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[{"key": "dc.contributor.advisor", "value": "H\u00e4kkinen, Arja", "language": "", "element": "contributor", "qualifier": "advisor", "schema": "dc"}, {"key": "dc.contributor.author", "value": "Lepp\u00e4korpi, Tanja", "language": "", "element": "contributor", "qualifier": "author", "schema": "dc"}, {"key": "dc.date.accessioned", "value": "2020-12-07T13:54:00Z", "language": null, "element": "date", "qualifier": "accessioned", "schema": "dc"}, {"key": "dc.date.available", "value": "2020-12-07T13:54:00Z", "language": null, "element": "date", "qualifier": "available", "schema": "dc"}, {"key": "dc.date.issued", "value": "2020", "language": "", "element": "date", "qualifier": "issued", "schema": "dc"}, {"key": "dc.identifier.uri", "value": "https://jyx.jyu.fi/handle/123456789/73003", "language": null, "element": "identifier", "qualifier": "uri", "schema": "dc"}, {"key": "dc.description.abstract", "value": "V\u00e4lilevyn pullistumasta johtuvia iskiasoireita hoidetaan sek\u00e4 konservatiivisesti, ett\u00e4 operatiivisesti v\u00e4lilevytyr\u00e4leikkauksella. Erilaisia konservatiivisia hoitomuotoja on tutkittu paljon, mutta edelleen on ep\u00e4selv\u00e4\u00e4, mik\u00e4 menetelm\u00e4 olisi tehokkain oireiden lievityksess\u00e4 ja leikkausten v\u00e4hent\u00e4misess\u00e4. T\u00e4m\u00e4n tutkimuksen tarkoituksena oli arvioida McKenzie-menetelm\u00e4n vaikutusta leikkausarvioon l\u00e4hetettyjen iskiasoireisten potilaiden selk\u00e4- ja alaraajakipuun, toimintakykyyn sek\u00e4 v\u00e4lilevytyr\u00e4leikkausten m\u00e4\u00e4r\u00e4\u00e4n verrattuna tavanomaiseen hoitoon. \n\nTutkimukseen rekrytoitiin 150 tutkittavaa, joilla oli v\u00e4hint\u00e4\u00e4n kuusi viikkoa kest\u00e4nyt iskiasvaiva. Sis\u00e4\u00e4nottokriteerit t\u00e4ytt\u00e4neet tutkittavat satunnaistettiin interventioryhm\u00e4\u00e4n (n=43) ja kontrolliryhm\u00e4\u00e4n (n=46). Interventioryhm\u00e4l\u00e4iset saivat McKenzie-menetelm\u00e4n mukaista hoitoa 1-2 kertaa viikossa enint\u00e4\u00e4n 7 hoitokertaa, ja kontrolliryhm\u00e4l\u00e4iset tavanomaista hoitoa, eli 90 minuuttia kest\u00e4neen fysioterapeutin ohjauksen, sek\u00e4 ohjekirjasen. Tutkimuksen p\u00e4\u00e4tulosmuuttujina olivat selk\u00e4- ja alaraajakipu, joita mitattiin Visual Analogue Scale -mittarilla, sek\u00e4 toimintakyky, jota mitattiin Oswestry Disability Index 2.0 -kyselyll\u00e4 (ODI). V\u00e4lilevytyr\u00e4leikkaukseen p\u00e4\u00e4tyneiden m\u00e4\u00e4r\u00e4\u00e4 selvitettiin sairaalan tietoj\u00e4rjestelm\u00e4n avulla. Seurantamittaukset toteutettiin 3 ja 12 kuukauden kohdalla. Ryhmien v\u00e4lisi\u00e4 eroja kivun ja toimintakyvyn suhteen tarkasteltiin toistomittausten varianssianalyysill\u00e4 ja leikkausten m\u00e4\u00e4r\u00e4\u00e4 \u03c72-testill\u00e4. \n\nVuoden seurannan aikana v\u00e4lilevytyr\u00e4leikkauksen v\u00e4ltti 63 tutkittavaa (77%), joista 31 kuului interventioryhm\u00e4\u00e4n ja 32 kontrolliryhm\u00e4\u00e4n. Leikkauksen v\u00e4ltt\u00e4neiden m\u00e4\u00e4r\u00e4ss\u00e4 ei ollut eroa ryhmien v\u00e4lill\u00e4 3 kuukauden (p=0.56), eik\u00e4 12 kuukauden seurannassa (p=0.80). McKenzie-menetelm\u00e4n mukaisella luokittelulla havaittiin olevan yhteys v\u00e4lilevytyr\u00e4leikkausten m\u00e4\u00e4r\u00e4\u00e4n, ja derangement-luokkaan kuuluneista suurempi osa v\u00e4ltti leikkauksen verrattuna MUR-luokkaan (Mechanically Unresponsive Radicular syndrome) kuuluneisiin (p=0.004). Interventioryhm\u00e4n selk\u00e4kipu oli tutkimuksen alkuvaiheessa 44 mm ja v\u00e4heni 12 kuukauden seurannassa -21 mm (p<0.001). Kontrolliryhm\u00e4n selk\u00e4kipu oli alkuvaiheessa 50 mm ja v\u00e4heni -15 mm (p=0.003). Interventioryhm\u00e4ll\u00e4 kipu lievittyi kontrolliryhm\u00e4\u00e4 enemm\u00e4n (p=0.04). Interventioryhm\u00e4n alaraajakipu oli tutkimuksen alkuvaiheessa 55 mm ja v\u00e4heni vuoden seurannassa -29 mm (p<0.001). Kontrolliryhm\u00e4n alaraajakipu oli alussa 54 mm ja v\u00e4heni -19 mm (p<0.001). Interventioryhm\u00e4n ODI-toimintakykyindeksi oli tutkimuksen alkuvaiheessa 36, parantuen vuoden seurannassa 16 pisteell\u00e4 (p<0.001). Kontrolliryhm\u00e4n toimintakykyindeksi oli alussa 37 ja parantuen 14 pisteell\u00e4 (p<0.001). Ryhmien v\u00e4lill\u00e4 ei ollut eroa alaraajakivun lievityksess\u00e4 (p=0.14) eik\u00e4 toimintakyvyn parantumisessa (p=0.11).\n\nT\u00e4m\u00e4n tutkimuksen tulosten perusteella McKenzie-menetelm\u00e4 ja tavanomainen itsehoidon ohjaus olivat yht\u00e4 vaikuttavia hoitomuotoja v\u00e4hent\u00e4m\u00e4\u00e4n alaraajakipua ja parantamaan toimintakyky\u00e4 12 kuukauden seurannassa. My\u00f6s v\u00e4lilevytyr\u00e4leikkauksen v\u00e4ltt\u00e4neiden m\u00e4\u00e4r\u00e4t olivat samanlaiset molemmissa ryhmiss\u00e4. Sen sijaan McKenzie-menetelm\u00e4 oli hiukan vaikuttavampi hoitomuoto selk\u00e4kivun lievityksess\u00e4 verrattuna tavanomaiseen hoitoon. Jatkossa tarvitaan lis\u00e4\u00e4 tutkimusta siit\u00e4, mill\u00e4 menetelm\u00e4ll\u00e4 iskiasoireiden kokonaisuutta voidaan tehokkaimmin hoitaa, ja v\u00e4lilevytyr\u00e4leikkausten m\u00e4\u00e4r\u00e4\u00e4 v\u00e4hent\u00e4\u00e4.", "language": "fi", "element": "description", "qualifier": "abstract", "schema": "dc"}, {"key": "dc.description.abstract", "value": "Sciatica due to herniated disc can be treated conservatively or operatively by surgery. A variety of conservative therapies have been extensively studied, but it remains unclear which method is most effective in relieving sciatica symptoms and reducing surgery rates. The purpose of this study was to evaluate the effect of McKenzie method on back and leg pain, disability, and the number of lumbar disc surgeries in sciatica patients sent for surgery assessment compared to usual care.\n\nOne hundred fifty subjects with sciatica lasting at least six weeks were recruited for the study. Subjects who met the inclusion criteria were randomized into intervention group (n = 43) and the control group (n=46). The patient in the intervention group were treated by using the McKenzie method 1-2 times per week for up to 7 therapy sessions during two months period, and patients assigned into the control group were advised to stay active and received usual care treatment that included 90 minutes of physiotherapist guidance, and an educational booklet. Primary outcomes were intensity of low back and leg pain measured with Visual Analogue Scale, and disability measured with Oswestry Disability Index 2.0 -questionnaire (ODI). In addition, the number of subjects who had surgery was recorded into hospitals database. Outcomes were measured at baseline, and at 3 and 12 months after randomization. Between group differences in pain and disability were calculated by repeated measures ANOVA. Between group differences in the surgery rates was assessed by \u03c72-test. \n\nDuring the 12-month follow-up, 63 subjects (77%), avoided spine surgery, 31 from the intervention group and 32 from the control group. No significant between-group differences were found at 3-month follow up (p=0.56), and 12-month follow up (p=0.80). McKenzie method classification was related to the number of spine surgeries, and a larger proportion of those in the derangement group avoided surgery compared to the MUR (Mechanically Unresponsive Radicular syndrome) classification group. In the intervention group, back pain was 44 mm at baseline and decreased -21 mm at 12-month follow-up (p<0.001). In the control group, back pain was 50 mm at baseline, and decreased -15 mm (p=0.003). Significant between-group difference was found in back pain (p = 0.04). In the intervention group, leg pain was 55 mm at baseline and decreased -29 mm (p<0.001). In the control group, leg pain was 54 mm at baseline, and decreased -19 mm (p<0.001). In the intervention group, disability scores were 36 at baseline and decreased -16 (p<0.001). In the control group, scores were at baseline 37 and decreased -14 (p<0.001). No significant between-group differences were found in leg pain (p=0.14) or in disability (p=0.11).\n\nBased on the results of this study, McKenzie method and usual care were as effective in reducing leg pain and disability at 12-month follow-up. The numbers of those who avoided spine surgery were also similar in both groups. In contrast, the McKenzie method was a slightly more effective in reducing back pain compared to usual care. Further research is needed on the most effective method of treating sciatica and reducing the number of lumbar disc surgeries.", "language": "en", "element": "description", "qualifier": "abstract", "schema": "dc"}, {"key": "dc.description.provenance", "value": "Submitted by Paivi Vuorio (paelvuor@jyu.fi) on 2020-12-07T13:54:00Z\nNo. of bitstreams: 0", "language": "en", "element": "description", "qualifier": "provenance", "schema": "dc"}, {"key": "dc.description.provenance", "value": "Made available in DSpace on 2020-12-07T13:54:00Z (GMT). No. of bitstreams: 0\n Previous issue date: 2020", "language": "en", "element": "description", "qualifier": "provenance", "schema": "dc"}, {"key": "dc.format.extent", "value": "76", "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": "McKenzie-menetelm\u00e4", "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": "v\u00e4lilevytyr\u00e4leikkaus", "language": "", "element": "subject", "qualifier": "other", "schema": "dc"}, {"key": "dc.title", "value": "McKenzie-menetelm\u00e4n vaikutus kipuun, toimintakykyyn ja v\u00e4lilevytyr\u00e4leikkausten m\u00e4\u00e4r\u00e4\u00e4n iskiasoireisilla potilailla 12 kuukauden seurannassa verrattuna tavanomaiseen hoitoon", "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-202012076950", "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": "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": "iskias", "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": "hoitomenetelm\u00e4t", "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.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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