Constraint induced movement therapy is one of many neurorehabilitation methods, based on principle of overcoming the learned non-use phenomenon by a specific therapeutic protocol including some behavioral techniques. A classification of currently available studies on the topic have been made on the model of literature review, with an in-depth focus on using Constraint induced movement therapy in occupational therapy for adult patients after stroke who have upper limb motor disorders. The present study is structured into two sections: a theoretical part and an analytic-descriptive one. In theoretical part history of the method is presented together at Basic method principles and detail contents of a therapeutic protocol. The analytical and descriptive section is aimed to analyse international studies important and relevant with respect to an occupational therapy practice. In this second section are also proposed many possible activities of shaping and task practice techniques which can be used by occupational therapists. Translation of the most widely used test (Motor Activity Log and Wolf Motor Function Test) into Czech language is included. Keywords: constraint induced movement therapy, stroke, upper extremity, occupational therapy

The submitted diploma thesis shows overview of the problem using upper extremity orthoses for adult with spasticity after the stroke. The aim of the thesis is to explore possibilities of using orthoses at different stages of the spasticity development. The theoretical part includes main information about the important point from central motoneuron disorder, it means spasticity. There is information about materials, production, availability and usability in various types of orthoses. Main part of the theoretical section shows research studies and available literature, which interprets using kinds of orthoses in various time when the spasticity was developed. The theoretical part follows the practical part. In the practical part are demonstrated available possibilities of using orthoses for interference spasticity in the upper extremity. For the practical part were chosen three groups of patients and each group of patients represents one case study. In the thesis are represented patients in acute, subacute and chronic stadium after the stroke. In each stadium were used different kind of orthoses: neoprene brace for acute, static-progressive for subacute and static thermoplastic for the chronic stadium. The measurement neuromuscular parameters were conducted according to Five steps clinical...

Neurorehabilitation is a multidisciplinary rehabilitation process used in patients with neurological diseases. These patients have not only movement disorders but also cognitive and neurobehavioral problems as well as aphasias. Their rehabilitation is a long term process and the results are often unsatisfactory. Neuroplasticity - physiological basis for neurorehabilitation induces functional restitution or recovery after secondary brain damage. Various neuroprotective substances (e.g. erythropoietin - EPO) are tested to empower mechanisms of plasticity after brain injury. Preclinical studies testing efficacy of those substances in animal brain damage models are essential to prepare clinical trials. The aim of the study was to reveal the influence of EPO combined with rehabilitation on functional outcomes after global cerebral hypoxia. FIM (Functional independence measure) test was used for functional evaluation and Meilli test for visual memory of the patients who attended special program for rehabilitation in clinical part. Patients who came earlier had better prognosis than patients who came later. In experimental part three-months old male Wistar albino rats were exposed to hypobaric hypoxia for 60 minutes in an experimental chamber, simulating an altitude of 8000 m. Half of the animals received...

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Polydendrocytes, or NG2 glia, are fourth type of glial cells in mammal central nervous system. In the adult brain, NG2 glia represent important cell type with respect to their role in gliogenesis and nervous tissue regeneration following injury. Ligands from the Wingless/Int (Wnt) family play key role in proliferation and differentiation of NG2 glia and they can also influence regeneration of nervous tissue after ischemia. The aim of this thesis was to elucidate the role of NG2 glia in neurogenesis and gliogenesis following ischemic brain injury and investigate the impact of Wnt signalling on the reaction of NG2 glia to this type of injury. To fulfil these aims, transgenic mouse strains with tamoxifen-inducible recombination, that enabled simultaneous expression of red fluorescent dye and either activation or inhibition of the Wnt signalling pathway in NG2 glia, were employed. To induce ischemic injury, middle cerebral artery occlusion model was used. Changes in differentiation and electrophysiological properties of NG2 glia were analysed using patch-clamp technique. Activation of the Wnt signalling pathway under physiological conditions and 7 days after ischemic injury led to increased differentiation of NG2 glia toward astrocytes, while 3 days after ischemic injury activation of this signalling...

The main aim of this dissertation is to determine the predictors of social participation of pupils with cerebral palsy in elementary schools in the Czech Republic and the Republic of Serbia which, in other words, means identifying factors that could determine the level of its social participation in primary education. Considering the fact that it is established that the participation of pupils with cerebral palsy is an important indicator of their successful social participation in adolescence and adulthood, it is necessary to estimate the factors that influence their participation in school age. Social participation is within this dissertation viewed from the perspective of independent execution of non-academic school activities that the pupils with cerebral palsy are performed daily in the school environment, which they need in order to be able to fulfill the academic obligations expected from them. In order to assess their participation in the school environment, the first and third part of the SFA questionnaire were used (The School Function Assessment), in order to measure pupils' participation in 6 situations within the school environment and 21 concrete non- academic school activities. As independent variables, we have determined 9 individual factors that relate to the characteristics of...

The Abstract The Title: Effect of Peroneal Nerve Functional Electrical Stimulation on Gait in Post-stroke Patients The Goal: The aim of this work was to compare two different ways of applying functional electrical stimulation of the peroneal nerve as to their impacts on the gait speed and performance and the spastic paresis of lower leg in adult patients suffering from chronic stages of stroke accompanied by foot drop. The Method: An open, randomized, controlled clinical pilot study combining elements of both controlled and pragmatic experiments in comparing two different clinical approaches to peroneal nerve functional electrical stimulation. With the first group of patients (group A, consisting of 14 subjects), the intervention was carried out as an outpatient, strictly controlled and intense training of gait with electrical stimulation over the period of four weeks, five times a week; the B-group patients (13 subjects) were all provided with their own stimulator which they applied continuously throughout all their daily routines at their homes and community over the equal period of time. The Results: The four-week intervention turned out to cause no statistically significant difference in our two groups in terms of its impact on any of the monitored parameters of the gait speed and performance as well as...

The thesis deals with with handwriting in adult patients after stroke. The main aim is to design and evaluate a therapeutic program for stroke patients focused on hand function and handwriting. The secondary aims are to translate Handwirting Assessment Battery for Adults into the Czech language by the method of back translation and to determine patient satisfaction with the program. The theoretical part of the thesis briefly summarizes the issue of stroke. General knowledge about handwriting is followed by a summary of handwriting difficulties of stroke patients. The theoretical part is concluded by available handwriting examinations and different ways of occupational therapy intervention. The practical part of the thesis was a case study. Five patients participated in the four- week therapeutic program. The designed program includes task-specific training and Constraint Induced Movement Therapy (CIMT) elements. The tools of the Jebsen Taylor Hand Function Test, the Frenchay Arm Test and Score for Visual Evaluation of Functional Task of the Hand were used to assess the effect of the program on hand function. The practical part mentions the back translation of the handwriting tool Handwriting Assessment Battery for Adults, which was used to evaluate the effect of the program on handwriting...

Title: Neurological deficit after focal cerebral ischemia in rats - pharmacological intervention Objectives: The goal of the thesis was to determine the effect of 7-nitroindazole, a selective inhibitor of neuronal nitric oxide synthase, after focal ischemic stroke in rats. Methods: Twenty adult male Wistar rats were used in this experiment. The rats were randomly divided into four groups: ischemic stroke was given to half of them, the rest were sham operated. 10 animals were given 7-nitroindazole (25mg/kg) to protect neuronal ischemic brain damage. After a few weeks the rats were tested with a set of behavioral tests: Ladder rung walking test, Bar holding test, Rotarod test and Open field test. To evaluate the volume of brain damage the stereotactic method was used. The brain sections were cut and compared with atlas. This study was supported by Institute of Physiology, Academy of Sciences ČR in Prague. Results: The present results show that the 7-nitroindazole has no side effects on healthy rats. The long-term effect on rats after ischemic stroke was not proved. There were a few positive trends observed such as an increase of locomotor speed, increased explorative behaviour and better coordination outcome on RotaRod. On the other hand the brain tissue damage was bigger and the time of hanging in...

Neurorehabilitation is a multidisciplinary rehabilitation process used in patients with neurological diseases. These patients have not only movement disorders but also cognitive and neurobehavioral problems as well as aphasias. Their rehabilitation is a long term process and the results are often unsatisfactory. Neuroplasticity - physiological basis for neurorehabilitation induces functional restitution or recovery after secondary brain damage. Various neuroprotective substances (e.g. erythropoietin - EPO) are tested to empower mechanisms of plasticity after brain injury. Preclinical studies testing efficacy of those substances in animal brain damage models are essential to prepare clinical trials. The aim of the study was to reveal the influence of EPO combined with rehabilitation on functional outcomes after global cerebral hypoxia. FIM (Functional independence measure) test was used for functional evaluation and Meilli test for visual memory of the patients who attended special program for rehabilitation in clinical part. Patients who came earlier had better prognosis than patients who came later. In experimental part three-months old male Wistar albino rats were exposed to hypobaric hypoxia for 60 minutes in an experimental chamber, simulating an altitude of 8000 m. Half of the animals received...