Background: COVID-19 affects the multiorgan system, mostly the respiratory system. Symptoms might vary from upper respiratory manifestation to acute respiratory distress syndrome, with the main feature being impairment of gas exchange. This pulmonary impairment might lead to a decrease in functional capacity, which cause activity limitation. Thus, COVID-19 patient requires the right pulmonary rehabilitation strategy to improve pulmonary function and prevent further pulmonary complications. This study aimed to compare the effectiveness of incentive spirometry and diaphragm breathing exercise on cardiorespiratory functional capacity in COVID-19 patients. Methods: Subjects were divided into two groups of breathing exercises, the incentive spirometry group and the diaphragm breathing exercise group. They performed breathing exercises for 5 days, and the functional capacity was measured by a test named 4-meter gait time test (4MGT) and 30 sit-to-stand test (30STS). The test was taken before and after performing breathing exercises. Results: These two respiratory exercises significantly affected the functional capacity in a good manner (p < 0.05). The incentive spirometry had improved 30STS (P = 0.763) and 4MGT results (P = 0.674), as well as diaphragm breathing exercise did to 30STS (P = 0.456) and 4MGS (P = 0.441). Conclusion: In conclusion, diaphragm breathing exercises and incentive spirometry improved the functional capacity of COVID-19 patients. However, incentive spirometry showed a larger effect on 30STS and 4MGT compared to diaphragm breathing exercises.

Introduction. COVID-19 patient not only experienced respiratory manifestation, but they also generate generalized muscle weakness. This manifestation results in deterioration of physical capacity. Methods. This cross-sectional study identified the characters of COVID-19 patient based on their age, gender, severity of disease and whether they have comorbidities or not. This study also described the functional capacity using a modified 30-Second Sit-to-Stand Test (m30STS) and chest expansion measured at three levels (axillary, nipple, and xiphisternum). Result. M30STS was one of reliable measure that used for physical or functional capacity. Chest wall expansion determines lung volume and functional capacity as well. Eighty-five subjects in isolation ward were enrolled. This study shows there is reduction of functional capacity in COVID-19 patients. Majority of subjects tend to reached lower number of repetitions in m30STS or about 10.37 times in average. Clonclusion. The thoracic expansion was reduced below normal range in all subjects.

The radial nerve divides into two terminal branches the superficial radial nerve and the posterior interosseous nerve. Posterior interosseous nerve entrapment is associated with weakness in the extension of fingers, atrophy of the forearm muscles, and localized pain in the lateral aspect of the elbow and proximal forearm without sensory deficits. A 37-year-old man complained of difficulty of right finger extension (MMT 2) and persistent pain (VAS 5) at the forearm after a fall from a motorcycle six months before admission. We treated the patient with a physical rehabilitation program for three months and a total of 12 visits. Sonography and electromyography (EMG) biofeedback were performed to evaluate improvement after the physical rehabilitation program. After three months, the pain was relieved, and forearm extensor muscle strength increased. This showed that sonography and EMG biofeedback play a role in the detection and evaluation of muscle and nerve abnormality due to posterior interosseous nerve (PIN) syndrome.

Metastatic spinal disease is considered a terminal stage of primary cancer and palliative treatment focuses around symptom control and reducing spinal complications such as cord compression. A 60 years man with complete spinal cord injury AIS A post laminectomy with Th2-Th4 decompression and tumor biopsy due to canal stenosis et causa Th3 compression fracture. Patient has history of paraparesis in level Th4-Th8, also bladder and bowel incontinence. The prognosis of patients with epidural metastasis is not promising and difcult to predict. Tokuhashi and Tomita scores are one of tools that used widely to predict the patient’s survival prognosis, in particularly for spinal metastatic treatment decision. These scores provide guidance decision whether aggressive operative or palliative. Tokuhashi score in this patient indicated the survival rate was below 6 months and Tomita score referred to palliative treatment. Physical medicine and rehabilitation treatment focus on palliative treatment for this patient include diminished pain, maintain vertebral stability, improve physical tness and mobility to reduce further complication of prolonged bedridden and improve quality of life. Other treatment was given according to complaint and symptom. Patient was died less than 2-month post-surgery after readmission to the hospital due to bed ridden complications.