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[{"key": "dc.contributor.advisor", "value": "H\u00e4kkinen, Arja", "language": "", "element": "contributor", "qualifier": "advisor", "schema": "dc"}, {"key": "dc.contributor.author", "value": "Poutanen, Joonas", "language": "", "element": "contributor", "qualifier": "author", "schema": "dc"}, {"key": "dc.date.accessioned", "value": "2019-10-25T06:12:09Z", "language": null, "element": "date", "qualifier": "accessioned", "schema": "dc"}, {"key": "dc.date.available", "value": "2019-10-25T06:12:09Z", "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/123456789/66043", "language": null, "element": "identifier", "qualifier": "uri", "schema": "dc"}, {"key": "dc.description.abstract", "value": "Iskiaksessa kivun kokemiseen ja kroonistumiseen, sek\u00e4 siit\u00e4 aiheutuviin toimintarajoitteisiin vaikuttaa fyysisten syiden lis\u00e4ksi psykososiaalisia tekij\u00f6it\u00e4, kuten pelkov\u00e4ltt\u00e4misuskomuksia. Pelkov\u00e4ltt\u00e4misuskomuksilla on negatiivisia vaikutuksia muun muassa toimintakykyyn ja kipuun, jonka vuoksi ne tulisi huomioida iskiaksen hoidossa pyritt\u00e4ess\u00e4 optimoimaan kuntoutuksen tuloksellisuus. T\u00e4m\u00e4n tutkimuksen tarkoituksena oli arvioida McKenzie terapian vaikutusta pelkov\u00e4ltt\u00e4misuskomuksiin iskiasoireisilla potilailla verrattuna K\u00e4yp\u00e4 hoito -suosituksen mukaiseen ohjaukseen, jossa ohjataan pysym\u00e4\u00e4n normaalisti aktiivisena. Lis\u00e4ksi tarkasteltiin pelkov\u00e4ltt\u00e4misuskomusten muutoksen yhteytt\u00e4 toimintakyvyn, depressiivisten oireiden ja kivun muutoksiin.\nTutkimukseen osallistui yhteens\u00e4 136, i\u00e4lt\u00e4\u00e4n 18\u201360-vuotiaista henkil\u00f6\u00e4, joilla oireet olivat kest\u00e4neet v\u00e4hint\u00e4\u00e4n kuusi viikkoa. Tutkittavat satunnaistettiin interventioryhm\u00e4\u00e4n (n = 66), joita hoidettiin McKenzie terapialla ja kontrolliryhm\u00e4\u00e4n (n = 70), jotka saivat K\u00e4yp\u00e4 hoito -suosituksen mukaista ohjausta. Pelkov\u00e4ltt\u00e4misuskomuksia arvioitiin Fear-Avoidance Beliefs Questionnaire (FABQ) -kyselyll\u00e4, johon osallistujat vastasivat tutkimuksen alussa ja kolmen kuukauden j\u00e4lkeen. Pelkov\u00e4ltt\u00e4misuskomusten muutosten yhteytt\u00e4 toimintakyvyn, depressiivisten oireiden ja kivun muutoksiin arvioitiin Oswestry Disability Index (ODI), Depression Scale (DEPS) ja Visual Analogue Scale (VAS) -kyselyill\u00e4.\nLopulliseen tilastolliseen analyysiin otettiin mukaan yhteens\u00e4 71 tutkittavaa (Interventioryhm\u00e4: n = 39, kontrolliryhm\u00e4: n = 32). Tulosten mukaan pelkov\u00e4ltt\u00e4misuskomuksissa ei ollut eroja ryhmien v\u00e4lill\u00e4 kolmen kuukauden seurannassa (p = 0,651). Pelkov\u00e4ltt\u00e4misuskomukset v\u00e4heniv\u00e4t ainoastaan kontrolliryhm\u00e4ll\u00e4 (FABQ kokonaispisteiden keskiarvon muutos: -10,2, p = 0,006). Puolestaan fyysiseen aktiivisuuteen liittyv\u00e4t pelkov\u00e4ltt\u00e4misuskomukset v\u00e4heniv\u00e4t molemmissa ryhmiss\u00e4 (FABQ-PA osapisteiden keskiarvon muutos: Interventioryhm\u00e4 -4,7 ja kontrolliryhm\u00e4 -6,9, p < 0,001). Pelkov\u00e4ltt\u00e4misuskomusten muutos oli positiivisesti yhteydess\u00e4 toimintakyvyn, selk\u00e4kivun ja alaraajakivun muutoksiin molemmissa ryhmiss\u00e4 (r = 0,360\u20130,585, p < 0,05). Lis\u00e4ksi interventioryhm\u00e4ll\u00e4 havaittiin vastaavanlainen yhteys depressiivisten oireiden muutokseen (r = 0,429, p = 0,014).\nT\u00e4m\u00e4n tutkimuksen tulosten perusteella McKenzie terapia ei ollut K\u00e4yp\u00e4 hoito -suosituksen mukaista ohjausta vaikuttavampi hoitomuoto v\u00e4hent\u00e4m\u00e4\u00e4n pelkov\u00e4ltt\u00e4misuskomuksia iskiasoireisilla potilailla lyhyell\u00e4 aikav\u00e4lill\u00e4. Tulevaisuudessa tutkimuksissa tulisi tunnistaa ne henkil\u00f6t, joilla jo l\u00e4ht\u00f6kohtaisesti on kliinisesti merkitt\u00e4v\u00e4sti pelkov\u00e4ltt\u00e4misuskomuksia ja fokusoida interventiot heihin, jolloin muutosten aikaansaaminen saattaa olla todenn\u00e4k\u00f6isemp\u00e4\u00e4. Lis\u00e4\u00e4 tutkimuksia tarvitaan pelkov\u00e4ltt\u00e4misuskomuksiin kohdistuvista erilaisista kuntoutusinterventioista eri potilasryhmill\u00e4.", "language": "fi", "element": "description", "qualifier": "abstract", "schema": "dc"}, {"key": "dc.description.provenance", "value": "Submitted by Paivi Vuorio (paelvuor@jyu.fi) on 2019-10-25T06:12:09Z\nNo. of bitstreams: 0", "language": "en", "element": "description", "qualifier": "provenance", "schema": "dc"}, {"key": "dc.description.provenance", "value": "Made available in DSpace on 2019-10-25T06:12:09Z (GMT). No. of bitstreams: 0\n Previous issue date: 2019", "language": "en", "element": "description", "qualifier": "provenance", "schema": "dc"}, {"key": "dc.format.extent", "value": "61", "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": "pelkov\u00e4ltt\u00e4misuskomukset", "language": "", "element": "subject", "qualifier": "other", "schema": "dc"}, {"key": "dc.subject.other", "value": "McKenzie terapia", "language": "", "element": "subject", "qualifier": "other", "schema": "dc"}, {"key": "dc.subject.other", "value": "MDT", "language": "", "element": "subject", "qualifier": "other", "schema": "dc"}, {"key": "dc.title", "value": "McKenzie terapian vaikutus pelkov\u00e4ltt\u00e4misuskomuksiin iskiasoireisilla potilailla", "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-201910254608", "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.funding", "value": "0", "language": "", "element": "contractresearch", "qualifier": "funding", "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": "openAccess", "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": "hoitomenetelm\u00e4t", "language": null, "element": "subject", "qualifier": "yso", "schema": "dc"}, {"key": "dc.subject.yso", "value": "fysioterapia", "language": null, "element": "subject", "qualifier": "yso", "schema": "dc"}, {"key": "dc.subject.yso", "value": "kipu", "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": "toimintakyky", "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.type.okm", "value": "G2", "language": null, "element": "type", "qualifier": "okm", "schema": "dc"}]
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