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[{"key": "dc.contributor.advisor", "value": "H\u00e4kkinen, Arja", "language": "", "element": "contributor", "qualifier": "advisor", "schema": "dc"}, {"key": "dc.contributor.advisor", "value": "Kilpikoski, Sinikka", "language": "", "element": "contributor", "qualifier": "advisor", "schema": "dc"}, {"key": "dc.contributor.author", "value": "Niemist\u00f6, Esa", "language": "", "element": "contributor", "qualifier": "author", "schema": "dc"}, {"key": "dc.date.accessioned", "value": "2019-06-14T11:28:03Z", "language": null, "element": "date", "qualifier": "accessioned", "schema": "dc"}, {"key": "dc.date.available", "value": "2019-06-14T11:28:03Z", "language": null, "element": "date", "qualifier": "available", "schema": "dc"}, {"key": "dc.date.issued", "value": "2019", "language": "", "element": "date", "qualifier": "issued", "schema": "dc"}, {"key": "dc.identifier.uri", "value": "https://jyx.jyu.fi/handle/123456789/64643", "language": null, "element": "identifier", "qualifier": "uri", "schema": "dc"}, {"key": "dc.description.abstract", "value": "Alaselk\u00e4kipua ja siihen liittyv\u00e4\u00e4 iskiasoireyhtym\u00e4\u00e4 esiintyy yleisesti ty\u00f6- ja keski-ik\u00e4isess\u00e4 v\u00e4est\u00f6ss\u00e4. Iskiasoireyhtym\u00e4st\u00e4 paraneminen on hitaampaa kuin alaselk\u00e4kivusta. Magneettikuvanta-misen avulla voidaan tutkia lannerangan ja sen ymp\u00e4r\u00f6ivien kudosten poikkeavuuksia. Yleinen kuvantamisl\u00f6yd\u00f6s on v\u00e4lilevypullistuma tai -tyr\u00e4, joka voi aiheuttaa hermojuurikompression. Mekaanisen diagnosointi ja terapia (MDT) -menetelm\u00e4n kliininen arviointi pohjautuu potilaan esitietoihin, neurologisiin ja neurodynaamisiin testeihin sek\u00e4 alasel\u00e4n liikkeiden toistotesteihin ja staattisiin asentoihin. Kliinisen arvioinnin aikana voidaan havaita oireiden sentralisoituminen tai periferioituminen, joiden oletetaan viittaavan v\u00e4lilevyper\u00e4iseen ongelmaan. Jos oireisiin ei tule muutoksia, kyseess\u00e4 oletetaan olevan muu kuin v\u00e4lilevyper\u00e4inen ongelma. T\u00e4m\u00e4n tutkimuksen tarkoituksena on testata MDT -menetelm\u00e4n kyky\u00e4 l\u00f6yt\u00e4\u00e4 v\u00e4lilevyper\u00e4inen iskiasoireyhtym\u00e4. MDT -menetelm\u00e4n kriteerivaliditeettina toimii magneettikuvantamisen l\u00f6yd\u00f6kset.\n\nTutkimusaineisto on ker\u00e4tty Keski-Suomen keskussairaalaan pitkittyneen iskiasvaivan vuoksi l\u00e4hetetyist\u00e4 potilaista 2016-2018 aikana. Potilaat (N=121) ovat 18-65 -vuotiaita, joilla on ollut iskiasoireyhtym\u00e4\u00e4n viittaavia oireita v\u00e4hint\u00e4\u00e4n kuuden viikon ajan molemmissa tai toisessa alaraajassa. Kokeneet fysioterapeutit tekiv\u00e4t kliinisen arvioinnin ja luokittelivat potilaat sentralisoitujiin, periferioitujiin ja heihin, joilla ei tapahtunut oireiden muutoksia. Radiologit tekiv\u00e4t magneettikuvantamiseen perustuvat lausunnot, joista luokiteltiin erikseen hermojuurikompressiot sek\u00e4 v\u00e4lilevypullistuma ja -tyr\u00e4l\u00f6yd\u00f6kset. Tulosten analysoinnissa k\u00e4ytetiin SPSS-ohjelman ristiintaulukointia, jonka avulla laskettiin MDT-luokituksen sensitiivisyys (Sn), spesifisyys (Sp) ja uskottavuusosam\u00e4\u00e4r\u00e4 (LR+/-). \n\nMagneettikuvantamisen tulosten mukaan 81 potilaalla oli v\u00e4lilevytyr\u00e4n aiheuttama hermojuuri-kompressio ja 101 potilaalla oli v\u00e4lilevypullistuma tai -tyr\u00e4. Yhdeks\u00e4ll\u00e4 potilaalla oli normaali v\u00e4lilevy ja 11 potilaalla hermojuurikompression aiheuttaja oli jokin muu kuin v\u00e4lilevytyr\u00e4. MDT -menetelm\u00e4ll\u00e4 l\u00f6ydettiin 67 v\u00e4lilevytyr\u00e4n aiheuttamaa hermojuurikompressiota (Sn 0.83, Sp 0.18, LR+ 1.01, LR- 0.94) ja 85 v\u00e4lilevypullistumaa tai -tyr\u00e4\u00e4 (Sn 0.84, Sp 0.25, LR+ 1.12, LR- 0.64). MDT-menetelm\u00e4n sensitiivisyys havaita v\u00e4lilevyper\u00e4inen iskiasoireyhtym\u00e4 on korkea, mutta spesifisyys ja uskottavuusosam\u00e4\u00e4r\u00e4 ovat alhaisia. \n\nMDT -menetelm\u00e4 ei ollut diagnostisesti tarkka l\u00f6yt\u00e4m\u00e4\u00e4n v\u00e4lilevytyr\u00e4n aiheuttamaa hermojuuri-kompressiota tai v\u00e4lilevypullistumaa ja -tyr\u00e4\u00e4. MDT-menetelm\u00e4n diagnostisesta tarkkuudesta tarvitaan lis\u00e4tutkimusta.", "language": "fi", "element": "description", "qualifier": "abstract", "schema": "dc"}, {"key": "dc.description.abstract", "value": "Low back pain and sciatica are common health problem among working and middle-aged peo-ple. Recovering from sciatica is slower than low back pain. Magnetic resonance imaging (MRI) is used to find abnormalities from lumbar spine. A common finding is a disk bulge or disc herniation, which can cause a nerve root compression. Mechanical Diagnosis and Therapy (MDT) method is based on patient\u2019s history, neurologic and neurodynamic tests, repeated movement tests and static postures of low back. During clinical assessment centralization or peripheralization can occur, which are assumed to indicate disc-based condition. If there aren\u2019t any changes in patient\u2019s symptoms, it is assumed to be something else than disc-based condition. The pur-pose of this Master Thesis is to study MDT method\u2019s ability to find disc-based sciatica. MDT method\u2019s criterion validity is based on MRI findings. \n\nResearch data was gathered from patients, who are send to Central Finland\u2019s Central Hospital due to prolonged sciatica symptoms during years 2016-2018. Patients (N=121) are 18-65 years old, who have had sciatica symptoms for at least six weeks in both or one other lower limb. Experienced physiotherapists performed clinical assessment and classified patients as centralizers, peripheralizers and those whose symptoms did not change. Radiologists analyzed MRI findings and classified nerve root compressions, disc bulges, herniations and other findings. SPSS program\u2019s crosstabs were used in statistical analysis to calculate MDT classification\u2019s sensitivity (Sn), specificity (Sp), positive and negative likelihood ratio (LR+/).\n\nAccording of MRI results 81 patients had nerve root compressions caused by disk herniation and 101 patients had disk bulge or herniation. Nine patients had normal disk and 11 patients had nerve root compression caused by another lumbar spine abnormality. With MDT method 67 nerve root compressions caused by disk herniation (Sn 0.83, Sp 0.18, LR+ 1.01, LR- 0.94) and 85 disk bulges or herniations (Sn 0.84, Sp 0.25, LR+ 1.12, LR- 0.64) were found. MDT meth-od\u2019s sensitivity to find disc-based sciatica is high, but specificity and likelihood ratios are low.\n\nMDT method wasn\u2019t diagnostic accurate to find nerve root compression caused by disk herniation nor disk bulge or herniation. MDT method\u2019s diagnostic accuracy needs more research.", "language": "en", "element": "description", "qualifier": "abstract", "schema": "dc"}, {"key": "dc.description.provenance", "value": "Submitted by Paivi Vuorio (paelvuor@jyu.fi) on 2019-06-14T11:28:02Z\nNo. of bitstreams: 0", "language": "en", "element": "description", "qualifier": "provenance", "schema": "dc"}, {"key": "dc.description.provenance", "value": "Made available in DSpace on 2019-06-14T11:28:03Z (GMT). No. of bitstreams: 0\n Previous issue date: 2019", "language": "en", "element": "description", "qualifier": "provenance", "schema": "dc"}, {"key": "dc.format.extent", "value": "66", "language": "", "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": "fin", "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": "MDT -menetelm\u00e4", "language": "", "element": "subject", "qualifier": "other", "schema": "dc"}, {"key": "dc.subject.other", "value": "magneettikuvantaminen", "language": "", "element": "subject", "qualifier": "other", "schema": "dc"}, {"key": "dc.subject.other", "value": "alaselk\u00e4kipu", "language": "", "element": "subject", "qualifier": "other", "schema": "dc"}, {"key": "dc.subject.other", "value": "iskiasoireyhtym\u00e4", "language": "", "element": "subject", "qualifier": "other", "schema": "dc"}, {"key": "dc.subject.other", "value": "diagnostinen tutkimus", "language": "", "element": "subject", "qualifier": "other", "schema": "dc"}, {"key": "dc.title", "value": "Mekaanisen Diagnosointi ja Terapia -menetelm\u00e4n diagnostinen tarkkuus havaita v\u00e4lilevyper\u00e4inen iskiasoireyhtym\u00e4", "language": "", "element": "title", "qualifier": null, "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-201906143229", "language": "", "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": "Master\u2019s thesis", "language": "en", "element": "type", "qualifier": "ontasot", "schema": "dc"}, {"key": "dc.contributor.faculty", "value": "Liikuntatieteellinen tiedekunta", "language": "fi", "element": "contributor", "qualifier": "faculty", "schema": "dc"}, {"key": "dc.contributor.faculty", "value": "Faculty of Sport and Health Sciences", "language": "en", "element": "contributor", "qualifier": "faculty", "schema": "dc"}, {"key": "dc.contributor.department", "value": "Liikunta- ja terveystieteet", "language": "fi", "element": "contributor", "qualifier": "department", "schema": "dc"}, {"key": "dc.contributor.department", "value": "Sport and Health Sciences", "language": "en", "element": "contributor", "qualifier": "department", "schema": "dc"}, {"key": "dc.contributor.organization", "value": "Jyv\u00e4skyl\u00e4n yliopisto", "language": "fi", "element": "contributor", "qualifier": "organization", "schema": "dc"}, {"key": "dc.contributor.organization", "value": "University of Jyv\u00e4skyl\u00e4", "language": "en", "element": "contributor", "qualifier": "organization", "schema": "dc"}, {"key": "dc.subject.discipline", "value": "Fysioterapia", "language": "fi", "element": "subject", "qualifier": "discipline", "schema": "dc"}, {"key": "dc.subject.discipline", "value": "Physiotherapy", "language": "en", "element": "subject", "qualifier": "discipline", "schema": "dc"}, {"key": "yvv.contractresearch.collaborator", "value": "public", "language": "", "element": "contractresearch", "qualifier": "collaborator", "schema": "yvv"}, {"key": "yvv.contractresearch.funding", "value": "0", "language": "", "element": "contractresearch", "qualifier": "funding", "schema": "yvv"}, {"key": "yvv.contractresearch.initiative", "value": "student", "language": "", "element": "contractresearch", "qualifier": "initiative", "schema": "yvv"}, {"key": "dc.type.coar", "value": "http://purl.org/coar/resource_type/c_bdcc", "language": null, "element": "type", "qualifier": "coar", "schema": "dc"}, {"key": "dc.rights.accesslevel", "value": "restrictedAccess", "language": null, "element": "rights", "qualifier": "accesslevel", "schema": "dc"}, {"key": "dc.type.publication", "value": "masterThesis", "language": null, "element": "type", "qualifier": "publication", "schema": "dc"}, {"key": "dc.subject.oppiainekoodi", "value": "50422", "language": "", "element": "subject", "qualifier": "oppiainekoodi", "schema": "dc"}, {"key": "dc.subject.yso", "value": "diagnostiikka", "language": null, "element": "subject", "qualifier": "yso", "schema": "dc"}, {"key": "dc.subject.yso", "value": "iskias", "language": null, "element": "subject", "qualifier": "yso", "schema": "dc"}, {"key": "dc.subject.yso", "value": "magneettikuvaus", "language": null, "element": "subject", "qualifier": "yso", "schema": "dc"}, {"key": "dc.format.content", "value": "fulltext", "language": null, "element": "format", "qualifier": "content", "schema": "dc"}, {"key": "dc.rights.url", "value": "https://rightsstatements.org/page/InC/1.0/", "language": null, "element": "rights", "qualifier": "url", "schema": "dc"}, {"key": "dc.rights.accessrights", "value": "The author has not given permission to make the work publicly available electronically. Therefore the material can be read only at the archival workstation at Jyv\u00e4skyl\u00e4 University Library (https://kirjasto.jyu.fi/en/workspaces/facilities).", "language": "en", "element": "rights", "qualifier": "accessrights", "schema": "dc"}, {"key": "dc.rights.accessrights", "value": "Tekij\u00e4 ei ole antanut lupaa avoimeen julkaisuun, joten aineisto on luettavissa vain Jyv\u00e4skyl\u00e4n yliopiston kirjaston arkistoty\u00f6semalta. Ks. https://kirjasto.jyu.fi/fi/tyoskentelytilat/laitteet-ja-tilat..", "language": "fi", "element": "rights", "qualifier": "accessrights", "schema": "dc"}, {"key": "dc.type.okm", "value": "G2", "language": null, "element": "type", "qualifier": "okm", "schema": "dc"}]
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