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[{"key": "dc.contributor.advisor", "value": "Avela, Janne", "language": "", "element": "contributor", "qualifier": "advisor", "schema": "dc"}, {"key": "dc.contributor.author", "value": "Peltoniemi, Mika", "language": "", "element": "contributor", "qualifier": "author", "schema": "dc"}, {"key": "dc.date.accessioned", "value": "2019-12-18T11:07:06Z", "language": null, "element": "date", "qualifier": "accessioned", "schema": "dc"}, {"key": "dc.date.available", "value": "2019-12-18T11:07:06Z", "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/123456789/66925", "language": null, "element": "identifier", "qualifier": "uri", "schema": "dc"}, {"key": "dc.description.abstract", "value": "CP-vamma kulkee ihmisen mukana koko el\u00e4m\u00e4n ajan varhaislapsuudesta aikuisuuteen, sill\u00e4 t\u00e4ysin parantavaa keinoa aivovaurion korjaamiseen ei ole l\u00f6ydetty. Ongelmat n\u00e4ytt\u00e4ytyv\u00e4t erityisesti liikkumisessa ja muussa motorisessa toiminnassa. Kasvun my\u00f6t\u00e4 cp-vamman oirekuva muuttuu, jonka my\u00f6t\u00e4 moniammatillisia kuntoutuskeinoja on kehitetty cp-vammaisten toimintakyvyn ja yleisen terveyden tukemiseksi. Liikunnallisen kuntoutuksen on todettu tutkimuksissa parantavan cp-vammaisten lihasvoimaa, k\u00e4velykyky\u00e4 ja kest\u00e4vyyskuntoa. Uusien cp-vammaisten liikuntasuositusten mukaisesti teht\u00e4v\u00e4\u00e4 k\u00e4velyharjoittelua ja voimaharjoittelua yhdist\u00e4m\u00e4ll\u00e4 ajatellaan saatavan hy\u00f6tyj\u00e4 k\u00e4velynopeudessa, k\u00e4velyn kinematiikassa ja k\u00e4velykyvyss\u00e4 laajemmin kuin pelk\u00e4st\u00e4\u00e4n yhden tyyppisell\u00e4 harjoittelulla. Lis\u00e4ksi 3D-k\u00e4velyanalyysin avulla voidaan suunnitella voima- ja k\u00e4velyharjoittelu yksil\u00f6idysti. T\u00e4m\u00e4n tutkimuksen tarkoituksena on tarkastella kahdesta kolmeen viikkoharjoitusta sis\u00e4lt\u00e4v\u00e4n yksil\u00f6idyn kolmen kuukauden liikuntaintervention vaikutuksia alaraajojen k\u00e4velyn kinematiikkaan, voimatasoihin ja k\u00e4velysuorituskykyyn kolmella cp-vammaisella.\n\nKolme spastisen (hemiplegia tai diplegia, GMFCS-tasot I-III) cp-vamman (16-21 vuotta) omaavaa miest\u00e4 osallistui tutkimukseen osana EXECP-tutkimusta. Kolmen kuukauden liikuntainterventio koostui kahdesta kolmeen valvotusta harjoituskerrasta viikossa. Kukin harjoituskerta sis\u00e4lsi k\u00e4velyharjoittelua moottoroimattomalla k\u00e4velymatolla, voimaharjoittelua ja liikkuvuusharjoittelua t\u00e4rkeimmille alaraajojen lihaksille. Mittausten 3D-liikeanalyysiss\u00e4 tutkittavat k\u00e4veliv\u00e4t kuudesti yhden minuutin mittausk\u00e4velyn minuutin palautusajalla. Alaraajojen 3D-kinematiikka mitattiin kahdeksan kameran liikkeenkaappausj\u00e4rjestelm\u00e4ll\u00e4 200 Hz mittaustaajuudella, lis\u00e4ksi samalla mitattiin s\u00e4\u00e4ren lihasten lihasaktiivisuuksia langattomalla EMG:ll\u00e4 sek\u00e4 k\u00e4velyn reaktiovoimia kahdella upotetulla voimalevyll\u00e4 1 kHz mittaustaajuudella. Kinematiikka analysoitiin Visual3D-ohjelmalla. Kuuden minuutin k\u00e4velytesti (6MWT) suoritettiin liikeanalyysimittausten j\u00e4lkeen. Nilkan koukistaja- ja ojentajalihaksien voimantuottoa mitattiin nilkkadynamometrissa erillisen\u00e4 testikertana. Kaikki mittaukset toistettiin ennen ja j\u00e4lkeen intervention. \n\nTutkimuksen perusteella liikuntainterventio voi todenn\u00e4k\u00f6isesti kehitt\u00e4\u00e4 k\u00e4velysuorituskyky\u00e4 ja alaraajojen voimatasoja nuorilla CP-vammaisilla. Kuitenkaan k\u00e4velysuorituskyvyn positiiviset muutokset eiv\u00e4t kulje k\u00e4si k\u00e4dess\u00e4 kinematiikalla arvioidun k\u00e4velytekniikan muutoksien kanssa. Suurin osa vahingollisista nivelten kompensaatioista ja ep\u00e4edullisista k\u00e4velymalleista toistuivat my\u00f6s intervention j\u00e4lkeen k\u00e4velyanalyysimittauksissa. Hemiplegia-tutkittavalla ep\u00e4symmetriaa vasemman ja oikean jalan v\u00e4lill\u00e4 saatiin v\u00e4hennetty\u00e4 spatiotemporaalisten k\u00e4velymuuttujien ja isometristen voimamuuttujien osalta. Vain yksi tutkittava, diplegikko, pystyi parantamaan heikomman puolen varpaiden nostoa k\u00e4velysyklin p\u00e4\u00e4teheilahdusvaiheessa. S\u00e4\u00e4ren lihasten aktivoitumisj\u00e4rjestyksest\u00e4 havaittiin kolmip\u00e4isen pohjelihaksen aktivoituvan kahdella tutkittavalla ennenaikaisesti jo heilahdusvaiheessa, jolloin aktiivisuus meni p\u00e4\u00e4llekk\u00e4in etummaisen s\u00e4\u00e4rilihaksen kanssa. K\u00e4velysuorituskyky kehittyi kahdella tutkittavalla (5,8 ja 8,1 %). Intervention pituus ei mahdollisesti ollut riitt\u00e4v\u00e4n pitk\u00e4 aiheuttamaan muutoksia ep\u00e4edullisissa k\u00e4velymalleissa, mutta toi silti muutoksia k\u00e4velysuorituskykyyn. K\u00e4vely on CP-vammaisilla hyvin yksil\u00f6llist\u00e4 ja t\u00e4m\u00e4 tutkimus tarjoaa huomioon otettavia seikkoja CP-vammaisten nuorten harjoittelua ja kuntoutusta yksil\u00f6it\u00e4ess\u00e4.", "language": "fi", "element": "description", "qualifier": "abstract", "schema": "dc"}, {"key": "dc.description.abstract", "value": "Cerebral palsy (CP) affects individuals throughout their lifetime, usually introducing detrimental changes in ambulatory abilities. Various management strategies to support functional abilities and overall health in order to minimize the effects of the CP have been published. Several studies have shown positive results using different kinds of exercise therapy interventions to increase strength, motor activity or cardiovascular fitness. It is hypothesized that the intervention including both treadmill training and muscle strengthening will enhance walking speed, improve gait kinematics and ankle dorsiflexion. Also, evaluating lower limb functionality with gait analysis could improve the prescription of resistance training exercises for people with CP. The purpose of this study is to show does the three-month tailored exercise therapy intervention, consisting of two to three supervised sessions per week, provide benefits to lower-body gait kinematics, gait performance and lower limb function for three different CP case subjects.\n\nA convenience sample of three male (16-21 years old) with spastic CP (hemiplegic or diplegic, GMFCS I-III) participated in the study. The twelve-week exercise therapy intervention consisted of two to three supervised sessions per week. Each training session started with gait training on a non-motorized incline treadmill with hands supported, was followed by strength and flexibility training for main lower limb muscles. In the gait analysis session, participants performed six times one-minute walking trials with one-minute rest between trials. Lower limb 3D kinematics were acquired with an eight-camera motion capture system at 200 Hz, and in addition to calf muscle wireless EMG, forces were simultaneously measured with two mounted force plates at 1 kHz sampling frequency. Kinematics were analyzed in Visual3D software. Six-minute walk test (6MWT) was performed after the gait analysis. Plantar and dorsiflexor force production was measured in custom-built ankle dynamometer. Measurement results PRE and POST intervention were compared.\n\nIntervention may likely improve the gait performance and strength in adolescents and young adults with CP. However, improvements do not happen hand in hand with gait quality as mostly the same compensations and pathological gait patterns were present also after the intervention. The differences in spatiotemporal gait and isometric torque parameters between affected and non-affected limbs reduced after intervention in the hemiplegic participant. Toe lift of the more affected leg in the terminal swing was slightly improved in one diplegic case. While one diplegic participant had typical EMG onset pattern, triceps surae muscle activity started prematurely in terminal swing in the other two participants overlapping with TA activity. The distance walked in 6MWT improved in two participants (5.8 and 8.1%). This study provides more means and considerations to individualize the training or treatment for children with CP. The intervention period may not be long enough to induce changes on motor patterns and major gait deviations such as crouch gait but may improve gait performance. The underlying neuromechanical and cortical mechanisms should be studied to understand better the changes that are induced because of a training intervention.", "language": "en", "element": "description", "qualifier": "abstract", "schema": "dc"}, {"key": "dc.description.provenance", "value": "Submitted by Paivi Vuorio (paelvuor@jyu.fi) on 2019-12-18T11:07:06Z\nNo. of bitstreams: 0", "language": "en", "element": "description", "qualifier": "provenance", "schema": "dc"}, {"key": "dc.description.provenance", "value": "Made available in DSpace on 2019-12-18T11:07:06Z (GMT). No. of bitstreams: 0\n Previous issue date: 2019", "language": "en", "element": "description", "qualifier": "provenance", "schema": "dc"}, {"key": "dc.format.extent", "value": "129", "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": "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": "gait analysis", "language": "", "element": "subject", "qualifier": "other", "schema": "dc"}, {"key": "dc.title", "value": "Effects of exercise intervention on gait kinematics and lower limb function of adolescents and young adults with cerebral palsy", "language": "", "element": "title", "qualifier": null, "schema": 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