AbstrakAmputasi merupakan pengangkatan anggota tubuh yang melibatkan pemotongan sebagian atau seluruh anggota badan. Masalah yang muncul akibat amputasi di antaranya nyeri luka operasi, penurunan lingkup gerak sendi, penurunan kekuatan otot, dan penurunan kemampuan fungsional. Tujuan penelitian ini yaitu untuk mengetahui intervensi fisioterapi pada kasus post amputasi transtibial sinistra akibat chronic limb ischemia. Penelitian ini merupakan studi kasus yang dilakukan di RSPAD Gatot Subroto pada bulan Februari-Maret tahun 2018. Data diperoleh dari wawancara, pengamatan, pengkajian, dan penatalaksanaan fisioterapi. Dalam studi kasus ini batasan permasalahan yang akan dibahas yaitu nyeri, kekakuan, spasme, keterbatasan lingkup gerak sendi dan penurunan kekuatan otot. Modalitas yang akan diterapkan yaitu Trans Electrical Nerve Stimulation (TENS) dan terapi latihan berupa latihan gerak aktif, peregangan, penguatan, dan latihan core stability. Hasil studi kasus ini menunjukkan modalitas TENS mampu menurunkan nyeri diam, nyeri tekan dan nyeri gerak pada penderita amputasi. Latihan gerak aktif, peregangan, penguatan, dan latihan core stability mampu mengurangi kekakuan, spasme, dan meningkatkan lingkup gerak sendi serta meningkatkan kekuatan otot sehingga mampu mempersiapkan pasien untuk berjalan dengan menggunakan alat bantu. Abstract Physiotherapy Management In The Transtibial Post Amputation Case Sinistra Due To Chronic Limb IschemiaIn RSPAD Gatot Soebroto. Amputation is the removal of a member of the body which involves cutting a part or all of the limb. Problems arising from amputation include surgical wound pain, decreased joint motion, decreased muscle strength, and decreased functional ability. The purpose of this study was to determine physiotherapy interventions in cases of sinistra transtibial amputation due to chronic limb ischemia. This research is a case study conducted at the Gatot Subroto Army Hospital in February-March 2018. Data obtained from interviews, observation, assessment, and management of Physiotherapy. In this case study the limitations of the problem to be discussed are pain, stiffness, spasm, limited scope of joint motion and decreased muscle strength. The modalities that will be applied are Trans Electrical Nerve Stimulation (TENS) and exercise therapy in the form of active motion exercises, stretching, strengthening, and core stability exercises. The results of this case study show that the TENS modality can reduce silent pain, tenderness and motion pain in amputees. Active motion exercises, stretching, strengthening, and core stability exercises can reduce stiffness, spasm, and increase the scope of joint motion and increase muscle strength so as to be able to prepare patients to walk using aids.
Stroke merupakan hilangnya fungsi otak secara mendadak dan memicu kelumpuhan unilateral yang dapat mengurangi kontrol postur dan keseimbangan sehingga pasien kesulitan untuk berjalan. Tujuan studi kasus ini adalah mengetahui efektivitas balance exercise dan gait training terhadap peningkatan keseimbangan dan kecepatan berjalan pada pasien stroke menggunakan parameter Timed Up and Go Test (TUGT) dan 10 Meter Walk Test (10MWT). Metode yang digunakan adalah evidence-based case report dengan pertanyaan klinis, “Bagaimana efektivitas balance exercise dan gait training terhadap peningkatan keseimbangan dan kecepatan berjalan pada kasus stroke iskemik?” dengan penelusuran bukti pada 3 database, yaitu Pubmed, science direct, dan scopus. Setelah dilakukan 6 kali evaluasi terdapat peningkatan keseimbangan dan kecepatan dimana pada evaluasi pertama didapatkan hasil pengukuran TUGT sebesar 14,14 detik, self selected velocity 0,63m/s dan fast velocity 0,66m/s. Pada evaluasi keenam didapatkan hasil sebesar 09,50 detik, self selected velocity 1,34m/s dan fast velocity 1,40m/s sehingga dapat disimpulkan bahwa balance exercise dan gait training efektif dalam meningkatkan keseimbangan dan kecepatan berjalan pada pasien stroke dengan nilai minimal detectable change (MDC) TUGT sebesar 2,9 detik dan 10MWT pada self selected velocity sebesar 0,18m/s dan fast velocity sebesar 0,13m/s serta nilai minimally clinically important difference (MCID) TUGT sebesar 3,4 detik dan 10MWT sebesar 0,16m/s.
Background: Hernia Nucleus Pulposus (HNP) is a condition in which the nucleus pulposus has bulged from the intervertebral disc, consequently damages the walls of the annulus fibrosus and compresses the nerves. Clinical problems such as radiating pain, sensory disturbances according to dermatomes, muscle weakness, restricted range of motion, especially during flexion, and decreased functional ability. Core stability exercise is one of the physiotherapy treatments to reduce pain and improve the patient's functional ability with lumbar HNP. The purpose of this study is to determine the effectiveness of core stability exercise on increasing functional ability in cases of lumbar HNP with Modified Oswestry Low Back Pain Disability Questionnaire as a parameter. Methods: A single case study provided a physiotherapy intervention to a 56-year-old female patient for four weeks with four evaluations. The dose of exercise given was three times a week, three sets, five repetitions, 6-9 minutes of each type of exercise, and hold time 5-10 seconds. The improvement of functional ability is measured by using the Modified Oswestry Low Back Pain Disability Questionnaire. Results: There was an improvement in functional ability as measured by Modified Oswestry Low Back Pain Disability Questionnaire. At pre-intervention, the Modified Oswestry score was 52% meaning the patient had severe disability. On the 4th week evaluation, the patient's Modified Oswestry score decreased to 26%, indicating moderate disability. Conclusion: This study showed that core stability exercise effectively improved functional ability in a patient with lumbar HNP.
Latar Belakang : Osteoarthritis (OA) merupakan penyakit kronik jangka panjang yang ditandai dengan rusaknya kartilago sendi yang menyebabkan terjadinya gesekan antar tulang sehingga menyebabkan adanya kekakuan, nyeri, dan pembatasan gerakan pada sendi lutut. Sedangkan osteoarthritis genu adalah suatu penyakit sendi degeneratif yang berkaitan dengan kerusakan kartilago pada sendi lutut. Terapi latihan Quadriceps Setting Exercise (QSE) umumnya memberikan manfaat dalam mengurangi keluhan yang diperkirakan mampu meningkatkan kemampuan fungsional pasien dalam melakukan aktivitas secara optimal. Tujuan dari studi ini adalah untuk mengetahui efektivitas metode latihan Quadriceps Setting Exercise (QSE) pada kasus osteoartritis lutut. Metode: Studi kasus tunggal, dengan memberikan intervensi fisioterapi pada seorang wanita 77 tahun dengan diagnosis OA lutut genu bilateral. QSE diberikan selama 2 minggu dengan 4 kali evaluasi. Penilaian kekuatan otot menggunakan MMT. Hasil: Terdapat peningkatan MMT dari 4 menjadi 5 yang dikaitkan dengan skor WOMAC dari nilai 37 menjadi 27, yang menunjukkan bahwa terdapat peningkatan terhadap kemampuan fungsional pasien Kesimpulan: Studi ini menunjukan bahwa metode terapi latihan Quadriceps Setting Exercise (QSE) dapat meningkatkan kemampuan fungsional pada osteoartritis lutut yang diukur menggunakan parameter WOMAC.
Background: Myofascial trigger point syndrome is a musculoskeletal disorder characterized by the presence of a trigger point in a sensitive area within the skeletal muscle band linkages, if pressure is applied to the area it will cause specific pain at a point that is pressed (tenderness). Myofascial trigger point syndrome is influenced both by mechanism and by positioning factors. Myofascial trigger point syndrome upper trapezius muscle radiates along the upper back and neck, behind the ears and at the temples. Methods: The research method used is in the form of a case study with 1 patient who was given physiotherapy intervention and evaluation 4 times. To overcome the problem of muscle pain in bilateral trapezius m.upper in this study, using manual physiotherapy intervention therapy in the form of friction massage. Result: The results obtained, there was a decrease in tenderness in the upper trapezius muscle VAS 5 during the first evaluation to VAS 2 at the fourth evaluation with an average VAS value pre and post after one month for four interventions, namely 1.72. The MDC value (95) is 0.196 and the MCID range is 0.88-1.7, and 1.46-2.28. Conclusion: Based on these results, it can be concluded that physiotherapy intervention with the manual method of therapy, friction massage is considered effective in reducing pain in patients with myofascial trigger point syndrome, upper trapezius muscle with visual analogues scale (VAS) parameters. Keyword : Myofascial Trigger Point Syndrome, Manual Therapy, Friction Massage
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