Nury Nusdwinuringtyas
Faculty of Medicine University of Indonesia/ Dr. Cipto Mangunkusumo Hospital, Jakarta,

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Healthy adults maximum oxygen uptake prediction from a six minute walking test Nusdwinuringtyas, Nury; Widjajalaksmi, Widjajalaksmi; Bachtiar, Adang
Medical Journal of Indonesia Vol 20, No 3 (2011): August
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (363.858 KB) | DOI: 10.13181/mji.v20i3.452

Abstract

Background: A parameter is needed in medical activities or services to determine functional capacity. This study is aimed to produce functional capacity parameter for Indonesian adult as maximum O2.Methods: This study used 123 Indonesian healthy adult subjects (58 males and 65 females) with a sedentary lifestyle, using a cross-sectional method.Results: Designed by using the followings: distance, body height, body weight, sex, age, maximum heart rate of six minute walking test and lung capacity (FEV and FVC), the study revealed a good correlation (except body weight) with maximum O2. Three new formulas were proposed, which consisted of eight, six, and five variable respectively. Test of the new formula gave result of maximum O2 that is relevant to the golden standard maximum O2 using Cosmed® C-Pex.Conclusion: The Nury formula is the appropriate predictor of maximum oxygen uptake for healthy Indonesians adult as it is designed using Indonesian subjects (Mongoloid) compared to the Cahalin’s formula (Caucasian). The Nury formula which consists of five variables is more applicable because it does not require any measurement tools neither specific competency. (Med J Indones 2011;20:195-200)Keywords: maximum O2, Nury’s formula, six minute walking test
Inspiratory Muscle Trainer Effectiveness in Chronic Obstructive Pulmonary Disease Rehabilitation Program Nusdwinuringtyas, Nury; Islamadina, Balqis; Rumende, Cleopas Martin; Kamelia, Telly
Majalah Kedokteran Bandung Vol 51, No 1 (2019)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (625.998 KB) | DOI: 10.15395/mkb.v51n1.1600

Abstract

Chronic obstructive pulmonary disease (COPD) is marked by persistent respiratory disturbance which results in altered health status as well as functional capacity. Pulmonary rehabilitation (PR) is a part of comprehensive therapy in patients suffering from respiratory disturbance. This study focused on inspiratory muscles exercise using the inspiratory muscle trainer(IMT), which is a form of a weight training exercise. This experiment was conducted at the COPD outpatient clinic of Dr. Cipto Mangunkusumo Hospital during the period of September 2017 until April 2018. Patients were recruited consecutively. The criteria for inclusion were stable COPD patient with GOLD criteria A-D and never received prior exercise for pulmonary rehabilitation. Patients underwent interview about their medical history followed by spirometry testing using Carefusion® and  inspiratory muscle strength assessment using Micro RPM Carefusion®. The St George Respiratory Questionnaire (SGRQ) was used to assess the health status and the 6-minute walking test (6MWT) was conducted to assess the functional capacity. Subject exercised using IMT (Philips Respironic®) for eight weeks. Data were analyzed using paired t-test in statistical package for social sciences (SPSS) version 21. A total of 15 subjects with and average age of 65.6±8.40 years old were recruited. Pre-Post difference in inspiratory muscle strength was 11.31 cmH2O, showing a statistically significant impact. The significant impact was also shown clinically through the results of the Minimal Clinical Important Difference (MCID) on health status and functional capacity. The health status was evaluated using SGRQ with p exceeding 4%. A combined Pulmonary Rehabilitation (PR) and inspiratory muscles exercise program is proven to improve the health status and functional capacity.Key words: COPD, inspiratory muscle trainer, pulmonary rehabilitation, SGRQ, 6MWT Keefektifan Inspiratory Muscle Trainer Pada Program Rehabilitasi  Penyakit Paru Obstruktif KronikPenyakit paru obstruktif kronik (PPOK) ditandai dengan gangguan pernapasan yang persisten yang mengganggu status kesehatan dan kapasitas fungsional. Pulmonary rehabilitation (PR) merupakan bagian dari terapi komprehensif pasien dengan ganguan respirasi. Penelitian ini memfokuskan pada latihan otot inspirasi menggunakan inspiratory muscle trainer (IMT), suatu bentuk latihan otot pernapasan dengan pemberian beban. Eksperimen ini dilakukan di Rumah Sakit Cipto Mangunkusumo selama periode September 2017 hingga April 2018. Pasien direkrut secara consecutive sampling. Kriteria inklusi adalah pasien PPOK yang stabil dengan kriteria GOLD A-D yang belum pernah menerima latihan sebelumnya untuk rehabilitasi paru. Pasien menjalani wawancara, diuji dengan spirometri Carefusion®, dan kekuatan otot inspirasi dinilai menggunakan Micro RPM Carefusion®. St George Respiratory Questionnaire (SGRQ) digunakan untuk menilai status kesehatan dan 6-minute Walking Test (6MWT) dilakukan untuk menilai kapasitas fungsional. Subyek menggunakan alat IMT (Philips Respironic®) selama 8 minggu. Data dianalisis menggunakan SPSS versi 21 dengan uji T berpasangan. Subjek penelitian berjumlah 15 orang dengan rerata usia 65,6 ± 8,40 tahun. Kekuatan otot inspirasi awal didapatkan perubahan sebesar 11,31 cmH2O, yang memberikan dampak bermakna dilihat dengan pencapaian minimal clinical important difference (MCID) pada status kesehatan dan kapasitas fungsional. PR bersama dengan program latihanotot inspirasiterbukti memberikan hasil perbaikan status kesehatan dan kapasitas fungsional.Kata kunci: COPD, inspiratory muscle trainer, pulmonary rehabilitation, SGRQ, 6MWT 
SIX MINUTE WALKING DISTANCE CUT-OFF POINT IN INDONESIAN (MONGOLOID) POPULATION Nusdwinuringtyas, Nury
Majalah Kedokteran Indonesia Vol 68 No 8 (2018): Journal of the Indonesian Medical Association Majalah Kedokteran Indonesia Volum
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

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Abstract

Introduction: Six-minute walk test has been a recommended valid and reliable tool used for functional capacity assessment. American Thoracic Society (ATS) had stated that there are no global standards in interpreting 6-minute walking distance (6MWD) as a one-time measurement of functional assessment, which may be caused by population differences and various 6MWT technique utilized in previous studies. Single time cut off is required to evaluate functional status at the start of a program as a baseline for further follow-up evaluations. It is then a necessity to determine these cut off points in every country/race. Methods: The study was performed on healthy subjects, sedentary lifestyle, age 18-50, Indonesian ethnicity (Mongoloid race). Recorded data were 6 minute walking distance,also body height and weight. Predicted walking distance based on gender is obtained by calculating walk distance, body weight, body height, gender and subject age in Nury?s predicted walk distance formula. Data is analysed with SPSS 20, utilizing independent T-test. Results: As much as 123 subjects (58 males, 65 females) were included in this study. Mean walking distance for males is 581,98 meters, while females are 516,80 meters, and these differences were statistically significant. Walking distance cut off point between gender were compared. In male subjects, actual walking distance were taken as normalif >483 meters, poor if 434-483 meters, and very poor <434 meters. As for female subjects, normal when >442 meters, poor when 405-442 meters, and very poor in distance <405 meters. General percentage cut off point in comparison to predicted walking distance was categorized into normal, poor and very poor subgroups. Normal percentage was >85%, poor when distance is 77-85%, and <77% categorized as very poor. Conclusion: There are varying cut off points for walking distance in both males and females. Percentage cut off point as compared to predicted walking distance were not differentiated between genders.
SIX MINUTE WALK TEST AS A MEASUREMENT TOOL FOR FUNCTIONAL CAPACITY Nusdwinuringtyas, Nury
Majalah Kedokteran Indonesia Vol 68 No 4 (2018): Journal of the Indonesian Medical Association Majalah Kedokteran Indonesia Volum
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

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Abstract

Various scientific articles which include scientific writing, books or journals have been known to provide evidence based scientific facts. Thus, in order to achieve accurate evidence based results, a clear outcome measurement is required. Besides, the measurement should be based on precise measurements, both in methods and tools utilized during the measurement. This is a very essential matter, as the accuracy of an outcome measurement would correlate to intervention, program and prognosis of an individual.
Four-Meter Gait Speed Cut-off and Correlation with 6-Minute Walk Test in Adults Nusdwinuringtyas, Nury; Fransiska, Tresia; Sunarjo, Peggy; Triangto, Kevin; Santausa, Febrian; Dahlan, M. Sopiyudin
Majalah Kedokteran Bandung Vol 54, No 1 (2022)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v52n4.2449

Abstract

In facilities where a track required is not available for gait speed test, a simpler method using a shorter track and test duration is needed. One of such methods is the 4-meter gait speed. This study aimed to determine the cut off values for 4MGS and its correlation with the 6-minute walk test (6MWT), a more common functional performance test with shorter track and time. Data for this study were collected at the Department of Rehabilitation of Dr. Cipto Mangunkusumo General Hospital during the period of August 2016 to March 2017. The consecutive sampling approach was used to recruit healthy Indonesian adults (n=61) aged 18–50 years into this cross sectional study. The anthropometric and respiratory variables were measured as descriptive data and the cut-off values were determined by calculating the mean 4-meter gait speed (4MGS)-2SD for each gender. The 6MWT was performed afterwards to assess the correlation between 4MGS and 6-minute walk distance (6MWD). Results presented a mean 4MGS value of 2.114±0.309 m/s (male) and 1.908±0.227m/s (female) with the cut-off values for normal gait speed of 1.496 m/s and 1.454m/s for male and female, respectively. Factors affecting 4MGS were body height, body weight, forced vital capacity (FVC), and forced expiratory volume in 1 second (FEV1). The 4MGS is only shown to be weakly correlated with 6MWD (r=0.314, p=0.014). The cut-off values for 4MGS can be used as a reference to assess the normality of gait speed as a parameter of functional mobility in healthy Indonesian adults and should be used in adjunct to 6MWT to represent a comprehensive functional capacity status.