This study deals with the effects of botulinum toxin A treatment on pathological muscular hyperactivity in a group of 53 children. The thesis objective was to evaluat eeffect of botulinum toxin on muscle tone, range of movement and motor performance of the patient. The theoretical part summarizes the knowledge about this theme, characterizes the term spasticity and an impact of botulinum toxin on abnormal muscular hyperactivity. The practical part evaluates the effect of botulinum toxin in two groups of patients. The first group consists of 14 children, who were tested before and at least one month after botulinum toxin application. Clinical assessment involved range of movement measurement, the evaluation of spasticity with Modified Ashworth scale, Global Assesment of Spasticity Scale (GSA), assessment of motor performance with the use of GMFM test and Functional Independence Meassure for children WeeFIM and summarized physical therapeutic methods used in treatment of patients before and after the application. The second group consists of 39 patients who administered the GSA survey forms within a period of one month. The results confirmed positive effect of botulinum toxin treatment on reduction of spasticity, increasing of range of movement and improvement of motor performance of children. Powered by...

This study has brought an overview of botulinum toxin and its influence on the human muscles, especially on spastic muscles. In the practical part is resumed experience with botulinum toxin A therapy in children with cerebral palsy. There were observed two groups. Group A (n=9) was measured before and after therapy. Patients in group B (n=24) filled out a table of the global spasticity scale, which they returned by mail. All the patients improved after the treatment. Powered by TCPDF (www.tcpdf.org)

Title: Evaluation of sensation in hands area in patients with multiple sclerosis Objective: Summarize findings about multiple sclerosis and sensation in the hands area. Find suitable testing methods and use them to evaluate the quality of deep sensation in the hands area in patients with multiple sclerosis. Method: With help of selected tests to evaluate the quality of deep sensation in the fingers and palms area in selected probands with multiple sclerosis. Compare the results depending on the current spasticity and condition of the patient. Results: There were founded, that in people with multiple sclerosis the quality of vibrating and discriminating sensation and stereognosis in the hands area is reduced. The quality of statesthesia, kinesthesia, vibrating and discriminating sensation isn't directly linearly dependent on the current spasticity. The quality of stereognosis is directly linearly dependent on the current spasticity. Keywords: sensation, multiple sclerosis, spasticity

Title: The influence of a passive rehabilitation on spasticity in multiple sclerosis Objectives: The main objective is to summarize the current knowledge about multiple sclerosis and the possibilities of influencing the spasticity as a serious symptom. Another objective is to verify the effectiveness of the antispastic passive rehabilitation of the lower limbs of selected patient in practice. Methods: Verification of the effectiveness of the system of antispastic passive rehabilitation of the lower limbs was through a qualitative research. For the work design is used the type of qualitative experiment. The research sample is a person with spasticity in the lower limbs. In the first two parts of the work was used an analysis of scientific literature and a content analysis. The strategy of data obtaining is also in the form of observation, interviewing, measuring, scale and variety. A medical documentation, anamnesis, casuistry and a secondary analysis were used. Results: Individual use of each method resulted in the influence of spasticity only for a short time. Mobility was affected in the sense of passive movement the most after the soft techniques and massage therapy. The most striking results were achieved after the use of all methods when the spasticity was positively influenced in accordance...

Author's first name and surname: Michaela Opálková Title of the master thesis: Evaluation of selective voluntary muscle control in children with spastic cerebral palsy. Impact on the severity of spasticity and gross motor function level. Department: Department of rehabilitation and sports medicine, Charles University in Prague, 2nd Faculty of Medicine Supervisor: doc. PaedDr. Pavel Kolář, PhD. The year of presentation: 2012 Abstract: This thesis should provide comprehensive information about pathophysiological mechanisms underlying spasticity and spastic movement disorder with special attention to children with cerebral palsy. Spasticity and selective voluntary motor control assessment possibilities will be summarized. Classification systems of the gross motor functions (levels of locomotion) are also mentioned. The main objective is to elaborate selective motor control ability scale (IP) which is newly proposed in this study. The need for such instrument and its feasibility for clinical practice intend to be confirmed. The level of locomotion of 25 children with spastic cerebral palsy is compared with IP outputs, spasticity measurement outputs using Ashworth scale respectively. Keywords: spasticity, selective voluntary motor control, locomotion, scale

The aim of this master thesis is to evaluate the effect of selective dorsal rhizotomy (SDR) on gross motor functions in children with spastic cerebral palsy with Gross Motor Function Measure (GMFM). I had also collected knowlegdes about SDR and GMFM. I investigated four children undergoing selective dorsal rhizotomy in the Czech republic and I took data from 16 foreign studies to discuss it and to compare the results and conclusions. I tried to identify the factors responsible for different outcomes of the studies. Powered by TCPDF (www.tcpdf.org)

The electrical stimulation (ES) according to Jantsch was created with a primary aim to reduce spasticity, however its impact has been neither proved nor disproved by any study. Therefore, the aim of the thesis is to find out if this type of the ES can reduce spasticity of m. triceps surae within the patients with multiple sclerosis (MS). Apart from the spasticity, there was as well observed the influence of the ES on an active movement performed by the antagonists of spastic muscle and the walking speed. Fifteen probands participated in our pilot controlled non- randomized study, probands were divided into two groups - first with the application of the ES (STIM) and second without the application of the ES (NOSTIM) during the hospitalization. We used the concept of Jean-Michel Graciese - Five-step clinical assessment in spastic paresis during the examination process. From this protocol, we choose Tardieu scale to measure spasticity, examination to measure active range of motion and 10MWT. Furthermore, TUG was added. The measurements took place on the 1st, 4th and 8th day of the hospitalization. The intragroup difference was evaluated by the ANOVA for repetitive measures with Fisher's post- hoc test and the level of importance p=0.05. From acquired data it follows that the ES according to Jantsch...

This Master's thesis focuses on Occupational therapy for patients after application of botulinum toxin to upper limb. The aim of the thesis was to evaluate and compare a progress of functional independence in patients after acquired brain injury. There were twenty patients involved in the research, who were further divided into two groups and separated by ten people in each group. Both groups underwent the application of botulinum toxin whereas the experimental group A went through the occupational therapy. The control group had ordinary rehabilitation at home and without any occupational intervention for the duration of twelve week under guided self-rehabilitation contract of spastic paresis, so-called GSC. A programme of the group A included over the counter rehabilitation outpatient occupational therapy. The patients attended the course twice a week for the duration of four weeks. Afterwards, they received a home programme for the duration of eight weeks, during which they had two examinations at occupational therapy. All the participants were evaluated by Global Subjective Self-Assessment which is focused on spasticity. There were further evaluated according to Functional Independece Measure and modified Frenchay Arm Test. The experimental group with outpatient occupational therapy was...

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...

Title: Evaluation of the spasticity level in wheelchair bound individuals, observing movement in a virtual reality environment Objective: Investigate whether people watching movement in virtual reality, experience changes in the level of spasticity due to intervention of the therapeutic programme. Methods: A pilot study was orchestrated with probands diagnosed with spastic paraplegia due to an incomplete spinal cord lesion. Seven probands have partaken in the study (5 men and 2 women) aged 49 ± 8 years. All probands were clients of Centrum Paraple, where they have been undergoing a regular rehabilitation programme. In addition to their regular programme they have undergone a virtual reality therapeutic programme, where each intervention consisted of 10 minutes spent in a therapeutic virtual environment. 3 probands resigned after the first intervention. Interventions were organized into 5 consecutive days. The levels of spasticity were evaluated by a modified Tardieu scale on plantar flexors of both ankles and knee joints of both lower limbs. Furthermore, a modified, subjective spasticity scale was created in order to observe individual, subjective inputs of each proband. Using this scale, probands evaluated their feelings towards individual spasticity changes on a scale 1-10 (0 = no spasticity, 10...