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[{"key": "dc.contributor.advisor", "value": "Juutinen, Taija", "language": "", "element": "contributor", "qualifier": "advisor", "schema": "dc"}, {"key": "dc.contributor.advisor", "value": "Kulmala, Juha-Pekka", "language": "", "element": "contributor", "qualifier": "advisor", "schema": "dc"}, {"key": "dc.contributor.author", "value": "Thiel, Tom", "language": "", "element": "contributor", "qualifier": "author", "schema": "dc"}, {"key": "dc.date.accessioned", "value": "2022-06-15T11:19:59Z", "language": null, "element": "date", "qualifier": "accessioned", "schema": "dc"}, {"key": "dc.date.available", "value": "2022-06-15T11:19:59Z", "language": null, "element": "date", "qualifier": "available", "schema": "dc"}, {"key": "dc.date.issued", "value": "2021", "language": "", "element": "date", "qualifier": "issued", "schema": "dc"}, {"key": "dc.identifier.uri", "value": "https://jyx.jyu.fi/handle/123456789/81749", "language": null, "element": "identifier", "qualifier": "uri", "schema": "dc"}, {"key": "dc.description.abstract", "value": "T\u00e4ss\u00e4 pro gradu -tutkielmassa tarkasteltiin monitasokirurgisten toimenpiteiden (SEMLS, Single-Event Multilevel Surgery) vaikutuksia spastisten CP-potilaiden k\u00e4velynopeuteen ja askelluspoikkeamien m\u00e4\u00e4r\u00e4\u00e4n. Ty\u00f6 oli retrospektiivinen analyysi 33 potilaan kohorttiin, joka koottiin Helsingin ja Uudenmaan sairaanhoitopiirin (HUS) liikelaboratoriossa toteutetuista kliinisist\u00e4 3-D k\u00e4velyanalyysituloksista. \n\nPotilaiden askellusta oli mitattu 3D-liikeanalyysill\u00e4 osana leikkausarviota ennen toimenpidett\u00e4 (pre) ja seurantamittauksissa vuosi (post1), kaksi vuotta (post2) ja viisi vuotta (post5) toimenpiteen j\u00e4lkeen. Liikeanalyysist\u00e4 saatuja tietoja hy\u00f6dynnettiin k\u00e4velynopeuden analysointiin ja kahden askelluspoikkeaman m\u00e4\u00e4r\u00e4\u00e4 kuvaavan indeksin laskentaan. Gait Deviation Index (GDI) kokoaa yhteen k\u00e4velyn kinemaattisia muuttujia ja kuvaa poikkeaman m\u00e4\u00e4r\u00e4n suhteessa normaaliin askellukseen. Plantar Flexion, Knee Extension -indeksi (PFKE, nilkan koukitus \u2013 polven ojennus) puolestaan kuvaa sagittaalitason poikkeamaa normaalista, polven ja nilkan osalta, keskitukivaiheen ajalta. PFKE-indeksist\u00e4 saatuja arvoja hy\u00f6dynnettiin my\u00f6s potilaiden automaattisessa, Roddan -mallin mukaisessa luokittelussa.\n\nKeskeisen\u00e4 tuloksena havaittiin, ett\u00e4 alaraajan pituuteen suhteutettu k\u00e4velynopeus laski pre- ja post1- tilanteen v\u00e4lill\u00e4 keskim\u00e4\u00e4rin 26 % (p < 0,05), eik\u00e4 tilastollisesti merkitsev\u00e4\u00e4 nousua tapahtunut post2 ja post5 mittauksiin. K\u00e4velyn kokonaispoikkeamaa kuvaava GDI puolestaan parani 14 % (p < 0,001) pre ja post1 tilanteen v\u00e4lill\u00e4, eik\u00e4 siin\u00e4 havaittu muutosta post2 ja post5 tilanteissa. Toimenpiteiden my\u00f6t\u00e4 PFKE-indeksill\u00e4 mitattu nilkan ja polven poikkeamien kokonaism\u00e4\u00e4r\u00e4 laski 39 % (p < 0,001). Nilkan ja polven poikkeamilla pystyttiin selitt\u00e4m\u00e4\u00e4n 81 % GDI-arvojen muutoksesta (p < 0,001). \n\nT\u00e4m\u00e4n tutkimuksen yhteenvetona voidaan todeta, ett\u00e4 monitasokirurgian j\u00e4lkeen CP-vammaisten lasten k\u00e4vely on keskim\u00e4\u00e4rin normaalimpaa, mutta hitaampaa. Tutkimus oli my\u00f6s ensimm\u00e4inen, jossa PFKE-indeksin ja GDI-arvoja verrattiin ja niiden v\u00e4lill\u00e4 havaittiin olevan selke\u00e4 yhteys. Muutokset k\u00e4velyn nopeudessa ja poikkeavuudessa eiv\u00e4t olleet ennustettavissa leikkausta edelt\u00e4v\u00e4ll\u00e4 i\u00e4ll\u00e4, painoindeksill\u00e4, k\u00e4velynopeudella tai GDI-arvolla.", "language": "fi", "element": "description", "qualifier": "abstract", "schema": "dc"}, {"key": "dc.description.abstract", "value": "The purpose of this study was to conduct a retrospective analysis on the effects of orthopedic single-event multilevel surgery (SEMLS) in children with spastic cerebral palsy (CP). The aim was to calculate changes in walking speed and gait deviations for a cohort of 33 patients that underwent through three-dimensional gait analysis that is commonly used to assess gait parameters preoperatively and in follow-up sessions after the surgery. \nThe dataset contained measurements of preoperative (pre) and follow-up sessions with of 1 (post1), 2 (post2) and 5 (post5) years after surgery. Data was collected in Motion Analysis Laboratory of Helsinki University Hospital. Walking speed was scaled to leg length and kinematics was used to calculate two indices. Gait Deviation Index (GDI) measures the subject\u2019s gait deviation from a reference, normative data using 15 different kinematic features. Plantar Flexion - Knee Extension (PFKE) Index calculates the distance of the patient's ankle and knee kinematics in mid-stance from normative data. An automatic sagittal gait pattern classification was created for the cohort from the ankle and knee deviations.\n\nThe walking speed decreased significantly between pre and post1 conditions 26 % (p < 0.05). There were no significant changes in speed for post2 and post5 measurements. GDI increased by 14 % (p < 0.001) between then pre and post1 and the patients maintained the new level of gait quality for post2 and post5 measurements. A decrease of 39 % (p < 0,001) was calculated for knee and ankle deviations (PKFE) after the surgery. Deviations in PFKE negatively correlated with GDI (r = -0.81, p < 0,001). The changes in walking speed or GDI could not be predicted with preoperative age, BMI, GDI or walking speed. \nEmerging evidence suggests that on average SEMLS procedures have an effect on increasing GDI but decreasing walking speed. This study was also the first to compare GDI and PFKE values. A clear connection between the values was detected in both pre and post conditions.", "language": "en", "element": "description", "qualifier": "abstract", "schema": "dc"}, {"key": "dc.description.provenance", "value": "Submitted by Miia Hakanen (mihakane@jyu.fi) on 2022-06-15T11:19:59Z\nNo. of bitstreams: 0", "language": "en", "element": "description", "qualifier": "provenance", "schema": "dc"}, {"key": "dc.description.provenance", "value": "Made available in DSpace on 2022-06-15T11:19:59Z (GMT). No. of bitstreams: 0\n Previous issue date: 2021", "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": "k\u00e4velynopeus", "language": "", "element": "subject", "qualifier": "other", "schema": "dc"}, {"key": "dc.subject.other", "value": "askelluspoikkeama", "language": "", "element": "subject", "qualifier": "other", "schema": "dc"}, {"key": "dc.subject.other", "value": "CP-vamma", "language": "", "element": "subject", "qualifier": "other", "schema": "dc"}, {"key": "dc.subject.other", "value": "kuntoutuksen seuranta", "language": "", "element": "subject", "qualifier": "other", "schema": "dc"}, {"key": "dc.title", "value": "K\u00e4velynopeuden ja poikkeamien muutokset monitasokirurgiapotilailla", "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-202206153359", "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": "Biomekaniikka", "language": "fi", "element": "subject", "qualifier": "discipline", "schema": "dc"}, {"key": "dc.subject.discipline", "value": "Biomechanics", "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": "openAccess", "language": null, "element": "rights", "qualifier": "accesslevel", "schema": "dc"}, {"key": "dc.type.publication", "value": 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