The journal "Rehabilitace a fyzikální lékařství" focuses on presenting results of research studies and theoretical studies from the field of rehabilitation and physical medicine. The scope of the journal covers topics related to diagnostics, therapy, biomechanics, exercise physiology, public health, etc. The journal also welcomes submissions that present results of interdisciplinary research.
Směrem k národní síti respirační fyzioterapie: celonárodní průřezové dotazníkové šetření
Objective: This cross-sectional survey aimed to map the current practice of respiratory physiotherapy (RPT) in the Czech Republic, identify key barriers and facilitators to RFT delivery, and assess interest in establishing a network of trained respiratory physiotherapists. Methods: A questionnaire (12 closed and 2 open-ended questions) was distributed via REDCap (June–July 2025) using a snowball sampling method. Eligible respondents were physiotherapists with any postgraduate training and active use of RPT. Descriptive statistics, Pearson’s χ² test with Cramer’s V, and Spearman’s ρ were applied; open-ended responses were thematically categorized. Results: A total of n = 183 responses were analyzed. RPT was performed regularly by 50.3% and occasionally by 49.7% of respondents. Annually, > 50 patients were treated by 44.8% of physiotherapists. Hospital-based settings reported higher annual patient volumes than other workplaces (χ²3 = 19.5; p < 0.001; V = 0.35). Self-reported RPT knowledge correlated with annual patient volume (ρ = 0.39; p < 0.001). Use of airway clearance devices was more frequent in Prague than in the rest of the country (χ²2 = 7.2; p = 0.03; V = 0.20). The most common barriers to active provision of RFT were low physician awareness of RFT benefits (47.8%), insufficient professional networking (42.8%), and lack of time/capacity for patients (36.1%). Key expectations from a potential national RPT network included professional courses, workshops, webinars, supervision, internships (85.7%), regular sharing of updates and new findings (76.9%), and the creation and updating of methodological materials (69.8%). Interest in joining the emerging network was expressed by 36.1% of respondents (an additional 37.7% answered “maybe”). Conclusion: The data support the plan to establish and develop a national network of experts in respiratory physiotherapy.
Copyright (c) 2026 Rehabilitation & Physical Medicine
The ghostly shadow of posture, or the very convoluted history of misquoting
The metaphor of posture accompanying movement as a shadow is an integral part of our understanding of the nature of posture and its significance for movement. Authorship is usually attributed to Robert Magnus or Sir Charles Sherrington, but it does not actually appear in the sources usually cited. A search using the current capabilities of online libraries and search tools has shown that the original author of the metaphor was probably Ramsay Hunt, from whom Sherrington took it. This particular example underlines the importance of returning to the original sources and taking a responsible approach to citation, no matter how tedious this often is. And also the importance of critical reading of a professional text, regardless of the aura or laurel wreath surrounding the head of its author.
Ischiofemorální impingement: přehled pro klinickou praxi a diagnostiku
The article provides a concise overview of the extant literature pertaining to ischiofemoral impingement (IFI) as a potentially underdiagnosed etiology of deep gluteal pain, categorized within the broader spectrum of posterior hip pain disorders. IFI is characterized by a reduction in the ischiofemoral space, which is the space between the ischial tuberosity and the lesser trochanter. In addition to this, there is a restriction of space for the quadratus femoris muscle, which can lead to its irritation and, secondarily, to irritation of the sciatic nerve. Clinically, the manifestation of this condition is characterized by discomfort, primarily caused by extended periods of sitting. The etiology is multifactorial, including congenital morphological variants, postoperative/post-traumatic changes, and functional disorders in the pelvis and hip area. The diagnosis is based on the correlation of clinical findings with imaging methods. Magnetic resonance imaging (MRI) is a valuable diagnostic tool that allows for precise quantification of the narrowing and the detection of oedema or atrophy of the quadratus femoris muscle.
Ultrasound as the Primary Investigative Method in the Diagnosis of Cam-Type Femoroacetabular Impingement: A Case Report and Literature Review
Femoroacetabular impingement syndrome is a condition arising from a mechanical conflict between the proximal femur and the acetabulum. The standard initial imaging method when this impingement is suspected is an anteroposterior radiograph of the pelvis and an axial view of the proximal femur. In imaging examinations, the axial radiograph is often overlooked or not performed correctly, which may result in underdiagnosis of this significant condition. In this article, we present a review of the literature concerning femoroacetabular impingement syndrome and a case report demonstrating the use of ultrasound in diagnosing this disease.
Therapeutic Potential of Transcutaneous Spinal Cord Stimulation in Individuals with Spinal Cord Injury
Introduction: Transcutaneous spinal cord stimulation (tSCS) is a non-invasive neuromodulation technique that provides a novel approach to the rehabilitation of individuals with spinal cord injury (SCI). Its goal is to increase the excitability of spinal circuits and facilitate residual neuronal connections that remain preserved but dysfunctional after SCI. Methods: This review summarizes the current knowledge on the use of tSCS in motor, autonomic, and respiratory functions, as well as its effects on spasticity and postural stability. It draws from available scientific literature, including randomized controlled trials, case reports, and pilot studies focused on the impact of tSCS in individuals with different levels and severities of SCI. The studies were evaluated based on their mechanisms of action, technical stimulation parameters, and the clinical outcomes achieved. Results: Studies have demonstrated that tSCS increases the excitability of spinal neuronal networks and promotes the activation of previously dysfunctional motor pathways. Notable improvements include enhanced voluntary movement in the upper and lower limbs, increased muscle strength, improved trunk control while sitting, and positive effects on respiratory parameters such as respiratory muscle strength. Additionally, enhancements in autonomic functions—particularly micturition, defecation, and blood pressure regulation—along with reduced spasticity, have been observed. These effects were also evident in the chronic phase of injury and, in some cases, persisted after stopping stimulation, indicating the potential for long-term neuroplasticity. Conclusion: tSCS is a promising, safe, and easily accessible method that could expand treatment options in neurorehabilitation for individuals with SCI. Future research should focus on optimizing stimulation protocols and combining them with other rehabilitation methods.
Akupunktura jako součást moderní rehabilitace
Acupuncture represents a complementary approach in rehabilitation medicine, with its therapeutic potential and safety supported by a growing body of clinical evidence. It is applied for pain relief, modulation of spasticity, support of neuroplasticity, and regulation of autonomic and psychosomatic functions. This review article summarizes the main physiological mechanisms of acupuncture, its range of clinical indications, and the possibilities for practical application in rehabilitative care. The text includes up-to-date evidence from meta-analyses and international guidelines, as well as examples of clinical implementation. Acupuncture represents a valuable non-pharmacological tool, whose full potential depends on interdisciplinary collaboration, professional expertise, and systematic evaluation of effectiveness.
Copyright (c) 2025 Rehabilitation & Physical Medicine
Femoropelvilumbar complex – anatomical and radiological notes
The connection of the pelvis with the adjacent areas of the locomotor system, i.e. with the femurs and lumbar spine, is a key area for the position of the lower limbs and the alignment of the trunk in standing and walking. Significant factors in the alignment of the hip-pelvic-lumbar complex (FPLC) include the collodiaphyseal angle, offset and anteversion of the neck, anteinclination of the acetabulum, the degree of coverage of the head by the acetabulum, the type of sacroiliac joint, as well as the degree of anteversion of the pelvis and the curvature of the lumbar lordosis, together with varying degrees of wedging of the caudal lumbar vertebrae and the degree of openness of the prezygapophyseal angles. Sexual dimorphism is clearly manifested in this area because of the need to ensure the passage of a relatively large head during childbirth. Knowledge of anatomical relationships and radiological parameters is important for understanding the functional relationships within the FPLC as well as functional connections to other parts of the locomotor system and their clinical consequences.
Femoropelvilumbar complex – functional relations and clinical manifestations
The connection of the pelvis with the adjacent areas of the musculoskeletal system, i.e. with the femurs and lumbar spine, is a key area for the position of the lower limbs and the alignment of the trunk in standing and walking. This is associated with the typical chains of malfunction, both in the proximodistal or distoproximal direction, as well as in the caudocranial or craniocaudal direction. These chains of malfunction are then reflected in specific clinical units.
Measurement of vaginal pressure profile during horseback riding and its effect on pelvic floor function in a woman with stress urinary incontinence: A case report
Stress urinary incontinence, the complaint of involuntary leakage during effort or exertion, occurs at least weekly in one third of adult women. Additional studies have demonstrated that horseback riding promotes pelvic floor training in women with stress incontinence, leading to increased resting pelvic floor tension and stronger tension during active pelvic floor muscle contraction. No study to date has measured the vaginal pressure profile during different types of horseback riding or assessed its effects on pelvic floor function in a woman with mild symptoms of stress urinary incontinence (SUI). This Case Report describes a 46-year-old woman with SUI practiced recreational horseback riding over a period of 12 weeks. Significant differences were observed between the gallop and all other types of riding, with the highest values recorded during the gallop. Examination of pelvic floor muscle function (via perineometer, 2D ultrasound, and 3D/4D ultrasound using volume contrast imaging software) revealed an increase in maximal voluntary contraction from 27.5(1.4) to 45.7(2.2) cm H2O and its duration from 5(0.2) to 8(0.4) seconds. A decrease in hiatal area was noted during contraction (from 16.5(0.8)to15.0(0.7) cm2) and during the Valsalva maneuver from 19.6(0.9) to18.8(0.9)cm2.Horseback riding with pelvic floor muscle activation positively improved pelvic floor muscle function and reduced urinary leakage symptoms. It would be beneficial to perform similar measurements on larger groups of female horse riders.
Multidisciplinary Telerehabilitation in the Home Environment – A New Path to Improving Access to Care for Patients with Disabilities
Introduction: Access to rehabilitation care is not uniform across regions. However, the number of individuals with disabilities who wish to utilize various forms of assistance directly in their home environment is increasing. Objective: To inform the professional community and encourage their potential involvement in a new project focused on telerehabilitation and assistive technologies within the health and social care system. Conclusion: The use of modern technologies in health and social care represents one of the effective ways to deliver essential services directly to the home environment of individuals with disabilities.
Availability of Outpatient Occupational Therapy Care in the Czech Republic
SUMMARY Background: Occupational therapy is one of the non-medical health professions and for many years has been associated primarily with care in inpatient settings. However, over the past few years, occupational therapy has developed at the outpatient level, but until now there has been no comprehensive data to support this care and thus support the indication of outpatient occupational therapy (OOT) by physicians. Aim: The aim of this thesis is to point out the existence of occupational therapy clinics in the Czech Republic and their availability in individual regions. Methods: In 2023, a list of contracted health service providers for OOTs was requested from individual insurance companies. The numbers of occupational therapy facilities by insurance company were filtered and then a back check was performed to verify the accuracy of the results for occupational therapy providers. In addition, the most frequently reported occupational therapy codes according to the National Health Information Portal for 2022 were compiled. Results: Based on the data obtained, there are 94 occupational therapy clinics in the Czech Republic with at least 1 contract with a health insurance company. The highest availability of OOT is provided by the health insurance companies OZP (n = 80) and VZP (n = 70) and the lowest by ZPMVČR (n = 31). The highest number of OOT clinics is located in the Moravian-Silesian Region (n = 26) and Prague (n = 16), while the lowest number is in the Vysočina Region (n = 0) and the Pilsen Region (n = 1). The most reported occupational therapy codes for 2022 are individual basic occupational therapy (n = 271 484), training in activities of daily living - ADL (n = 212 249) and group basic occupational therapy (n = 61 021). Conclusion: This work presents the first comprehensive data on the status of OOT in the Czech Republic, which points to its existence and should increase doctors awareness of the possibility of its indication via FT voucher. It is important to emphasize that this analysis includes only facilities with contracts with health insurance companies, while private facilities are not included. It can be assumed that the actual number of facilities providing OOT is likely to be higher. Further research in this area is necessary.
Guide to the Peer Review Process in the Journal of Rehabilitation and Physical Medicine
recenzní řízení, odborný časopis, recenzenti, publikace
Copyright (c) 2025 Central European Journal of Rehabilitation
Current evidence of Rehabilitation in badminton injuries, conservative treatment and prevention
Badminton injuries, despite the worldwide popularity of this sport, remain a relatively overlooked issue. The sport is characterized by factors such as explosiveness, speed, anticipation, and deception. Injuries in badminton are accompanied by musculoskeletal pain, which negatively affects the player's performance. This paper focuses on analyzing these injuries in the context of current conservative therapy options, with an emphasis on physiotherapy. Taking into account the biomechanics of the sport, physiological demands, and insights into badminton injuries, the aim of this work is to describe the most common injuries among badminton players and provide an overview of the currently most common treatment approaches, highlighting the possibilities of conservative treatment using physiotherapeutic methods.
Evaluation of pelvic orientation, type of spinal curvature and posture in the sagittal plane
The femoropelvilumbar complex is of fundamental importance for the posture of the trunk and the position of the lower limbs. The orientation of the pelvis in the sagittal plane determines both the different X-ray types of spinal curvature, as well as the different types of body posture, which we evaluate visually and palpating during the physical examination. Evaluation of body posture in the sagittal plane should therefore begin with an assessment of the orientation and position of the pelvis. The type of pelvic orientation also makes it possible to compare and connect the results of these two different methods of examination and evaluation. The general result of degeneration of different types of spine is its kyphotization. Different types of posture have a typical combination of shortening or weakening of different muscle groups.
lumbopelvic-hip complex – pelvis – spine – posture – degeneration
The effect of tetrapolar application of medium frequency currents interferential on the autonomic nervous system.
The purpose of the study was to evaluate the effect of tetrapolar application of medium frequency currents (isoplanar vector field) in the thoracic spine area on cardiac autonomic nervous system evaluated using the selected spectral and temporal indicators of heart rate variability (HRV) in healthy probands. The results of the study showed only a very small effect on the cardiac autonomic nervous system (ANS).
heart rate variability - spectral analysis - autonomic nervous system – medium frequency currents
Perspective of occupational therapists, physiotherapists and patients on the conventional and innovative methods of Constraint-induced movement therapy in the Czech Republic
The comprehensive therapeutic programme Constraint-induced movement therapy (CIMT) focuses on functional training of the paretic upper limb and the transfer of acquired skills in daily life. Based on existing research, one way to increase accessibility of the intervention is using information and communication technologies. The aim of the survey was to map the current experience of occupational therapists, physiotherapists and patients with the CIMT therapeutic toolkit and home activity monitoring. The components of CIMT currently used, the forms of monitoring, the barriers to CIMT provision, and the motivations and subjectively perceived limitations for the use of technology in rehabilitation for activity monitoring were explored. Czech therapists reported the most common perceived barriers that limit CIMT provision as follows: low number of suitable patients, lack of knowledge about the method, increased administrative and time demands, or concerns about the high demands of the method for patients. Patients themselves are then limited in participating in the programme due to its low accessibility (having to commute or not meeting the indication criteria) or fear of the high difficulty of the exercise. According to the survey results, patients with upper limb paresis after brain injury as well as therapists are motivated to participate in remote therapy and share home exercise results remotely (via email, mobile or web application, or using sensors). The present work aims to increase awareness of innovative CIMT practices and activity monitoring to improve its accessibility and potentially reduce its costs in clinical practice.
Differences in the performance of standardised fine motor assessment among Czech and Slovenian occupational therapists
Introduction: Purdue Pegboard Test (PPT) is objective standardized test for fine motor skills assessment. It contains four physically administered subtests. The task is to place as many components as possible on the pegboard in a limited amount of time to holes exactly according to the given instructions. Specific situations often arise. It is necessary to react to them immediately and then take them into account when calculating the score. The aim of the project was to determine whether occupational therapists (OTs) from the Czech Republic and Slovenia react uniformly to selected specific situations during PPT testing and whether they agree on their evaluation. Methodology: In 2021, an online questionnaire survey was addressed to Czech and Slovenian OTs. The questions included video demonstrations of six specific situations. Answers from 87 Czech a 67 Slovenia OTs were analysed using descriptive statistics. The results clearly confirm that OTs from neither country agreed on the ways of responding to the selected specific situations nor on their evaluation. Reusing a dropped peg on the test board would be counted by 20 respondents, with a further 17 stating the exact opposite. A pair of pegs, one of which was not completely tucked into the hole, was counted by 31 OTs and not counted by 8 OTs. A total of 16 OTs would immediately stop the attempt due to skipping holes during Completion, while 13 others would not consider it as a mistake. Due to the wrong order of the hands during making assemblies, 20 OTs would invalidate the attempt, while 13 others would count it. Conclusion: The questionnaire survey confirmed that the new rules for dealing with specific situations arising during PPT and for their evaluation presented in the Czech extended version of the PPT manual are absolutely necessary for uniform objective testing in clinical practice.
Influence of dynamic sitting on back and pelvic pain during pregnancy
Influence of dynamic sitting on back and pelvic pain during pregnancy Original work Abstract Objective: The aim of this pilot study was to investigate the impact of dynamic sitting on the level of back and pelvic pain during pregnancy, as well as on mobility and quality of life during pregnancy. Participants and Methods: The study included 22 pregnant women who were divided into an experimental and a control group. The experimental group (n=11), with an average age of 32.55±5.5 years and an initial Body Mass Index (BMI) of 24.81±3.26, used a dynamic cushion while sitting for 20 minutes daily over a period of two months. The control group (n=11), with an average age of 31.64±5.12 years and an initial BMI of 24.27±2.4, did not use the dynamic cushion. The effect was assessed using a shortened version of the McGill Pain Questionnaire and a questionnaire evaluating the mobility and quality of life of pregnant women, known as the "Pregnancy Mobility Index." Results: According to the shortened version of the McGill Pain Questionnaire, there was an improvement in part of the pain prescriptors score in the experimental group and a deterioration of pain in the control group. The difference between the groups was not statistically significant. According to the questionnaire evaluating mobility and quality of life during pregnancy, there was a deterioration in the control group. The difference between the groups was not statistically significant. Conclusions: The use of a dynamic cushion cannot be unequivocally recommended as a preventive measure for back pain or for preserving mobility and quality of life during pregnancy. However, partial results from the pilot study suggest that further exploration of this issue is warranted, and additional research should be conducted, particularly with a larger sample size. Keywords dynamic sitting, lower back pain, pain questionnaire, pregnancy
dynamický sed, bolest dolní části zad, dotazník bolesti, těhotenství
Occupational Therapy of People with Acquired Brain injury in The Home Environment: Focusing on Barriers and Facilitators
Aim: The aim of the article is to present the results of occupational therapy intervention in the framework of coordinated community rehabilitation. The main aim is to address the disabling situations of people after acquired brain injury in the home setting, which are mainly related to the evaluation of housing and the indication of facilitation resources. Methods: A methodological triangulation was used with a predominantly qualitative component in an action research study of a 3-month coordinated interprofessional rehabilitation in a home setting. The data collection techniques are interviews with clients and their family members, observations in the home environment, document analysis and the use of standardized tests (FIM, WHODAS 2.0) to assess the development of self-sufficiency, functional status and subjective perception of the probands quality of life. Results: A total of 17 people from the South Bohemia region and 6 additional people from the Prague and Central Bohemia region were included in the final processing of the results focusing on occupational therapy intervention. Overall, the predominant diagnosis was stroke. Most of the clients needed minor adjustments or minor aids indicated by the occupational therapist after the stroke, i.e. especially financially less demanding facilitators, which are essential in terms of independence and safety in performing normal daily activities. For people with tetraplegia or more severe hemiparesis, more substantial modifications were indicated, such as a wheelchair lift or installation of a ramp, platform, stairlift, or a wheelchair accessible bathroom with shower. Here, cooperation with a social worker regarding funding seems to be highly desirable. Conclusion: Clients perceive the positive benefits of the intervention but lack further follow-up rehabilitation. The occupational therapist is irreplaceable in the team. From the analysis of the interviews, the need for family care for the client is evident, but the care and guidance of the family cannot be neglected. Both needs should be an appeal to professionals for a quality interprofessional approach, where the family and the clients are a full part of the team.
Copyright (c) 2024 Central European Journal of Rehabilitation
The effect of gait imagery and its more demanding variant on muscle activity in stroke survivors
One of the main goals of rehabilitation for stroke survivors is functional recovery of gait. The gait imagery appears to be the suitable adjunct to comprehensive rehabilitation for stroke survivors, as it improves its subsequent performance. The aim of this study was to determine how muscle activity of selected paretic and non-paretic lower limb muscles changes in patients in the subacute phase after stroke when imagining normal gait and its more challenging variant, gait on the line. The electromyographic (EMG) activity of m. rectus femoris, m. biceps femoris, m. tibiais anterior and m. gastrocnemius medialis was recorded during three tasks of imagining both types of gait (resting task without gait imagery, gait imagery before and after its actual execution) in 40 stroke survivors. Muscle activity decreased significantly in most of the selected muscles of both lower limbs during each of the tasks of normal gait imagery and gait on the line imagery. We found lower EMG activity in paretic m. gastrocnemius medialis and non-paretic m. rectus femoris and m. biceps femoris during the tasks of imagining more challenging situation. Muscle activity of paretic and non-paretic lower limbs did not differ during imagination before and after execution of both types of gait. The results of the study show that normal gait imagery and gait on a line imagery alters muscle activity in both paretic and non-paretic lower limbs. The findings may facilitate the application of imagining these movements as part of a comprehensive rehabilitation approach in subacute stroke survivors.
Vocational Rehabilitation and Its Impact on the Quality of Life of People with Disabilities
Goal: The article presents the results of research on the impact of vocational rehabilitation on the quality of life of individuals with disabilities. Vocational rehabilitation was provided by employment offices in collaboration with three experimental vocational rehabilitation centers (Chomutov, Brno, Pardubice) between 2021 and 2022. The research was conducted as part of a European project from 2020 to 2023. Methods: Quality of life was examined among participants of vocational rehabilitation (n = 93) who participated in a pilot study and agreed to participate in the research, which was conducted using the WHO DAS II questionnaire. The results of testing were compared among participants before entering vocational rehabilitation (A), at the completion of vocational rehabilitation (B), and among employed participants (n = 59) also three months after starting employment (C). Conclusion: The quality of life of the participants in vocational rehabilitation improved in the areas of life activities (including work) and participation in society, regardless of whether they retained employment for at least three months. Participation in society and life activities were perceived as the most problematic at the start of vocational rehabilitation. The most significant improvements in these areas were observed among clients who retained employment for at least three months. Clients who retained employment for at least three months did not experience an improvement in quality of life only in the area of mobility difficulties and self-care. Mobility difficulties and self-care were perceived as the least problematic overall by clients at the start of vocational rehabilitation.
Vliv viscerální manipulace na gastrointestinální obtíže u osob se spinální lézí – kazuistická studie
People with spinal cord injury have a number of permanent health problems that get worse during the bad lifestyle and aging. Among them there are gastrointestinal complications, which have a significant negative impact on their health, quality of life and wellbeing. The purpose of this pilot study was to determine the efficacy of visceral manipulation in reducing the severity of bowel dysfunction symptoms of chronic patients with spinal cord injury. The standardized questionnaire Neurogenic bowel dysfunction score (NBD Score), the standardized questionnaire Irritable Bowel Syndrome – Quality of Life survey (IBS-QOL) and non-standardized Czech version questionnaire Burwood Questionnaire were used to objectify the study results. The assessment was added with information from the anamnestic interviews. This pilot study demonstrated the positive impact visceral manipulation to reducing NBD score, abdominal pain and discomfort. Defecation characteristics were positively changed too (frequency, amount, consistency, faecal incontinence). Physiotherapists should not neglect the need for diagnosis and therapy of gastrointestinal problems in persons with spinal cord injury in clinical practice. However, this issue also depends on the patient's compliance with dietary measures, optimal bowel management and healthy lifestyle.
Screening function of the pelvic floor muscles and prevalence of dysmenorrhea in women
Summary: The aim of this screening prevalence study was to evaluate pelvic floor muscle (PFM) function and the prevalence of dysmenorrhea in a population of parturient and non-parturient women. The PFM function was evaluated for its endurance, speed component, and ability to relax. This study also included evaluation of women‘s experience with PFM exercises, and the prevalence of dysmenorrhea and endometriosis. A total of 362 women were included in the study population, of which 297 (82%) were parturients and 65 women (18%) were non-parturients. The mean age of the study population was 37.4 ± 9.8 years. Measurements and data collection were performed at the workplaces of the non-state medical facility REHASPRING centre in Prague. The protocol of the gynaecological-urological concept of Palascak Pelvic Approach (PPA) for women was used to obtain the research data. The PERFECT-SM-R scale was used to evaluate the PFM function. PFM function values were recorded by per vaginam examination and biofeedback of PFM function using 2D ultrasound. According to the results of the data analysis, only 53% of the women studied in the supine position and 60% of the women in the standing position achieved the norm of the PFM endurance contraction function. For velocity contractions, 55% of the women in the supine position and 59% of the women in the standing position met the established norm. Dysmenorrhoea, a common symptom of endometriosis, is present in almost half of the women (48%), mostly in non-parents (74%). More than half of the women (53%) in our study group were unaware of the symptoms and the consequences of endometriosis. Only less than 20% of the women reported experience of PFM exercises.
Application of the evaluation sheet according to the Dynamic Neuromuscular Stabilization in clinical practice
Summary: This article presents the Czech version of the examination protocol according to the Dynamic Neuromuscular Stabilization (DNS) concept and its use in the clinical practice. In the introductory part, the DNS protocol is compared with the examination protocols according to the Mechanical Diagnosis and Therapy and Functional Movement Screen in terms of “intra-rater” and “inter-rater” reliability. A case report presenting complex functional assessment of a patient using a combination of DNS examination protocol, DNS Brace to evaluate postural stabilization, and a short version of the McGill University Pain Questionnaire is presented within this paper. The patient was examined by the combination of the three methods before therapy and after six weeks of the therapy. The results of the patient‘s subjective assessment and the therapist‘s clinical examination using the DNS protocol and DNS Brace confirmed a positive effect of the therapy. The combination of the DNS protocol, DNS Brace and a standardised pain questionnaire may be an appropriate examination procedure for patients with musculoskeletal disorders.
short version of the McGill University Pain Questionnaire
Stress fractures are injuries that result from overuse. They most commonly occur in the lower extremities as a consequence of repetitive impacts and the transmission of large forces to the bones of the lower limbs. Endurance runners are at the highest risk of developing stress fractures, but they can also affect other athletes such as sprinters, basketball players, or gymnasts. They are also prevalent among soldiers. Early diagnosis and proper treatment of stress fractures prevent the progression of this injury into a complete fracture or avascular necrosis. Therefore, knowledge of this issue is important for both medical professionals and athletes and their coaches. The goal of this article is to summarize current knowledge regarding stress fractures in runners. Individual sections focus on the pathophysiology of stress fracture development and the risk factors contributing to their occurrence. The main focus is given to the diagnosis, classification, and treatment of this injury.
Stress fracture, overuse injury, pathophysiology, risk factors, classification, diagnostics, therapy, runners
The effect of a respiratory physiotherapy program on extraoesophageal reflux disease symptoms
Introduction: Using methods of respiratory physiotherapy, diaphragmatic breathing and inspiratory muscle training, it is possible to reduce the incidence and intensity of esophageal symptoms in patients with gastroesophageal reflux. Whether this therapy has the same impact on extraoesophageal symptoms of reflux disease has not been investigated yet. Therefore, the aim of this study was to assess the effect of a respiratory physiotherapy program on the intensity of symptoms of extraoesophageal reflux disease. The respiratory physiotherapy program included activating and strengthening the diaphragm using inspiratory muscle training performed in different postural positions. A secondary aim was to determine whether the effectiveness of a respiratory physiotherapy program differs in patients with decreased inspiratory muscle strength compared to those with normal inspiratory muscle strength. Methods: A total of 36 patients (8 men) with a diagnosis of extraoesophageal reflux disease were included in the study (an average age was 46.4±10.4 years and a BMI was 25.6±4.5 kg.m-2). Patients' inspiratory muscle strength (PImax) and intensity of extraoesophageal reflux symptoms using the Hull Reflux and Airways Questionnaire were assessed before and after completion of an 8-week respiratory physiotherapy program. Based on initial PImax values, patients were divided into two groups: “Group 1” – patients with PImax ≥ 90% predicted values (15 patients, mean age 45.6±10.4 years); "Group 2" - patients with PImax < 90% predicted values (21 patients, mean age 46.9±10.9 years). The respiratory physiotherapy program included diaphragmatic breathing and inspiratory muscle training with a resistance inspiratory device the Threshold inspiratory muscle trainer performed in three postural positions. Results: A statistically significant difference was found in the intensity of symptoms between the groups at baseline. In both groups, after completing the respiratory physiotherapy program, there was a statistically significant increase in inspiratory muscle strength and a decrease in the intensity of symptoms of extraoesophageal reflux disease. Conclusion: The results of the study suggest that the respiratory physiotherapy program including diaphragmatic breathing and inspiratory muscle training leads to an increase in inspiratory muscle strength and a reduction in symptom intensity, regardless of initial inspiratory muscle strength.
extraoesophageal reflux disease symptoms
Diagnostika a trénink neuro-vizuálních funkcí v rehabilitaci a ve sportu
Sensory integration contributes to the optimal execution of movement. With repeated non-ideal intake of information from the surrounding environment, the process of motor learning can be disrupted. The dominant human sense is sight. Visual information is integrated at the level of the central nervous system (CNS) with input information from other sensory organs and continuously influences motor activity. Currently, the term neuro-visual system (NVS) is used in the field of rehabilitation and in sports, which considers the connection of the eye-brain-body axis. The article summarizes recent information about the NVS and presents the possibilities of NVS diagnostic procedures in clinical practice such as testing visual acuity, eye motility, and the near point of convergence. Based on available literature, indication groups of patients are described, for whom neuro-visual training (NVT) could be an effective part of rehabilitation, as well as possibilities for use by athletes as part of sports training. The publication includes two case studies that demonstrate the assessment of the NVS and the use of NVT in clinical practice in an adolescent with attention disorder and congenital diplopia, and in a young tennis player with headaches.
Short-term effects of extracorporeal shockwave therapy in the treatment of Achilles tendinopathy: an ultrasound and clinical evaluation
Achilles tendinopathy (AT) is a commonly used term to describe the clinical manifestations of pain and dysfunction of the Achilles tendon associated with loading. One of the recommended and often used methods in the treatment of these disorders is focused shockwave therapy (ESWT). The aim of this study was to observe changes in the structure of the Achilles tendon using ultrasonography (USG) and in clinical manifestations after treatment with low-energy ESWT in the short-term follow-up period. A total of 18 patients with AT were involved in the study, randomly divided into two groups in a ratio of 1:1. Patients in group A were treated with ESWT. In group B, placebo-ESWT was used. A total of five applications were done with a weekly interval. The following parameters were evaluated – tendon cross-sectional area (CSA), tendon diameter (TD), maximum pain rating (NRS) and VISA-A questionnaire. In the eight week after the first application of ESWT, no statistical significance in the reduction of CSA was observed. Compared with the control group, there was only a statistically significant reduction in NRS (P <,05). In addition, there was a significant decrease in NRS by an average of 4 points (P <,001), TD by 0,3 mm (P < .05), and VISA-A score increased by 20,3 points (P < .001) in group A. In group B, no statistically significant difference (P >.05) was found in any measured parameter. From the results achieved, it can be concluded that ESWT has a significant effect on pain reduction in the short term compared to placebo. In addition, a significant improvement in patients' overall subjective perception of the disorder was observed in the ESWT group and not in the control group. However, ESWT had no significant effect on tendon CSA and only a minimal effect on TD. Nevertheless, given the short-term follow-up, we cannot confirm or deny whether ESWT affects tendon macromorphology in the long term. It should be mentioned that the lower number of included patients may affect the statistical significance.
Flossing is a relatively new compressive therapeutic technique, used mainly in physiotherapy and sports medicine. This method uses the application of specially designed elastic bands circularly wrapped around individual body segments. The therapeutic effect of the technique consists primarily in the short-term compression of soft tissues and joints, which are located directly in the treatment zone during the application of the flossing tape, with subsequent release of segment compression. Among the most common indications of the technique are: improvement of soft tissue mobility, support of regeneration, improvement of circulation, acceleration of healing processes, acceleration of muscle contraction, improvement of movement coordination and reduction of pain. The main goal of the paper is to point out the possibilities and limits of this relatively new physiotherapeutic method with an overview of relevant information from the available literature. Selected case reports of patients after traumatic hand injury are also included.
flossing, compression methods, physiotherapy, sports medicine
Measurement of brain activity in a professional dance environment - study
The connection of body and mind and their mutual conjunction is an increasingly topical topic in many fields. Objective: The aim of the work was to find out to what extent our thoughts in a professional dance environment affect the course of brain frequencies and how they are prescribed in our organism and movement. Methods: As part of the study, brain activity was measured with the Muse wearable EEG device and visual analysis of movement from the dance environment, the plié element (flexion and extension of the knee joints). The monitored and measured individuals were sixteen students of the Dance Department of Music and Dance Faculty of the Academy of Performing Arts in Prague. We monitored brain frequencies in many phases (situations): without a specific thought (concentration) and without movement, with a specific thought without movement, movement without a specific thought, movement with a specific thought, and finally again a thought without movement, which was out of scope and research framework. Results: For fourteen participants in the experiment, we obtained an EEG signal of sufficient quality so that it could be further analyzed. A change in brain frequencies distinguishing activities with lower and higher conscious concentration was demonstrated in twelve participants. Conclusion: The output describes the findings regarding the connection of thoughts, body and movement based on measurable data. The Muse EEG device is useful for obtaining an EEG signal of sufficient quality in experiments requiring movement and taking place in real conditions. In the obtained EEG signal, it is possible to detect changes in the participant's brain activity during states of relaxed alertness and conscious concentration. Visual analysis of movement reflects that the synthesis of a specific thought and movement contributes to the elimination of bad habits, which destroy not only the technical purity of the performance of the movement element, but also optimal posture, coordination of movement and individual anatomical structures.
Key words: attention, movement, basic brain frequency, EEG, Muse headband, Franklin Method