PURPOSE: To assess motor performance among Czech paediatric off therapy patients of acute lymphoblastic leukaemia (ALL) and to compare their data with normative data. METHODS: Thirty-nine off therapy patients (21 girls, 18 boys; aged 4-21 years) were evaluated using the Complete Form of the Bruininks-Oseretsky Test Second Edition (BOT-2 CF) approximately 1.5 years post-therapy cessation. Gross and fine motor skills were assessed. Normative data from BOT-2 CF served as the basis for comparison. RESULTS: The total motor composite (p = .381, Cohen's d = 0.14) and overall fine (p = .743; Cohen's d = 0.05) and gross (p=.312; Cohen's d = 0.16) motor performance were similar to the normative data. Motor deficits in manual coordination (p = .018; Cohen's d = 0.45), strength and agility (p = .012; Cohen's d = 0.51), manual dexterity (p < .001; Cohen's d = 0.59) and running speed and agility (p < .001; Cohen's d = 0.97) were identified, along with performance better than the established norms on fine motor integration (p = .048; Cohen's d = 0.33) and bilateral coordination (p = .018; Cohen's d = 0.47). CONCLUSION: The findings suggest nuanced motor skill outcomes in ALL off therapy patients, with both deficits and strengths observed. Comprehensive assessments are vital for tailoring rehabilitation strategies to address the varied impacts of ALL and its treatment on motor skills.

• MeSH
• Precursor Cell Lymphoblastic Leukemia-Lymphoma * drug therapy   physiopathology   MeSH
• Child MeSH
• Humans MeSH
• Adolescent MeSH
• Young Adult MeSH
• Motor Skills * MeSH
• Child, Preschool MeSH
• Check Tag
• Child MeSH
• Humans MeSH
• Adolescent MeSH
• Young Adult MeSH
• Male MeSH
• Child, Preschool MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Geographicals
• Czech Republic MeSH

Pronator teres syndrome is characterized by compression of the median nerve, leading to dysfunction of the affected limb. Median nerve entrapment causes paresthesia, changes in sensitivity, and loss of strength in the fingers, in addition to causing loss of hand dexterity. The diagnosis of pronator teres syndrome is complicated, due to its similarity with other neuropathies of the median nerve. So, it is important to emphasize the need for a physical examination together with imaging tests, especially ultrasound, for its correct diagnosis. We report the case of a 28-year-old woman who complained of tingling for ten years in the proximal third of the left forearm at rest that worsens on exertion and weakness if not moving. On physical examination, she has no limitation of movement but refers to a feeling of weakness and numbness in his forearm. Ultrasonography demonstrates compression of the median nerve between the ulnar and humeral heads of the pronator teres muscle, a finding confirmed by magnetic resonance imaging and electroneuromyography. The patient was treated with physiotherapy presenting improvement of symptoms after 45 days.

• MeSH
• Arthrogryposis MeSH
• Adult MeSH
• Electromyography methods   MeSH
• Hereditary Sensory and Motor Neuropathy MeSH
• Humans MeSH
• Magnetic Resonance Imaging * methods   MeSH
• Median Neuropathy diagnosis   MeSH
• Forearm MeSH
• Ultrasonography methods   MeSH
• Nerve Compression Syndromes diagnosis   physiopathology   MeSH
• Check Tag
• Adult MeSH
• Humans MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Case Reports MeSH

BACKGROUND: Stroke often impairs upper extremity motor function, with recovery in the sub-acute phase being crucial for regaining independence. This study examines changes in isometric muscle strength, dexterity, and self-care independence during this period, and evaluates the effects of a comprehensive intensive rehabilitation (COMIRESTROKE). METHODS: Individuals in sub-acute stroke recovery and age- and sex-matched controls were assessed for pre- and post-rehabilitation differences in primary outcomes (grip/pinch strength, Nine Hole Peg Test [NHPT], Action Research Arm Test [ARAT]). COMIRESTROKE's effects on primary and secondary outcomes (National Institute of Health Stroke Scale [NIHSS], Modified Rankin Scale [MRS], Functional Independence Measure [FIM]) were evaluated. Outcomes were analyzed for dominant and non-dominant limbs, both regardless of impairment and with a focus on impaired limbs. RESULTS: Fifty-two individuals with stroke (NIHSS 7.51 ± 5.71, age 70.25 ± 12.66 years, 21.36 ± 12.06 days post-stroke) and forty-six controls participated. At baseline, individuals with stroke showed significantly lower strength (dominant grip, key pinch, tip-tip pinch, padj < 0.05), higher NHPT scores (padj < 0.05), and lower ARAT scores (padj < 0.001). COMIRESTROKE led to improvements in dominant key pinch, non-dominant tip-tip pinch, NHPT, and both dominant and non-dominant ARAT (padj < 0.05). Notably, non-dominant key pinch improved significantly when considering only impaired hands. Pre- and post-test differences between groups were significant only for ARAT (both limbs), even after adjustment (padj < 0.05). All secondary outcomes (NIHSS, MRS, FIM) showed significant improvement post-COMIRESTROKE (padj < 0.001). CONCLUSION: Individuals with stroke exhibit reduced muscle strength and dexterity, impairing independence. However, comprehensive intensive rehabilitation significantly improves these functions. Data are available from the corresponding author upon request and are part of a sub-study of NCT05323916.

• Publication type
• Journal Article MeSH

Publikace se zaměřuje na různé poruchy komunikační motoriky, na jejich testování a na jejich rehabilitaci. Určeno odborné veřejnosti.; V této knize jsou podrobněji rozebrány aspekty jemné a komunikační motoriky z pohledu léčebné rehabilitace. V úvodu jsou představeny základní typy jemné a komunikační motoriky, jejich fylogenetický a ontogenetický vývoj, kineziologické aspekty a řízení. Jsou zde představeny vybrané testy jemné a komunikační motoriky, často využívané v klinické praxi fyzioterapeutů a ergoterapeutů v České republice či ve výzkumu. Text je pro větší srozumitelnost a přehlednost doprovázen četnými příklady z praxe včetně fotografií a podrobným popisem a tabulkami.

• MeSH
• Physical Examination MeSH
• Motor Skills MeSH
• Musculoskeletal Manipulations MeSH
• Nonverbal Communication MeSH
• Motor Skills Disorders diagnosis   rehabilitation   MeSH
• Somatosensory Disorders diagnosis   rehabilitation   MeSH
• Publication type
• Monograph MeSH

• Conspectus
• Fyziologie člověka a srovnávací fyziologie
• NML Fields
• fyziologie
• rehabilitační a fyzikální medicína

INTRODUCTION: Surgical training traditionally adheres to the apprenticeship paradigm, potentially exposing trainees to an increased risk of complications stemming from their limited experience. To mitigate this risk, augmented and virtual reality have been considered, though their effectiveness is difficult to assess. RESEARCH QUESTION: The PASSION study seeks to investigate the improvement of manual dexterity following intensive training with neurosurgical simulators and to discern how surgeons' psychometric characteristics may influence their learning process and surgical performance. MATERIAL AND METHODS: Seventy-two residents were randomized into the simulation group (SG) and control group (CG). The course spanned five days, commencing with assessment of technical skills in basic procedures within a wet-lab setting on day 1. Over the subsequent core days, the SG engaged in simulated procedures, while the CG carried out routine activities in an OR. On day 5, all residents' technical competencies were evaluated. Psychometric measures of all participants were subjected to analysis. RESULTS: The SG demonstrated superior performance (p < 0.0001) in the brain tumour removal compared to the CG. Positive learning curves were evident in the SG across the three days of simulator-based training for all tumour removal tasks (all p-values <0.05). No significant differences were noted in other tasks, and no meaningful correlations were observed between performance and any psychometric parameters. DISCUSSION AND CONCLUSION: A brief and intensive training regimen utilizing 3D virtual reality simulators enhances residents' microsurgical proficiency in brain tumour removal models. Simulators emerge as a viable tool to expedite the learning curve of in-training neurosurgeons.

• Publication type
• Journal Article MeSH

BACKGROUND: There is growing evidence for the effectiveness of mirror therapy (MT) on pain reduction in patients with type I complex regional pain syndrome (CRPS I). AIM: To evaluate the efficacy of MT on pain reduction and hand function in subjects with unilateral upper extremity CRPS I. DESIGN: Randomized controlled trial with control group cross-over (half cross-over design). SETTING: Subjects with CRPS I were outpatients of a university hospital and cooperating centers. All patients carried out the daily exercise at home. POPULATION: Subjects with unilateral upper extremity CRPS I meeting the Budapest diagnostic criteria. METHODS: Subjects were randomly divided into two groups. Group A (N.=13) carried out a ten-minute MT exercise daily, for a total duration of six weeks. Group B (N.=14) acted as a control group for six weeks followed by six weeks of MT with the same characteristics as Group A. Upper extremity active range of motion, strength, dexterity, limb volume, affected-to-unaffected hand temperature difference, and health-related quality of life were evaluated before and after each period. Daily records on the visual analogue scale were used for pain evaluation. Effectiveness was calculated using mixed-effects modelling for between-group comparisons and within-group variability, and identification of significant predictors. RESULTS: Twenty-three females and four males with an average age of 56.1±9.6 years completed the study. Except for the affected-to-unaffected hand temperature difference, both groups consistently demonstrated significant or near-significant improvements in measured parameters after MT period. The improvements were evident upon an intergroup comparison of Group A and the control period of Group B as well as longitudinally within Group B. No significant improvement was found during the control period. CONCLUSIONS: Principles focused on mirror visual feedback to the central nervous system can sustain promising therapeutic potential as part of the treatment for pain reduction and hand function in CRPS I patients. CLINICAL REHABILITATION IMPACT: MT can be considered as part of the therapeutic regimen employed for the treatment of CRPS I.

• MeSH
• Pain MeSH
• Upper Extremity MeSH
• Complex Regional Pain Syndromes * therapy   MeSH
• Quality of Life MeSH
• Middle Aged MeSH
• Humans MeSH
• Aged MeSH
• Feedback, Sensory MeSH
• Reflex Sympathetic Dystrophy * therapy   MeSH
• Treatment Outcome MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Randomized Controlled Trial MeSH

This study aims to investigate sex-related differences in raw item scores on the Movement Assessment Battery for Children, 2nd Edition (MABC-2) in a large data set collected in different regions across the world, seeking to unravel whether there is an interaction effect between sex and the origin of the sample (European versus African). In this retrospective study, a secondary analysis was performed on anonymized data of 7654 children with a mean age of 8.6 (range 3 to 16; SD: 3.4), 50.0% of whom were boys. Since country-specific norms were not available for all samples, the raw scores per age band (AB) were used for analysis. Our results clearly show that in all age bands sex-related differences are present. In AB1 and AB2, girls score better on most manual dexterity and balance items, but not aiming and catching items, whereas in AB3 the differences seem to diminish. Especially in the European sample, girls outperform boys in manual dexterity and balance items, whereas in the African sample these differences are less marked. In conclusion, separate norms for boys and girls are needed in addition to separate norms for geographical regions.

• Publication type
• Journal Article MeSH

Cíl práce: Cílem našeho projektu bylo ověřit vliv sportovního aktivačního programu na následnou pohybovou aktivitu a duševní zdraví psychiatrických pacientů v ambulantní péči. Materiál a metoda: 19 pacientů s diagnózou schizofrenie (10 mužů, medián věku = 37, a 9 žen, medián věku = 52) a 9 pacientů s diagnózou bipolární porucha (5 mužů, medián věku = 36, a 4 ženy, medián věku = 59) v ambulantní péči se zúčastnilo prostředky výzkumu plně hrazeného 6denního aktivačního pobytu se 6 hodinami individuálně zvolené pohybové aktivity denně a motivačními pohovory a následně jim byly hrazeny 2 lekce vybraného sportu týdně po dobu 6 měsíců. Dalších 7 měsíců cvičili samostatně na vlastní náklady. Před začátkem programu, po 6denním pobytu, po 6 měsících a po 13 měsících byly sledovány následující proměnné: čas a frekvence lehké a těžké pohybové aktivity pomocí International Physical Activity Questionnaire, vnímaná tělesná vytrvalost, obratnost a síla na vlastní 10bodové škále, psychomotorické tempo pomocí testu Trail Making Test, míra úzkosti a deprese pomocí Hospital Anxiety and Depression Scale a aktuální funkční výkonnost pomocí Global Assessment of Functioning Scale. Výsledky: U pacientů s diagnózou schizofrenie pohybový program statisticky významně zvýšil frekvenci lehké pohybové aktivity u žen (p = 0,034, W = 0,455) , zvýšil vnímanou sílu (p < 0,001, W = 0,637) a vytrvalost (p = 0,034, W = 0, 287) u mužů a vnímanou obratnost (p = 0,002, W = 0,473) u žen. Zlepšil ukazatele psychomotorického tempa u mužů (p < 0,001, W = 0,843) i u žen (p = 0, 002, W = 0,766). U mužů došlo v průběhu programu k mírnému zvýšení úzkosti (p < 0,001, W = 0,818) a deprese (p < 0,001, W = 0,837), u žen ke změně nedošlo. Aktuální funkční výkonnost vzrostla z 60 na 75 bodů u mužů a z 60 na 80 u žen; 2 muži a 1 žena nadále pokračují v pravidelném cvičení. U pacientů s diagnózou bipolární porucha došlo u mužů k statisticky významnému zlepšení psychomotorického tempa (p = 0,027, W = 0,762) a mírnému snížení hladiny úzkosti (p = 0,045, W = 0,669). U obou pohlaví došlo ke zvýšení aktuální funkční výkonnosti u žen ze 70 na 80 bodů, u mužů z 50 na 70. Ostatní měřené proměnné se nezměnily. V pravidelné pohybové aktivitě pokračuje nadále 1 muž a 1 žena. Závěr: V průběhu účasti v aktivačním pohybovém programu došlo u pacientů k pozitivním změnám v oblasti psychomotorického tempa a funkční výkonnosti. Možným vysvětlením je zvýšení tělesného sebehodnocení a začlenění se do společnosti při pohybových aktivitách, což některým umožnilo nechat se zaměstnat, jiným častěji využívat podpůrné programy. Úzkostné a depresivní příznaky byly programem ovlivněny spíše situačně, celkově došlo pouze k mírnému posunu. Naše studie naznačuje, že psychiatričtí pacienti mohou být pravidelně fyzicky aktivní, pokud jim bude poskytnuta vhodná motivace a podpora, včetně finanční.

Objective: The goal of our project was to verify the effect of a sports activation program on the subsequent physical activity and mental health of psychiatric patients in outpatient care. Material and method: 19 patients with a diagnosis of schizophrenia (10 men, median age = 37, and 9 women, median age = 52) and 9 patients with a diagnosis of bipolar disorder (5 men, median age = 36, and 4 women, median age = 59) in outpatient care participated in the research. They took part in fully paid 6-day activation stay with 6 hours of individually chosen physical activity per day and motivational interviews. They attended 2 lessons (again fully paid from the study) of the chosen sport per week for subsequent 6 months. For the next 7 months, they practiced independently at their own expense. Before the start of the program, after a 6-day stay, after 6 months and after 13 months, the following variables were measured: time and frequency of light and heavy physical activity using the International Physical Activity Questionnaire, perceived physical endurance, agility and strength on 10-point scale, psychomotor pace using the Trail Making Test, the level of anxiety and depression using the Hospital Anxiety and Depression Scale and current functioning score using the Global Assessment of Functioning Scale. Results: In patients diagnosed with schizophrenia, the exercise program statistically significantly increased the frequency of light physical activity in women (p = 0.034, W = 0.455), increased perceived strength (p < 0.001, W = 0.637) and endurance (p = 0.034, W = 0.287) in men and perceived dexterity (p = 0.002, W = 0.473) in women. It improved psychomotor pace indicators in men (p < 0.001, W = 0.843) and in women (p = 0.002, W = 0.766). In men, anxiety (p < 0.001, W = 0.818) and depression (p < 0.001, W = 0.837) slightly increased, there was no change in women. Current functional performance increased from 60 to 75 points in men and from 60 to 80 in women; 2 men and 1 woman continue to exercise regularly. In men with a diagnosis of bipolar disorder, there was a statistically significant improvement in psychomotor pace (p = 0.027, W = 0.762) and a slight decrease in the level of anxiety (p = 0.045, W = 0.669). For both sexes, there was an increase in current functional performance for women from 70 to 80 points, for men from 50 to 70. The other measured variables did not change; 1 man and 1 woman continue to exercise regularly. Conclusion: During the participation in the activation movement program, the patients experienced positive changes in the area of psychomotor pace and functional performance. A possible explanation is an increase in body self-esteem and integration into society during physical activities, which enabled some to get employed, others to use support programs more often. Anxiety and depressive symptoms were affected by the program rather situationally, overall there was only a slight shift. Our study suggests that psychiatric patients can be physically active on a regular basis if given appropriate motivation and support, including financial support.

• MeSH
• Ambulatory Care MeSH
• Bipolar Disorder MeSH
• Diagnostic Self Evaluation MeSH
• Persons with Psychiatric Disorders * MeSH
• Mental Health MeSH
• Humans MeSH
• Motivation MeSH
• Motor Activity * MeSH
• Surveys and Questionnaires MeSH
• Schizophrenia MeSH
• Research Design MeSH
• Check Tag
• Humans MeSH

Spasticita je jedním z hlavních následků ischemické cévní mozkové příhody. Důsledkem ischemické léze descendentních motorických drah je syndrom horního motoneuronu, který zahrnuje jako negativní (slabost, ztráta jemné motoriky), tak pozitivní příznaky (zvláště spasticita). Těžká postiktální spasticita má za následek snížení kvality života, manuální dexterity, mobility, zhoršení chůze a pády a omezení činností denního života (ADL). Komplexní léčba postiktální spasticity obvykle zahrnuje fyzioterapeutické postupy a aplikaci botulotoxinu A, avšak mechanismy působení terapie spasticity nejsou zcela objasněny. Dostupná data, včetně námi získaných, nabízejí průkaz modulace centrálních senzorimotorických sítí během terapie postiktální spasticity, studie jsou však omezeny malou velikostí souborů, různým stupněm motorického deficitu a rozdílnou metodologií. V tomto projektu navrhujeme komplexní protokol studia centrálních senzorimotorických sítí u pacientů s postiktální spasticitou během cílené terapie. Nálezy mohou přispět k budoucí optimalizaci terapie spasticity.; Post-stroke spasticity (PSS) is one of the major sequelae following ischemic stroke. Ischemic lesions of descending motor tracts result in upper motor neuron syndrome comprising both negative signs (weakness and loss of dexterity) and positive signs (especially spasticity). Disabling PSS affects patient quality of life; causes significant reductions in manual dexterity, mobility, walking/falling, and performance of activities of daily living (ADL) have been reported among patients with PSS. Comprehensive treatment of PSS usually includes physiotherapy procedures and botulinum toxin A application, however, the therapeutic mechanisms are only incompletely understood. Available data, including our own, provide evidence of modulation in central sensorimotor networks during PSS therapy, however, the studies are limited by small samples, different degree of motor deficits and different methodology. We propose a new comprehensive protocol to study central sensorimotor networks in patients with PSS during focused therapy. The findings may inform future optimization of PSS therapy.

• MeSH
• Stroke complications   MeSH
• Molecular Targeted Therapy MeSH
• Magnetic Resonance Imaging MeSH
• Neuronal Plasticity MeSH
• Stroke Rehabilitation MeSH
• Muscle Spasticity etiology   therapy   MeSH

• Conspectus
• Patologie. Klinická medicína
• NML Fields
• neurologie
• rehabilitační a fyzikální medicína
• NML Publication type
• závěrečné zprávy o řešení grantu AZV MZ ČR

The development of new endoscopic methods is advancing rapidly. Current standard methods such as endoscopic balloon dilatation have only limited long-term effects. Surgery is more effective, but it also carries a higher risk of complications. Endoscopic stricturotomy and stricturoplasty are new methods expanding the range of possibilities of endoscopic treatment. These methods are advanced, technically demanding, and require adequate expertise and training. It is, therefore, necessary to have a tool for training and teaching these new methods. The live large animal model is a valuable tool in the development and testing of new, difficult, and dexterity intensive therapeutic methods thanks to its natural properties including bowel movements and tissue reactions such as swelling or bleeding. Animal model simulating secondary stricture in the site of the entero-colonic anastomosis has been created allowing not only to practice but also to develop new minimally invasive endoscopic techniques for the treatment of strictures in Crohn's disease (CD). High cost and stringent legislation represent the main limitations of more widespread use of large animal models in endoscopy.

• MeSH
• Crohn Disease * complications   surgery   MeSH
• Dilatation methods   MeSH
• Endoscopy, Gastrointestinal methods   MeSH
• Humans MeSH
• Swine MeSH
• Retrospective Studies MeSH
• Constriction, Pathologic etiology   surgery   MeSH
• Treatment Outcome MeSH
• Animals MeSH
• Check Tag
• Humans MeSH
• Animals MeSH
• Publication type
• Journal Article MeSH
• Review MeSH