Úvod: Pacienti po mozkových příhodách se potýkají s poruchami motoriky a jejího řízení. Jejich důsledkem dochází k omezení funkce a soběstačnosti a ke snížení kvality života. Náš výzkum ukazuje na využití zařízení Armeo Spring k hodnocení kvality pohybu. Posuzuje její souvislost s funkcí horní končetiny (HK) a s kvalitou života spojenou se zdravím (HRQoL). Cílem pilotní studie bylo zhodnocení vlivu terapie Armeo Spring na kvalitu pohybu HK, její funkci a změnu kvality života pacientů po absolvování lůžkové rehabilitace. Metodika: Prospektivní randomizovaná studie probíhala na lůžkové stanici KRTL FN Ostrava v dubnu až září 2022. Intervenční skupinu (IG) tvořilo šest osob (čtyři muži, dvě ženy, průměrný věk 67,33 ± 13,25 let), kontrolní skupinu (CG) tvořilo šest osob (čtyři ženy a dva muži, průměrný věk 65,33 ± 13,38 let). Hodnocení zahrnovalo dotazník kvality života EuroQoL EQ-5D-5L, kineziologický rozbor, hodnocení AGOAL (angl., česky Cíl A) na Armeo Spring, testování pomocí modifikovaného Frenchayského testu paže a soběstačnosti podle Barthelové. Doba denní terapie byla 120 minut, CG absolvovala 120 minut konvenční fyzioterapie a ergoterapie denně. IG pak 30 minut denně na Armeo Spring a 90 minut konvenční terapie po iktu. Celkový počet terapeutických sezení byl 10 až 12 po dobu 3 týdnů. Výsledky: IG dosáhla vyššího skóre ve třech z celkem čtyř sledovaných domén. U HRQoL jsme sledovali proměnnou EQ-5D index, kde dosáhla statisticky významného rozdílu IG. V rámci hodnocení parametrem HPR dosáhli probandi z IG většího zlepšení, které však není statisticky významné z důvodu malého počtu probandů. V hodnocení Modifikovaným Frenchayským testem paže pacienti v IG dosáhli statisticky významného rozdílu skóre. V Základním testu ADL podle Barthelové došlo ke statisticky významnému zlepšení u IG. Závěr: Funkční trénink na exoskeletu s antigravitační podporou HK vede k signifikantnímu zlepšení funkce končetiny a HRQoL Došlo i ke zvýšení přesnosti pohybu HK, přestože tento rozdíl nebyl statisticky signifikantní. Studie je východiskem pro další výzkum, který by měl pracovat s vyšším počtem probandů a podrobněji prozkoumat domény kvality života specifické pro populaci po iktu.
Background: Stroke patients are facing motor impairments which result in limited function, disability and decrease of the healthrelated quality of life (HRQoL). We introduce the use of Armeo Spring device as an assessment tool for movement quality. The aim of our pilot study was to assess the impact of Armeo Spring training on quality of upper limb (UL) movement and its linkage to HRQoL changes in stroke patients after rehabilitation. Methodology: Prospective randomized trial took place at the Department of Rehabilitation and Sports Medicine at University Hospital in Ostrava from April to September 2022. Intervention group (IG) consisted of six people (2 females, 4 males, mean age 67,33 ± 13,25 years), control group (CG) consisted of six people (4 females, 2 males, mean age 65,33 ± 13,38 years). Assessments were comprised of EQ-5D-5L quality of life questionnaire, kinesiological assessment, AGOAL assessment on Armeo Spring device, modified Frenchay Arm Test, Barthel Index (activities of daily living). The average duration of therapy was 120 minutes daily (CG 120 min conventional treatment), (IG 30 min Armeo Spring + 90 min conventional treatment). The total sum of therapeutic sessions was 10 to 12 during 3 weeks. Results: IG reached significantly higher scores in 3 of total 4 variables. Health-related quality of life was measured by EQ-5D-5L system. IG obtained significantly higher score in EQ-5D index. In the AGOAL assessment, participants from IG performed larger improvement, although the difference was not statistically significant due to small number of participants. In the Modified Frenchay Arm Test and in the Barthel Index participants in the IG showed significantly higher progress. Conclusion: The functional task-oriented training with anti-gravitational support led to significant improvement in UL function and perceived HRQoL. Progress in movement accuracy was higher in the IG, although it was not statistically significant. These outcomes of our pilot study form the base and implications for our future research which should work with larger sample and focus more profoundly on specific HRQoL domains in population of stroke survivors.
Přehledový článek shrnuje nejaktuálnější poznatky o vztahu mezi pohybovou aktivitou, kvalitou života a psychickými obtížemi u pacientů s roztroušenou sklerózou. Cílem je upozornit na negativní vlivy, které ovlivňují kvalitu života s roztroušenou sklerózou, jejich vzájemnou provázanost a možnosti jejich ovlivnění. Zároveň popisuje možnosti pohybových aktivit aerobním, anaerobním tréninkem a fyzioterapií, jejich přínos, vyváženost a omezení. Vztah mezi únavou a depresemi způsobeného samotnou podstatou nemoci jako i vedlejšími účinky farmakologické léčby.
This review article summarizes the most recent findings on the relationship between physical activity, quality of life and psychological difficulties in patients with multiple sclerosis. The aim is to highlight the negative influences that affect the quality of life with multiple sclerosis, their interdependence and the possibilities to influence them. It also describes the possibilities of physical activities by aerobic, anaerobic training and physiotherapy, their benefits, balance and limitations. The relationship between fatigue and depression caused by the very nature of the disease as well as the side effects of pharmacological treatment.
- MeSH
- deprese patologie terapie MeSH
- kvalita života MeSH
- lidé MeSH
- pohybová aktivita * MeSH
- roztroušená skleróza * psychologie rehabilitace MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
Background and Objectives: The consequences of stroke have a significant impact on self-sufficiency and health-related quality of life (HRQoL). Virtual reality (VR)-based rehabilitation has the potential to impact these modalities, but information on timing, volume, and intensity is not yet available. The aim of this randomized controlled trial (1:1) was to evaluate the impact of conventional rehabilitation combined with VR on self-care and domains of HRQoL in patients ≤6 months post-stroke. Materials and Methods: The intervention group completed a total of 270 min of conventional VR + rehabilitation sessions. The control group underwent conventional rehabilitation only. Primary assessments with the WHO disability assessment schedule 2.0 (WHODAS 2) questionnaire were conducted before rehabilitation (T0), after completion of the intervention (T1), and at the 4-week follow-up (T2); secondary outcomes included self-sufficiency and balance assessments. Results: Fifty patients completed the study (mean age 61.2 ± 9.0 years, time since stroke 114.3 ± 39.4 days). There were no statistically significant differences between the groups in WHODAS 2, self-sufficiency, and balance scores (p > 0.05). Conclusions: In the experimental group, there was a statistically significant difference in WHODAS 2, assessment of self-sufficiency, and balance scores before and after therapy (p < 0.05). VR appears to be a suitable tool to supplement and modify rehabilitation in patients after stroke.
- MeSH
- cévní mozková příhoda * komplikace terapie MeSH
- kvalita života MeSH
- lidé středního věku MeSH
- lidé MeSH
- pacienti MeSH
- péče o sebe MeSH
- potravní doplňky MeSH
- senioři MeSH
- terapie pomocí virtuální reality * MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- senioři MeSH
- Publikační typ
- časopisecké články MeSH
- randomizované kontrolované studie MeSH
Výskyt bolestí zad u dětí je méně častý než u dospělých, novější literární odkazy poukazují na relativně vysokou incidenci s tím, že jen část pacientů vyhledá lékařskou péči. Alarmující jsou zjištění, že incidence bolestí zad především v bederní oblasti je na vzestupu. Většinu případů bolesti zad dětí řadíme do skupiny tzv. funkčních bolestí, kdy za příčinou obtíží nestojí příčiny organické, ale většinou svalové dysbalance a dlouhodobé přetěžování. Příčinou těchto stavů je především špatný životní styl. Neřešení příčin potíží u této kategorie dětských pacientů představuje riziko zhoršení problémů v dospělém věku.
The occurrence of back pain in children is less frequent than in adults, newer literature references point to a relatively high incidence, with only a part of patients seeking medical care. Alarming are the findings that the incidence of back pain, especially in the lumbar region, is on the rise. Most cases of children's back pain are classified as functional pain, when the cause of the problem is not organic, but mostly muscle imbalance and long-term overuse. The cause of these conditions is primarily a bad lifestyle. Failure to address the causes of problems in this category of pediatric patients poses a risk of worsening problems in adulthood.
- Publikační typ
- abstrakt z konference MeSH
In this retrospective study, we used data from the hospital information system (HIS) to evaluate the influence of the COVID-19 pandemic on rehabilitation care at the University Hospital of Ostrava (UHO). From March 2020 to December 2021, 5173 COVID-19 cases were hospitalized at UHO. Cases within individual groups and categories are shown in a flowchart. The average patient age was 64.9 ± 16.9 years. The mean BMI value was 30.6 ± 6.8 in the rehabilitated group, which was significantly higher compared to that among the non-rehabilitated cases 29.1 ± 6.9 (p < 0.001). Among the admitted patients, 16.6% required artificial pulmonary ventilation (APV), 1.8% extracorporeal membrane oxygenation (ECMO), and 11.9% high-flow oxygenation (HF). The days of rehabilitation ranged from 1-102 days. Among all rehabilitated patients, 92.0% (n = 1302) had a hospitalization duration ranging from 1-15 days and 8.0% (n = 114) longer than 15 days. Overall, rehabilitation care plays an important role in providing exercise, mobilization, and rehabilitation interventions to survivors of critical illness associated with COVID-19, enabling the early and functional return to home, and it must, therefore, be integrated into the clinical care of patients with COVID-19.
- Publikační typ
- časopisecké články MeSH
OBJECTIVES: In 2020, measures against the spread of COVID-19 were adopted, including nationwide school closures, restrictions on the free movement of persons and leisure time sports activities. The aim was to assess the impact of COVID-19-associated restrictions on the performance of paediatric and adolescent competitive athletes by comparing basic anthropometric and performance parameters. METHODS: The sample comprised 389 participants (115 girls, 274 boys). All participants were examined during regular preventive sports health checks from September to November 2019 and a year later. At the initial examination, the mean age of the entire sample was 12.2 ± 2.7 years (median 12.0, minimum 7.0; maximum 17.0). The examination consisted of a complete medical history and physical examination including maximal exercise testing on a leg cycle ergometer. RESULTS: In the entire sample, as well as in the boy and girl subgroups, body height, weight, body mass index (BMI), BMI percentile, and power output significantly increased according to a percentile graph for boys and girls in 2020. A reduction in power output (W/kg) was found. By 2020, W/kg dropped in 56.4% of the youngest participants (7-13 years), 75% of those aged 14-16 years and 64.9% of the oldest individuals (16-17 years). The percentage of the youngest children with power output reductions was statistically significantly lower than the percentages of the other age subgroups (p = 0.007). There were no significant differences in results between genders. CONCLUSIONS: Performance and anthropometric parameters worsened especially among older children. This should be reflected when planning epidemic measures in case of any similar situation in the future.
- MeSH
- antropometrie metody MeSH
- COVID-19 * epidemiologie MeSH
- dítě MeSH
- index tělesné hmotnosti MeSH
- lidé MeSH
- mladiství MeSH
- pandemie * MeSH
- sportovci MeSH
- Check Tag
- dítě MeSH
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH
- MeSH
- diabetes mellitus prevence a kontrola rehabilitace MeSH
- kardiovaskulární nemoci MeSH
- kardiovaskulární rehabilitace MeSH
- lidé MeSH
- multimorbidita MeSH
- nemoci dýchací soustavy rehabilitace MeSH
- nemoci ledvin prevence a kontrola rehabilitace MeSH
- nemoci nervového systému rehabilitace MeSH
- neurorehabilitace MeSH
- osteoporóza rehabilitace MeSH
- pohybová aktivita MeSH
- rehabilitace * metody MeSH
- tělesná výkonnost MeSH
- terapie cvičením metody MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
INTRODUCTION: Insulin resistance (IR), a key pathogenesis mechanism of metabolic disorders, can be tested using homeostatic model assessment (HOMA). HOMA-IR quantifies peripheral tissue IR, whereas HOMA-β determines insulin secretion. The cross-sectional study aimed to examine non-linear associations of HOMA indices with age when adjusting for body mass index (BMI), and thus to investigate the indices' ability to reflect the real development of glucose metabolism disorders over time. MATERIAL AND METHODS: The sample comprised 3406 individuals without diabetes mellitus (DM) divided into those with normal glucose metabolism (NGT, n = 1947) and prediabetes (n = 1459) after undergoing biochemical analyses. Polynomial multiple multivariate regression was applied to objectify associations of HOMA with both age and BMI. RESULTS: Mean values of HOMA-IR and HOMA-β in individuals with NGT were 1.5 and 82.8, respectively, while in prediabetics they were 2.2 and 74.3, respectively. The regression proved an inverse non-linear dependence of pancreatic b dysfunction, expressed by HOMA-β, on age, but did not prove a dependence on age for HOMA-IR. Both indices were positively, statistically significantly related to BMI, with a unit increase in BMI representing an increase in HOMA-IR by 0.1 and in HOMA-β by 3.2. CONCLUSIONS: The mean values of HOMA indices showed that, compared with NGT, prediabetes is associated with more developed IR but lower insulin secretion. Both HOMA-IR and HOMA-b are predicted by BMI, but only HOMA-β is predicted by age. HOMA indices can reflect non-linear, closer-to-reality dependencies on age, which in many epidemiological studies are simplified to linear ones. The assessment of glucose metabolism using HOMA indices is beneficial for the primary prevention of IR and thus DM.
- MeSH
- glukosa MeSH
- homeostáza MeSH
- index tělesné hmotnosti MeSH
- inzulinová rezistence * MeSH
- lidé MeSH
- prediabetes * metabolismus MeSH
- průřezové studie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
