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[{"key": "dc.contributor.author", "value": "Lankinen, Katariina", "language": null, "element": "contributor", "qualifier": "author", "schema": "dc"}, {"key": "dc.date.accessioned", "value": "2014-11-21T07:43:48Z", "language": "", "element": "date", "qualifier": "accessioned", "schema": "dc"}, {"key": "dc.date.available", "value": "2014-11-21T07:43:48Z", "language": "", "element": "date", "qualifier": "available", "schema": "dc"}, {"key": "dc.date.issued", "value": "2014", "language": null, "element": "date", "qualifier": "issued", "schema": "dc"}, {"key": "dc.identifier.other", "value": "oai:jykdok.linneanet.fi:1451803", "language": null, "element": "identifier", "qualifier": "other", "schema": "dc"}, {"key": "dc.identifier.uri", "value": "https://jyx.jyu.fi/handle/123456789/44707", "language": "", "element": "identifier", "qualifier": "uri", "schema": "dc"}, {"key": "dc.description.abstract", "value": "Syd\u00e4men vajaatoiminta on kasvava terveysongelma. Monet tutkimukset ovat osoittaneet, ett\u00e4 syd\u00e4nt\u00e4 synkronoi-valla tahdistinhoidolla (CRT) voidaan parantaa syd\u00e4men vajaatoimintapotilaan suorituskyky\u00e4 ja el\u00e4m\u00e4nlaatua. Kuitenkin tutkimuksia liikuntaharjoittelun vaikutuksesta vajaatoimintatahdistinpotilaan suorituskykyyn ja el\u00e4m\u00e4nlaatuun on rajoitetusti. T\u00e4m\u00e4n tutkimuksen tarkoituksena oli selvitt\u00e4\u00e4 syd\u00e4nt\u00e4 synkronoivan tahdistinhoidon yhteytt\u00e4 syd\u00e4men kroonista vajaatoimintaa (NYHA I-IV) sairastavien henkil\u00f6iden suorituskykyyn ja el\u00e4m\u00e4nlaatuun kolme kuukautta tahdistimen asentamisen j\u00e4lkeen. Lis\u00e4ksi tarkoituksena oli tutkia, saadaanko kolmen kuukauden kohdalla tahdistinhoitoon liitetyll\u00e4 omatoimisella liikuntaharjoittelulla lis\u00e4hy\u00f6ty\u00e4 syd\u00e4men vajaatoiminnan hoidon tuloksellisuuteen kuuden kuukauden kohdalla.\r\nTutkimusjoukko koostui 35 (46 % naisia, keski-ik\u00e4 71 \u00b1 8 vuotta) syd\u00e4men vajaatoimintaa sairastavasta potilaasta, joille oli asennettu vajaatoimintatahdistin. Potilaiden fyysist\u00e4 suorituskyky\u00e4 mitattiin viiden toiston tuoliltanousutestill\u00e4, 6 minuutin k\u00e4velytestill\u00e4 ja Jamar-puristusvoimatestill\u00e4. Fyysist\u00e4 aktiivisuutta mitattiin Sovelletun Kasarin Frequency Intensity Time (FIT) -indeksill\u00e4. Keuhkokapasiteettitestit suoritettiin mikrospirometrialla ja potilaat arvioivat kokemaansa hengenahdistustaan siihen tarkoitetulla modifioidulla kyselylomakkeella. El\u00e4m\u00e4nlaatua arvioitiin Minnesota-el\u00e4m\u00e4nlaatukyselyll\u00e4. Kaikki mittaukset suoritettiin ennen tahdistimen asentamista sek\u00e4 3 ett\u00e4 6 kuukautta tahdistimen asentamisen j\u00e4lkeen. Kolmen kuukauden kohdalla potilaat saivat yksil\u00f6llisen liikuntaneuvontaohjauksen fysioterapeutilta ja potilaita ohjattiin omatoimiseen kotona tapahtuvaan, progressiiviseen liikuntaharjoitteluun.\r\nTutkimustulokset osoittivat, ett\u00e4 kolme kuukautta tahdistimen asentamisen j\u00e4lkeen fyysisess\u00e4 suorituskyvyss\u00e4 tapahtui positiivinen muutos viiden toiston tuoliltanousutestiss\u00e4 (p=.0030) ja 6 minuutin k\u00e4velytestiss\u00e4 (p<.001) verrattuna tilanteeseen ennen tahdistinta. Fyysinen aktiivisuus lis\u00e4\u00e4ntyi my\u00f6s Sovelletun Kasarin FIT-indeksill\u00e4 mitattuna. FIT-indeksin kokonaispistem\u00e4\u00e4r\u00e4 nousi (p=.014) sek\u00e4 liikunnan m\u00e4\u00e4r\u00e4 (p=.0060) ett\u00e4 teho (p=.040) kasvoivat ja hengenahdistus v\u00e4hentyi (p<.001). Kuuden kuukauden kohdalla, kolmen kuukauden omatoimisen harjoittelun j\u00e4lkeen, fyysinen suorituskyky kehittyi entisest\u00e4\u00e4n verrattuna kolmen kuukauden tuloksiin. Tuoliltanousutestin kokonaisaika (p<.001) ja k\u00e4velymatka 6 minuutin k\u00e4velytestiss\u00e4 (p=.031) parantuivat. Fyysisen aktiivisuuden osalta liikunnan m\u00e4\u00e4r\u00e4 ja teho lis\u00e4\u00e4ntyiv\u00e4t (p<.001) ja el\u00e4m\u00e4nlaatu parantui (p<.001) kolme kuukautta tahdistimen asentamisen j\u00e4lkeen verrattuna tilanteeseen ennen tahdistinta sek\u00e4 my\u00f6s kuuden kuukauden kohdalla verrattuna kolmen kuukauden tuloksiin (p=.026).\r\nTutkimuksen mukaan syd\u00e4nt\u00e4 synkronoivalla tahdistinhoidolla on positiivinen yhteys fyysiseen suorituskykyyn, fyysiseen aktiivisuuteen ja el\u00e4m\u00e4nlaatuun alkuvaiheessa tahdistimen asentamisen j\u00e4lkeen syd\u00e4men kroonista vajaatoimintaa sairastavilla potilailla. N\u00e4ytt\u00e4isi silt\u00e4, ett\u00e4 n\u00e4it\u00e4 positiivisia muutoksia pystytt\u00e4isiin viel\u00e4 kehitt\u00e4m\u00e4\u00e4n omatoimisen liikuntaharjoittelun kautta. Liikuntaharjoittelu olisi n\u00e4ht\u00e4v\u00e4 osana syd\u00e4men vajaatoimintatahdistinhoitoa ja ammattihenkil\u00f6iden tulee rohkaista potilaita omatoimisen liikuntaharjoittelun pariin.", "language": "fi", "element": "description", "qualifier": "abstract", "schema": "dc"}, {"key": "dc.description.abstract", "value": "Chronic heart failure is an increasing health problem. Several studies have demonstrated that Cardiac Resynchronization Therapy (CRT) can improve exercise capacity and quality of life in heart failure patients. There are only small number of trials, which have examined the effect of exercise training on physical capacity and quality of life following CRT. The aim of this study was to determine the association of CRT on physical capacity and quality of life 3 months after CRT device implantation in chronic heart failure patients in NYHA functional class I-IV. Another objective was to explore if self-monitored exercise training following cardiac resynchronization therapy (CRT) would have additional benefits to physical capacity and quality of life at 6 months.\r\n35 patients (46 % women, mean age 71 \u00b1 8 years) with chronic heart failure received CRT. Patients underwent evaluation of physical capacity, which was measured by 5-repetition sit to stand test (STST), 6-min walk test (6MWT) and JAMAR grip strength. Level of physical activity was evaluated by Frequency Intensity Time (FIT) index of Kasari. Lung function was measured with Micro Spirometer and severity of dyspnea was evaluated with modified self-reported scale. Quality of life was assessed with Minnesota Living with Heart Failure Questionnaire (MLHFQ). All measurements were taken before CRT implantation and 3 and 6 months after CRT. At 3 months all patients received an individual exercise instruction by physiotherapist and they were instructed to perform self-monitored, progressive exercise training at home.\r\nAt 3 months there were improvements in physical capacity in 5-repetition STST (p=.0030) and 6MWT (p<.001). There were also improvements in the level of physical activity. Total score of FIT-index of Kasari increased (p=.014) and there were seen also improvements in frequency (p=.0060) and intensity of exercise (p=.040). There was an improvement in the severity of dyspnea after 3 months of CRT (p<.001). At 6 months - 3 months after self-monitored exercise training - there were seen further significant improvements in physical capacity. The time in 5-repetition STST reduced (p<.001) and the length of 6MWT increased (p=.031). There were also significant improvements in the level of physical activity. FIT index score increased (p<.001) and also the frequency and intensity of exercise increased significantly (p<.001). Quality of life improved significantly 3 months after CRT vs. before CRT (p<.001) and furthermore at 6 months vs. 3 months after CRT (p=.026).\r\nThis study suggests that CRT seems to have a positive association with physical capacity, level of physical activ-ity and quality of life in early stages after CRT device implantation in patients with chronic heart failure. These positive findings seem to be further enhanced with self-monitored exercise training. Exercise training following CRT should be seen as part of CRT treatment and patients should be encouraged to perform self-monitored exer-cise training by professionals.", "language": "en", "element": "description", "qualifier": "abstract", "schema": "dc"}, {"key": "dc.description.provenance", "value": "Submitted using Plone Publishing form by Miia Hakanen (mihakane) on 2014-11-21 07:43:47.527764. Form: Admin-lomake opinn\u00e4ytteiden julkaisuun (https://kirjasto.jyu.fi/julkaisut/julkaisulomakkeet/admin-lomake-opinnaytteet). JyX data: [jyx_publishing-allowed (fi) =True]", "language": "en", "element": "description", "qualifier": "provenance", "schema": "dc"}, {"key": "dc.description.provenance", "value": "Submitted by jyx lomake-julkaisija (jyx-julkaisija@noreply.fi) on 2014-11-21T07:43:47Z\r\nNo. of bitstreams: 2\r\nURN:NBN:fi:jyu-201411213327.pdf: 354746 bytes, checksum: 83965c097a5902f5ee53c1335bb9d78a (MD5)\r\nlicense.html: 107 bytes, checksum: a7d86e598caa500b1b433bbb9dc8ef1c (MD5)", "language": "en", "element": "description", "qualifier": "provenance", "schema": "dc"}, {"key": "dc.description.provenance", "value": "Made available in DSpace on 2014-11-21T07:43:48Z (GMT). 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{"key": "dc.title", "value": "Liikuntaharjoittelu syd\u00e4nt\u00e4 synkronoivassa tahdistinhoidossa : omatoimisen liikuntaharjoittelun yhteys vajaatoimintatahdistinpotilaan fyysiseen suorituskykyyn ja el\u00e4m\u00e4nlaatuun", "language": null, "element": "title", "qualifier": null, "schema": "dc"}, {"key": "dc.title.alternative", "value": "Omatoimisen liikuntaharjoittelun yhteys vajaatoimintatahdistinpotilaan fyysiseen suorituskykyyn ja el\u00e4m\u00e4nlaatuun", "language": null, "element": "title", "qualifier": "alternative", "schema": "dc"}, {"key": "dc.type", "value": "master thesis", "language": null, "element": "type", "qualifier": null, "schema": "dc"}, {"key": "dc.identifier.urn", "value": "URN:NBN:fi:jyu-201411213327", "language": null, "element": "identifier", "qualifier": "urn", "schema": "dc"}, {"key": "dc.type.ontasot", "value": "Pro gradu -tutkielma", "language": "fi", "element": "type", "qualifier": "ontasot", "schema": "dc"}, {"key": "dc.type.ontasot", "value": 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