analysis was compared to conventional methods by the use of clinical trial simulations and the power to detect a drug effect was improved with a pharmacometric design and analysis. Throughout this thesis several examples have shown the possibility of significantly reducing sample sizes in clinical trials with a pharmacometric model-based analysis. This approach will reduce time and costs spent in the development of new drug therapies, but foremost reduce the number of healthy volunteers and patients exposed to experimental drugs.