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<p>Latihan bersepeda berbasis virtual reality (VR-Bicycling) bagi penderita pasca stroke merupakan teknologi yang dikembangkan untuk meningkatkan gerak motorik otot. Penerapan VR-Bicycling umumnya untuk melatih gerak motorik ekstremitas bawah daripada gerak motorik ekstremitas atas. Penggunaan terapi cermin (Mirror Therapy-MT) merupakan bentuk terapi gerak motorik ekstremitas atas dengan mempengaruhi propriosepsi otak yang berfikir bahwa eksterimitas atas yang mengalami hemiparesis dapat bergerak baik. Dalam penelitian ini dikembangan modul VR-Bicycling untuk melatih gerak motorik ekstremitas atas berbasis MT dengan mengkombinasikan umpan balik visual dan audio pada lingkungan virtual (Virtual Environment-VE). Umpan balik visual untuk mengetahui waktu tunda dan perbedaan spasial berupa ketepatan lengan virtual dalam menangkap apel atau menghindari bom sepanjang lintasan bersepeda. Sedangkan umpan balik audio menggunakan metronome untuk melatih operabilitas dan kontrol lengan virtual. Kinect digunakan sebagai motion capture gerakan lengan nyata. Pengujian melibatkan sepuluh penderita pasca stroke untuk melatih gerak motorik ekstremitas atas yang mengalami hemiparesis dalam mengontrol gerakan lengan virtual pada VR-Bicycling. Evaluasi sistem dilakukan dengan meminta penderita pasca stroke menjawab daftar pertanyaan yang mengandung faktor operabilitas, konsentrasi, kontrol gerakan, waktu tunda, dan perbedaan spasial dari terapi ekstremitas atas pada VR-Bicycling menggunakan konsep terapi cermin. Dari hasil evaluasi diketahui bahwa waktu tunda dan perbedaan spasial pada terapi ekstremitas atas menggunakan VR-Bicycling dengan MT merupakan dua variabel penting untuk mengontrol arah dan ketepatan gerakan lengan virtual pada VE.</p><p> </p><p class="Judul2"><strong><em>Abstract</em></strong></p><p class="Abstract"><em>A virtual reality bicycling (VR-Bicycling) was encouraged to address motor control and fitness deficits of person post-stroke. The applied of VR-Bicycling for therapy of person post-stroke has focused primarily on improving movement and use of the lower extremity than upper extremity. Mirror therapy (MT) is an instrument that enables a person with an amputation to view a reflection of an intact limb in the visual plane of the missing limb by tricking the brain into believing the missing limb is actually moving. The use of virtual reality (VR) over MT is that VR allows more complete immersion into the illusion, whereas MT requires tight focus and concentration to truly see the illusion as real. In this research, we had developed a VR-Bicycling module based MT for training upper extremity of person post-stroke while doing simulated bicycling. Person post-stroke cycled with guidance of visual cueing (represented as apples and bombs) and auditory condition (provided by metronome) in the virtual environment (VE). We tested ten person post-stroke as they cycled on a stationary bicycle while moving their virtual limb to hit apples or avoid bombs in VE. A VR-Bicycling module measures the motion data of upper extremity by Kinect and evaluate immersion and motor cognition by using factor analysis with three factors consisting of controllability, concentration, sense of delay, and spatial difference. The evaluation result indicates that temporal delay and spatial fluctuation have strong relationship to control virtual limb movement correctly.</em></p>

IntroductionVirtual reality (VR) cycling exercise was developed as a physical rehabilitation therapy to impair the deficit on motoric function and cardiorespiratory fitness on post-stroke patients with lower extremity disorder. This study aims to figure out the effectiveness of VR cycling exercise towards the impairment of lower extremity motoric function and cardiorespiratory fitness on the post-stroke patients.MethodsThis study engaged 15 people chosen through a purposive sampling method which were divided into 8 intervention groups of post-stroke patients without comorbid (post stroke ≥ 2 years) and 7 healthy people in a control group. Fugl Meyer assessment was used to decide the participation of the patients. To assess the lower extremity motoric functions, timed up-and-go test (TUGT) was carried out. 6-minute walking test (6-MWT) was conducted to assess the function of gaits. VO₂max was carried out to assess the cardiorespiratory fitness. VR cycling exercise had been conducted for 3 months, twice a week.ResultsBoth groups performed significant difference (<i>p</i> < 0.05) in terms of balance, gait ability, and cardiorespiratory fitness. The decrease of TUGT score and increase of 6-MWT and VO₂max tests’ scores of the intervention group obtained after having VR cycling exercise was significantly bigger than it was before taking the exercise. The group of post-stroke patients were able to take the exercise in 40–60 minutes/time of exercise.ConclusionsVR cycling exercise is such an effective intervention to increase motoric function and cardiorespiratory fitness on chronic post-stroke patients. Therefore, taking VR cycling exercise is recommended for a stroke rehabilitation and clinical practice purposes.

Abstract. Purpose: Dengue Hemorrhagic and Malaria fevers are the most common arthropod-borne diseases caused by mosquito bites and they also have similar signs and symptoms. Based on the problems, the researcher makes an expert system that aims to help people early detect fever diseases. This system is expected to help and support the infectious disease prevention and control program by the Ministry of Health of the Republic of Indonesia.Methods: This study uses an expert system with a combination of Forward Chaining and Certainty Factor to detect the symptoms of fever. Forward Chaining is a technique that begins with gathering information related to known facts, then combining rules to produce conclusions. The certainty Factor method is used to define a measure of certainty against a fact or rule and to describe the level of expert confidence in dealing with problems. There are 32 symptoms of the disease consisting of dengue fever, malaria and typhoid, it was obtained based on the literature and interviews with internal medicine specialist with 20 case datasets.Result: Based on 20 test data, obtained one data that does not match the test results and the desired target so that the system accuracy obtained is 95%. In addition, the combination of Forward Chaining and Certainty factor has better accuracy when compared to expert systems in previous studies.Novelty: Forward Chaining to find three rules and assigning weights to the Certainty Factor that has been set by the expert makes the combination of the two methods produce better accuracy.