The thesis topic is "The influence of the early therapy by reflex locomotion according to Vojta on children with brachial plexus palsy postpartum and its social impact from the perspective of their parents."The brachial plexus (BP) consists of nerve bundles based on radicular segments C5-Th1. Innervate muscles girdle blades, shoulder, arm and hand. When BP is damaged the mobility may be impaired (paresis to plegia of muscles), sensation (hypoesthesia to anesthesia, paresthesia, pain) and vegetative symptoms can appear (discoloration and skin temperature changes, changes in hair, nail brittleness). Types of BP palsy are classified according to clinical and anatomic course. Paresis of upper type (Erb-Duchene) is the most common and has the best prognosis, clinically manifest by the adduction and internal rotation of the upper limb, the elbow in extension, the wrist in flexion,the limb is poor, the gripping reflex present. During the paralysis of the lower type (Déjerine-Klumpke) the wrist flexion is not possible and the hand grip is poor or absent, and when there is a disruption of the cervical sympathetic the Horner's syndrome appears. An isolated paresis of the secondary trunk with disabilities muscles innervated n. Radialis is rare. During the complete lesion BP the whole limb is plegic with anesthesia all dermatomes excluding the inner arm. The complete lesion BP has the worst prognosis. BP perinatal injury arises in connection with childbirth. Despite the knowledge of risk factors we fail to prevent these injuries. With all children with postnatal paresis BP the initiation of conservative treatment is indicated, some children require neurosurgery. With some children a residual limb dysfunction remains after the treatment. Among the consequences we include permanent residual paresis, postural abnormalities, limb bone deformities, contractures of joints, shortened arm. Delays in mental development and cognitive impairment are related to motor disorders. The early and quality diagnosis and the immediate initiation of therapy is the prerequisite for successful treatment. The therapy should prevent the development of pathological patterns of movement and evoke and restore optimum momentum. The main aim is the restoration of innervation and hand function and the second one is the elbow flexion and the third is the arm abduction. Vojta method of reflex locomotion is one of the methods used for conservative treatment of peripheral paresis. In therapy, congenital partial patterns of forward movement global models, which is reflective crawling and reflective rotation, are activated. These patterns are inborn but with children with locomotor disorders these are blocked. By repeated targeted activation we can achieve the correct fixation of the correct models and thus enable their use in spontaneous motor fluctuations and pathological compensatory movements are displaced. Reflex locomotion favorably influences other functions such as posture and its management, neurological status, the development of mental and autonomic functions, and oculomotoric and disproportionate growth. The goal of the treatment is to reduce the disability degree and to minimize the future disability and handicap. Improving the quality of the child´s life leads to improvement of the life quality for the entire family. The theoretical part is devoted to BP palsy therapy and reflex locomotion according to Vojta. First, the function of peripheral nervous system is characterised, the other part is devoted to BP injury - mechanisms of injury, diagnosis, treatment options, BP perinatal injuries and rehabilitation of patients with spinal BP. The chapter dealing with Vojta describes the basic principles of Vojta method - reflexive crawling and reflexive rotation. The final chapter deals with the birth of a handicapped child, the need to support families and individuals affected especially in the psychological and sociological levels.
| Identifer | oai:union.ndltd.org:nusl.cz/oai:invenio.nusl.cz:200619 |
| Date | January 2015 |
| Creators | PLACHÁ, Milena |
| Source Sets | Czech ETDs |
| Language | Czech |
| Detected Language | English |
| Type | info:eu-repo/semantics/masterThesis |
| Rights | info:eu-repo/semantics/restrictedAccess |
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