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: Two case studies were orchestrated, both of probands diagnosed with spastic paraplegia due to an incomplete spinal cord lesion. Both probands did undergo a therapeutic programme in virtual reality, where each intervention consisted of 30 minutes in said programme. Interventions were organised in 10 consecutive days in the case of the first proband and 5 consecutive days in the case of the second. The levels of spasticity before and after each intervention were taken into account and evaluated by a modified Tardieu scale on plantar flexors of both ankle 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 = unbearable spasticity sensations). This evaluation took place before and after each individual intervention. Results: Seven hypotheses were defined in...

1 Abstract Electrical stimulation by coupled impulses according to Hufschmidt was created with the primary goal of reducing spasticity. However, there are currently few studies that confirm or refute the effect of this type of electrical stimulation in reducing spasticity. The aim of this diploma thesis was to determine the effect of electrostimulation according to Hufschmidt on the reduction of biceps brachii spasticity in patients after stroke. In addition, the effect of electrical stimulation on increasing the active range of movement of the antagonist of the examined muscle and on the active function of the spastic limb was investigated. For these purposes, a non-randomized controlled pilot study was created, which involved a total of 16 probands, 8 - in the therapeutic group, 8 - in the control group. Five-step clinical assessment in spastic paresis according to Gracies were used for the examination. In the therapeutic group, electrostimulation took place 3 times a week, a total of 8 times. The intragroup difference was evaluated using the Friedman and Wilcoxon paired tests, the intergroup difference was subsequently evaluated using the Mann-Whitney U test. The significance level p = 0.05 applies to all tests. The measured values show that Hufschmidt's electrical stimulation has a positive effect on...

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...

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)

Title: Starts of sprint disciplines performed by spastic athlete and particularities of the training process Aim of work: The aim of this work was analyzing of the specifics of athletic training determined for spastic sprinter class T38 and observation of the long term effect. Methods: This work presents an empiric-theoretical study. Due to the uniqueness of the theme, method of case study has been chosen (intra-individual observation). This method was applied on the particular spastic sprinter by using longitudinal quantitative observation during her top sport career and applying one-off analysis focused on evaluation of different types of starts. This observation had qualitative and quantitative part. The quantitative part was based on the interpretation of 2D video comparing three types of start (low start, mid-low start and low start with a diagonal arm position) with the optimal start position described in the books. Comparison of average time for 10 metre distance was determined as quantitative element. . The observational group consists of the sprinter with Cerebral Palsy at Czech representative level. Results: Our research resulted as follows: The mid-low start was assessed as the best one for the examined sprinter from the quality of start position point of view including the three...

Hipotherapy is a complex therapy, broaden and recently very sought after rehabilitation method, which is being more and more recognized by experts for its broaden scene. It is a complex therapy thanks to involving medicine, psychology, pedagogy and also a social sphere. That's why is this method indicated at many different levels of disablement. It's being used with pacients with children's cerebral palsy, diverse level of cerebral dysfunction and multiple sclerosis. And it's the therapy's effect on multiple sclerosis that this thesis paper discusses. It also applies to brain and spinal traumas, scoliosis, back pain, orthopedic defects, cardiovascular disease, degenerative muscle disease, obesity, as well as it provides help at emotional and mental aspect, e.g. children with behavioral disorders and many others. At hipotherapy is being used a three dimensional (multidimensional) horse motion. Horse's spine moves up - down, forward - backward, right - left. Imitating a mechanisms of human walking, which leads to relaxation of spasticity. Impulses are transmitted onto back which brings interaction of impeller and back muscles, stand up pose, and posture interference. All this brings a walking improvements, movements coordination, balance and consolidation of a flabby muscles. Each horse has a different nature...

Hipotherapy is a complex therapy, broaden and recently very sought after rehabilitation method, which is being more and more recognized by experts for its broaden scene. It is a complex therapy thanks to involving medicine, psychology, pedagogy and also a social sphere. That's why is this method indicated at many different levels of disablement. It's being used with pacients with children's cerebral palsy, diverse level of cerebral dysfunction and multiple sclerosis. And it's the therapy's effect on multiple sclerosis that this thesis paper discusses. It also applies to brain and spinal traumas, scoliosis, back pain, orthopedic defects, cardiovascular disease, degenerative muscle disease, obesity, as well as it provides help at emotional and mental aspect, e.g. children with behavioral disorders and many others. At hipotherapy is being used a three dimensional (multidimensional) horse motion. Horse's spine moves up - down, forward - backward, right - left. Imitating a mechanisms of human walking, which leads to relaxation of spasticity. Impulses are transmitted onto back which brings interaction of impeller and back muscles, stand up pose, and posture interference. All this brings a walking improvements, movements coordination, balance and consolidation of a flabby muscles. Each horse has a different nature...

Title: Starts of sprint disciplines performed by spastic athlete and particularities of the training process Aim of work: The aim of this work was analyzing of the specifics of athletic training determined for spastic sprinter class T38 and observation of the long term effect. Methods: This work presents an empiric-theoretical study. Due to the uniqueness of the theme, method of case study has been chosen (intra-individual observation). This method was applied on the particular spastic sprinter by using longitudinal quantitative observation during her top sport career and applying one-off analysis focused on evaluation of different types of starts. This observation had qualitative and quantitative part. The quantitative part was based on the interpretation of 2D video comparing three types of start (low start, mid-low start and low start with a diagonal arm position) with the optimal start position described in the books. Comparison of average time for 10 metre distance was determined as quantitative element. . The observational group consists of the sprinter with Cerebral Palsy at Czech representative level. Results: Our research resulted as follows: The mid-low start was assessed as the best one for the examined sprinter from the quality of start position point of view including the three...

The aim of the thesis was to assess a construct validity of "Muscle Excitability Scale" in assessment of spasticity in patients with spinal cord injury. The correlation between this scale and other clinical tests evaluating various aspects of spasticity was investigated. 48 participants with symptoms of a spasticity were included in the study. The Spearman rank correlation coefficient was used for quantification of correlation between each two tests. The most significant correlation was found between the Muscle Excitability Scale and the Modified Ashworth Scale (rs=0,26 - 0,35, p<0,05). Less significant correlation was found in comparison with the Clonus Scale (rs=0,27, p<0,05) and with the SCI-SET (rs=0,25 - 0,26, p<0,05). There was no correlation between the Muscle Excitability Scale and the Penn Spasm Frequency Scale. Additionally every test was compared to each other and then the outcomes was discussed and compared to results of other similar studies. Keywords Muscle Excitability Scale, validity, spasticity, spinal cord injury, Modified Ashworth Scale, Penn Spasm Frequency Scale, Clonus Scale, SCI-SET