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...

Dystonia is a neurological syndrome characterized by the involuntary contraction of opposing muscles, causing twisting movements or abnormal postures (modified by Fahn, 1987). Writer's cramp is the most common form of task-specific focal dystonia. In the first study, patients with writer's cramp were evaluated for differences in cortical activation during movements likely to induce cramps (complex movements) and movements which rarely lead to dystonia (simple movements). Although complex patient movements during fMRI were never associated with dystonic cramps, they exhibited abnormally decreased cortical activity. This was not observed in simple movements and was unrelated to the character of handwriting or the presence/absence of visual feedback. Our results support the theory of dualistic sensorimotor system behavior in writer's cramp. As the somatosensory system is believed to be affected in focal dystonia, we focused on modulation of the primary somatosensory cortex (SI) induced by repetitive transcranial magnetic stimulation (rTMS) in the second study, in order to improve writer's cramp. In conclusion, 1 Hz rTMS of the SI cortex can improve manifestations of writer's cramp while increasing cortical activity in both hemispheres. Handwriting as well as subjective assessment improved in most...

Introduction: The surgical and endovascular results of the treatment of pial AVM provided at our Neurosurgical centre are presented. These results are supported by neuropsychological outcomes of subgroup of treated patients. Going by these results and by an overview of literary data on the efficacy and complications of each therapeutic modality, the optimal algorithm of indications is presented Cohort of patients: The main series comprises 222 patients aged 9 to 87 years treated in the years 1998 - 2013. The surgical group consists of 85 patients, 55 patients received solely endovascular treatment. Thirty-four patients were consulted and referred directly to the Radiosurgical unit. The remaining 48 were recommended to abide by the strategy of "watch and wait". A subgroup of 66 patients, who underwent treatment of AVM was neuro-psychologically tested at least two years after treatment using a battery of tests constructed specifically for this study. A control group consisted of 10 subjects without any neurological disease. Results: In the surgical group, serious complications were 3.5% at a 96.5% therapeutic efficacy. As for AVM treated with purely endovascular methods, serious procedural complications were seen in 5.5% of patients, with efficacy totalling 36.4%. One observed patient suffered...

Deep brain stimulation (DBS) of the globus pallidus internus (GPi) is an effective symptomatic treatment for pharmacoresistant dystonic syndromes. The relationship between grey matter volume and intracortical inhibition of the primary motor cortex (MI) in regard to the effectiveness and the state (ON/OFF) of GPi DBS was analysed in the first study. The grey matter of chronically treated patients showed hypertrophy of the supplementary motor area and cerebellar vermis whereas this difference was more significant in patients with a better clinical outcome. The grey matter of the cerebellar hemispheres of the patients showed positive correlation with the improvement of an intracortical inhibition which was generally less effective in patients regardless of the GPi DBS state. Moreover, we showed the same level of SICI in the good responders as in the healthy controls, while in non-responders was the SICI decreased. In the second study, by using paired associative stimulation (PAS) we studied the influence of primary somatosensory cortex (SI) on the MI excitability in dystonia in regards to the effectiveness of GPi DBS. SI PAS decreased the MI excitability in the GPi DBS ON state while switching the stimulation off decreased an inhibitory effect of SI on MI excitability. Non-responders showed a...

KITTNAROVÁ, Denisa. Communication training and social integration of people over cerebral apoplexy. Prague 2021. Diploma thesis. Charles University in Prague. Hussite Theological Faculty. Department of Psychosocial Sciences and Ethics. Thesis supervisor PhDr. Beáta Krahulcová, CSc. The main goal of my diploma thesis was to find out, how successful it is to integrate people over cerebral apoplexy into normal social and working life. The theoretical part introduces the reader to the cerebral apoplexy as such. It also deals with phatic disorders caused by cerebral apoplexy and brain trauma, rehabilitation and its possibilities, communication, and communication training and, last but not least, social services. In this thesis, I chose a qualitative method to obtain data using a semi-structured interview. At the end of this diploma thesis, the results of the research survey are processed and interpreted.

Master's thesis called Spiritual needs in people with cerebral palsy and their saturation in social care focuses on expressing spirituality in people with cerebral palsy (CP) and studies what the spiritual needs may be and if personal care assistants (PCAs) can help to fulfil clients' spiritual needs. The theoretical part shows the issues of CP and the view to people with this disability, with the emphasis to the options of their participation for life in society. It deals with the topic of spirituality and spiritual dimension as one of many dimensions of human personality. After presenting several important theories of needs it continuous with the role of PCAs and their role in fulfilling the clients' spiritual needs. The practical part proceeds from the combination of quantitative and qualitative research; from a questionnaire inquiring the expressiveness of the spirituality and its sharing with PCAs, and interviews seven people with CP inquiring their spiritual needs and possibilities of their fulfilling by PCAs. The results show concrete and stronger spirituality expressing in people with CP than in major population and that the spiritual needs come out from their live situation. Besides spiritual needs and forces that allow them to fulfil their needs on their own. The PCAs are also a rich...

The aim of this Ph.D. thesis was to analyze the morphine-induced changes of frontal brain cortex protein composition in rats exposed to increasing doses of morphine (10-50 mg/kg) for prolonged period of time (10 days). The first part of this work was oriented to the analysis of the phenomenon of hypersensitization/superactivation of adenylyl cyclase (AC), which is regarded as one of the crucial molecular mechanisms causing drastic pathological consequences of drug addiction. The increase of AC activity represents a "compensatory" response and is functionally related to the desensitization of G protein response to prolonged morphine exposure of target cells. The clear desensitization of µ-OR- and δ-OR-stimulated G protein response by morphine was demonstrated in our laboratory by analysis of the dose-response curves of DAMGO and DADLE-stimulated, high-affinity [35 S] GTPγS binding in plasma membranes isolated from frontal brain cortex of rats exposed to morphine according to the same protocol as that used in my Ph.D. thesis (10-50 mg/kg, 10 days). The κ-OR-stimulated [35 S] GTPγS binding was unchanged. It has been determined the amount of all AC isoforms (AC I-IX) in plasma membranes (PM) isolated from control and morphine-treated rats which were sacrificed 24 hours since the last dose of morphine....

The diploma thesis - "Psychosocial Aspects of Changes in Human Mobility," focuses on family and siblings of people with physical disabilities, as well as on finding the appropriate support for these families in their specific situation. It particularly deals with people suffering cerebral palsy and spina bifida and possibilities to support the families with disabled individuals in the Czech Republic. The thesis is based on theoretical knowledge gained from publications and laws, hands-on experience acquired in service as a personal care assistant, as well as own research project on siblings of people with physical disabilities. In the first part of the thesis, the author gives basic information about classifications, diagnostics and manifestations of cerebral palsy and spina bifida with major influence of the change in human mobility. In addition, the thesis focuses on the relationship of both parents and siblings, to the handicapped child. The next part is devoted to a research project called "Life with a Sibling with Physical Disability". The research project deals with the direct experience of siblings of people with physical disabilities, critical moments in their lives, resources of coping with this difficult life situation, but also looks at benefits for their personal growth. The aim of...

Annotation: The thesis is focused on educating parents of children with perinatal risks. The work focuses on justifying the need of special educator within the multidisciplinary team of therapists and his role in the work with children with perinatal stress. Based on the questionnaire results it shows how parents are informed about the therapy options, leisure activities and other source of information. The work highlights how essential is to coordinate all offers of variety organizations and the need for long-term and systematic educational work. In the theoretical part of the thesis is the child examination and the importance of early detection of children with threats followed by clearly elaborated complex of the child psychomotor development. Further characteristics describe children with perinatal risks to define their basic diagnosis and the consequences of individual systems damages and the relevance of further development. The work shows the possibility of intervention using the latest trends in work with children at risk and the importance of early initiation and the need to combine the therapies.

The diploma thesis considers possibilities of using therapies for preschool children with multiple disabilities in special nursery schools and in common nurseries with special classes. Provides an overview of therapies which mostly occur in schools. Based on the theoretical knowledge about single therapies identifies, how are integrated into the educational process in kindergartens. The analysis of the questionnaire survey highlights the shortcomings, that were the basis for a proposal to streamline therapies in these facilities.