Slovo úvodem

prof. MUDr. Eva Havrdová, CSc.

Neurol. praxi 2016; 17(Suppl.4)  

Evidence-based rehabilitation in multiple sclerosis

MUDr. Martina Hoskovcová, Ph.D.

Neurol. praxi 2016; 17(Suppl.4): 10-14  

Rehabilitation is an integral part of complex multiple sclerosis (MS) management. Nevertheless thereare no clear-cut evidence-based recommendations regarding particular therapeutic modalities andtheir intensity, frequency or length. In this respect it is necessary to pursue the latest systematicreviews of systematic reviews and meta-analyses which show what methods are currently recommendedin clinical practice. It is also necessary to rely on one’s long term clinical experience, assome methods are not yet recommended only because of few published studies or variable designof studies. Currently the most recommended rehabilitation method are surprisingly...

Problematika spastické parézy u pacientů s roztroušenou sklerózou

MUDr. Martina Hoskovcová, Ph.D., Mgr. Ota Gál

Neurol. praxi 2016; 17(Suppl.4): 15-19  

Physical activity in patients with multiple sclerosis and physiotherapy techniques on neurophysiological basis

Bc. Daniela Hillayová

Neurol. praxi 2016; 17(Suppl.4): 20-24  

Physical activity should undoubtedly be a part of the treatment in patients with multiple sclerosis(MS). We fi nd a combined circuit training in which one alternates between resistence exercise stationsand aerobic exercise stations to be the most eff ective form of exercise. The article discusses theappropriate physical programs and their prescriptions, the principles and recommendations aboutexercise, and neurophysiological techniques used in physical therapy in patients with MS.

Gait impairment in multiple sclerosis patients and their rehabilitation treatment options

Mgr. Klára Novotná

Neurol. praxi 2016; 17(Suppl.4): 25-33  

Gait impairment is one of the most common symptoms in multiple sclerosis patients. Changes inspatiotemporal gait parameters are present even in those with mild or moderate neurological disability.As a result, rehabilitation care should be off ered to all patients with gait and balance problemswith the aim to prevent muscle weakness and loss of endurance capacity. Rehabilitation therapyshould be based on an individual assessment by the physiotherapist and focused on the main gaitdisturbing symptom.

Ataxia and postural instability: rehabilitation options in patients with multiple sclerosis

Mgr. Ota Gál

Neurol. praxi 2016; 17(Suppl.4): 34-36  

This paper summarizes the current knowledge about ataxia and balance rehabilitation in patientswith multiple sclerosis with respect to evidence -based medicine and clinical experience from theauthor’s department.

Fatigue and its management options in patients with multiple sclerosis

Mgr. Lucie Suchá

Neurol. praxi 2016; 17(Suppl.4): 37-40  

Despite advances in pharmacological and rehabilitation therapies, fatigue is among the most common andmost limiting symptoms in patients with multiple sclerosis (MS). Along with motor and sensory manifestationsof the disease, it results in restriction of physical activities, social isolation, worse mental health, and anoverall reduction in the quality of life. Comprehensive management (pharmacotherapy, psychotherapy,physiotherapy) including lifestyle measures and energy conservation strategies can signifi cantly reducefatigue and positively aff ect activities of daily living as well as integration of the patient into the community.

Pelvic fl oor dysfunctions: an interdisciplinary approach

Mgr. Michaela Havlíčková

Neurol. praxi 2016; 17(Suppl.4): 41-48  

Pelvic fl oor dysfunctions occur in up to 80 % of patients with multiple sclerosis (MS). Symptomsinclude overactive bladder, urgency, urge urinary/fecal incontinence, pollakiuria, nocturia, andsexual dysfunction. Despite their common occurrence, pelvic fl oor dysfunctions are often a taboosubject for patients and are frequently overlooked by clinicians during assessment, particularly in theearly stages of the disease. Notwithstanding the development of modern investigative instrumentsin the clinical assessment process, the author believes that comprehensive assessment of pelvicfl oor dysfunction must include a range of manual examinations, including...

Dysphagia in patients with multiple sclerosis

MUDr. Lenka Mrázková, MUDr. Jaroslav Sýba, MUDr. Martin Kysilko, MUDr. Aleš Kavka, Mgr. Markéta Hrušková, MUDr. Lucie Dostálová

Neurol. praxi 2016; 17(Suppl.4): 49-52  

Swallowing disorders are common complains in patients with multiple sclerosis. In milder cases theycan cause discomfort and reduced quality of life, in more serious cases they can be life threateningparticularly because of the risk of dehydration, malnutrition and aspiration bronchopneumonia. Thearticle therefore provides a brief overview of investigative methods and possibilities of infl uencingdysphagic diffi culties in MS patients.

Exercise motivation in patients with multiple sclerosis

Mgr. Klára Novotná

Neurol. praxi 2016; 17(Suppl.4): 53-57  

The importance of regular physical activity in multiple sclerosis patients has been described in manyrecent studies. Healthcare professionals (physiotherapists) should not only have information aboutthe type, frequency, and intensity of training, but they should also know how to motivate patientsto engage in long-term physical activity. This article presents common barriers in physical activityin multiple sclerosis patients and the factors which facilitate engaging in physical activities.

Occupational therapy

Bc. Tereza Krejsková

Neurol. praxi 2016; 17(Suppl.4): 58-61  

Occupational therapy is a relatively new and sometimes even unrecognized healthcare fi eld belongingto comprehensive rehabilitation. The options of an occupational therapist are extensive andcan therefore be used in all stages of the disease. The article provides an insight into occupationaltherapy, including the options of using this discipline in patients with MS.

Rehabilitation of cognitive functions

Mgr. Dana Chmelařová

Neurol. praxi 2016; 17(Suppl.4): 62-69  

Disorders of cognitive functions are among the main manifested symptoms of multiple sclerosis (MS)and, most commonly, their character is of a mild cognitive disorder; however, they impact essentiallyon the patients’ mental condition and social capacity. Recent studies have been aimed at the possibilityof using brain plasticity and its capacity of restructuring neural networks and, through cognitivetraining, restoring or at least maintaining cognitive functions in MS patients. In order for cognitivetraining to be eff ective, there must be not only targeted diagnosis (neuropsychological assessment,imaging techniques), but mainly a precisely designed...

Adherence and self-confi dence in psychotherapeutic work with patients with multiple sclerosis

Mgr. Jana Tomanová, Ph.D.

Neurol. praxi 2016; 17(Suppl.4): 70-73  

The article deals with the relationship between adherence (put simply, the patient’s willingness to cooperatein treatment) and self-confi dence in treating patients with multiple sclerosis. The importanceof well realized self-esteem as a prerequisite for good-quality cooperation with the patient becomesobvious in the therapeutic practice every day. It is valid that a healthy relationship to self, a functionalvalue system, and self-consciousness all lead to a more rapid coming to terms with the disease and,in the late stages associated with attacks and progression of the disease, facilitate acceptance of thisprocess. In psychotherapeutic care,...

Signifi cance of psychotherapy in treating multiple sclerosis

Renata Malinová

Neurol. praxi 2016; 17(Suppl.4): 74-80  

Generally, psychotherapy is defi ned as therapy using psychological means (e.g. interview, learning,suggestion, establishing a psychotherapeutic relationship) wherein the goal of treatment is to relievethe patient from complaints. (Kratochvíl, 2012) Psychotherapy is not meant to solve a problem for thepatient or give them life advice. Rather, it is supposed to help a person realize the context of theircomplaints and learn to use their own potential more eff ectively. In the stricter sense, it is a question ofchange of attitudes, self-awareness, and developing an active approach to treatment as well as creatinga new, healthier lifestyle with respect...

Multiple sclerosis: later stages including palliative care

Bc. Tereza Krejsková, Mgr. Alena Hagarová

Neurol. praxi 2016; 17(Suppl.4): 81-87  

In later stages of multiple sclerosis, the cooperation in patient care is more focused on stabilizationand endurance of the unchangeable. Physiotherapy is primarily aimed at muscle stretching andrelaxation as well as at preserving the function of respiratory muscles. Occupational therapy is intendedto help patients fi nd their way through the options they have in self-care skills and in usingthe aids that facilitate the life of the patient as well as of those around them, and to teach patientsto utilize these options eff ectively. The goal of psychotherapy is to aid the patient in fi nding theoptions of how to best live their life with the disease....

“As long as I can, at least a little bit…”

Mgr. Alena Hagarová

Neurol. praxi 2016; 17(Suppl.4): 88-91  

Case report of a man, aged 52 years. He is staying in a residential care facility in a diffi cult life situation.Primary disease: multiple sclerosis; palliative; deteriorating health as well as mental condition.Anxiety; depressive states; repeated suicidal thoughts. Painful surgical procedures repeatedly overthe course of several years; lower limb amputation; decreasing self-suffi ciency.

Intensive weekend programmes with physiotherapy and psychotherapy
can improve the quality of life in patients with multiple sclerosis in the long term

Mgr. Lucie Suchá, Renata Malinová

Neurol. praxi 2016; 17(Suppl.4): 92-101  

The varied symptoms and a very individual course of the disease can, to varying degrees, adversely aff ectthe quality of life of a patient with multiple sclerosis (MS). In addition to pharmacological treatment, themodern trend recommends early initiation of rehabilitation, particularly physiotherapy and psychotherapy.In 2011, we began to organize intensive weekend stays for people with MS. The main goal is to teachpatients, through psychotherapy and physiotherapy, to better understand psychosomatic relationships,increase their self-effi cacy, teach them to better manage the disease symptoms and, thus, improve theirquality of life in the long term....