This thesis is occupied with the issues of development of the fine motor skills and graphomotorics of an individual suffering from the central mobility disorder. The main aim of the thesis is to discover and describe what development possibilities of these abilities and skills are. The theoretical part deals with basic terms related to diagnosis of Cerebrovascular accident (CVA) and its rehabilitation options. There are also described the fine motor skills, graphomotorics, grasping process, classification of grasps and their development. There is a separate chapter that is engaged only with development of the fine motor skills and graphomotorics. The thesis also contains evaluation surveys that are applied in practice and that are important for comparison before and after a therapeutic intervention. The practical part is based on qualitative oriented methodology and it operates with data gained from five case studies. Based on comparison of values gained from the entry and control examinations, particular data have been elaborated. It was discovered from the performed research that it had come up to improvement of the fine motor skills as well as graphomotorics by use of various therapeutic methods. Each method had been chosen in accordance with the client's current condition and their individual...

OF DIPLOMA THESIS Name and surname: Bc. Lia Medková Thesis supervisor: MUDr. Yvona Angerová, Ph. D., MBA Referee: Title thesis: The effect of sensation disorders on upper limb function in patients after brain injury Abstract The aim of this thesis was to determine The effect of sensation disorders on upper limb function in patients after brain injury. Method: The research for this thesis involved non-experimental pre-research and quasiexperiments. The thesis' theoretical hypothesis was developed on the basis of previous studies that had looked at the effect of brain damage on patients' upper limb function. A total of twenty patients between the ages of 20 - 59 were selected to participate in the empirical study reported in this thesis. All participating patients had suffered damage to their cerebral cortex. The causes of their brain damage included strokes, trauma and tumor. The participants were divided into two groups of ten using the Nottingham Sensory Assessment. Participants with sensory disorders were allocated to the experimental group. Participants without sensory disorders were placed in the control group. The Jebsen-Taylor test was performed on all participants to assess their upper limb function after they had suffered brain damage. Results: Hypothesis thesis: Disorders of superficial,...

The topic of this diploma thesis is speech therapy and intervention of people after stroke with a diagnosis of aphasia. The thesis consists of four chapters. The theoretical framework is presented in three chapters, the fourth one is an empirical part of thesis. The first theoretical chapter deals with the concept of communication and defines the basic terminology, it also describes the area of the central and peripheral nervous system and its influence on the human's communication ability. The second chapter approaches the issue of ictus focusing especially on etiology and symptomatology of the disease, diagnostics, therapy and prevention. The third theoretical chapter describes aphasia - a kind of communication disorder arising from a stroke. It focuses on the definition, etiology and symptomatology of aphasia, the process of diagnosis and therapy. In conclusion, this chapter also describes the possibilities of providing speech therapy and intervention in the Czech Republic. The fourth chapter of diploma thesis describes a qualitative research that was conducted within two-weeks complex rehabilitation stays for people after stroke. The main objective of the research was to analyze speech therapy and intervention in adult clients after stroke with a diagnosis of aphasia in the chronic phase. Then...

1 Abstract: Time-dependent and three-dimensional flow of Newtonian fluid is studied in context of two biomechanical applications, flow in cerebral aneurysms and flow in stenotic valves. In the first part of the thesis, the computational meshes obtained from the medical imaging techniques are used for the computation of hemodynamic parameters associated with the rupture potency of the cerebral aneurysms. The main result is the computation within twenty geometries of aneurysms. It is shown that the aneurysm size has more important role in wall shear stress distribution than the fact whether the aneurysm is ruptured or unruptured. The second part of the thesis is addressed to the flow in stenotic valves. It is shown that the method cur- rently used in medical practice is based on assumptions which are too restrictive to be apply to blood flow in the real case. The full continuum mechanics model is presented with physiologically relevant boundary conditions and it is shown that results are consistent with measured data obtained from literature. Then we focus on the obtaining the pressure field from the velocity field. The presented method provides more accurate pressure approximation than commonly used Pressure Poisson Equation. The last chapter of the thesis is dedicated to Nitsche's method for treating slip boundary...

The thesis focuses on coordinated rehabilitation components, which are used at individuals with cerebral palsy (combined disability) in a concrete non state medical institution in České Budějovice. Cerebral palsy is the most frequent neurodevelopmental disease, wherein the health disability may occur in one or more fields. We can find crucial factor in care of individuals with handicap in coordinated rehabilitation, which is currently perceived as an interdisciplinary field seeking the fastest and widest participation of personal with disabilities in all usual activies of society with the use of medical, educational, social and labour resources. A prerequisite for success is a multidisciplinary team (circular support), which consists of experts and parents of individuals with disabilities. The thesis contains theoretical background, where health disbility, coordinated rehabilitation and cerebral palsy is mentioned, at which the occurrence, forms, associated disorders and treatment are described. A separate chapter is devoted to families of individuals with health disability, where I mentioned the reaction of parents on the birth of a child with a disability, the impact of disability on the family and family support. Furthermore I focus on social services for handicapped people and to ARPIDA centre, where my research took place. In the research section there is defined the aim of the thesis, which was to chart a coordinated rehabilitation components, which are used at individuals with cerebral palsy (combined disability) in ARPIDA centre in České Budějovice. The partial target of my thesis was also to compare the usage of coordinated rehabilitation components at individuals under 15 years of age and at individuals over 15 years. According to target of the work there were developed three hypotheses. Thesis research was conducted through quantitative research. To obtain the data, I used the method of questioning. The sample was comprised of individuals with cerebral palsy (combined disability), who attend the centre ARPIDA, while the questionnaires were filled out by their parents. The research undertaken within the thesis, which was supported by rehearsed literature, confirmed the third hypothesis of more often usuage of Vojta reflex locomotion method at individuals with cerebral palsy in the centre ARPIDA compared to individual therapeutic physical training. The remaining two hypotheses were disproved. Statistical survey also shows that care for people with cerebral palsy is a long-term care, where interconnection of services within the coordinated rehabilitation is needed. In the group of individuals under 15 years of age and over 15 years it has been used different coordinated rehabilitation components, this is associated with cerebral palsy, disorders, age and other factors. Problematic remains the job placement of individuals with disabilities, who remain at home without further stimulation possibility. Care and services in the centre ARPIDA were assessed positively. The results and conclusions of the thesis will be used as a feedback centre ARPIDA to map the coordinated rehabilitation components and further to the clearing of needs of single coordinated rehabilitation components in a group of individuals under 15 years of age and over 15 years.

The thesis aimed at finding out whether parents of toddlers with delayed psychomotor development undergoing curative spa stays administer food supplements, their reasons for administering them and what kinds and how often food supplements are administered. Eating habits of these children were looked into as well. Children with polio and central infantile hypotonic syndrome took part in the research. Quantitative research method using an anonymous questionnaire was employed for data collection. Altogether, there were 50 respondents. The results showed that 72 % (n=36) of parents already administered their children food supplements at such an early age. The most frequent motive for this was to strengthen the immune system. Vitamin supplements counted among the most frequently administered supplements in the sample. Furthermore, the research showed that not even the food composition of children in the sample was ideal. The results proved that it is highly desirable to pursue nutrition education of parents of children with neurological handicaps and chiefly also assure higher awareness of food supplements. Key words: dietary supplements, nutrition, toddler period, delayed psychomotor development, vitamins, cerebral palsy

1 Abstract Body weight changes have been described in the course of Parkinson's disease (PD) as well as following bilateral deep brain stimulation of the subthalamic nucleus (STN DBS) performed in advanced PD. According to the literature weight changes occur in 50-100% of patients who undergo STN DBS. In the last 15 years extensive efforts have been put in understanding the underlying mechanisms behind the weight changes following STN DBS in advanced PD patients however many sources still report conflicting evidence. Improved motor status, reduction in dyskinesias, decrease in energy expenditure, dopaminergic medication reduction, modification of food intake, hormonal factors, regional effects of stimulation were all speculated to cause this weight gain. We hypothesized that patients who underwent STN DBS procedure in our center would gain weight as reported in the literature (study 1, study 2). The etiology of post STN DBS weight gain has not been fully elucidated up to date, in our second study we further hypothesized that the weight changes are due to dysregulation of food related hormones and parameters (study 2). In the third study we hypothesized that weight gain is associated with position of active electrode contact (study 3). Aims of the study: The primary aims of our studies were to assess body...

Background: Sonolysis is an important factor in therapeutic use of ultrasound in patients with cerebrovascular diseases, it is ultrasound induced lysis of thrombus or embolus. The aim of this work was to asses safety and efficacy of therapeutic ultrasound effect (sonolysis) in acute stroke patients and in patients undergoing carotid artery intervention. First partial aim of this work was to confirm the safety and efficacy of endovascular sonolysis by using the EkoSonic Endovascular System in subjects with acute ischemic stroke. Second partial aim of this work was to test the clinical efficacy of sonolysis for reducing the risk of incidence of new brain ischaemic lesions detected on brain magnetic resonance imaging in patients undergoing elective CEA or CAS for severe internal carotid stenosis. In addition, we assessed the effects of sonolysis on cognitive function, morbidity, and mortality at 30 days post-surgery. Methods: Patients with acute ischemic stroke and occlusion of the middle cerebral artery or basilar artery were enrolled consecutively to the prospective study tested safety and efficacy of endovascular sonolysis using the EkoSonic Endovascular System (EKOS) in patients with acute stroke. The control group (44 MCA and 12 BA occlusions) was selected from historical controls. EkoSonic...

Cerebrovascular accident (CVA, stroke) is a disease that affects the central nervous system. Many people, even younger in age, have suffered the stroke, and especially in developed countries. For adults it falls into the most common causes of disability. Greater attention is now focused on medical rehabilitation, but all the elements of rehabilitation are important. The status after stroke results in physical, psychological and social consequences. Therefore, early and coordinated rehabilitation is important, since it increases the possibility of the person´s integration. The diploma thesis aims to describe particular components of coordinated rehabilitation granted to the patients after the CVA in the treatment and rehabilitation centre Chvaly. More specifically, the author tries to analyse the coherence of the individual components of coordinated rehabilitation. In the theoretical part, the author focuses at first on the definition of the CVA, follows up with a general treatise about the coordinated rehabilitation, and then she specifies coordinated rehabilitation for patients after the CVA, and briefly describes the facility under examination. To achieve the objective there has been used qualitative research, the method of questioning, the technique of a semistructured interview. The research sample includes people after the CVA, and the staff of the treatment and rehabilitation centre Chvaly, applying specific elements of rehabilitation. Research indicates that in the examined centre they use therapeutic and social elements, where the treatment dominates. The treatment center puts emphasis on self-sufficiency of a person after the CVA, working with the family and a multidisciplinary team, which is also perceived by the clients after the CVA. The results of the diploma thesis can serve as a feedback for the examined treatment centre, they can be used to improve the quality of coordinated rehabilitation. This work can be used as a source of information for people after the CVA and their families.

Present situation The theoretical part of the diploma thesis is divided into four separate chapters. The first chapter deals with cerebrovascular accident (CVA). Another chapter describes the consequences of illness in various areas of human life. The third chapter defines the concept of follow-up care and the fourth chapter deals with diagnosed obesity. Aims of the work and research questions The aim of the diploma thesis is to map out the influence of obesity on follow-up care of patients after cerebrovascular accident. Research questions: 1. How does obesity affect patient mobility after CVA? 2. How does obesity affect the hygienic care of patients after CVA? 3. How does obesity affect normal daily activities of CVA patients? 4. What is the impact of obesity on developing self-sufficiency in CVA patients? Quality research was done through semi-structured interviews with CVA patients who were hospitalized in the aftercare department. Other interviews were conducted with general nurses providing nursing care to CVA patients. Research group The research group consisted of 11 general nurses working at different follow-up care hospital stations, and 16 patients who were hospitalized at these departments after the CVA. Results By analyzing the information obtained, it has been determined that obesity affects the patients mobility especially after the cerebrovascular event. At the same time, it represents a physical and psychological burden for nursing staff, but also for patients. The problem has been the fact, that most patients do not perceive obesity as a condition affecting their whole life. Conclusion The diploma thesis has provided insight into the problematic of the influence of obesity on the follow-up care in patients after cerebrovascular accident. The findings should lead to a reflection on the issue of prevention of obesity in terms of both CVA risk and follow-up care, but also the need for educational activities.