This diploma work deals with the situation of married couples, people who suffered a brain damage. After a brain damage many various mental changes of grave importance may appear apart from the physical consequences. These consequences affect not only the person that suffered the brain damage but also his closest mainly his partner and affect also the quality of their marriage. The theoretical part of the diploma work deals primarily with the importance of the marriage from the sociological and the psychological point of view as well. Further the work focuses on the brain damage itself and its consequences. The attention is further drawn to the impact of such situation on the husband or wife of a person after brain damage. Following part deals with the motivations for marriage. The empirical part of the work focuses on qualitative research based on eight individual in-depth interviews with husbands/wives of a person after a brain damage. The main goal of the work is to map the motivation of a husband/wife of the individual after a brain damage for remaining in marriage and identify other factors connected with this motivation.

Patients with a brain injury must overcome a central neurological insult and a systematic metabolic response. The systematic response includes hypermetabolism, hypercatabolism, altered vascular permeability, increased hormone and cytokine release, altered gastric emptying, altered mineral metabolism and altered immune status. This response may initiate mechanisms which lead to secondary brain injury and may adversely affect the function of other organs. Last two decades have improved our knowledge of pathophysiology in patients with primary and secondary brain injury including traumatic contusions. In a moment of injury, primary brain injury which is traumatic contusion can not be therapeutically prevented it can only have a preventive effect. Secondary brain injury can be therapeutically affected although both types of injuries have common pathophysiological signs of disturbed metabolism on cells and subcellular level. Research methods based on molecular biology opens a new zone of research reaction of central neurological system for trauma or ischemia with effort to get involved immediately at the beginning of developing adverse pathophysiological cascade leading to a death of neurotic cell. The brain contusion is a primary centre of brain injury with anatomic changes which can be graphically proved. In...

Patients with a brain injury must overcome a central neurological insult and a systematic metabolic response. The systematic response includes hypermetabolism, hypercatabolism, altered vascular permeability, increased hormone and cytokine release, altered gastric emptying, altered mineral metabolism and altered immune status. This response may initiate mechanisms which lead to secondary brain injury and may adversely affect the function of other organs. Last two decades have improved our knowledge of pathophysiology in patients with primary and secondary brain injury including traumatic contusions. In a moment of injury, primary brain injury which is traumatic contusion can not be therapeutically prevented it can only have a preventive effect. Secondary brain injury can be therapeutically affected although both types of injuries have common pathophysiological signs of disturbed metabolism on cells and subcellular level. Research methods based on molecular biology opens a new zone of research reaction of central neurological system for trauma or ischemia with effort to get involved immediately at the beginning of developing adverse pathophysiological cascade leading to a death of neurotic cell. The brain contusion is a primary centre of brain injury with anatomic changes which can be graphically proved. In...

This thesis is focused on the problematics of aftercare in patients with brain damage. The thesis has an informative character and its aim is to introduce the problematics to the readers and give them valuable advices. This topic has come to the fore of the interest of the professional and general public especially in recent years. Partly because numbers of brain damage especially those of the traumas are increasing, but also because of the development of acute medicine, which is nowadays at a very high level, there is an increase in the number of patients who survive brain damage. However, the problem is a large quantity of these patients have permanent consequences, and they and their closest neighbors have to deal with. These permanent consequences are manifested as cognitive impairment, impairment of sensory functions, physical disability and changes in behavior and emotions. Following care in patients with brain damage is a major problem in our country. We see the problem especially in the continuity and availability of care for locally available services and rehabilitation care for these individuals. The continuity of care after the patient is released from the acute bed is very low and sometimes chaotic. To obtain the necessary informations for thesis and to achieve the goals, it was necessary to study a large amount of professional literature. Used sources are specialized Czech and foreign literature, professional journals and articles searched in professional databases. This thesis should show the possible problems of patient aftercare with brain damage. The results of the thesis can be used as a subsidy to professional conferences, seminars or courses to deal with the issue. The thesis could increase public interest about this topic.

The aim of this final thesis is to apply Feuerstein's instrumental enrichment program (FIE) to a person with traumatic brain injury (TBI). The theoretical part deals with the problematic of traumatic brain injury and Feuerstein's approach to the development of cognitive functions. The empirical part focuse on qualitative research to find out whether there has been an improvement in cognitive functions with three respondents with TBI after five months of intervention using the FIE program, or not. Respondents are young men aged between 23 and 32, about 10 years after the accident, who regularly rehabilitate and undergo reeducation at the Jedlička Institute and Schools (JÚŠ). The aim of the research is to compare whether the influence of the FIE program has improved cognitive functions. The comparison is achieved by objective assessment of cognitive functions using Klecanská opakovatelná neuropsychologická baterie (KONB; Klecany Repeatable Neuropsychological Battery). The results of the research are presented in structured case studies. These in addition to the results of the KONB examination and the description of several months of intervention, follows the respondents throughout their past from life before the accident, through the rehabilitation of the consequences of the accident to the present...

6 Abstract The rehabilitation of patients with brain damage is an interprofessional, complex, intensive, long-lasting and individually oriented process. One frequent consequence of brain damage is hemiparesis, which also causes a disorder of the upper extremity movement pattern. The movement ability of the upper extremity is essential for an individual's self-sufficiency, the performance of common daily activities, and thus for an independent life in a family setting. Special therapeutic rehabilitation approaches should involve the training of new activities, including the motor learning mechanism that activates brain plasticity. A functional reorganization of the motor cortex occurs along with the activation of reserve neurons and the replacement of damaged synapses. One of the aims of this work was to demonstrate, using objective function methods, the possibility of influencing the movement patterns of a paretic upper extremity by means of intensive interprofessional rehabilitation even several years after the brain damage. The second aim was to demonstrate that the monitoring of motor functions in patients after brain damage leads to improved motivation, thereby improving motor functions. A study was conducted among 55 selected patients after brain damage with central hemiparesis who participated in the...

Rehabilitation of patients after brain damage is an multidisciplinary, complex, intensive, long- term and individual process. Standardized functional instruments for the assessment of the degree of disability and functional abilities of patients are not usually used in rehabilitation in the Czech Republic. Often, motor disorder post brain damage results in hemiparesis and causes impairment of upper arm movement pattern. Movement ability of the upper arm is vital for self-sufficiency, activities of daily life and maintaining an independent family life. Special rehabilitation therapeutic techniques must involve the training of new activities including the mechanism of motor learning which is responsible for functional reorganization of the motor cortex regions, and the activation of reserve neurons for reparation. The aim of the study is to demonstrate that an accelerometer is a suitable instrumet for objective monitoring of impairment of the upper arm movement pattern. Another aim of the study is to demostrate if the FIM test (Functional Independence Measures) and Jebsen-Taylor (JT) test are appropriate instruments for detecting changes of the upper arm movement pattern after intensive, individual and multidisciplinary rehabilitation brain damage patients. Clinical study was undertaken with selected...

Recently, the literature concerned with the possibilities and limitations of working memory training has been growing rapidly. Nonetheless, there are still no clear answers about the principles of its effectiveness or transfer effect. The main questions we ask are about effectiveness of cognitive training in patients after stroke or TBI. To our knowledge this group hasn't been studied in this context yet. To do this, we compare two types of cognitive training - extensively studied N-back training (n=11) and still more popular group cognitive therapy (n=9) with a placebo control group (n=5) who recieves "training" in a simple computer game. The placebo control group then continues in N-back training. Our hypothesis is that after 3 weeks the two trainings should lead to significantly higher gains in cognitive tests scores than the placebo condition. Also, we expected N-back to be more effective than group cognitive training in domains more closely related to executive control. We tested attention, fluid intelligence, short-term and working memory. We also recorded participants well-being. Following training, there were no significant differences between N-back and group training. N-back group scored significantly higer on Trail Making Test A than control group (p=0,026). Although our study doesn't...

Title: The usage of qi-gong for training of perceiving body schema Summary: The goal of the work is to prove the presence of alpha activity in the electroencencefalographic record throughout the duration of the exercise qi-gong with open eyes and closed eyes, and to evaluate changes in the distribution of the scalp alpha activity with native EEG before and after the exercise. The observed research file was created from five probands between the ages of twenty-seven to fifty-two, which all practiced qi-gong for a duration of at least twelve months. The results showed the presence of alpha activity during exercising qi-gong with closed eyes in four probands, and in three probands there was also a present alpha activity during the exercise of qi-gong with open eyes. Furthermore was proven that the change in distribution of alpha activity during exercise of qi-gong with open eyes was from parietooccipital regions going temporo-frontally in comparison with the exercise of qi- gong with closed eyes and native EEG before and after exercise. The acquired results support in literature the described change of generators of alpha activity localized in the deeper structures of the brain. This process is connected with the decreased activity of the cerebral cortex with an increase in the particular limbic structures....

Title: Structural changes in model of hypoxic-ischemic encephalopathy in rat Objectives: The aim of the research is to develop a model of hypoxic-ischemic encephalopathy in a rat that would represent perinatal injury in a human and then histologically differentiate the most commonly damaged cerebral structures. Methods: This is an experimental study. Five laboratory rats underwent hypoxic-ischemic conditions causing encephalopathy according to the Rice-Vannucci model. The control group representing the other five rats underwent hypoxia for 1.5 hours. Subsequently, the animals were returned to their mother. 48 hours later, cerebral perfusion, paraffinisation, slicing the brain into sections and followed by applying these sections onto slides. Sections to represent morphological changes and degeneration of neurons were stained with Hematoxylin-Eosin, Fluoro Jade B and immunohistochemically. The sections were then observed and evaluated under a light microscope. Results: Following the onset of hypoxic-ischemic encephalopathy in 7-day-old rat pups, damage to the investigated structures was observed in two animals. Other animals in the experimental group exhibited only minor morphological changes in neurons observable in H&E staining. Brains of the control group were intact. Keywords: necrosis,...