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Effect of Low Level Laser Therapy (LLLT) on Pain, Trismus and Quality of Life (QOL) in Post Lower Third Molar Removal Patients : A Randomized Controlled Trial Andi Dala Intan; Nyoman Murdana; SA Nuhonni; Lilies Dwi
Indonesian Journal of Physical Medicine & Rehabilitation Vol 5 No 01 (2016): Indonesian Journal Of Physical Medicine and Rehabilitation
Publisher : Indonesian Journal of Physical Medicine & Rehabilitation

Background: Low-Level Laser Therapy (LLLT) is a physical modality used in a rehabilitation support service. Patients with lower third molar impacted experience decline in QOL due to inflamatory response,such as bleeding, swelling, stiffness and pain. This leads to disability in daily activities, such as eating and drinking during several days post removal.Methods: It is a randomized controlled trial (RCT) and single blind study. A total of 21 subjects in LLLT and 21 subjects in control groups with the age range of 18-30 years. Subjects in the study group were given a totaldose of 54 J, energy density 18J/cm2 on day 0, 3 and 7 post lower third molar impacted surgery. Both groups were assessed for QOL values using the Short Form 36 (SF-36) before and after therapy.Result: Decrease in Pain (VAS) and Trismus on the third and seventh day post operatively were statistically significant (p <0.05) between the two groups. QOL improvement on the SF-36 domains of Role Physically(RP), Bodily Pain (BP), General Health (GH) was statistically significant (p <0.05) in both groups. Moreover, QOL improvement in Physical Components (PCS) was also significant between the two groups.Conclusion: LLLT could reduce postoperative pain of lower third molar impacted patients from day 0 to 3 and completely painless on the seventh day postoperatively. LLLT therapy eliminated Trismus on the third dayafter the surgey. Increase QOL in patients with lower third molar impacted removal after LLLT was evident in the physical component. The positive changes in pain and trismus reduction, also QOL improvement postLLLT can restore patients’ activities of daily living as usual in a short period of time.Keywords : Low Level Laser Therapy (LLLT), Pain, Trismus, Quality of Life, Rehabilitation, Lower Third Molar Removal.

Effect of Low Level Laser Therapy (LLLT) on Pain, Trismus and Quality of Life (QOL) in Post Lower Third Molar Removal Patients : A Randomized Controlled Trial Andi Dala Intan; Nyoman Murdana; SA Nuhonni; Lilies Dwi
Indonesian Journal of Physical Medicine & Rehabilitation Vol 5 No 01 (2016): Indonesian Journal Of Physical Medicine and Rehabilitation
Publisher : Indonesian Journal of Physical Medicine & Rehabilitation

Background: Low-Level Laser Therapy (LLLT) is a physical modality used in a rehabilitation support service. Patients with lower third molar impacted experience decline in QOL due to inflamatory response,such as bleeding, swelling, stiffness and pain. This leads to disability in daily activities, such as eating and drinking during several days post removal.Methods: It is a randomized controlled trial (RCT) and single blind study. A total of 21 subjects in LLLT and 21 subjects in control groups with the age range of 18-30 years. Subjects in the study group were given a totaldose of 54 J, energy density 18J/cm2 on day 0, 3 and 7 post lower third molar impacted surgery. Both groups were assessed for QOL values using the Short Form 36 (SF-36) before and after therapy.Result: Decrease in Pain (VAS) and Trismus on the third and seventh day post operatively were statistically significant (p <0.05) between the two groups. QOL improvement on the SF-36 domains of Role Physically(RP), Bodily Pain (BP), General Health (GH) was statistically significant (p <0.05) in both groups. Moreover, QOL improvement in Physical Components (PCS) was also significant between the two groups.Conclusion: LLLT could reduce postoperative pain of lower third molar impacted patients from day 0 to 3 and completely painless on the seventh day postoperatively. LLLT therapy eliminated Trismus on the third dayafter the surgey. Increase QOL in patients with lower third molar impacted removal after LLLT was evident in the physical component. The positive changes in pain and trismus reduction, also QOL improvement postLLLT can restore patients’ activities of daily living as usual in a short period of time.Keywords : Low Level Laser Therapy (LLLT), Pain, Trismus, Quality of Life, Rehabilitation, Lower Third Molar Removal.

Cardiac Rehabilitation in Patient with Inferior STEMI, CAD 3VD Post Stent to RCA, DM Type II, Dyslipidemia, and Obesity Grade I Andi Dala Intan; Tresia Fransiska U.T
Indonesian Journal of Physical Medicine & Rehabilitation Vol 4 No 01 (2015): Indonesian Journal Of Physical Medicine and Rehabilitation
Publisher : Indonesian Journal of Physical Medicine & Rehabilitation

Objective: to assess the benefit of Cardiac Rehabilitation (CR) in patient with Inferior STEMI,CAD 3VD Post Stent to RCA, DM Type II, Dyslipidemia, and Obesity Grade IMethods: A retired 59 years old man with presenting diagnosis of STEMI Inferior, CAD 3VD PostStent to RCA, DM Type II, Dyslipidemia, and Obesity Grade I. His medical rehabilitation problemswere myocardial ischemia post revascularization, immobilization, low endurance cardiorespiration,mild dependency of ADL, resolved chest pain and discomfort, and obesity grade I. His rehabilitationdiagnosis (ICF) were B4 of body function and S4 of body structures in cardiovascular, immunological,and respiratory system functions; and D2 of activities and participation in general tasks and demands.His non-pharmacologic therapies of phase I CR program plans included patient education; chestphysical therapy, such as deep breathing exercise, chest expansion exercise; mobility by sittingon a chair and walking around the room for about 5 – 10 minutes in duration, 2 – 3 times/ dayunder supervision; physical Activities about 2-3 Mets, and meet independent ADL. Five days afteradmission, patient underwent 2.5-3 Mets physical activities, starting from getting in and out of thebed with partially independent ADL. Pre-discharge examinations performed were 6 Minute WalkingTest (6MWT). Patients were then assessed on the second week post-discharge for walking distance,VO2max, vital signs, O2 Saturation, Modified Borg Scale before and after tests.Results: On the 5th day of hospitalization when meet the 2.5-3 Mets physical activities, patient wascapable of walking for 100 meters with stabile vital sign (Before: BP 130/70mmHg, HR 70x/m,RR 18x/m, and SpO2 98%; After: BP 131/65mmhg, HR 75x/m, RR 18x/m, and SpO2 98%) andno significant symptoms presented. Pre-discharge 6MWT showed EF 62% without significantsymptoms, maximum distance of 220 meters and VO2 max associated with 3 Mets. Pre-test resultsshowed BP 125/73 mmHg, HR 61 x/m, RR 18 x/m, and SpO2 98%, and Modified Borg Scale 9-0-0. Post-test results included BP 142/76 mmHg, HR 71 x/m, RR 22 x/m, SpO2 98%, Modified BorgScale 11-0.5-0. On the second week post-discharge, the 6MWT was re-performed and showedmaximum distance of 333 meters and VO2 max was associated with 4 Mets. He presented nosignificant symptoms with stabile vital signs (Pre-test results: BP 120/80 mmHg, HR 87x/m, RR 18x/m, SpO2 97-98%, and Modified Borg Scale 7-0-0; Post-test results: BP 142/76 mmHg, HR 107 x/m, RR 20 x/m, SpO2 96-98%, and Modified Borg Scale 9-0-0).Conclusion: CR is essential in comprehensive care of cardiovascular disease patients considering it’s effectivity and efficiency. CR should be monitored and carried out by highly trained health professional along with the active participation of patients and their families. CR will provide satisfying outcome if it is carried out and monitored in a good way.Keywords: Cardiac Rehabilitation, Coronary Artery Disease, Physical Therapy, Exercise, 6MWT

Pulmonary Rehabilitation in Guillain-Barré Syndrome (GBS) Andi Dala Intan; Anita Ratnawati
Indonesian Journal of Physical Medicine & Rehabilitation Vol 4 No 01 (2015): Indonesian Journal Of Physical Medicine and Rehabilitation
Publisher : Indonesian Journal of Physical Medicine & Rehabilitation

GBS was first described by Landry in 1859, a post-infectious polyneuropathy primarily not only affecting the motor system, but also on the sensory nervous system and the autonomic nervous system. It is acute and known as an autoimmune disease. The disease is more common in male, 1.5 times higher than women in western countries, affects any ages, mostly adults. 60% of GBS patients will be preceded by an upper respiratory tract disease and 27% unidentified illness that preceded it. Started with lower limb weakness and progresses to the upper limb and eventually the bulbar muscles; known as Landry’s Ascending Paralysis or rubbery legs. The diagnosis can be confirmed by history and physical examination. The prognosis depends on the subtype of GBS. For about 85% of patients will have functional recovery within a few months to a year. Rehabilitation in GBS management generally emphasis on immobilization and management of pneumonia and respiratory failure. GBS patients with respiratory dysfunction should get immediate rehabilitation and obtain a specific treatment program.Keywords: Guillain Barre Syndrome,Respirasi Rehabilitation,Breathing Exercise, Inspiratory muscle training

Improvement of Physical Performance and Quality of Life After Rehabilitation Program for Total Knee Replacement in Geriatric Patient Andi Dala Intan; Juan Suseno
Indonesian Journal of Physical Medicine & Rehabilitation Vol 8 No 01 (2019): Indonesian Journal Of Physical Medicine and Rehabilitation
Publisher : Indonesian Journal of Physical Medicine & Rehabilitation

Introduction: Early medical rehabilitation after Total Knee Replacement (TKR) was necessary to optimize healing process and reduce pain postoperative that can restrain patients’ activity.Case Presentation: A 66-years-old women had right TKR due to osteoarthritis genu dextra with chronic pain. Patient has muscle weakness on affected leg, and still not able to walk. Medical Rehabilitation(MR) program started one day after surgery for 4 weeks. After 4 weeks of MR program, patient had mild pain, and can walk for 100 m. Pain intensity by visual analogue scale (VAS) reduced from 7/10 to2/10, knee flexion increased from 70° to120°, right quadriceps muscle strength increased from 4 to 5 by manual muscle test (MMT), time to do physical performance by time up and go (TUG) was reduced from15 to 12.8 sc, activity daily living (ADL) by Barthel Index sco re increased from 4 to 8.Conclusion: Four weeks Rehabilitation Medicine program in geriatric patient with post Right TKR for 4 weeks, effective to improved muscle strength, balance, and ADL.Keywords: Medical rehabilitation, total knee replacement, geriatric, physical performance, quality of life

Cardiac Rehabilitation in Patient with Inferior STEMI, CAD 3VD Post Stent to RCA, DM Type II, Dyslipidemia, and Obesity Grade I Andi Dala Intan; Tresia Fransiska U.T
Indonesian Journal of Physical Medicine & Rehabilitation Vol 4 No 01 (2015): Indonesian Journal Of Physical Medicine and Rehabilitation
Publisher : Indonesian Journal of Physical Medicine & Rehabilitation

Objective: to assess the benefit of Cardiac Rehabilitation (CR) in patient with Inferior STEMI,CAD 3VD Post Stent to RCA, DM Type II, Dyslipidemia, and Obesity Grade IMethods: A retired 59 years old man with presenting diagnosis of STEMI Inferior, CAD 3VD PostStent to RCA, DM Type II, Dyslipidemia, and Obesity Grade I. His medical rehabilitation problemswere myocardial ischemia post revascularization, immobilization, low endurance cardiorespiration,mild dependency of ADL, resolved chest pain and discomfort, and obesity grade I. His rehabilitationdiagnosis (ICF) were B4 of body function and S4 of body structures in cardiovascular, immunological,and respiratory system functions; and D2 of activities and participation in general tasks and demands.His non-pharmacologic therapies of phase I CR program plans included patient education; chestphysical therapy, such as deep breathing exercise, chest expansion exercise; mobility by sittingon a chair and walking around the room for about 5 – 10 minutes in duration, 2 – 3 times/ dayunder supervision; physical Activities about 2-3 Mets, and meet independent ADL. Five days afteradmission, patient underwent 2.5-3 Mets physical activities, starting from getting in and out of thebed with partially independent ADL. Pre-discharge examinations performed were 6 Minute WalkingTest (6MWT). Patients were then assessed on the second week post-discharge for walking distance,VO2max, vital signs, O2 Saturation, Modified Borg Scale before and after tests.Results: On the 5th day of hospitalization when meet the 2.5-3 Mets physical activities, patient wascapable of walking for 100 meters with stabile vital sign (Before: BP 130/70mmHg, HR 70x/m,RR 18x/m, and SpO2 98%; After: BP 131/65mmhg, HR 75x/m, RR 18x/m, and SpO2 98%) andno significant symptoms presented. Pre-discharge 6MWT showed EF 62% without significantsymptoms, maximum distance of 220 meters and VO2 max associated with 3 Mets. Pre-test resultsshowed BP 125/73 mmHg, HR 61 x/m, RR 18 x/m, and SpO2 98%, and Modified Borg Scale 9-0-0. Post-test results included BP 142/76 mmHg, HR 71 x/m, RR 22 x/m, SpO2 98%, Modified BorgScale 11-0.5-0. On the second week post-discharge, the 6MWT was re-performed and showedmaximum distance of 333 meters and VO2 max was associated with 4 Mets. He presented nosignificant symptoms with stabile vital signs (Pre-test results: BP 120/80 mmHg, HR 87x/m, RR 18x/m, SpO2 97-98%, and Modified Borg Scale 7-0-0; Post-test results: BP 142/76 mmHg, HR 107 x/m, RR 20 x/m, SpO2 96-98%, and Modified Borg Scale 9-0-0).Conclusion: CR is essential in comprehensive care of cardiovascular disease patients considering it’s effectivity and efficiency. CR should be monitored and carried out by highly trained health professional along with the active participation of patients and their families. CR will provide satisfying outcome if it is carried out and monitored in a good way.Keywords: Cardiac Rehabilitation, Coronary Artery Disease, Physical Therapy, Exercise, 6MWT

Pulmonary Rehabilitation in Guillain-Barré Syndrome (GBS) Andi Dala Intan; Anita Ratnawati
Indonesian Journal of Physical Medicine & Rehabilitation Vol 4 No 01 (2015): Indonesian Journal Of Physical Medicine and Rehabilitation
Publisher : Indonesian Journal of Physical Medicine & Rehabilitation

GBS was first described by Landry in 1859, a post-infectious polyneuropathy primarily not only affecting the motor system, but also on the sensory nervous system and the autonomic nervous system. It is acute and known as an autoimmune disease. The disease is more common in male, 1.5 times higher than women in western countries, affects any ages, mostly adults. 60% of GBS patients will be preceded by an upper respiratory tract disease and 27% unidentified illness that preceded it. Started with lower limb weakness and progresses to the upper limb and eventually the bulbar muscles; known as Landry’s Ascending Paralysis or rubbery legs. The diagnosis can be confirmed by history and physical examination. The prognosis depends on the subtype of GBS. For about 85% of patients will have functional recovery within a few months to a year. Rehabilitation in GBS management generally emphasis on immobilization and management of pneumonia and respiratory failure. GBS patients with respiratory dysfunction should get immediate rehabilitation and obtain a specific treatment program.Keywords: Guillain Barre Syndrome,Respirasi Rehabilitation,Breathing Exercise, Inspiratory muscle training

Improvement of Physical Performance and Quality of Life After Rehabilitation Program for Total Knee Replacement in Geriatric Patient Andi Dala Intan; Juan Suseno
Indonesian Journal of Physical Medicine & Rehabilitation Vol 8 No 01 (2019): Indonesian Journal Of Physical Medicine and Rehabilitation
Publisher : Indonesian Journal of Physical Medicine & Rehabilitation

Introduction: Early medical rehabilitation after Total Knee Replacement (TKR) was necessary to optimize healing process and reduce pain postoperative that can restrain patients’ activity.Case Presentation: A 66-years-old women had right TKR due to osteoarthritis genu dextra with chronic pain. Patient has muscle weakness on affected leg, and still not able to walk. Medical Rehabilitation(MR) program started one day after surgery for 4 weeks. After 4 weeks of MR program, patient had mild pain, and can walk for 100 m. Pain intensity by visual analogue scale (VAS) reduced from 7/10 to2/10, knee flexion increased from 70° to120°, right quadriceps muscle strength increased from 4 to 5 by manual muscle test (MMT), time to do physical performance by time up and go (TUG) was reduced from15 to 12.8 sc, activity daily living (ADL) by Barthel Index sco re increased from 4 to 8.Conclusion: Four weeks Rehabilitation Medicine program in geriatric patient with post Right TKR for 4 weeks, effective to improved muscle strength, balance, and ADL.Keywords: Medical rehabilitation, total knee replacement, geriatric, physical performance, quality of life

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