As a result of rapid development in Emergency Medicine and Intensive Care the patients with brain damage have better chances of surviving than they had in the past. However the survivors need to deal with severe loss of function and consequences resulting from that. An excellent primary care for patients who suffer from strok is provided in Czech Republic, the rehabilitation on the other hand is insufficient. The main problem is an absence of continuity of care which leads to aneffective outcomes and increase of total costs of treatment The purpose of this diploma theses was to evaluate the possibilities of occupational therapist of interprofessional collaboration in community based rehabilitation - in client's home environment. There are several categories of brain damage including acquired brain injury, genetic brain disorders and brain damage acquired during labor. The goal was to detect basic deficient fields. Results of this thesis based on knowledge from foreign literature as well as own experiencis in the team. Results might be used as basis for designed guidelines to improve situation. One client with degenerative brain disorder and five with acquired brain injury which live in home environment were selected. Three months long therapy was provided to them, occupational therapist as case...

We evaluated the effectiveness of two virtual reality therapies (VRT) with visual biofeedback, Armeo Spring® upper limb exoskeleton (Armeo) and Homebalance® interactive system (Homebalance), in early post-stroke rehabilitation. Using a randomized controlled study design, participants within 30 days after stroke with arm paresis (Armeo study) or with balance problem (Homebalance study) were assigned either to the respective intervention group (Armeo IG n=25; mean age 66.5 years, and Homebalance IG n=25; mean age 69.6 years) performing VRT instead of conventional physiotherapy or to the control group (Armeo CG, n=25, mean age 68.1 years, and Homebalance CG, n=25, mean age 65.9 years) having conventional physiotherapy only. Montreal Cognitive Assessment (MoCA), Functional Independence Measure (FIM), Fugl Mayer Assessment-Upper Extremity Scale (FMA-UE), Modified Rivermead Mobility Index (m-RIM) and Berg Balance Scale (BBS) were performed before and after the 3-week therapy with 12 therapies. Results of participants <65 and ≥65 years old were compared. Acceptance of both VRTs was evaluated by self-rated questionnaire. In the Armeo study, paretic upper arm function improved significantly in both IG and CG groups, the improvement in FMA-UE was significantly higher in Armeo IG as compared to CG (p=0.02)...

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 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...

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...

Introduction: Multiple sclerosis is a chronic autoimmune neurodegenerative affection of the central nervous system with various neurological symptoms. Disability of upper extremities with other symptoms leads to impaired ability to work and ADL-activities of daily living. The purpose of the pilot study was to evaluate the effect of hand training with the Hand Tutor® rehabilitation system. Methods: The study involved 9 probands, completed 6 probands (2 females and 4 males) at an average age of 36 (SD 4), with a mean disease duration of 13 years (SD 4). Patients received a series of 10 Hand Tutor® therapies, 1-2 times a week. The effect of the therapy was evaluated using the Nine Hole Peg Test (9HPT), the Modified Frenchay Scale and the subjective evaluation of the probands. Results: Before the therapies, the average performance in the 9HPT test was 85 seconds and 83 points in the Modified Frenchay scale. After the therapies, the average 9HPT performance was 67 seconds and 86 points in the Modified Frenchay scale. According to the subjective evaluation of probands, the therapy had a positive effect on the tremor of the upper limb and on the use of the upper limb in the ADL. Conclusion: Therapy with a special rehabilitation system provides patients with MS with more intensive hand training using...

The Aim of the Study: The aim of this diploma thesis is to capture the change of clinical state of patients with spinal cord injury while watching videos of virtual reality fot three 3 months using ASIA assessment. The goal is to determine the effect of the change of clinical state on the patient's quality of life while using SQUALA and on their imagery ability (WIAQ) while a therapeutic video of virtual reality is regularly played through virtual reality headset. Methods: The research was conducted with 7 probands (n=7, 5 males, 2 females) aged between 31 and 61 years (the average age of 49,6 years), which regular visitors of Centrum Paraple, o. p. s. The propands who participated in research suffer with incomplete spinal lesion. Before any intervention the probands were assessed by ASIA, standardised assessment to estimate neurological level of spinal lesion by assigning the number of motor and sensitive points in each segment. The assessment was conducted by proffessional and specificly trained staff of Centrum Paraple, o. p. s. Furthermore the probands completed the psychological questionnaires to evaluate their quality of life (SQUALA) and imagery ability of the movement (WIAQ) in the pacient with spinal cord injury. As in the beginnig, so in the end of the research the ASIA was conducted once...

OF MASTER THESIS Author: Bc. Tereza Sádlová Supervisor: Mgr. Barbora Vaculíková, MBA Expert guarantor: plk. MUDr. Michal Říha, PhD., MBA Title of master thesis: Quality management of rehabilitation in patients with cerebrovascular accident This master thesis deals with quality management of rehabilitation in patients with cerebrovascular accident and we can also seen her as a basic summary of everything what is connected with quality rehabilitation understood as a service provided in medical devices. The main goal of this master thesis was determined as a presentation of possible form for monitoring and evaluating quality of rehabilitation using Indicator of quality stroke rehabilitation in patients with cerebrovascular accident. For the complex assessment of functional status of patient before and after stroke rehabilitation was reflected all items which are trained during physiotherapy, occupational theray, speech therapy etc. This master thesis is divided into two parts - theoretical and empirical. Theoretical part provides basic information of cerebrovascular accident, system of stroke rehabilitation and quality management of health care, which si relative to stroke rehabilitation. Empirical part describes a process of creating of Indicator of quality management of rehabilitation in patients...

OF MASTER THESIS Author: Bc. Anna Stiborová Supervisor: Mgr. Kateřina Svěcená, Ph.D. Title of master thesis: Utilization of Functional Independence Measure and Functional Assessment Measure on acute inpatient rehabilitation unit with brain damage patients Abstract: This master thesis focuses on the utilization of Functional Independence Measure and Functional Assessment Measure (FIM+FAMUK ). The subject of interest is the use of FIM+FAMUK in an acute phase of rehabilitation in brain damaged patients. The aim of the thesis is to demonstrate the usefulness of FIM+FAMUK as an assessment of functional status on an acute inpatient rehabilitation unit. Theoretical part provides basic information on the system of cerebrovascular care in Czech republic, on the importance of assessing functional status in neurorehabilitation and on some other assessments of disability in neurorehabilitation besides FIM+FAMUK . It also brings insight into FIM+FAMUK , its items, evaluation process and its utilization. Practical part presents the results of a clinical application of FIM+FAMUK on a stroke unit. Fifteen people were assessed with FIM+FAMUK as input and output assessment. Statistical data analysis has confirmed the utilization of FIM+FAMUK as an assessment of functional status on acute inpatient rehabilitation...