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[{"key": "dc.contributor.author", "value": "Nyk\u00e4nen, Kati", "language": null, "element": "contributor", "qualifier": "author", "schema": "dc"}, {"key": "dc.date.accessioned", "value": "2010-02-28T17:04:55Z", "language": null, "element": "date", "qualifier": "accessioned", "schema": "dc"}, {"key": "dc.date.available", "value": "2010-02-28T17:04:55Z", "language": null, "element": "date", "qualifier": "available", "schema": "dc"}, {"key": "dc.date.issued", "value": "2010", "language": null, "element": "date", "qualifier": "issued", "schema": "dc"}, {"key": "dc.identifier.other", "value": "oai:jykdok.linneanet.fi:1124153", "language": null, "element": "identifier", "qualifier": "other", "schema": "dc"}, {"key": "dc.identifier.uri", "value": "https://jyx.jyu.fi/handle/123456789/23001", "language": null, "element": "identifier", "qualifier": "uri", "schema": "dc"}, {"key": "dc.description.abstract", "value": "Robottiavusteisen terapian vaikuttavuus yl\u00e4raajakuntoutuksessa AVH-potilailla \u2013 j\u00e4rjestelm\u00e4llinen kirjallisuuskatsaus\r\nKati Nyk\u00e4nen\r\nFysioterapian pro gradu-tutkielma\r\nJyv\u00e4skyl\u00e4n yliopisto, Liikunta- ja terveystieteiden tiedekunta, terveystieteiden laitos\r\nKev\u00e4t 2010\r\n73 sivua, 8 liitett\u00e4\r\nOhjaajat: Tuulikki Sj\u00f6gren, Ari Heinonen.\r\n\r\nT\u00e4m\u00e4n tutkimuksen tarkoituksena oli selvitt\u00e4\u00e4 j\u00e4rjestelm\u00e4llisen kirjallisuuskatsauksen perusteella, yl\u00e4raajoihin kohdistuneen robottiavusteisen terapian vaikuttavuuden n\u00e4yt\u00f6naste aivoverenkiertoh\u00e4iri\u00f6n (AVH) saaneilla kuntoutujilla. \r\n\r\nKirjallisuushaku suoritettiin CINAHL (1982\u20138/2008), MEDLINE (1950\u20138/2008) ja EMBASE (-10/2008) s\u00e4hk\u00f6isist\u00e4 tietokannoista seuraavilla hakusanoilla: aivoverenkiertoh\u00e4iri\u00f6, halvaus, hemiplegia, yl\u00e4raaja, kuntoutus, fysioterapia, robotti, satunnaistettu kontrolloitu koe. Lis\u00e4ksi tutkimus sis\u00e4lsi k\u00e4sihakua. Tarvittaessa tutkijoihin otettiin yhteytt\u00e4 tarkentavien tietojen saamiseksi. Kaikki satunnaistetut kontrolloidut tutkimukset, jotka liittyiv\u00e4t robottiavusteiseen yl\u00e4raajaterapiaan aikuisilla AVH-kuntoutujilla sek\u00e4 oli julkaistu suomen, ruotsin, englannin tai saksan kielell\u00e4 otettiin mukaan katsaukseen.\r\n\r\nLaadun arviointi perustui van Tulder:n (2003) julkaisemiin kriteereihin.Yksitt\u00e4isen tutkimuksen laatupisteiden summa voi saada arvon 0-11. Laadun arvioinnissa k\u00e4ytettiin kahta itsen\u00e4ist\u00e4 ja sokkoutettua arvioijaa. Meta-analyysi ja suuruudet terapian vaikutukselle (effect size) laskettiin Cochrane Collaboration\u2019s Review Manager Software 5.0.16-ohjelmalla. \r\nSis\u00e4\u00e4nottokriteerit t\u00e4ytt\u00e4vi\u00e4 satunnaistettuja kontrolloituja tutkimuksia l\u00f6ytyi 18, joissa oli yhteens\u00e4 545 eri toipumisen vaiheessa olevaa AVH-kuntoutujaa. Tutkimusten laatupisteiden keskiarvo oli 5.5 (SD 1.1) ja vaihteluv\u00e4li 4-7. Terapiassa k\u00e4ytettiin kymment\u00e4 erilaista robottia ja eniten harjoitettiin olka- ja kyyn\u00e4rnivelt\u00e4. Kaikissa tutkimuksissa harjoittelua verrattiin muuhun fysioterapiaan. Robottiavusteinen terapia paransi tilastollisesti merkitsev\u00e4sti (p<0.01) yl\u00e4raajan toimintaa motorisia taitoja vaativissa p\u00e4ivitt\u00e4isiss\u00e4 toiminnoissa akuuteilla AVH-kuntoutujilla. Ero ei ollut merkitsev\u00e4 my\u00f6h\u00e4isemm\u00e4ss\u00e4 toipumisen vaiheessa tai kognitiivisia taitoja vaativissa toiminnoissa. Olka- ja kyyn\u00e4rnivelen motorinen hallinta parani merkitsev\u00e4sti (p<0.05) kaikissa toipumisen vaiheissa. Akuuteilla AVH-kuntoutujilla lihasvoima parani merkitsev\u00e4sti (p\u22640.05) harjoitusta saaneissa yl\u00e4raajan proksimaalisissa lihaksissa. Yl\u00e4raajan proksimaaliosien robottiavusteinen harjoittelu ei vaikuttanut distaaliosien motoriseen hallintaan tai lihasvoimaan. Robottiavusteista terapiaa ei todettu vaikuttavaksi yl\u00e4raajan spastisuuden, nivelliikkuvuuden, kivun, masennuksen tai el\u00e4m\u00e4nlaadun osalta. \r\nRobottiavusteinen terapia on lupaava ja turvallinen terapiamenetelm\u00e4 AVH-kuntoutujan yl\u00e4raajakuntoutuksessa erityisesti akuutissa kuntoutumisen vaiheessa. Menetelm\u00e4n k\u00e4ytett\u00e4vyytt\u00e4 ja soveltuvuutta kliiniseen k\u00e4ytt\u00f6\u00f6n on tutkittava lis\u00e4\u00e4.", "language": null, "element": "description", "qualifier": "abstract", "schema": "dc"}, {"key": "dc.description.provenance", "value": "Submitted using Plone Publishing form by Kati Nyk\u00e4nen (kamakamp) on 2010-02-28 17:04:51.655462. Form: Pro gradu -lomake (1 tekij\u00e4) (https://kirjasto.jyu.fi/julkaisut/julkaisulomakkeet/pro-gradu-lomake-1-tekijae). JyX data:", "language": "en", "element": "description", "qualifier": "provenance", "schema": "dc"}, {"key": "dc.description.provenance", "value": "Submitted by jyx lomake-julkaisija (jyx-julkaisija@noreply.fi) on 2010-02-28T17:04:54Z\r\nNo. of bitstreams: 2\r\nURN:NBN:fi:jyu-201002281295.doc: 486912 bytes, checksum: ba5fea0c95ec91e59e6c838a4688bafd (MD5)\r\nlicense.html: 5066 bytes, checksum: 77e6ad591fbc5f572adbb9bf06073680 (MD5)", "language": "en", "element": "description", "qualifier": "provenance", "schema": "dc"}, {"key": "dc.description.provenance", "value": "Made available in DSpace on 2010-02-28T17:04:55Z (GMT). No. of bitstreams: 2\r\nURN:NBN:fi:jyu-201002281295.doc: 486912 bytes, checksum: ba5fea0c95ec91e59e6c838a4688bafd (MD5)\r\nlicense.html: 5066 bytes, checksum: 77e6ad591fbc5f572adbb9bf06073680 (MD5)\r\n Previous issue date: 2010", "language": "en", "element": "description", "qualifier": "provenance", "schema": "dc"}, {"key": "dc.format.extent", "value": "73 sivua", "language": null, "element": "format", "qualifier": "extent", "schema": "dc"}, {"key": "dc.format.mimetype", "value": "application/pdf", "language": null, "element": "format", "qualifier": "mimetype", "schema": "dc"}, {"key": "dc.language.iso", "value": "eng", "language": null, "element": "language", "qualifier": "iso", "schema": "dc"}, {"key": "dc.rights", "value": "In Copyright", "language": "en", "element": "rights", "qualifier": null, "schema": "dc"}, {"key": "dc.subject.other", "value": "aivoverenkiertoh\u00e4iri\u00f6", "language": null, "element": "subject", "qualifier": "other", "schema": "dc"}, {"key": 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