This diploma thesis deals with the topic of nutritional support in patients with neurological diseases (stroke and Critical-Illness-Polyneuropathy). The aim of this thesis is to find out, how implemented unified system of nutritional support affects the well-being of patients at neuro-rehabilitation clinic Asklepios Schlossberg Klinik in Bad König. There were observed 55 patients (30 men and 25 women) for 8 weeks. The theoretical part of this thesis describes basic components of nutrition, energy expenditure and needs, selected neurological diseases, dysphagia, malnutrition. The emphasis is put on nutrition in intensive neurological care. The practical part of the thesis analyses data obtained by the observation. There are observed changes of body weight, BMI and laboratory values of total protein, albumin and glycaemia in serum. These data are divided by sex, age, type of disease and initial BMI values. The observed patients had mainly overweight and obesity, which have lost a part of their excess weight due to catabolism. At the beginning of the observation 13 patient had normal BMI value, this number of patients rose to 24 after eight weeks. At the end of the observation the reduction of BMI value was on the average 2.45 units. Based on the results, it was found that although patients due to...

The thesis is focused on the support of communication skills by graphomotorics in the context of comprehensive rehabilitation, on the improvement of the quality of life of people with aphasia after stroke and the support in their families. The main aim of this work is to monitor the development of influence of special pedagogical intervention on strengthening graphomotorics and supporting communication skills. The sub-goals are to design a program of special pedagogical intervention for people after a stroke and evaluation of the effectiveness of a special pedagogical intervention in robotically assisted rehabilitation and distance rehabilitation led by a special pedagogue. We set research questions. The target group consists of 34 people aged 45 to 75 years, 3-50 months after a stroke, with an affected dominant hand and a diagnosis of aphasia located in follow-up institutional care and outpatient care. For empirical research, we chose an observation, an interview, and an experiment. In the participatory research, we involved the researched person in the role of a researcher. Through exploratory research, we addressed robotically assisted rehabilitation and distance rehabilitation. The research used a record sheet for special pedagogical diagnostics of fine motor skills, a functional communication...

1 Abstract Electrical stimulation by coupled impulses according to Hufschmidt was created with the primary goal of reducing spasticity. However, there are currently few studies that confirm or refute the effect of this type of electrical stimulation in reducing spasticity. The aim of this diploma thesis was to determine the effect of electrostimulation according to Hufschmidt on the reduction of biceps brachii spasticity in patients after stroke. In addition, the effect of electrical stimulation on increasing the active range of movement of the antagonist of the examined muscle and on the active function of the spastic limb was investigated. For these purposes, a non-randomized controlled pilot study was created, which involved a total of 16 probands, 8 - in the therapeutic group, 8 - in the control group. Five-step clinical assessment in spastic paresis according to Gracies were used for the examination. In the therapeutic group, electrostimulation took place 3 times a week, a total of 8 times. The intragroup difference was evaluated using the Friedman and Wilcoxon paired tests, the intergroup difference was subsequently evaluated using the Mann-Whitney U test. The significance level p = 0.05 applies to all tests. The measured values show that Hufschmidt's electrical stimulation has a positive effect on...

Title: Rehabilitation of Child with Cerebral Palsy in the Preoperative and Postoperative Period Author: Renata Šmídová Objective: During my practice I have met with a number of pediatric patients affected by cerebral palsy who underwent corrective orthopedic surgery, which in some cases were unfortunately unsuccessful. Based on the initial acquisition of information on this issue, I found a number of studies and articles on the success of orthopedic surgery in cerebral palsy. In many studies point out that the proper choice of physiotherapy has great benefit for orthopedic intervention, so I decide to map a connections orthopedic and physiotherapy approaches on the case and describe the elements of rehabilitation used in the treatment of selected patient. In the first part of the thesis I process in detail neurological disorder cerebral palsy (CP) and surgical treatment of deformities resulting from the operation of this disease. The second part includes a case study that describes the rehabilitation work of the physiotherapist with a child patient who undergoes corrective surgery on the lower limb. The third section contains qualitative research, conducted on the parents. Using the survey was to determine the effect of parents' opinion and the whole course of therapy. The aim: Demonstrate the...

The thesis evaluates the effect of four-week home therapy using stabilometric platform Nintendo Wii Balance Board and tablet with integrated software HomeBalance in patients with brain injury. Software HomeBalance has been developed for the treatment of balance disorders and cognitive function. Manipulating the platform and the tablet may also develop grip and handling abilities of hand, both will be evaluated in this work as well. The theoretical part describes new trends in rehabilitation of cognitive-motor interference, dual-task therapy and therapy using technological equipments. Methods: A total of 9 subjects underwent four weeks of therapy using a therapeutic set HomeBalance. The control group of 12 subjects received therapy without any technological equipment. Patients participated in the initial examination, home therapy and final examination. As an evaluation of the therapy Mini-BESTest, Timed Up and Go test, Montreal cognitive assessment, 9- hole peg test, and also two games from HomeBalance software and questionnaire assessing satisfaction with therapy have been used. Results: After treatment the whole group improved in only two tests evaluated: in Mini- BESTest and the time of diagnostic scene in HomeBalance software. The research group had statistically better results in both tests...

The aim of the study was to evaluate the effect of specific rehabilitation concept on the motor deficit in patients after stroke. This concept is used at the Department of inpatient rehabilitation FN Motol, the main component is exercise on the principles of dynamic neuromuscular stabilization (DNS) and is based on the principles of developmental kinesiology. The study included 12 patients after stroke. Probands participated in the 3 week therapy, exercise was carried out twice a day. Significant (p <0.05) improvement in motor function of the arm, hand, leg and foot was demonstrated by using Student`s paired t-test. There was a statistically significant improvement in postural control and reducing shoulder pain (all assessed using a specific scale: Chedoke McMaster Stroke Assessment). Changes in the degree of spasticity were evaluated by Modified Ashworth scale. A statistically significant improvement in the degree of spasticity was observed in these muscle groups: the elbow flexors , adductors of lower limb, knee extensors and hamstrings. It has been shown that the concept of dynamic neuromuscular stabilization can be advantageously used in selected patients after stroke. It is appropriate to supplement the DNS therapy with training of ADL.

The thesis entitled "Stimulation of people with physical and multiple disabilities - using the TheraSuit Method" focuses on the using of different stimulation methods in the care of people with physical and multiple disabilities and is aimed in particular mentioned method TheraSuit and its modifications (Klim-Therapy) whose main element is a special support suit. In the Czech Republic, this method has been used for relatively short time. It is a little widespread, especially due to financial demands. The clients have to pay the therapy almost themselves. Therefore, the thesis aims to gather available information about the method using special support suit. Another objective is to obtain a quantitative overview of the research on the awareness and attitudes of adult clients of selected institutions for people with physical and multiple disabilities, their parents of children with physical and multiple disabilities and staff who work with these people, to discuss methods and new methods of stimulation at all. The thesis also focuses on other stimulation methods used in selected institutions providing services to peoples with physical and multiple disabilities.

Introduction: The theoretical part of the thesis summarizes findings from foreign literature on virtual reality and its use in rehabilitation, as well as the possibility of the benefits of active video games as part of balance training, specifically gaming console Nintendo Wii. The practical part is a pilot study to evaluate the effect of balance training in patients with cerebral palsy using this gaming console. Methods: The study included five patients with cerebral palsy, three in the form of spastic hemiparesis, two in the form of spastic triparesis. Patients were aged 8-18 years. Therapy took place on the Nintendo Wii, selecting five games from cd/dvd Wii Fit Plus. Patients underwent a total of 8 treatments with a frequency of once a week. One therapy lasted 20-30 minutes, according to success in individual games. The effect of therapy was evaluated using the Balance Master, specifically through tests Weight / Bearing squat (weight distribution of the lower limbs), mCTSIB (modified test balance sensory interaction) Limits of Stability (CoG sway to the borders of support base), Rhytmic Weight Shift (fast active transfer of CoG), Walk Across, Tandem walk and Step/Quick Turn (walking with a turn). For statistical evaluation and comparison of the results before and after treatment was used...

Name: Alice Oktábcová Supervisor: Mgr. et Mgr. Jaromíra Uhlířová Oponent: ……………. Diploma thesis: The Application of Robot-Assisted Therapy of Hand after Stroke: Follow-Up Trial of Application of AMADEO Instrument Key words: stroke, robot-assisted therapy, Amadeo Instrument, follow-up study, upper extremity In recent years, western countries noted a gradual increase in stroke survivors. Stroke can cause motor activity impairment and also senzoric and cognitive disorders which lead into restriction of participation of activities of daily living and also reduction of social and community activities. Functional improvment of upper and lower extremity after stroke is a very complex proces which has to be solved in multidiscplinary and multifactorial approach in result of every stroke survivor to live in the most independent way as possible. Robot-assisted therapy for motor recovery could be a successful way to improve motor activity of stroke survivors. Amadeo Instrument is one of robot-assisted therapy for hand rehabilitation of stroke survivors. This instrument can be described as final effector without exoskeleton which allows functional motor therapy for fingers and also a motivational feedback. Amadeo therapy can be passive, assisted, active and also interactive. The aim of this thesis is to...

This thesis deals with the effectiveness of individual vs. group cognitive therapies in stroke patients by training sheets, and pencil-paper exercises. The thesis is divided into theoretical and practical part. The theoretical part of the thesis describes the issue of this disease and the current study of cognitive training. The main aim of the practical part is to compare the effectiveness of group and individual cognitive training by means of intensive cognitive training in patients after stroke (within a year after a stroke). Another aim of the study is to find out how patients were satisfied with cognitive function by using the Schwartz scale of therapy. The study included 20 patients who were selected based on predetermined entry criteria. Subsequently, they were divided into two groups of 10 patients. Group 1 underwent individual cognitive therapy and group 2 underwent group therapy. In both groups, cognitive therapy was performed three times a week for one month. The time of one therapy was always 35-40 minutes. Patients were examined at baseline with the Montreal Cognitive Test and Schwartz's scale of therapy evaluation was added to the test at the end of the test. The results showed comparable improvements in the Montreal cognitive test in both groups. Furthermore, they showed comparable...