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All Journal Medical Journal of Indonesia Mutiara Medika: Jurnal Kedokteran dan Kesehatan Universa Medicina Health Notions Amerta Nutrition Indonesia Journal of Physical Medicine and Rehabilitation

Angela BM Tulaar

Department Of Physical Medicine And Rehabilitation, Faculty Of Medicine, Universitas Indonesia, Jakarta

Author-ID : 2179022

Decision Sciences, Operations Research & Management Dentistry Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Physics Public Health Other

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Articles

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The effect of medial arch support over the plantar pressure and triceps surae muscle strength after prolonged standing Saadah, Hindun; Furqonita, Deswaty; Tulaar, Angela
Medical Journal of Indonesia Vol 24, No 3 (2015): September
Publisher : Faculty of Medicine Universitas Indonesia

Background: The activity with prolonged standing position is one of the causes of abnormalities in the lower leg and foot. The aim of this study is to discover the effect of medial arch support over the distribution of plantar pressure when standing and walking.Methods: This was an experimental study with pre- and post-design the strength of triceps surae muscle after prolonged standing, was also evaluated in an experimental study with pre- and post-design. Variables of plantar pressure measurement are the contact area and pressure peak were measured by using the Mat-scan tool. The measurement of the triceps surae muscle strength was done with a hand-held dynamometer, before and after using the medial arch support. Measurement was performed before and after working with prolonged standing position which took place about seven hours using the medial arch support inserted in the shoes. Data was analyzed using paired T-test.Results: There was a significant difference of peak pressure between standing (p = 0.041) and walking (p = 0.001). Whereas the contact area showed a significant decrease in the width of the contact area when standing (104.12 Â± 12.42 vs 99.08 Â± 10.21 p = 0.023). Whereas, the triceps surae muscle strength pre- and post-standing prolonged did not indicate a significant difference.Conclusion: There was decrease in peak pressure when standing and walking and decrease in contact area when standing on plantar after used of the medial arch support after prolonged standing.

Validity and reliability of Preschool Language Scale 4 for measuring language development in children 48-59 months of age Sidarta, Nuryani; Tulaar, Angela BM; Nasution, Amendi; Suryanto, Suryanto
Universa Medicina Vol 27, No 4 (2008)
Publisher : Faculty of Medicine, Trisakti University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2008.v27.174-182

Prevalence rates for speech and language delay have been reported across wide ranges. Speech and language delay affects 5% to 8% of preschool children, often persisting into the school years.Â A cross-sectional study was conducted in 208 children aged 48-59 months to determine the validity and reliability of the Indonesian edition of the Preschool Language Scale version 4 (PLS4) as a screening tool for the identification of language development disorders. Construct validity was examined by using Pearson correlation coefficient. Internal consistency was tested and repeated measurements were taken to establish the stability coefficient and intraclass correlation coefficients (ICC) for test-retest reliability. For construct validity, the Pearson correlation coefficient ranged from 0.151-0.526, indicating that all questions in this instrument were valid for measuring auditory comprehension (AC) and expressive communication skills (EC). Cronbachâ€™s alpha level ranged from 0.81-0.95 with standard error of measurement (SEM) ranging from 3.1-3.3. Stability coefficients ranged from 0.98-.0.99 with ICC coefficient ranging from 0.97-0.99 both of which showed an excellent reliability. This study found that PLS-4 is a valid and reliable instrument. It is easy to handle and can be recommended for assessing language development in children aged 48-59 months.

Effect of range of motion and isometric strengthening exercises on grip strength and hand function in rheumatoid arthritis patients Bastiana, Yefta Daniel; Tulaar, Angela BM; Hartono, Surjanto; Albar, Zuljasri
Universa Medicina Vol 27, No 4 (2008)
Publisher : Faculty of Medicine, Trisakti University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2008.v27.157-164

In previous studies, duration of hand exercises in patients with rheumatoid arthritis (RA) had widely varying ranges, from 3 weeks to 4 months. An experimental study was conducted to evaluate the effect of range of motion (ROM) and muscle strengthening exercises for 6 weeks on grip strength and hand function in RA patients. Seventeen patients with chronic RA were randomly assigned to a treatment group and a control group. The treatment group (n=8) was given muscle strengthening exercises and heat therapy using paraffin baths 3 times a week at the hospital and ROM exercises once a day at home for 6 weeks. The control group (n=9) was given only paraffin baths 3 times a week. After 6 weeks, there were significant differences in hand function (p=0.003), right and left grip strength (p=0.000 and p=0.001) and ROM in the interventional group only. ROM and isometric strengthening exercises significantly improved grip strength and hand function in patients with RA, while no impact was found when the patients were given paraffin baths only. In view of the small size of the study population, there is a need for further studies with larger populations.

Comparison of the effects of treadmill and ergocycle exercise on the functional capacity and quality of life of patients with chronic obstructive pulmonary disease Turnip, Helena; Ratnawati, Anita; Tulaar, Angela; Yunus, Faisal; Kekalih, Aria
Medical Journal of Indonesia Vol 23, No 1 (2014): February
Publisher : Faculty of Medicine Universitas Indonesia

Background: Physical excercises are hoped to improve functional capacity and quality of life of patients with chronic obstructive pulmonary disease (COPD). This study is aimed to assess the differences between treadmill and ergocycle exercise on changes in functional capacity and quality of life in patients with stable COPD.Methods: This is an experimental study with complete randomization and repeated pre- and post-intervention observation. The study was conducted on 44 subjects with COPD who were presented at Persahabatan Hospital, Medical Rehabilitation Clinic, consisting of 22 subjects undergoing ergocycle exercise and 22 subjects undergoing treadmill exercise test. Functional capacity was assessed by using the 6 minutes walking test (6 MWT) performed at week I, V and IX. Quality of life was measured using the St. George’s Respiratory Questionnaire (SGRQ) at week I and IX. Training program was conducted for 8 weeks with exercise dosage based on the results of exercise test on week I.Results: Treadmill and ergocycle exercise produce significant improvement in both the 6 MWT and SGRQ test since week I to IX. But in comparison, treadmill exercise improves 6 MWT distance better than ergocycle consistently at week I-V, V-IX and I-IX (p < 0.001). For the SGRQ score, both exercises did not differ significantly. Conclusion: Treadmill exercise is associated with significantly better improvement in functional capacity compared to ergocycle exercise in stable COPD subjects. Concerning quality of life, both exercises gave an equivalent improvement in stable COPD subjects.Keywords: chronic obstructive pulmonary disease, ergocycle exercise, functional capacity, treadmill exercise, quality of life

Clinical and ultrasound joint outcomes in severe hemophilia A children receiving episodic treatment in Indonesian National Hemophilia Treatment Center Sari, Teny T.; Chozie, Novie A.; Gatot, Djajadiman; Tulaar, Angela B.M.; Dharma, Rahayuningsih; Sukrisman, Lugyanti; Bardosono, Saptawati; Achmad, Harry R.; Prasetyo, Marcel
Medical Journal of Indonesia Vol 26, No 1 (2017): March
Publisher : Faculty of Medicine Universitas Indonesia

Background: Recurrent joint bleeds leading to arthropathy is the main problem in severe hemophilia children. This study aimed to investigate joint status in severe hemophilia A children receiving episodic treatment in Cipto Mangunkusumo Hospital, Jakarta.Methods: A cross-sectional study was conducted in Cipto Mangunkusumo Hospital as Indonesian National Hemophilia Treatment Center on children (4–18 years) with severe hemophilia A, who previously received episodic treatment, with no history of inhibitor factor VIII. Hemophilia Joint Health Score was evaluated according to HJHS version 2.1 2011. Joint ultrasonography was done for six index joints (bilateral elbows, knees and ankles) using Haemophilia Early Arthropathy Detection with Ultrasound (HEAD-US) methods. Data of age of first joint bleed, number of target joints and inhibitor factor VIII were obtained from the Pediatric Hemophilia Registry and medical records.Results: There were 59 subjects aged 4 to 18 years. Twenty-nine out of 59 (49.2%) subjects experienced first joint bleed before of 2 years of age. The most common of joint bleeds was a right ankle. Mean total HJHS was 8.71±8.73. Subjects aged 4–10 years showed lower HJHS (4.6±3.7) as compared to subjects aged >10–18 years (12.3±10.3), p<0.001; 95% CI=4.9–13. Mean HEAD-US scores in subjects aged 4–10 years (18.7±5.6) was lower than in subjects aged >10–18 years (28±7.9), p<0.001, 95% CI= -12.9–-5.6.Conclusion: HJHS and HEAD-US scores of severe hemophilia A children receiving episodic treatment aged 4–10 years are lower compared to subjects aged >10–18 years, indicating more severe joint destruction in older children and progressivity of joint damage over time. It is important to start prophylactic treatment to prevent progressivity of joint damage.

Effectiveness of Taping for the Short-Term Treatment of Pain and Walking Speed in Patients with Plantar Fasciitis Mira Muhammad; Angela BM Tulaar; Rosiana Pradanasari; Saptawati Bardosono
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

Plantar fasciitis causes pain in the heel and medial arch of the foot can interfere daily activities. Taping theplantar fasciitis will reduce pain by reducing strain on the plantar fascia during standing and ambulation.Objective: to see the effect of taping on pain and walking speed.Methods: fifteen subjects received taping and ultrasound diathermy therapy for one week. Fifteen othersubjects received ultrasound therapy alone. Pain measured by Visual Analogue Scale (VAS) and the walkingspeed is measured in meters / sec.Results: VAS score started to differ significantly on the first day after treatment (p = 0.008) and continuesuntil the last day of evaluation. On the first day, the VAS score changes differs significantly (p = 0.002). Butin the evaluation of the days, the change of VAS scores were not significantly different. VAS score changes onthe seventh day compared to the initial evaluation found significant (p <0.001). With multivariate analysis ofrepeated measurements, VAS scores in each group decreased significantly (p <0.001), but the decrease in VASscore taping group were significantly better compared with non-taping group (p = 0.004).Conclusion: combination of taping and ultrasound diathermy for people with plantar fasciitis can be used asa modality to reduce pain more quickly.Keywords:plantar fasciitis, taping, ultrasound diathermy, visual analog scale, walking speed.

The Effect of Nuhonni-Tulaar Rheumatic Exercise on Pain Reduction of Knee Osteoarthritis Patients Ferius Soewito; Siti Annisa Nuhonni; Elida Ilyas; Muchtaruddin Mansyur; Angela BM Tulaar
Indonesian Journal of Physical Medicine & Rehabilitation Vol 2 No 01 (2013): Indonesian Journal Of Physical Medicine and Rehabilitation
Publisher : Indonesian Journal of Physical Medicine & Rehabilitation

Objectives: Knee osteoarthritis patient has the risk for ambulation disability as a result of knee pain. Nuhonni-Tulaar rheumatic exercise was designed to prevent complications of rheumatic diseasesincluding knee osteoarthritis. The purpose of this study is to investigate the effectivity of Nuhonni-Tulaar rheumatic exercise to reduce pain of knee osteoarthritis patient.Methods: Twenty two subjects did the rheumatic exercise thrice a week in the gymnasium of medicalrehabilitation department Cipto Mangunkusumo hospital. Twenty other subjects, the control group, didthe standard hamstring stretching exercise at home. Each group performed the exercise for 8 weeks.Pain was measured using Visual Analog Scale (VAS) each week and analyzed before and after theintervention.Results: After 8 weeks VAS was reduced 1.5 in the intervention group while in the control group the reduction was 0.9. VAS was then transformed into no pain, mild pain, moderate pain and severepain. VAS was significantly reduced in the intervention group (p=0.002) but not in the control group (p=0.059). VAS changes between the two groups was significantly different (p=0.004).Conclusions: Rheumatic exercise has greater benefit in reducing pain than standard stretching exercise.Warming up, core exercise II and cooling down is safe and comfortable for knee osteoarthritis patientwith grade I-II Kellgren Lawrence radiographic grading.Keywords: Nuhonni-Tulaar Rheumatic exercise, Knee osteoarthritis, Visual Analog Scale

Efficacy of McConnell’s Medial Patellar Taping Application for Pain Management and Walking Velocity of Osteoarthritis Patients Wahju Hidajati1,; Angela BM Tulaar; Yoga Iwanoff Kasjmir; Sumariyono; Surjanto M.A
Indonesian Journal of Physical Medicine & Rehabilitation Vol 2 No 01 (2013): Indonesian Journal Of Physical Medicine and Rehabilitation
Publisher : Indonesian Journal of Physical Medicine & Rehabilitation

Objectives: to evaluate the efficacy of medial patellar taping in addition to exercise for pain relief and 15 meters walking time, and to find any correlation between the pain improvement and functional outcome.Methods: This study was a randomized controlled trial of knee patellar taping in combination with the isometric and stretching exercise in comparison to taping free- exercise. The inclusion criteria includesknee osteoarthritis patients with VAS score ranges four to eight of each knee, with or without tolerable pain on the other knee. The treatment group received knee tapping and isometric and stretching exercise of thequadriceps, iliotibial band, hamstring and gastrocnemius muscles. Both treatment and control group were assessed for about three weeks (day 1/week 0, day 2, day 28/week 4, and day 49/week 7). A visual analoguescale (VAS) was used to assess knee pain severity whereas 15 m walking time assessed to measure functional gait performance. On day 2, both measurements were done for study group only, with assumption the resultwould be the same with 1 day exercise only. A Lequesne index measured functional outcome.Results: There were 24 participants, twelve patients were in the tapped group while the remaining twelve were in the control group. Significant pain differences were visible during the treatment period at day 1, day2 and at the beginning of week 7. At day 2 and week 4, the study group showed significant pain reduction in comparison to the control group (p < 0.007).The walking time also showed significant improvement in the study group at day 2 (p < 0.000) but there were no significant difference at week 4 and week 7. At week 7, the study group experienced pain (p < 0.037) andoutcome improvement significantly. In addition, for about 75% of them had none to moderate disability post intervention. Meanwhile, from the total of eight patients in the control group who had severe to very severedisability, four of them had moderate (50%) and the rest had mild disability (50%). There was significant correlation between the pain and functional outcome on day two.Conclusions: Medial Patellar Taping in addition to isometric and stretching exercise of quadriceps, iliotibial band, hamstrings and gastrocnemius muscles showed significant improvement of disability superior to theuntapped group. Benefits of Medial Patellar Taping remained three weeks after removal.Keywords: Osteoarthritis, Knee Pain Severity, exercise, Medial Patellar Taping, Visual Analogue Scale, 15 Meter Walking Time, Functional Gait Performance, Lequesne Index.

Development of ‘16-Holes Manual Dexterity Pegboard’ and the Normal Value of 6 Years Old Children Fanny Aliwarga; Ferial Hadipoetro; Angela BM Tulaar; Surjanto H
Indonesian Journal of Physical Medicine & Rehabilitation Vol 2 No 01 (2013): Indonesian Journal Of Physical Medicine and Rehabilitation
Publisher : Indonesian Journal of Physical Medicine & Rehabilitation

Objectives: Obtaining the standard normal value of 6 years old children aged six year, and testing our hypothesis if girls’ dexterity is higher than boys.Methods: The design of this study was a cross sectional study of six years old students of public elementary school in South Jakarta. Inclusion criteria included age six years old, no neurological andorthopedic problem, normal nutritional status and right handed. Location based-random sampling was performed. Dependent variables comprised of age, sex and nutritional status. Independent variable wasthe result of ‘16-Holes Three-Jaw Chuck Manual Dexterity Pegboard’ test. Statistical analysis was done by descriptive analysis and Mann Whitney Test.Results: There were 191 girls and 191 boys who fulfilled the criteria. The ‘16-Holes Three-Jaw Chuck Manual Dexterity Pegboard’ test allowed subjects to be assessed for their ability to put numbers of pegwithin 15 seconds. The mean number of pegs placed for girls was 6.92 pegs (CI 95% 6.76 – 7.08) and boys was 6.49 pegs (CI 95% 6.33 – 6,65)Conclusions: Girls are able to place more pegs than boys in a given time. Furthermore, girls’ manual dexterity is superior to boys (p 0,000).Keywords: Manual dexterity, standard normal value, pegboard, sex differences.

The 400-Meter Walk Test to Evaluate Walking Performance between Diabetics and Healthy Females Ronald Pakasi; Angela BM Tulaar; Sarwono Waspadji; Corrie Wawolumaya
Indonesian Journal of Physical Medicine & Rehabilitation Vol 2 No 01 (2013): Indonesian Journal Of Physical Medicine and Rehabilitation
Publisher : Indonesian Journal of Physical Medicine & Rehabilitation

Objective: to evaluate walking performance in female with type 2 diabetes mellitus (DM2) with the 400-meters walk test (400-MWT) compared to healthy individuals.Methods: two groups of female subjects with DM2 and healthy individuals were matched by the age. The 400-MWT parameters to be compared were walking speed (WS) and predicted maximum oxygenconsumption (pVO2max). Baseline examination included body mass index (BMI), random blood glucose (RBG), and ankle-brachial index (ABI). All subjects performed 2 minutes warm up before thetest. Heart rate (HR) was recorded every 30 seconds, and blood pressure (BP) was measured before warm up and within 60 seconds after test. The test was performed twice on a different day.Results: Nineteen subjects on each group participated in the study. The mean WS was significantly different (p<0.0001) between the study group (1.26 + 0.19 and 1.31 + 0.17 m/s) and the control group(1.70 + 0.20 and 1.78 + 0.24 m/s) for the first and second tests respectively. There was a significant difference of mean pVO2max (p<0.0001) between the study group (17.22 + 2.94 and 17.99 + 2.36 ml/kg/min) and the control group (23.68 + 3.79 and 24.44 + 3.74 ml/kg/min).Conclusion: the 400-MWT demonstrated lower walking performance in female subjects with DM2 compared to healthy individuals.Keywords: Type 2 DM, healthy individuals, 400 meter walk test, walking speed, VO2max.

Co-Authors Achmad, Harry R. Amendi Nasution Andy Martahan Andreas Anita Ratnawati Aria Kekalih Arif Wicaksono Chozie, Novie A. Corrie Wawolumaya Deswaty Furqonita Dharma, Rahayuningsih Djajadiman Gatot Elida Ilyas Endang Ambarwati, Faisal Yunus Fanny Aliwarga Ferial Hadipoetro Ferial Hadipoetro Idris Ferius Soewito Hari Hari Peni Julianti Helda Helda Helena Turnip Hindun Saadah, Hindun I Dewa Putu Pramantara Ismail Ismail Jusuf Kristianto Leni Kopen Listya Tresnanti Mirtha Lugyanti Sukrisman Marcel Prasetyo Maria Regina Rachmawati Mira Muhammad Muchtaruddin Mansyur Muctarudin Mansyur Nuryani Sidarta, Nuryani Nyoman Murdana Ratna Darjanti Haryadi Ratna Djuwita Rini Sekartini Ronald Pakasi Rosiana Pradanasari Saptawati Bardosono Saptawati Bardosono Sari, Teny T. Sarwono Waspadji Sasanthy Kusumaningtyas Siti Annisa Nuhonni Sri Hartati R. Suradijono Sri Wahyudati Sumariyono Surjanto H Surjanto Hartono, Surjanto Surjanto M.A Suryanto Suryanto Tanti Ajoe Kesoema, Thjin Wiguna Tirza Z Tamin Wahju Hidajati1, Yefta Daniel Bastiana, Yefta Daniel Yoga Iwanoff Kasjmir Zuljasri Albar

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