SPECIFICS OF PHYSIOTHERAPY OF PATIENTS TRANSFERRED AFTER ORTHOPEDIC OPERATIONS DIRECTLY ON THE SO-CALLED SPA BUNK

This bachelor thesis addresses the specificity of physiotherapy of patients, transferred to a so-called spa bed, after orthopedic surgery. Among the most performed orthopedic surgeries are the total hip replacement and the total knee replacement. Arthrosis is the most common reason for the implantation of joint replacements. It is a painful and life-aggravating disease which has a tremendous impact on the patient's quality of life. In order to lower the risk of the patient having to take a revision surgery of joints, a promptly initiated rehabilitation is necessary. It has to be intensive and professionally conducted. The present time-tested trend of rehabilitation treatment is a prompt comprehensive care, which takes place in a spa resort in the form of a direct transfer "from one bed to another", i.e. the patient is transported directly from the hospital to a spa resort. Often, patients would get to a spa resort with delay, while already having intercurrent problems like vertebrogenic and other problems. This thesis is divided into a theoretical part and a practical part. The theoretical part includes the anatomy of the hip joint and the knee joint, the description of the joint replacements including the indications and the contraindications, the specifications of particular types of hip and knee joint replacements and possible complications after surgery. The most important topics of the theoretical part are stated in the last chapters. The individual therapeutic rehabilitation methods, which have a positive impact on the health status of the patient after surgery, spa therapy and physical therapy included, are discussed and described in those chapters in detail. A qualitative research strategy and a personal case study technique (case history), with the use of a secondary data analysis, were used in the practical part. This strategy was carried out on three chosen patients, who after being discharged from a hospital after surgery had continued their treatment in a spa resort, i.e. a so-called direct transfer from a hospital bed to a spa. The research was conducted in Berta's spa resort in Třeboň, where the patients were transferred on the tenth day after surgery. On their first therapy session, all patients had their personal history taken and data from their medical documents was added. The practical part also includes a pre-therapy and a post-therapy kinesiologic analysis which included visual inspection, palpation, goniometric and anthropometric examination of the knee and hip joint area. Furthermore, a muscle test and an examination of shortened muscle groups related to the knees and hip joints, created by Janda, were conducted. The gait, stereotypes and neurologic functions were also examined. Following the evaluation of the pre-therapy data, the patients were introduced to the short-term therapeutic plan. The results were acquired by comparing the pre-therapy data and the data which was obtained during the last therapy session from the post-therapy kinesiologic analysis. The rehabilitation in the spa resort consisted of different treatment procedures each day and the patients were getting medical attention and care from doctors, nurses and physiotherapists. In each therapy, we focused on removing the problems at hand and only after that we moved to correcting other imperfections. After the completion of the therapy, the patients stated a decline of pain and an improved balance of the extremity and the whole body. The data of the chosen patients shows improvement of muscle strength, decreasing of swelling and widening of range of motion. These results were achieved thanks to a comprehensive rehabilitation and a positive attitude of the patients