Dysphagia is associated with an increased risk of aspiration pneumonia which often results in death in stroke patients. Therefore, effective and efficient management is important. Behavioral therapy for swallowing rehabilitation based on the principles of neuroplasticity such as oropharyngeal strengthening and range of motion exercises are the alternative ones that often be used. This study aimed to assess the changes in swallowing function in ischemic stroke patients with neurogenic dysphagia after pharyngeal strengthening exercise, hyolaryngeal complex range of motion exercise and swallowing practice. Swallowing function was assessed using Penetration Aspiration Scale (PAS) and Functional Oral Intake Scale (FOIS) based on Flexible Endoscopic Evaluation of Swallowing before and after interventions. The interventions were given every day with a duration of 30-45 minutes for 4 weeks. There were six subjects who completed the study. The PAS before the interventions were 6.00± 1.79 and after the interventions was 1.67± 0.82 (P= 0.003). Meanwhile, the FOIS score before the interventions was 3 (1-5) and after the interventions were 5.00± 2.10 (P= 0.041). There was an improvement of PAS and FOIS after the interventions. Therefore, the interventions can be suggested to be used as one of the treatments to improve swallowing function in ischemic stroke patients with neurogenic dysphagia.

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AbstrakPenelitian ini bertujuan untuk mendapatkan karakteristik mekanik komposit serat alam khususnya serat rami dengan matriks epoksi yang akan diaplikasikan sebagai bahan alternatif pada desain soket prostesis. Fokus penelitian adalah pengujian komposit lamina serat rami epoksi mengacu standar American Society for Testing Material (ASTM) D 3039/D 3039M untuk pengujian tarik dan ASTM D 4255/D 4255M-83 untuk pengujian geser. Serat rami yang digunakan adalah serat kontinyu dengan kode produksi 100% Ne 14'S, menggunakan matriks berupa Epoxy Resin Bakelite EPR 174 dan Epoxy Hardener V-140. Metode pembuatan sampel uji komposit lamina dengan cara hand lay up terhadap serat rami kontinyu pada suhu kamar. Hasil pengujian karakteristik mekanik komposit serat rami epoksi akan dibandingkan dengan standard ISO untuk bahan plastik/polymer yang diaplikasikan pada bidang kesehatan, khususnya untuk Prosthetics dan Orthotics. Analisis dilengkapi dengan hasil pengamatan berbantuan Scanning Electron Microscope (SEM) untuk mengetahui modus kegagalan dan kriteria kegagalan. Berdasarkan hasil pengujian dapat disimpulkan bahwa komposit lamina serat rami epoksi berpotensi untuk dikembangkan lebih lanjut sebagai material alternatif dalam pembuatan soket prostesis atas lutut pada Vf 40-50%. Hasil penelitian akan dibahas secara lebih detail dalam makalah ini. AbstractMechanical properties of ramie fiber reinforced epoxy lamina composite for socket prosthesis. This paper presents an investigation into the application of natural fiber composite especially ramie fiber reinforced epoxy lamina composite for socket prosthesis. The research focuses on the tensile and shear strength from ramie fiber reinforced epoxy lamina composite which will be applied as alternative material for socket prosthesis. The research based on American Society for Testing Material (ASTM) standard D 3039/D 3039M for tensile strength and ASTM D 4255/D 4255M-83 for shear strength. The ramie fiber applied is a fiber continue 100 % Ne14'S with Epoxy Resin Bakelite EPR 174 as matrix and Epoxy Hardener V-140 as hardener. The sample composite test made by hand lay up method. Multiaxial characteristic from ramie fiber reinforced epoxy composite will be compared with ISO standard for plastic/polymer for health application and refers strength of material application at Prosthetics and Orthotics. The analysis was completed with the mode of the failure and the failure criterion observation by using Scanning Electron Microscope (SEM). Based on results of the research could be concluded that ramie fiber reinforced epoxy composite could be developed further as the alternative material for socket prosthesis on Vf 40-50%. Results of the research will be discussed in more detail in this paper.

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Introduction:Impaired turning patterns have been considered as 1 factor which potentially leads to disability in chronic stroke patients. Mobility comprises 80% of the chief disability, and would eventually lead to falls. Expanded Timed Up and Go (ETUG) is an effective mobility assessment method. It utilizes video recording to analyze the conventional Time Up and Go (TUG) Test components, which includes turning pattern analysis.Methods:Six healthy males without stroke history and 21 chronic ischemic stroke males (divided into subjects with or without the presence of flexor synergy pattern subgroups) capable of independent ambulation were recruited from Neurology and Medical Rehabilitation Department outpatient clinic. ETUG tests were recorded for each subject and were analyzed thoroughly using a computer program.Results:Timed Up and Go time was significantly different between the 3 groups (P = .001). As compared to control, and synergy absent group, median turning time was highest in chronic stroke patients with presence of flexor synergy by 2786 ms (P = .002), but was not significantly different in percentage ETUG (14%, P = .939). Further analysis revealed that Brunnstrom stage and number of steps taken for turning significantly affect TUG duration. Other factors such as hemiparetic side, or body height were not significantly associated.Discussion:The presence of flexor synergy would significantly affect turning time, this would then correlate to the disability of shifting body's center of gravity, as a part of the Stroke core set of International Classification of Functioning, Disability, and Health (ICF).Therefore, stroke patients need to have early ambulatory training regarding pivoting motion rather than solely focusing on straight walking. Instead of hemiparetic side, it is possible that overall turning time is affected by coordination and orientation capability, signifying the importance of cortical plasticity.