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Indonesia Journal of Physical Medicine and Rehabilitation

IJPMR
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Published by PB PERDOSRI

ISSN : 22528199 EISSN : 26217678 DOI : https://doi.org/10.36803/ijpmr.v10i02

Core Subject : Science,

Decision Sciences, Operations Research & Management Neuroscience Physics

Indonesian Journal of Physical Medicine and Rehabilitation publishes peer reviewed original articles, literature review and case report. This journal is published two times a year with 6 articles. Subjects suitable for publication include but are not limited to the following fields of Acute and chronic musculoskeletal disorders and pain, Neurologic conditions involving the central and peripheral nervous system, Rehabilitation of impairments associated with disabilities in adults and children neurophysiology and electrodiagnosis. Emphasizes principles of injury function and rehabilitation rehabilitation services which is orthotics or prosthetics exercise exercise for physiotherapy also referred to as physical therapy concerned with diagnosing and treating physical dysfunction of movement and occupational therapy help to solve the problems that interfere with a persons ability

Arjuna Subject : Kedokteran - Rehabilitasi

Articles 141 Documents

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The times, they are a changing Nicolino Ambrosino FERS
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

With the increasing life expectation and population age due to medical progress and better general lifeconditions, including among others nutrition and housing, patients’ clinical patterns are fast moving towardgreater complexity, multi-morbidity, comorbidity and chronic criticality.2 As a consequence health systemswill have to face increasing burden and different approaches compared to the past.At the same time in relatively few years Respiratory Rehabilitation has become a corner stone of comprehensivemanagement of Chronic Obstructive Pulmonary Disease (COPD) and, with less but increasing evidence, ofother respiratory and non respiratory diseases. The positive effects on symptom control, ability to cope withactivity of daily life and on quality of life are unquestioned and we don’t need any more randomised studieson these outcome measures in COPD patients. We need more studies on survival in COPD and on the otheroutcome indexes of diseases other than COPD.3Nevertheless to face the above changes, the present mean skills and training processes are not enough anymore. Also Rehabilitation clinicians and physiotherapists, while maintaining their present and historicalskills, must change their approach and add new competences along these lines at least:1. A comprehensive approach to the patients, moving from “disease-centered” to “patient-centered”paradigm of care.4 This task requires by cares a cultural revolution and an effort to improve andenlarge personal knowledge. In other words we have to face a greater effort to improve skills andtraining involving at the same time deeper and wider fields of knowledge and intervention in diseasesother than COPD and in patients with comorbididites with special attention to the most prevalentdiseases in each country like TB.52. Greater ability in facing the needs of “chronically critical” patients. This task requires skills in longtermcritical conditions like the effects of the so called “ICU induced neuro-myopathy” and relatedcognitive problems.63. A greater involvement in end-of-life and palliative care requiring abilities to be part of teams facingethical issues. This task requires a new approach to diseases including a deeper involvement inempathy with patients in the frame of the religious habits and traditions of each society.7“Nomina sunt consequential rerum”,8 therefore in the light the above issues, we should not speak about“Pulmonary Rehabilitation” anymore, but rather about “Rehabilitation of patients with (also) respiratoryproblems”. In the present Issue of IJPMR several qualified authors deal with this new approach, reporting dataon Rehabilitation in diseases other COPD, opening a window on the future developments of Rehabilitation.Nicolino Ambrosino FERSResearch Director and Director of Respiratory Department, Rehabilitation and Weaning CentreAuxilium Vitae, Volterra, Italy

Thorax Expansion and Its Correlation to Spirometry Agatha Narinda D. Mulyo; Vitriana Biben; Tertianto Prabowo
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 obtain normal value of thorax expansion in relation with age, gender, body weight,and body height and also its correlation with normal values of spirometry.Methods: Values of three levels of thorax expansion were attained from 196 normal healthy subjects(aged 21-40 years old) whose spirometry results were within normal range.Results: This study revealed mean thorax expansion in level I (axilla) as 6.03 (1.44) cm, level II(4th intercostal space) 6.69 (1.43) cm and level III (xyphoid process) 6.9 (1.7) cm. Male subjectsshowed bigger value of thorax expansion. In association with spirometry, thorax expansion positivecorrelatedsignificantly with FVC (p 0.01) and FEV1 (p 0.04).Conclusion: Normal values of thorax expansion and its relations with several variables weredescribed from within 196 normal-healthy subjects. Its correlation with spirometry values showedthe ability to predict the expansion of lung from the expansion of the external thorax.Keywords: thorax expansion, spirometry

Effectiveness of Partial Body-Weight Supported Treadmill Training-Audio Cues and Traditional Overground Walking in Improving Gait Speed and Cardiorespiratory Fitness After Stroke Hening Laswati; Meisy Andriana; Ida Yuanita
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 compare the effectiveness of Partial Body-Weight Supported Treadmill Training-Audio Cues (PBWSTT-AC) and the traditional over ground walking in improving gait speed andcardiorespiratory fitness after stroke.Methods: pretest-posttest control group design of patients with sub-acute and chronic ischemicstroke who came to Physical Medicine and Rehabilitation (PMR) Department of Dr. Soetomo andAirlangga University Hospital Surabaya. Patients with onset 3 weeks until 10 years, age between 21until 70 years old, able to walk independently for 6 minutes, sufficient vision and hearing and canfollow simple instructions were included in this study. There were 18 patients at beginning and 16patients completed the study. Patients underwent walking exercise for 20 minute, 3 times a week for12 sessions. PBWSTT-AC group received metronome auditory rhythmic stimulation, while controlgroup received traditional walking exercise with customized speed according to patient’s preference.Gait speed were assessed by 10 meter Walk Test and cardiopulmonary endurance counted fromresting heart rate.Results: There were improvements in gait speed and cardiorespiratory fitness within each subjectgroup. Traditional group showed significantly larger increases in fast gait speed (p=0.023) but notin self-selected gait speed (p=0.002). PBWSTT-AC group showed significantly larger decreases(p=0.002) in resting heart rate (p=0.003).Conclusion: PBWSTT-AC was not shown to be superior to traditional walking in improving gaitspeed, but superior in improving cardiorespiratory fitness. Further study are needed to evaluate thelong-lasting effect of using PBWSTT-AC in improving cardiorespiratory fitness.Keywords: Partial Body-Weight Supported Treadmill Training-Audio Cues, gait speed, cardiorespiratory fitness

The Effect of Treadmill Aerobic Exercise on Walking Distance, Lung Function and Quality of Life in Tuberculosis Patients Muhamad Ilham; Marina Moeliono; Prayudi Santoso
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 observe the effect of treadmill aerobic exercise on walking distance, lung functionand QoL in lung tuberculosis patients.Methods: It was an interventional study using controlled random sampling with pre- and post- interventionobservation. The study took place at Hasan Sadikin Hospital, Bandung. Subjects were post-category IImedicationpulmonary TB patients with negative AFB conversion, males and females aged 18-60 years,normal BMI (according to Indonesian Ministry of Health 2003), able to comprehend spoken, writtenand signed instructions (mini mental state examination - MMSE 22-30), able to undergo a six-minuteswalking test (6MWT), cooperative and willing to participate in the study. This study analyzed data from30 subjects divided into two groups (interventional vs control group, each 15 subjects). Control groupwas given educational program, breathing techniques and chest- expansion exercises to do at home for6 weeks (3 times a week), whereas the study group received additional aerobic exercise for 6 weeks(walking on a treadmill, 3 times a week, 30-60 minutes per session) with the intensity of 80% of the speeddetermined from the result of the 6MWT. Pre- and post- six weeks, walking distance (6MWT), lungfunction and St. George’s Respiratory Questionnaire (SGRQ) evaluation were obtained from subjects.Results: Walking distance of interventional group (mean 75.53 m, p<0.05) increased significantly after6 weeks. There were also significant difference between two groups in the SGRQ components exceptfor symptoms. Lung functions as shown on FVC and FEV1 increased significantly in interventionalgroup. However, this increase was not confirmed by the change of breathing impairment pattern.Conclusion: The significant difference between the study and the control groups showed that aerobicexercise using treadmill gives better improvement on the quality of life. This fact demonstratesthat exercise program in pulmonary rehabilitation remains the core program to increase functionalcapacity and quality of life.Keywords: lung tuberculosis, aerobic exercise, treadmill, walking distance, quality of life, SGRQ

Comparison of Asthma Gymnastic and Static Ergocycle Exercise in Improving VO2max and Quality of Life in Adult Asthmatic Patient Tina Susilawati; Tri Damiati Pandji; Arto Yuwono Soeroto
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 compare two aerobic exercise training program, asthma gymnastic and static ergocycleexercise, in improving VO2max and QoL based on St. George’s Respiratory Questionaire (SGRQ)for partially-controlled asthmatic patients.Methods: This study analysed 36 of partially-controlled asthmatic adult patients (aged 21-50 yearsold) which were divided into two groups, asthma gymnastic (A, n=18) and ergocycle exercise (B,n=18) each for 3x/week for 6 weeks. Before and after treatment, VO2max was measured usingAstrand ergocycle method and QoL using SGRQ.Results: Significant increase of mean VO2max in both groups (A 3.78 ml/kg/minute vs B 7.13 ml/kg/minute in group B; p 0.00). Significant improvements were also found in all component of SGRQ(p=0.00) in both groups, with higher total score found in group B (A 271.11 vs B 384.86, p=0.00).Conclusion: Static ergocycle exercise increased the level of VO2 max and QoL in partially-controlledasthmatic adult patients better than asthma gymnastic.Keywords: Asthma gymnastic, static ergocycle exercise, partially-controlled asthma, quality of life, VO2max

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

Long-Term Oxygen Therapy in Chronic Obstructive Pulmonary Disease Yuni Ekowati
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

Chronic Obstructive Pulmonary Disease (COPD) affects 210 million people worldwide and is predicted to increase more than 30% in the ten following years. Long-term oxygen therapy (LTOT) is the treatment of choice nowadays and widely used to reduce mortality in COPD. LTOT in COPD can improve hemodynamic status, exercise tolerance, dyspnoea, life expectancy, quality of life, cognitive function and frequency of hospitalization.The success of LTOT depends on patient compliance, duration of therapy and the accuracy of hypoxemia correction. Although LTOT provides many benefits in COPD patients, but it also has many disadvantages. Subjective factor is the determinant factor in the success of therapy. Follow-up session is required to evaluate the therapeutic efficacy, prevent side effects and detect any clinical deterioration or hypercapnia as early as possible for an immediate referral to the hospital.Keywords: Long-term Oxygen Therapy (LTOT), COPD, hypoxemia,quality of life.

Applicability of Acu-TENS in Patients with Chronic Obstructive Pulmonary Disease Melinda Harini; I Nyoman Murdana
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

Asthma and Chronic Obstructive Pulmonary Disease (COPD) are the most global prevalence disease.Accupunture has been proved to be the adjuvant therapy for both airway obstructive diseases. Butinvasive technique that were used in accupunture, is not comfortable for some patients and dependsso much to operator’s skill. Acu-TENS is an electrical stimulation therapy with low frequency,in which transcutaneous electrodes are placed over acupuncture points, Dingchuan (EX-B1). It isless invasive, easy to apply and offer advantages to patient with COPD. The Acu-TENS therapymechanism in COPD were related to lung function, functional capacity, quality of life improvement.Moreover, higher blood ß-endorphin is produced and in fact, it is found to be moderately correlatedwith reduction of respiratory rate, improvement of forced expiratory volume in one second (FEV1).Therefore, Acu-TENS could be used as alternative electrodes placement in order to improve symptoms, muscle function, and functional capacity in patients with COPD. However, long-termstudy to evaluate the application of Acu-TENS is highly recommended.Keywords: Acu-TENS, COPD, ß-endorphin

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

Cardiovascular Dysfunction in Spinal Cord Injury Neysa Calista
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

Cardiovascular functions ars altered by the impaired autonomic pathways in cervical and high thoracic spinal cord lesion, resulting in cardiovascular and thermoregulation dysfunction. The interruption of the motor and sensory functions in the high level spinal cord lesion also plays a role in lack of physical activity and reduce muscle metabolic mass, resulting in coronary heart disease and metabolic syndrome, thus premature mortality. Exercise program in these cases should be made specifically and individually related to the dysregulation of autonomic system and possibility impending autonomic dysreflexia.

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