Name and surname: Bc. Iveta Kovářová Supervisor: Mgr. Alice Oktábcová Thesis title: Summary of Principles and Recommendations for Stroke Patients and their Families after Discharge from Acute Stroke Units Background: Stroke is a very serious and common disease with a high mortality. It is important for patients to start rehabilitation as soon as possible. Early discharge allows stroke patients return home to continue rehabilitation in familiar surroundings. The responsibility for continued rehabilitation is in the hands of patients and their families and the main aim is to adjust to everyday life. Objective: The aim of this work is to create an educational material "Summary of Principles and Recommendations for Stroke Patients and their Families after Discharge from Acute Stroke Units", to help patients in the stroke problematics. This Summary includes information about stroke issues, stroke epidemiology, consequences and risks, practical advices, compensatory aids, possibilities of rehabilitation and information on social counseling, speech therapy and outpatient rehabilitation with relevant contacts. A case report in the practical part of this work tries to summarize possibilities of home occupational therapy and get a feedback on the educational material. Methods: This research work summarizes...

Cerebral palsy (CP) is one of the most frequent neurodevelopmental deseases. The brain lesion may disturb upper extremity functioning in children with cerebral palsy (CP). This thesis aims to create a therapeutic program focused on movability of upper limbs in school-aged children with CP and and verify the efficiency of this therapeutic program. Another goal is to consider the applicability of the Jebsen Taylor Test of Hand Function for assessment of hand function in children with CP. The theoretical part deals elaborately with cerebral palsy, therapeutic interventions in children with CP and its efficiency according to the evidence based medicine. This part also deals with standardized assassment tools and pays close attention to the Jebsen Taylor Test of Hand Function (JTTHF) and the Manual Ability Classification System (MACS). The practical part presents six case studies of children with cerebral palsy who attended the occupational therapy three times a week over three weeks. The created therapeutic program includes three areas focused on the bimanual training, grips and grafomotorics. This program was appropriate for four of six children patients. The program was too hard for children with quadruparesis classified as MACS IV. The other children were classified as MACS II. The efficiency of...

The diploma thesis at hand aims to find out to what extent Vojta method can stimulate child?s ability to receive and actively participate in other means of the comprehensive rehabilitation system. The diploma thesis observes application of Vojta method within the comprehensive system of rehabilitation provided in ARPIDA in České Budějovice. The diploma thesis is divided into two parts. The theoretical part deals with the current state of the issue in question, provides characteristics of individual means of the comprehensive system of rehabilitation, and acquaints the reader with the technique named reflex locomotion, which is referred to as the Vojta method. The practical part comprises of two chapters. The first chapter provides the reader with a description of the selected facility. The second chapter introduces case reports of the clients completed with analyses of interviews held with parents and other members of the multidisciplinary team. Using the mentioned materials, the author produced six case reports of selected clients of ARPIDA centre. Five out of six observed clients were diagnosed with infant cerebral palsy in different forms with combined defects. For the purposes of the diploma thesis, the author used the method of qualitative research. The practical part is based on analyses of medical records and personal documentations of selected clients of ARPIDA centre; author?s own direct observation; analyses of interviews held with parents and other members of the multidisciplinary team; and observations made by the author while performing her duties as a physiotherapist. Finally, it was concluded that application of Vojta method is necessary within the comprehensive system of rehabilitation which strives to reduce the effects of the disability and improve the quality of life in subjects with the said disability. The author?s own research was designed to verify the findings learned from the literature reviewed for the purposes of the theoretical part. The conclusion of the practical part contains a summary of results, assessment of accomplished goals; and research outcomes and recommendations. The thesis may be found useful by both experts and students who have professional interests in the issue; yet, it should also be made available to the members of the multidisciplinary team as a feedback.

Aim: The aim of this study is to assess benefits of therapy by Vojta method and by using the active videogame Nintendo Wii. The manual dexterity and gross motor function were evaluated. Methodology: The study was attended by 14 children aged 6 - 18 years. They were divided into two equal groups. The Vojta method was applied for the first group and exercising with Nintendo Wii for the second group. Each therapy took 30 days. After a 6 months break the two groups were changed. During those 6 months no targeted physiotherapy was done. The manual dexterity and gross motor functions were measured before and after the therapy and 8 weeks after finishing the therapy. The Box and Block test and the Nine Hole Peg test were used for assessment of manual dexterity and GMFM was used for testing of gross motor function. The children completed the PACES questionnaire after each of the interventions. Results: Statistics showed a significant change in the manual dexterity over the time when the Box and Block test was used. A difference between the two types of therapy has not been proven. Results of the Nine Hole Peg test were not statistically significant, neither in time nor when comparing the therapies. GMFM was not statistically significant either. The PACES did not show any difference between the therapies....

A neurosurgical method of the selective posterior rhizotomy (SPR) is used for a treatment of spasticity. The aim of this study is to evaluate an effect of the SPR on the reduction of the spasticity and on functional abilities of patients with cerebral palsy. Five patients (four males and a female) aged from 12 to 21 years with a spastic quadruplegia were tested by an Ashworth scale, modified Ashworth scale, Peacock scale and Barthel index of ADL. An initial assessment was preformed one day before the SPR. First assessment of changes was conducted one week after the SPR. An repeated follow-up assessment was done three to four years after the SPR procedure. In one week after SPR assessment a reduction of spasticity of lower and upper limb muscles and reduction of clonus were seen. A last three-year assessment detected some return of spasticity on hip adductors, plantar and dorsal flexors muscles. However, the return of the hypertonus did not reach initial values of spasticity. Powered by TCPDF (www.tcpdf.org)

Selective dorsal rhizotomy is a neurosurgical procedure for treating carefully selected patients with cerebral palsy. The aims of this thesis are to assess the influence of this treatment on changes in spasticity, functional abilities, locomotion and activities of daily living of these patients and also to assess the changes in these parameters in patients who were treated using this method at the neurosurgical department in University Hospital Motol in previous years. Six patients with CP diagnosis were tested - five 6 to 21 years old boys and one 35 years old woman. Ashworth and modified Ashworth scales were used to assess spasticity, goniometry was used to measure the range of passive movements. The Barthel index and Global care impairment scale by Dressler tested activities of daily living. Penn Spasm Frequency Score and Peacock's scale of locomotion were also used. The results showed a reduction in spasticity in lower as well as upper extremities, an increased range of passive movement of lower extremities, reduction of clonus the tendon of Achilles and an improvement of speech. Decreased pain and improved ability to perform activities of daily living were noted and hygienic care of a child was made easier thanks to this treatment. Powered by TCPDF (www.tcpdf.org)

(v AJ) Nursing care for patients with dysphagia after stroke is nowadays a very serious problem. This disease is particularly dangerous for patients because of the risk of imminent aspiration pneumonia. In 2015, Czech Republic has developed a standard treatment plan for patients with dysphagia after stroke and following this plan a new screening method was put into practice, which would prevent aspiration pneumonia (Salt, 2015). This method is called THE GUGGING SWALLOWING SCREEN - GUSS test. After a positive GUSS test result a standardized nursing care should follow, which would involve the whole medical team (doctors, health nurses, speech therapists, physiotherapists and orderly). The aim of this work is to verify whether the GUSS test and subsequently the determined process of the standard treatment together with the nursing care meets and the needs of the nurses. Another objective is to verify whether the nurses would want to add, innovate or make necessary updates based on the already acquired experiences. Furthermore, taking into consideration the frequent collaboration of nurses with the speech therapists, this study also aims to evaluate and asses the cooperation between nurses and the speech therapists. The work also evaluates the effectiveness of the use of GUSS test in providing nursing...

Need of nutritional intervention in patients after stroke Summary Aims: To identify how many patients after acute stroke have accurate oral intake of energy and proteins and how is this condition changed after one month of hospitalization. To evaluate the association between dysphagia and food intake. Methods: The evaluation was conducted by observations of food intake, eaten food records, calculating of energy and nutrients intake and comparing to needed energy (by Harris-Benedicts equation) and proteins. GUSS screening tool was used to evaluation of swallowing, ADL test for self-sufficiency assessment. Data included antropometrical indicators (weight, height, arm circumference) and nutritional screenings in Thomayer hospital in Prague. Results: Of the 35 patients, 54 % had adequate oral intake of energy and 23 % adequate intake of proteins in the first week after stroke. Adequate oral intake of energy was indicated in 66 % of patients and adequate intake of proteins in 11 % after one month of hospitalization. There were no significant improvements of oral energy intake (p=0,2891, α=0,05) or protein intake (p=0,1336, α=0,05) after one month of hospitalization. 84,4 % of patients suffered from dysphagia in first week after stroke and 60,6 % after one month of hospitalization. Correlation between inadequate...

This study aims to evaluate the effects of functional electrical stimulation on motor and functional abilities of paretic upper limb in patients after stroke. Specifically detects the immediate effect of functional electrostimulation on the increase of the active range of motion, reduction of the hand spasticity degree and the improvement of functional performance. The research covered a total of 6 patients after first stroke in the basin aretria middle cerebral artery. The research sample had a homogeneous distribution of the paresis heaviness from light, moderate, to severe. The research was conducted in total of three weeks, every working day, 60 minutes a day, with 30 minutes of indicated electrostimulation and 30 minutes of testing of monitored parameters. Patients were evaluated using the Modified Frenchay scale, Modified Tardieu scale and the range of motion goniometer. Research showed in 60 observations that the functional electrical stimulation has immediate and significant effect on increasing the active range of dorsal flexion motion of the wrist (p-value 0.043). The average improvement on 95% interval estimation is 0.08. During the monitoring of the improvement of the active range of wrist dorsal flexion motion between input and output examination there was no statistically significant...

DEUSOVA, Vendula. Psychosocial issues of people after stroke and their close persons. Prague 2021. Diploma thesis. Charles University Prague. Hussite theological faculty. Department of psychosocial sciences and ethics. Head of work Dr. Jirina Ondrusova, Ph.D. The theme of this thesis is psychosocial issues of people after stroke and close persons, who takes care about them. Theoretical part deals with the characteristics of strokes, risk factors, prevention, symptoms and treatment of ict. It also deals about the consequences rehabilitation of patients after stroke. The thought of how ictus affects and change existing behavior of person, who was affected, but also how affected close persons. Also describes options of formal support, social services, contributions and organizations, which helps to people after CMP. Theoretical chapters are added research part focused on quality in the form of semi-structured interviews with three people after CMP and three people which are close to them, and who takes care about them after ictus, or still they care about them. The aim of this diploma thesis is describe stroke as disease with serious consequences and summarize options formal support and help for people after ict and their close persons, and through research investigation map changes, which may occur...