The Abstract The Title: Effect of Peroneal Nerve Functional Electrical Stimulation on Gait in Post-stroke Patients The Goal: The aim of this work was to compare two different ways of applying functional electrical stimulation of the peroneal nerve as to their impacts on the gait speed and performance and the spastic paresis of lower leg in adult patients suffering from chronic stages of stroke accompanied by foot drop. The Method: An open, randomized, controlled clinical pilot study combining elements of both controlled and pragmatic experiments in comparing two different clinical approaches to peroneal nerve functional electrical stimulation. With the first group of patients (group A, consisting of 14 subjects), the intervention was carried out as an outpatient, strictly controlled and intense training of gait with electrical stimulation over the period of four weeks, five times a week; the B-group patients (13 subjects) were all provided with their own stimulator which they applied continuously throughout all their daily routines at their homes and community over the equal period of time. The Results: The four-week intervention turned out to cause no statistically significant difference in our two groups in terms of its impact on any of the monitored parameters of the gait speed and performance as well as...

Title: The Use of Physiotherapy in Spasticity Management Objectives: The purpose of this thesis is to provide a summary of present findings on spasticity, with particular regard to its pathophysiological mechanisms and clinical manifestations, and to present an overview of medical and physiotherapeutic approaches applied in its treatment. Furthermore, it aims at making a research in physiotherapeutic methods and techniques used for reduction of spasticity. The thesis shall present relevant studies, provide their comparison and critically evaluate the effect of methods and techniques examined in them. Methods: This thesis is a descriptive analysis based on a literature review. Results: Based on the research findings, it may be concluded that physiotherapy has proven to be effective in reducing spasticity. However, it is not possible to determine whether the techniques to reduce spasticity are more effective than techniques without this primary purpose. The examined studies have shown that the choice of physiotherapeutic practices to reduce spasticity was not influenced by disease etiology. Moreover, the same techniques and methods were applied in pediatric and adult patients, regardless of diagnosis. The relationship between reduced spasticity and change in motor function is unclear and our research...

Title: Measurement of lower extremities spasticity in patients with cerebral palsy Objectives: The aim of the theoretical part of this thesis is to evaluate possibilities of lower extremities spasticity measurement in adult patients with cerebral palsy. The main focus was given to the concept of French professor J.-M. Gracies: Five- step clinical assessment in spastic paresis. This unique concept presents differentiation of three main factors of motor impairment that emerge as a result of a lesion to central motor pathways: stretch sensitive paresis, soft tissue contracture and muscle overactivity. Ability to distinguish these factors is crucial for specific treatment indication. Finding a correlation between the Five-step clinical assessment in spastic paresis and muscle activity in gait measured with polyEMG was the main objective in the practical part of the thesis. Methodology: This thesis has a theoretical-empirical character. The theoretical part is in a form of a research on the topic of spasticity diagnosis, focused on cerebral palsy patients. The empirical part of the thesis has a form of pilot quantitative research, which was attended by 6 participants with cerebral palsy (4 men and 2 women; average age 29 years). There were 2 independent measurement made for each of them. Each...

Title: The effect of progressive static stretching on treatment of spastic paraparesis in patients with cerebral palsy Objectives: The goal of this dissertation is to evaluate the effect of progressive static stretching on treatment of spastic paraparesis in patients with paraparetic form of cerebral palsy (CP). Elements chosen for the treatment were those of the therapeutic concept Guided Self-rehabilitation Contract by French professor Jean-Michel Gracies, which is presented in detail in the theoretical part of the dissertation. Methodology: This dissertation has a theoretical-empirical character. First theoretical part of the dissertation is in a form of a research on the topic of spasticity and diagnosis and treatment of spastic paresis according to the concept of J.-M. Gracies. Second experimental part of the dissertation evaluating the effect of the selected treatment for spastic paresis in people with cerebral palsy, has a form of pilot qualitative research, which was attended by 6 participants. At the beginning of the research each participant has undergone an entrance examination that evaluated spasticity using at first an unique assessing protocol Five step clinical assessment and consequently a surface electromyography. Based on this examination, each participant was instructed to follow...

Title: Measurement of lower extremities spasticity in patients with cerebral palsy Objectives: The aim of the theoretical part of this thesis is to evaluate possibilities of lower extremities spasticity measurement in adult patients with cerebral palsy. The main focus was given to the concept of French professor J.-M. Gracies: Five-step clinical assessment in spastic paresis. This unique concept presents differentiation of three main factors of motor impairment that emerge as a result of a lesion to central motor pathways: stretch sensitive paresis, soft tissue contracture and muscle overactivity. Ability to distinguish these factors is crucial for specific treatment indication. Finding a correlation between the Five-step clinical assessment in spastic paresis and muscle activity in gait measured with sEMG was the main objective in the practical part of the thesis. Methodology: This thesis has a theoretical-empirical character. The theoretical part is in a form of a research on the topic of spasticity diagnosis, focused on cerebral palsy patients. The empirical part of the thesis has a form of pilot quantitative research, which was attended by 6 participants with cerebral palsy (4 men and 2 women; average age 29 years). There were 2 independent measurement made for each of them. Each measurement...

A large proportion of patients with central motoneuron lesions is at risk of spastic paresis and formation of contractures. One of the therapeutic techniques used in patients with spastic paresis is prolonged stretching. The theoretical part summarizes the knowledge regarding spastic paresis, its clinical evaluation, the development of contractures and therapeutic interventions, especially botulinum toxin (BTX) and stretching. The aim of this study was to compare the effectiveness of prolonged stretching on spastic muscle contracture before and after BTX application. In our retrospective comparative study there were included 30 patients divided into two groups. The first group consisted of 15 patients performing prolonged stretching of the m. rectus femoris (m. RF) for three months according to Guided Self-rehabilitation Contract of Professor J. M. Gracies. The second group (15 patients) performing the same procedure, but at the same time BTX was injected into the m. RF. We monitored the change in passive knee joint range of motion into flexion and the change in 10MWT time. Statistical evaluation showed that the difference in knee joint range of motion after three months of performing prolonged stretching was statistically insignificant (p=0.194). The difference in knee joint range of motion after...