Indonesian Journal of Physical Medicine and Rehabilitation
Indonesia Journal of Physical Medicine and Rehabilitation
All articles published in the Indonesian Journal of Physical Medicine and Rehabilitation (IJPMR) are licensed under the Creative Commons Attribution 4.0 International License (CC BY 4.0). This license allows others to share, copy, distribute, adapt, and build upon the work for any purpose, including commercial use, as long as proper attribution is given to the original authors. Indonesian Journal of Physical Medicine and Rehabilitation is Full license terms: https://creativecommons.org/licenses/by/4.0/
Integrating Pain Assessment and Personalized Goals: A Preliminary Study on Rehabilitation Outcomes for Post-Stroke Hemiplegic Shoulder Pain
Introduction: Hemiplegic shoulder pain (HSP) is a frequent complication in stroke survivors, negatively impacting rehabilitation and overall quality of life. HSP can make it hard to do everyday things, which can make patient anxious, stressed, and depressed because of muscle pain, spasticity, and less ability to do things. This study aims to clarify the correlation between shoulder pain intensity and clinical variables, also to evaluate the efficacy of Goal Attainment Scaling (GAS) in facilitating patients' achievement of rehabilitation goals following intervention. Methods: This cross-sectional study collected data from post-stroke patients with HSP at the Neurorehabilitation Department of Hasan Sadikin Hospital over a one-year period. The demographics of the patients (age, sex), clinical measure such as Range of Motion (ROM), Motor Assessment Scale (MAS), Brunnstrom stage, Manual Muscle Test (MMT), Depression Anxiety Stress Scales (DASS), Scale of Pain Intensity (SPIN), and Goal Attainment Scaling (GAS), were carefully recorded. Results: Pain during movement was considerably greater than pain at rest (3.3±0.9 vs 3.0±1.3; p<0.05). GAS analysis indicated improvements following to the rehabilitation program (37.2±0.44 vs 52.6±0.4; p<0.05). A significant correlation was identified only in DASS Depression scores (r=0.55; p<0.05), when other variables shown no significant correlation. Conclusions: HSP demonstrate greater intensity during movement and a moderate correlation with depression; a significant enhancement in GAS scores following intervention confirms the crucial role of goal-oriented rehabilitation in improving functional outcomes for post-stroke HSP patients. It is recommended to continue future research with larger sample sizes to strengthen the statistical correlations among clinical variables. Keywords : GAS, Hemiplegic, Shoulder, Stroke, Pain
Copyright (c) 2025 Indonesian Journal of Physical Medicine and Rehabilitation
Exploring the Relationship Between Muscle Tone, Echotexture, and Walking Speed in Chronic Stroke Patients : A Pilot Analysis
Latar Belakang: Spastisitas dan perubahan struktur otot diketahui memengaruhi kemampuan berjalan pasca-stroke. Sementara Skala Ashworth yang Dimodifikasi (MAS) dan Skala Heckmatt yang Dimodifikasi (MHS) umumnya digunakan dalam praktik klinis, hubungannya dengan luaran fungsional seperti kecepatan berjalan masih belum jelas. Tujuan: Studi percontohan ini mengeksplorasi hubungan antara spastisitas, ekotekstur otot, dan kecepatan berjalan pada pasien dengan stroke kronis. Metode: Delapan pasien rawat jalan, 8 – 24 bulan pasca-stroke pertama, dinilai di klinik neurorehabilitasi. Tonus otot diukur menggunakan MAS, ekotekstur otot menggunakan MHS, dan kecepatan berjalan diperoleh dari tes berjalan 6 menit. Data dianalisis menggunakan korelasi peringkat Spearman. Hasil: Kecepatan berjalan rata-rata adalah 0,82 ± 0,21 m/s, skor MAS rata-rata adalah 2,1 ± 0,6, dan skor MHS rata-rata adalah 2,7 ± 0,5. MAS dan MHS menunjukkan korelasi lemah hingga sedang (? = 0,067–0,417), sementara MHS dan kecepatan berjalan menunjukkan hubungan negatif yang sangat lemah (? = –0,126 hingga –0,206). Tidak ada hubungan yang mencapai signifikansi statistik (p > 0,05). Kesimpulan: Meskipun tidak ditemukan korelasi yang signifikan, temuan ini memberikan wawasan awal yang berharga. Penelitian yang lebih besar dan lebih beragam, terutama yang melibatkan pasien stroke subakut dan stratifikasi berdasarkan stadium Brunnstrom, diperlukan untuk memperjelas bagaimana spastisitas dan kualitas otot berkontribusi terhadap luaran mobilitas dalam rehabilitasi stroke. Kata kunci stroke kronis, tonus otot, ekotekstur, kecepatan berjalan, ultrasonografi
Keywords chronic stroke, muscle tone, echotexture, walking speed, ultrasonography
Effectiveness of Elastic Taping Compared to Sham Taping on Upper Trapezius Muscle Elasticity in Patients with Myofascial Pain Syndrome
Introduction: Elastic taping (ET) is believed to improve muscle elasticity in patients with myofascial pain syndrome (MPS); however, studies employing objective measurements of muscle elasticity remain scarce. This study aims to provide empirical evidence demonstrating that ET can objectively improve muscle elasticity. Methods: This double-blind randomized clinical trial investigated the efficacy of ET versus sham taping on upper trapezius muscle elasticity and pain pressure threshold (PPT) in patients with MPS. Participants were assigned to ET using the inhibition technique or sham taping without stretch. Shear wave elastography (SWE) and PPT were measured pre-intervention, 20 minutes, and 24 hours post-intervention. Results: The ET group demonstrated significant improvements in muscle elasticity (reduced SWE) and increased PPT at both 20 minutes and 24 hours (p<0.05). The sham group showed non-significant changes at 20 minutes (p=0,122) and partial improvement at 24 hours(p=0,019). Between-group comparisons revealed statistically significant differences at both post-intervention time points (p<0.05). Conclusion: ET proved effective as an adjunct to stretching, eliciting immediate and sustained benefits, and represents a non-invasive, easily applicable modality with potential for wide clinical use in upper trapezius MPS. Keywords: myofascial pain syndrome, upper trapezius, elastic taping, shear wave elastography, pain pressure threshold
myofascial pain syndrome, upper trapezius, elastic taping, shear wave elastography, pain pressure threshold
Case Report Functional Outcomes of Task-Oriented Circuit Training in a Middle-Aged Male with Vascular Parkinsonism and Recurrent Stroke: A Case Report
Introduction: Vascular parkinsonism (VP) due to small-vessel disease markedly impairs mobility and quality of life. As VP patients respond poorly to dopaminergic therapy, structured exercise rehabilitation is essential. This case report examines the functional outcomes of a six-week task-oriented circuit training (TOCT) program in a 59-year-old man with chronic VP (>6 months, four prior events). Presentation/Case Description: A 59-year-old male with VP from recurrent ischemic infarcts presented with gait unsteadiness, bradykinesia, and limited community ambulation. A six-week rehabilitation program centered on TOCT, integrating balance, gait, and functional task practice, was implemented. This was supplemented with aerobic conditioning and stretching. Post-intervention assessment revealed improvements in balance, walking endurance, pain reduction, and functional independence. Discussion: The structured TOCT protocol, emphasizing high repetition of task-specific movements and progressive challenges, effectively addressed the postural instability and endurance deficits characteristic of VP. The combination of TOCT with aerobic exercise provided a comprehensive approach to improve motor performance and patient-reported outcomes. Conclusions: An individualized six-week multidisciplinary rehabilitation program improved balance, endurance, pain, and QoL in a patient with VP; however, these findings are limited by the descriptive single-case design and require confirmation in larger, randomized, and blinded studies. Keywords : quality of life, rehabilitation, small vessel disease, stroke, TOCT, vascular parkinsonism.
Comprehensive Rehabilitation in Systemic Sclerosis with Complex Neurological Involvement: A Case Report Short running title: Complex Systemic Sclerosis Rehabilitation
Introduction: Systemic sclerosis (SSc) is a chronic autoimmune disorder characterized by fibrosis and vascular dysfunction affecting multiple organ systems. Neurological and pulmonary complications, though less common, can markedly worsen disability and impair quality of life. Multidisciplinary rehabilitation plays a crucial role in optimizing function, yet evidence in complex SSc cases remains limited. Case Presentation: A 65-year-old woman with known SSc developed progressive rigidity, mixed axonal–demyelinating polyneuropathy confirmed by electrodiagnostic studies, interstitial lung disease with an NSIP pattern on HRCT, and significant nutritional decline. She presented with bedridden status, marked balance impairment, stocking–glove sensory loss, digital ischemia, poor exercise tolerance, and complete dependence in mobility and self-care. An individualized inpatient rehabilitation program was initiated, including gradual mobility and strengthening exercises, adaptive self-care training, pulmonary rehabilitation, nutritional optimization, and psychological support. Over several weeks, she demonstrated measurable improvements in supervised ambulation with a walker, independence in daily activities, reduction of neuropathic symptoms, enhanced nutritional intake, and improved sleep. Discussion: This case illustrates the compounded functional burden imposed by the coexistence of neurological and pulmonary manifestations in SSc. Polyneuropathy further limits mobility, while interstitial lung disease contributes to fatigue, dyspnea, and exercise intolerance. The patient’s meaningful gains highlight the importance of early, coordinated rehabilitation approaches tailored to multisystem impairment. Strengthening, balance retraining, pulmonary conditioning, and nutritional support can produce synergistic benefits, even in severe disease stages. Conclusion: Comprehensive, individualized multidisciplinary rehabilitation can substantially enhance functional outcomes and quality of life in patients with systemic sclerosis complicated by neurological and pulmonary involvement. Early referral and integrated management are essential to mitigate disability and optimize recovery. Keywords: systemic sclerosis; polyneuropathy; interstitial lung disease; rehabilitation; functional recovery
systemic sclerosis; polyneuropathy; interstitial lung disease; rehabilitation; functional recovery
Bronchoscopy Balloon Dilatation and Pulmonary Rehabilitation To Prevent Recurrent Dyspnea In Post-Tuberculosis Lung Disease: A Case Report
Background: Post-tuberculosis lung disease (PTLD) frequently results in chronic airway complications, including cicatricial bronchial stenosis, which can cause recurrent dyspnea and impaired quality of life. Therapeutic bronchoscopy with balloon dilation and comprehensive pulmonary rehabilitation are emerging modalities for restoring airway patency and improving functional capacity. Case Description: A 23-year-old female with treated pulmonary tuberculosis in 2020 presented with worsening dyspnea and productive cough. Bronchoscopy revealed near-total cicatricial stenosis of the right main bronchus. Sequential electrocautery via the Mercedes-Benz technique and balloon dilations with 8 mm and 9 mm balloons achieved airway patency, confirmed by passage of a 5.4 mm bronchoscope beyond the stenotic segment. Discussion: Bronchoscopic balloon dilation has demonstrated safety and minimal invasiveness for tuberculosis-related bronchial stenosis, with low morbidity and manageable restenosis rates. Pulmonary rehabilitation, including Active Cycle Breathing Technique, diaphragmatic and deep-breathing exercises, mobilization, and energy conservation, aligns with WHO recommendations and significantly enhances lung function (FEV?, FVC, DLCO), exercise capacity, and quality of life. The combination of interventional and rehabilitative strategies offers a comprehensive approach, optimizing functional recovery and reducing dyspnea. Conclusions: Combining bronchoscopic balloon dilation with structured pulmonary rehabilitation effectively reduces airway obstruction and improves respiratory function in PTLD. Early intervention and ongoing rehabilitation are essential to sustain long-term benefits and prevent functional decline.
The Rehabilitative Management of Adult Scoliosis with Radicular Neuropathy and Lateral Spondylolisthesis of Lumbar Vertebrae: A Case Report
Introduction: Adult scoliosis is a progressive spinal deformity that can be further complicated by neurological symptoms and structural instability due to the asymmetric degenerative changes in the vertebral column. Radicular neuropathy and lateral rotational listhesis caused by curve progression may lead to significant functional impairment, chronic pain, and reduced quality of life. Case presentation: A 53-year-old female patient presenting with severe scoliosis complained of 6-months continuous radicular pain to our spine rehabilitation clinic. Scoliogram showed right thoracic curve (T4-T11) Cobb’s angle 70o, left lumbar curve (T11-L4) Cobb’s angle 65o, rotational lateral listhesis of L2-L3 grade I. Patient was prescribed with scoliosis-specific therapeutic exercise and physical modalities for 3 months. A rigid 3D adult scoliosis brace was custom-made and used part-time (4-5 hours daily) for 6 months. Our data demonstrated immediate and continuous improvement of pain and spinal stability. Discussion: Implementing individualized rehabilitative strategies targeting both mechanical and neurogenic disorders were able to help maintain symptoms and progression of adult scoliosis, as recommended by literature. Conclusion: Comprehensive rehabilitative approach to adult scoliosis patient with spondylolisthesis and radiculopathy is important to reduce symptoms and enhance function by emphasizing the integration of physical therapy, pain management, and bracing.
Effect of Umbilical Cord-Mesenchymal Stem Cells (UC-MSCs) Derived Secretome Combined with UC-MSCs in Anterior Cruciate Ligament Tear: A Case Report
Introduction: Anterior cruciate ligament (ACL) tears are common in athletes and active individuals, often requiring surgical reconstruction in grade 3 (complete) cases. Emerging regenerative approaches using mesenchymal stem cells (MSCs) and their secretome offer potential alternatives to surgery. Case: A male amateur futsal player in his 30s sustained a complete ACL tear with associated meniscal injury. He reported knee instability and severe pain (Numeric Pain Rating Scale [NPRS] score of 7). MRI confirmed a grade 3 ACL tear. The patient declined surgical intervention. Intervention: Treatment included periarticular trigger-point injection of 1.5?mL UC-MSC-derived secretome, followed later by intra-articular injection of 1×10? UC-MSCs suspended in 3?mL saline and 1.5?mL secretome. A structured home-based rehabilitation program and biomechanical correction using insoles were provided. Results: Pain improved from an NPRS score of 7 to 0 within six months. The patient returned to sport, reporting minimal residual instability. Follow-up MRI showed restored ACL continuity. No adverse events occurred. Conclusion: This case highlights the potential of UC-MSCs and secretome combination therapy as a non-invasive alternative for ACL repair. Further research is needed to validate its clinical efficacy and long-term safety.
ACL tear; UC-MSCs; secretome; pain; ligament
Evaluating the Efficacy of Breathing Exercises Among Healthy Adult Smokers
Introduction: Smoking contributes significantly to preventable diseases such as chronic obstructive pulmonary disease. Breathing exercises have emerged as potential complementary therapies aimed at improving lung function among smokers. This study aims to evaluate the efficacy of breathing exercises in improving lung function among adult smokers. Methods: A comprehensive search of peer-reviewed literature from PubMed, Semantic Scholar, and Google Scholar from the past ten years. Eligible studies included randomized controlled trials (RCTs), quasi-experimental studies, and pilot studies on the impact of breathing exercises on lung function in adult smokers. Narrative data synthesis was conducted. Results: Nine studies met the inclusion criteria. Diaphragmatic breathing, balloon blowing, and feedback breathing exercises significantly improved pulmonary parameters, including the FEV1/FVC ratio, tidal volume, inspiratory reserve volume, inspiratory capacity, vital capacity, and respiratory muscle activity. One study shows that FVC (3.77 ± 0.30) and FEV1 (3.13 ± 0.54) significantly improved after exercise (p < 0.05). Conclusions: Breathing techniques can be a beneficial complementary treatment for improving lung function, particularly in terms of vagus nerve control and the balance between sympathetic and parasympathetic systems, as well as the kinesiology and physiology of the lung’s dynamics. The findings are limited by study design, sample size, and intervention protocols. Future research should focus on high-quality randomized controlled trials (RCTs) with long-term follow-ups to evaluate the long-term effects. Keyword: Breathing exercise, lung function, adult smokers, respiratory muscle training, pulmonary rehabilitation
Introduction: The World Health Organization (WHO) defines an elderly individual as someone aged 65 years or older. With aging, the respiratory system undergoes structural and functional changes, leading to reduced pulmonary function, diminished exercise capacity, and increased susceptibility to respiratory diseases due to anatomical, physiological, and immunological alterations. Inspiratory muscle training (IMT) has been proposed as an intervention to counteract these age-related declines. Evidence suggests that IMT enhances inspiratory muscle strength, improves lung function, increases exercise tolerance and mobility, and promotes diaphragmatic hypertrophy in older adults. Thus, IMT may serve as a viable strategy to mitigate respiratory deterioration associated with aging. Method: A literature search was conducted using PubMed, Google Scholar, and the Cochrane Library to identify original research articles on inspiratory muscle training in the elderly. Results: IMT has been demonstrated to counteract physiological changes associated with aging, leading to improved respiratory function and overall physical performance. Conclusion: Given its documented benefits, IMT represents a promising adjunctive or alternative training modality for older adults. This literature review further explores the implementation and effectiveness of IMT in the elderly population. Keywords: Inspiratory muscle training, aging, respiratory function, diaphragm
Functional Breathing and Approaches in Pulmonary Rehabilitation: A Literature Review
Pulmonary rehabilitation is a multidisciplinary approach to improving individuals' quality of life and functional capacity with chronic respiratory diseases. Functional breathing exercises are essential to pulmonary rehabilitation programs, focusing on coordinating respiratory and postural mechanisms to optimize gas exchange, reduce dyspnea, and improve exercise tolerance. This paper discusses the importance of functional breathing exercises in pulmonary rehabilitation and outlines the fundamental principles and techniques used in their implementation. Keywords: Pulmonary rehabilitation, Functional breathing, Chronic respiratory diseases, Exercise tolerance, Dyspnea, Gas exchange.
Copyright (c) 2024 Indonesian Journal of Physical Medicine and Rehabilitation
Cardiac Rehabilitation in Post COVID-19 Patients with Cardiovascular Diseases Complipication: Review Article
Abstract Introduction: The outbreak of COVID-19 has been linked to an increased risk to heart health, emphasizing the significance of Cardiac Rehabilitation (CR) in tackling these concerns. This review is intended to improve comprehension of the effects of COVID-19 on cardiovascular health and to assist healthcare providers in their care of patients. Methods:This study employs a comprehensive literature review covering 2019 to 2021, using keywords "Sars-Cov-2" OR "COVID-19" AND "Cardiovascular Diseases" AND "Cardiac Rehabilitation" across various databases. After screening, 321 articles yielded 32 studies for the pooled analysis. Results: During the outbreak, 14.4% of the individuals developed acute cardiovascular issues, with a mortality rate ranging from 5.6% to 10.5%, surpassing the seasonal flu mortality rates. Patients post-COVID-19 exhibit similar clinical manifestations, necessitating rehabilitation to enhance their quality of life and prevent future complications. Amidst the pandemic, cardiac rehabilitation centers have shifted to virtual or telemedicine rehabilitation owing to interruptions in regular services. Discussion: COVID-19 commonly triggers myocarditis, heart failure (HF), arrhythmias, and venous thromboembolism (VTE). Pre-hospital diagnostics and post-discharge follow-up via telemedicine rehabilitation present effective strategies for managing patients with cardiovascular disease (CVD), offering additional clinical insights for cardiologists to diagnose and differentially diagnose patients without in-person consultations. Conclusion: COVID-19 survivors face potential CVD complications, underscoring the need for CR to improve the quality of life and mitigate CVD risks post-exposure. This rehabilitation approach holds promise for reducing mortality among patients with post-COVID-19 heart disease.
cardiac rehabilitation, cardiovascular complications, cardiovascular disease, COVID-19, sars-cov-2
Effectiveness of Adding Lower Extremity Isotonic Exercise on Hamstring Flexibility of Hajj Pilgrims Who Receive Walking Aerobic Exercise
ABSTRACT Introduction: Hajj is a pilgrimage that is mostly carried out walking. One of the muscles that plays an important role in walking activities is hamstring muscle. The hamstring muscles often experience shortening (tightness), so exercises to increase the flexibility of the hamstring muscles are something that needs to be done. The goals of this study is to investigate the effect of adding lower extremity isotonic exercise on hamstring flexibility in hajj pilgrims who receive walking aerobic exercise. Method: A randomized controlled trial was used for this research. A total of 36 individuals were divided into an 18-person treatment group and an 18-person control group. The groups received walking aerobic exercises five times a week and the treatment group were added lower extremity isotonic exercise twice a week. A sit-and-reach test was used to evaluate hamstring flexibility both before and after a six-week course of treatment. Result: After six weeks, there was a significant increase in hamstring flexibility in both the treatment group (p=0.0000) and the control group (p=0.0001). The treatment group experienced a significantly better improvement in hamstring flexibility (5,39 ± 3,47) compared to the control group. (2,17 ± 1,79) (p=0,001). Conclusion: Adding lower extremity isotonic exercise can significantly increase hamstring flexibility higher than aerobic walking exercise alone in hajj pilgrims. Keyword: hajj pilgrims, hamstring flexibility, aerobic walking exercise, lower extremity isotonic exercise
hajj pilgrims, hamstring flexibility, aerobic walking exercise, lower extremity isotonic exercise
Rehabilitation Treatment Of Tuberculosis Of The Knee Joint (Gonitis Tuberculosis) After Synovectomy Surgery: A Case Report
Introduction: The incidence of extrapulmonary tuberculosis (EPT) cases is increasing globally. with bones and joints being the most common sites, accounting for over 10% of occurrences. Tuberculosis of the knee is rare case, presents challenges in prompt diagnosis, leading to severe progressive pain and functional impairment that significantly impacts the patient's quality of life. Case Persentation: A 42-year-old male patient experienced chronic pain in the right knee joint, stiffness and limitations when moving the knee. Physical examination showed swelling, warmth and redness. The range of movement of the knee was limited. Histopathological examination showed that the patient was diagnosed with tuberculosis of the knee. Synovectomy was performed after a diagnosis of tuberculosis of the knee and followed by a 9-month anti-tuberculosis drugs regimen. Knee range of motion (ROM) exercise and diathermy therapy showed clinical improvement after prompt management since the initiation of progressive rehabilitation therapy. Conclusion: Tuberculosis of the knee is a rare complication of tuberculosis which has the potential to cause functional impairment and affect the quality of life. Providing physiotherapy interventions in the form of exercises and diathermy therapy in post-synovectomy cases for one year resulted in significant functional progress.
Preventing Progressivity in Becker Muscular Dystrophy Patient: A Rare Case Report
Introduction: Becker muscular dystrophy (BMD) is a genetic disease caused by mutation of the dystrophin gene due to defects in the Xp21.2 chromosome and inherited by X-linked recessive. BMD is a slowly progressive weakness from proximal muscle. BMD patients are rarer than duchenne muscular dystrophy (DMD). Case Description: An 18-year-old male came with weakness in both legs, mainly at the base of the thigh. The symptoms have been felt for the last three years and progressively for the last two years. He felt a change in walking style and difficulty standing from a sitting position. He denied any family history. Examinations found increased creatine kinase (CK) and electromyography (EMG) showed myopathy in the right femoral nerve. Patient took vitamins daily, done exercise therapy and neuromuscular electrostimulation (NMES) once a week. Conclusion: Diagnosing BMD is not only from history taking and physical examination but also necessary to consider CK levels and myopathy on EMG, even though genetic testing or muscle biopsy could not be done. Until now there is no guideline related to BMD therapy programs, further research is expected to discuss BMD therapy program in detail.
Rehabilitation Management of a Child with Severe Pain after Bacterial Meningoencephalitis
Introduction: Pain is a common finding in children with meningoencephalitis and can cause negative consequences. We reported a child with severe pain after Acinetobacter meningoencephalitis who underwent rehabilitation management in the outpatient setting. Case description: A 1-year-4-month-old child was brought to the rehabilitation outpatient clinic with stiffness and severe pain after Acinetobacter meningoencephalitis. She had post-repair amputated tongue, hypertonus muscles, spasticity, and asymmetrical posture. After the rehabilitation programs, the pain was decreased to a moderate intensity. Case discussion: The pain can cause a vicious cycle of pain-induced spasms or spasticity that further increases pain. Multiple organ system impairments can cause the pain. A multidisciplinary team is needed to evaluate and manage the multiple sources of pain. Multimodal rehabilitation interventions consisting of 24-hour postural management, spasticity medication, ultrasound therapy, massage, stretching, and orthosis prescription may help to manage the pain. Conclusion: Pain after meningoencephalitis can be caused by multiple sources and can be managed by multidisciplinary and multimodality approaches.
pain, brain lesion, meningoencephalitis, rehabilitation
Relationship between the Serum Cartilage Oligomeric Matrix Protein Concentration against Degree of Knee Osteoarthritis Pain in Elderly Patients at the Public Health Service Clinic
This study aims to assess the relationship between the serum concentration of Cartilage Oligomeric Matrix Protein (COMP) and the degree of osteoarthritis pain in elderly patients. The study was conducted at a public health service clinic, Faculty of Medicine, Syarif Hidayatullah State Islamic University (UIN) Jakarta, Indonesia. The indexes used to assess patients with OA in the knee are the Western Ontario and Mcmaster University Osteoarthritis Index (WOMAC). Sampling using the cross-sectional technique as many as 146 respondents with elderly knee OA patients. First, a physical and radiological examination is performed to confirm the diagnosis of knee OA. Second, measuring the degree of pain WOMAC. Third, the measurement of the COMP serum concentration used the ELISA test. Based on the Spearman correlation test, it was found that there was a statistically significant relationship between the COMP serum concentration and the degree of knee OA pain with the WOMAC scale in the elderly (p = 0.012). From the results of the study, it is suggested that patients maintain effective health management. Elderly patients come to community health service clinics to carry out routine/periodic checks to reduce pain. The main reason is that there is no truly effective and consistent method to prevent and cure this disease, especially for patients with age-related risk factors, excessive joint load, and a history of joint injury. AO also has an impact on a person's psychosocial well-being. These findings contribute to the study of the risk of degenerative diseases and the use of biomarkers with a level of evidence that will be more valid in the future.
Cartilage Olligomeric Matrix Protein (COMP), Osteoarthritis (OA)
Copyright (c) 2023 Indonesian Journal of Physical Medicine and Rehabilitation
The Effect of High-intensity Interval Training on Initial Claudication and Absolute Walking Distance in Peripheral Artery Disease Patient: A Case Report
Introduction: Peripheral arterial disease (PAD) causes significant functional impairment due to the presence of intermittent claudication (IC) during activities that caused activity restrictions. Aerobic exercise has been shown to improve walking ability and exercise performance. Case Description: A 55-year-old man undergoing phase II cardiac rehabilitation (CR) complained about moderate IC during activity and exercise that began from 2 weeks of exercise and increased until the end of phase II CR. Extended CR was given to increase initial claudication and absolute walking distances and physical activity level by giving a hybrid-CR program for 2 weeks. A supervised high-intensity interval training (HIIT) 2 times a week along with resistance exercise and home-based moderate-intensity aerobic exercise 3 times a week were given. After 2 weeks, there was an increase in initial claudication and absolute claudication distance of 23 meters and 91 meters from baseline, consecutively. Discussion: Aerobic exercise in PAD patients increases walking distance due to improvement in collateral flow, nitric oxide-dependent vasodilatation, inflammatory mediators, endothelial damage, oxygen delivery to working muscles, muscle contraction efficiency, and pain tolerance. Conclusion: Hybrid-CR with combination of a HIIT and moderate-intensity continuous aerobic exercise improved initial claudication and absolute walking distance in PAD patient.
Six Minutes Walking Test as Assessment in Determining Fitness to Work After Spinal Tuberculosis Post Stabilization and Comprehensive Rehabilitation: A Case Report
Introduction: Spinal tuberculosis is the most common extrapulmonary skeletal form of tuberculosis that can lead to neuromuscular deficit. Neuromuscular deficit may include paraplegia in both legs, inability to perform daily activities, and an increased risk of loss of occupation. Case Presentation: A 37-year-old male presented with a chief complaint of weakness in both legs and was unable to stand properly unassisted. This patient was diagnosed with spinal tuberculosis, confirmed by MRI. The rehabilitation program was designed for 6 months, focusing on the preservation of cardiorespiratory endurance and planning a return to work. Evaluation of physical fitness and working ability was carried out using the 6-Minute Walking Test (6MWT) and Work Ability Index (WAI) questionnaires to determine whether the patient was fit to work. Six months after the rehabilitation program, the patient showed moderate physical fitness and a WAI score of 37 indicating fitness to work. Conclusion: Complications of spinal tuberculosis can cause disability in daily activities and result in loss of occupation. In this case, after six months of a comprehensive rehabilitation program and evaluation of fitness capacity, the patient can return to work but still needs more support of his work ability than before the illness.
The Description of Functional Disorders in Children with Stunting in Puskesmas Rowosari Semarang
Abstracts Introduction: The consequences of stunting in children are immediate and long-term including increased morbidity and mortality, poor child development, decreased productivity and economic capacity. Decreased functional status can occur because stunting can affect the structure and function of the brain. Method: This research was observational research with cross-sectional data collection. The data were collected with consecutive techniques. The research subjects were obtained from the toddler attending Posyandu at the Puskesmas Rowosari Semarang. The identity of the subjects like gender, age, parent’s social economy and type of functional disorder were measured by the modified WeeFIM. All data were analyzed with the computer using SPSS® software to determine the description of functional disorders. Results: Of the 14 children with stunting, 11 of them experienced functional disorders. Among the toddlers who experienced functional disorders were dominated by 7 male toddlers (63.6%) and aged more than 2 years (72.7%). All subjects came from low socioeconomic families. Six subjects (54.5%) experienced impaired control of defecation and urination. Only 1 subject had hearing loss (9.1%). Four subjects had eating disorders (36.4%). Grooming disorders were found in 9 toddlers (81.8%). About 7 toddlers (63.6%) experienced bathing disorders. Eight toddlers experienced dressing disorders (72.7%) and 4 toddlers experienced toileting disorders (36.4%). Ambulation disorder was found in 1 toddler (9.1%). Conclusion: Toddlers with stunting are at risk of experiencing functional disorders. Keywords: Toddlers, Stunting, Functional Disorders, Modified WeeFIM
Toddlers, Stunting, Functional Disorders, Modified WeeFIM
Comparison of Lumbar Stabilization Exercise and Flexibility Exercise on Lumbal Flexibility in Chronic Mechanical Lower Back Pain (Study on Online Motorcycle Drivers)
Background : Flexibility plays an important role in increasing a person's capacity to perform daily activities. Decreased lumbar spine flexibility is both a will cause and a consequence of low back pain. Lumbar stabilization exercise and flexibility exercise are options that can be given for chronic mechanical low back pain. Objective: This study was knew the difference in the effect of lumbar stabilization exercise compared to flexibility exercise on lumbar flexibility in online motorcycle drivers with chronic mechanical low back pain. Methods: 26 subjects who fullfill the inclusion and exclusion criteria were randomly divided into the lumbar stabilization exercise group (n=13) and the flexibility exercise group (n=13). Each group was exercised five times a week for six weeks at home. Measurement of lumbar flexibility was performed using the modified-modified schober test and sit and reach test at baseline before the intervention and 6 weeks after the intervention. Results: Comparison of the delta value of the modified-modified schober test (p = 0.029) and the delta value of the sit and reach test (p = 0.025) between groups were showed significant differences in the lumbar stabilization exercise group compared to the flexibility exercise group. Conclusion: Giving the intervention of lumbar stabilization exercise and flexibility exercise were increased lumbar flexibility. However, the lumbar stabilization exercise intervention was a better on increasing lumbar flexibility than flexibility exercise for online motorcycle drivers with chronic mechanical low back pain.
Keywords: Lumbar stabilization exercise, flexibility exercise, chronic mechanical low back pain, lumbar flexibility.
The Correlation Between Eating Patterns and Nutritional Adequacy of Children with Cerebral Palsy
Due to sensory and motor dysfunction, some children with cerebral palsy (CP), have trouble chewing and ingesting, which may result in inadequate feeding. The goal of this study is to look into the correlation between eating patterns and nutritional adequacy of children with cerebral palsy. This research was carried out in 11 Special Schools Depok, Bogor and Jakarta. Taking into the topic inclusion requirements of the subjects (i.e. aged 5-18 years, had hemiplegic and diplegic types of cerebral palsy, had no infection, and good communication), 45 subjects were interviewed for data collection. A pre-test structured questionnaire which uncovered the identity and dietary intake (1x24-hour food record by caregiver) was used to guide the interviewer and also interview about the type of food of meal and snack and the frequency of eating in children. The results showed that the children with cerebral palsy liked to consume soft and liquid foods. Protein, fat, energy, and carbohydrate showed mean sufficiency levels of 80,9%, 53,5%, respectively. 62.0%, and 66.2%. Iron, calcium, zinc, Vitamins A, D, E, B9, C, calcium, iron, and zinc all exhibited mean sufficiency levels of 40.7%, 29.9%, 41.1%, 135.9%, 36.4%, 63.3%, 30.9%, and 70.8%. There was a substantial beneficial relationship between eating behaviors and protein and carbohydrate sufficiency (p<0.05). This implies that the children with cerebral palsy inadequately consume both macro- and micronutrient source foods. The result showed that there’s a correlation between eating patterns and nutritional adequacy in children with CP. Th
cerebral palsy, eating patterns, nutritional adequacy
Secretome Therapy, Potential Treatment for Rotator Cuff Tear: A Case Study
Introduction: Rotator cuff tears (RCTs) are the most frequent pathologies within the shoulder girdle, and this injury is the most commonly diseased tendons in the human body. RCTs can cause pain and weakness in the shoulder. A 42-year-old woman had right shoulder pain and arm lift problems for almost a year. Ultrasonography revealed a full-thickness Supraspinatus tear. The patient underwent an Ultrasound-guided supraspinatus tendon injection of 2 ml umbilical cord Mesenchymal Stem Cell (MSC) secretome. Methods: This is a case report analyzing the role of secretome therapy in rotator cuff tear potential treatment. The study was conducted at RSCM Hospital. Results: At the one-week follow-up, the patient's Shoulder Pain and Disability Index (SPADI) score decreased from 56,9% to 48,5%, her pain scale reduced from 8 to 6, and her shoulder Active Range of Motion (AROM) improved. After a month, there was an improvement in her shoulder AROM. However, the ultrasound shows no significant improvement in the supraspinatus tear structure after the secretome injection. Conclusion: Secretome has a potential effect on reducing pain and improving functional outcomes in rotator cuff tears. These findings raise the prospect of secretome as a potential regenerative therapy for rotator cuff tears. Keywords: mesenchymal stem cells conditioned-medium, rotator cuff tear, secretome, supraspinatus tear.
mesenchymal stem cells conditioned-medium
Cornelia De Lange Syndrome in the International Classification of Functioning, Disability and Health Perspetive: A Case Report
Background: Cornelia de Lange syndrome (CdLS) is a genetic disorder featured by multi-systemic malformations, such as microcephaly, hypertrichosis, upper limb defects, growth retardation, developmental delay, and a variety of associated malformations. Multidisciplinary and holistic care is needed in the management and rehabilitation of individuals with CdLS. One of the tools that can be used as a clinical measurement in holistic care is the International Classification of Functioning, Disability, and Health (ICF). Objective: To provide a holistic approach and intervention by using the ICF assessment in CdLS individuals. Case: A 53-month-old boy was admitted to Physical Medicine and Rehabilitation outpatient clinic of Primasatya Husada Citra (PHC) hospital of Surabaya in February 2021, due to global developmental and growth delay. The patient had low body weight and short stature. The patient had thick eyebrows, a short nose, a concave nasal ridge, thin upper lip vermillion, smooth philtrum, and small hands with small fifth fingers. Was only able to say several words, and it was not clearly pronounced. During the daily activity, he had difficulty going downstairs and wearing his socks, long pants, and shirt. Attended pre-school, had difficulties with speaking, reading, and focusing attention. Conclusion: ICF can help physicians to assess a patient’s condition thoroughly, to set goals, and to provide condition-appropriate treatment and rehabilitation programs for CdLS patients.
Cornelia de Lange Syndrome, International Classification of Functioning Disability and Health, Rehabilitation, Pediatrics
Effect of Qigong Exercise on Balance in Healthy Elderly
Introduction: The elderly experience various decline in life and cause a decrease in body's functional balance. Thus will affect the quality of life. Balance can be measured using various assessment instruments, one of them is the Berg Balance Scale (BBS). Qigong exercise is not widely known or well known among the elderly in Indonesia, in fact it has many benefits and is suitable for them. This study wanted to prove the effect of Qigong exercise on improving functional balance in elderly. Methods: This study is a randomized controlled trial with pre and post test controlled group design. The sampling method is using consecutive sampling method. The sample was 20 people and divided into intervention group (n=10 people) and control group (n=10 people). Participants in the intervention group performed Qigong exercises 3 times a week for 8 weeks. The control group received common elderly exercise 3 times a week. Balance was measured before and after the intervention using the Berg Balance Scale (BBS). Results: There was an increase in BBS scores before and after treatment in the elderly exercise group (p=0.003), and in the Qigong group (p=0.004). The Berg Balance Scale value in the control group (44.30±0.68) was higher than the Qigong group (44.18±0.60) at the beginning of the study but the difference was not significant (p=0.632). The Berg Balance Scale value in the control group (46.60±0.84) was lower than the Qigong group (48.45±1.13) at the end of the study and the difference was significant (p<0.001). Conclusion: Qigong exercise improves balance better than the elderly exercise.
functional balance, Berg Balance Scale, Qigong exercise, elderly exercise
Independence Status, Communication and Mobilization Profiles of Indonesian Hajj Pilgrims
Introduction: Hajj is a worship that is dominated by physical activity, so it is very important for a pilgrim who will perform the pilgrimage to ensure that he is ready and physically fit in addition to spiritual readiness. Methods: A cross-sectional descriptive study was conducted on 720 data of prospective pilgrims from 5 embarkations (Sumatra, Central Java (DIY), East Java, Makassar, and Pondok Gede) which were taken using randomized sampling method. Results: In this study, it was found that the age distribution of prospective Hajj pilgrims was mostly over 60 years old, able to carry out activities of daily life well (85%) independently. Most of the subjects needed assistance during mobilization (91%) although their cardiorespiratory endurance showed good results (above 4 METS). Conclusions: This study indicates the possibility of musculoskeletal disorders in most of the subjects that hinder independence in the mobilization. Therefore, it is important to check the function before performing the pilgrimage, so that a rehabilitation program can be carried out and the determination of the right tools so that the implementation of the pilgrimage can be carried out optimally. Guidance on aspects of the functional ability of prospective pilgrims during the waiting
Communication, Hajj Pilgrim, Independency, Mobilization
The Effect of Diaphragm Breathing Exercises on Physiological and Psychological Stress
Physiological and psychological stress causes changes in homeostasis characterized by an imbalance of activity between the autonomic nervous systems. Overactivity of the sympathetic nervous system leads to physical, psychological, and behavioral disorders. Diaphragmatic breathing exercises routinely have been shown to suppress sympathetic nerve activity through activation of the parasympathetic nervous system and an increase in tidal volume that creates a change in the cell membrane potential to hyperpolarization, with the result being an improvement in physiological and psychological stress conditions, which appear in various parameters. This paper reviews the anatomy, physiology, and biomechanics of the diaphragm muscle, as well as the mechanism of diaphragmatic breathing exercises in improving physiological and psychological stress conditions from a Physical Medicine and Rehabilitation point of view. Keywords: breathing, diaphragm, exercise, physiological stress, psychological stress
breathing, diaphragm, exercise, physiological stress, psychological stress
Cases, Prevalence and Treatment of Low Back Pain at Bandung Pain Rehab
Background: Low back pain (LBP) is one of the pain complaints that affects almost every aspect of a person's life, urging many patients to come for treatment. The incidence of LBP in Indonesia is estimated between 7,6% and 37%, but it is still precisely unknown. A clinician must be able to make an accurate diagnosis to treat patients according to the etiology. In this study, we aim to determine the distribution of prevalence, demographic data, and the success of LBP treatment in order to help clinicians in management of LBP to reduce the global burden. Methods: This was a descriptive analytic study with a cross-sectional design. This research was conducted at the Bandung Pain Rehab Center (BPRC) clinic from July 2019 to December 2021. We included all patients complaining of low back pain who came for treatment at the BPRC. The data of this study were taken from medical records. The success of therapy in the interventional pain management (IPM) and non-IPM groups was assessed by comparing the VAS values before and after treatment. Statistical analysis was performed using the IBM SPSS Statistics 23 program with the Wilcoxon test. Results: Of the 704 patients, the majority were female (59,2%), aged 51-60 years (23,6%), with obese body mass index (54,4%), and worked as housewives (35,5%). The most common etiology of LBP was piriformis syndrome (50,9%), followed by sacroiliac joint arthropathy (18,5%) and lumbar radiculopathy (14,8%). In the IPM and non-IPM groups, there was a significant decrease in pain intensity after therapy (p <0,001). Conclusion: Our research shows that LBP is most common at the age of 51-60 years, female gender, with a body mass index classified as obese, and working as a housewife. Piriformis syndrome is the most common prevalent etiology of LBP. The use of therapy in both IPM and non-IPM showed significant improvements in alleviating pain experienced by the patients. Keywords: Low back pain, case, prevalence, IPM, non-IPM, VAS score
Adherence in Following Phase II Cardiac Rehabilitation Program in Patients with Coronary Artery Disease Post-revascularization
Purpose: The aim of this study is to describe the adherence of patients with coronary artery disease (CAD) after revascularization with Coronary Artery Bypass Graft (CABG) and Percutaneous Coronary Intervention (PCI) in initiating, sustaining, and completing phase II cardiac rehabilitation (CR) programs. Methods: This study is a descriptive cross sectional study design. Data is taken retrospectively using secondary data from medical records. The population of this study is post-revascularization CAD patients who undergo phase II CR in Dr. Hasan Sadikin General Hospital in 2019-2020 and all samples are taken using the total sampling method. The adherence is described as adherence with initiating, sustaining, and completing the CR program in the CABG and PCI groups and expressed in percentage. Results: There are 96 subjects who meet the inclusion and exclusion criteria in this study. The adherence for initiating the CR program is 94.6% in the CABG group and 100% in the PCI group. A total of 50 people (67.56%) in the CABG group and 16 people (72.72%) in the PCI group undergo each training session on time as programmed. A total of 57 people (77.02%) in the CABG group and 16 people (72.72%) in the PCI group complete12 training sessions regardless of the time required to complete them. Conclusion: Overall, the level of adherence following the CR phase II program in the CABG and PCI groups is quite high. Adherence to initiating and sustaining CR phase 2 in the PCI group was higher than in the CABG group. Keywords: adherence, cardiac rehabilitation, Coronary Artery Bypass Graft, Percutaneous Coronary Intervention
adherence, cardiac rehabilitation, Coronary Artery Bypass Graft, Percutaneous Coronary Intervention
The Effect of Additional of Aerobic Exercise to Functional Therapy on Resting Heart Rate in Patients with Chronic Phase Post Stroke
Introduction: Regular aerobic exercise has a direct effect on resting heart rate, both acute and chronic effects. One of the chronic effects decrease resting heart rate which is beneficial for heart health. The objective of this study was to prove the effect of adding aerobic exercise to functional therapy on resting heart in post-stroke patients with chronic phase. Methods: The study used a randomized controlled trial with pre and post-test control group design. The treatment group (n = 10) received additional aerobic exercise and the control group only received functional therapy (n = 10). Assessment of resting heart rate measurements was carried out before and after exercise. Results: There was a significant difference (p=<0.001) in the mean resting heart rate in the treatment group before intervention 89.00 ± 9.13 and after intervention 76.10 ± 10.16. There was a significant difference (p=0.017) in the mean resting heart rate in the control group before intervention 88.60 ± 7.75 and after intervention 84.40 ± 6.98. There was a significant difference in the resting heart rate delta value between the treatment group (-12.90 ± 6.56) compared to the control group (-4.20 ± 4.37). Discussion: The value of resting heart rate pre and post-test in the treatment group showed a more significant difference than the control group. Aerobic exercise can inhibit the activation of the sympathetic nervous system and increase the activation of the parasympathetic nervous system due to the effects of cardiovascular adaptation Conclusion: The intervention of adding aerobic exercise can reduce resting heart rate in post-stroke patients with chronic phase. Keywords: Aerobic exercise, functional therapy