Surabaya Physical Medicine and Rehabilitation Journal

A Review of Scraping Therapy (Kerokan) as a Traditional Therapy in Medical Aspects

2025-05-20T20:21:59+07:00

Scraping therapy, also known as kerokan, is a traditional therapy practiced in East Asia for conditions like the common cold and musculoskeletal pain. While its mechanism of action (e.g., improved blood flow, reduced inflammation) suggests potential benefits, the effectiveness of scraping therapy requires further investigation. This review aimed to analyze the medical aspects of scraping therapy, including its efficacy, safety, and underlying mechanisms. We searched PubMed, ScienceDirect, Hindawi, and Scopus for studies published between 2014 and 2024 using keywords 'scraping therapy,' 'kerokan,' 'Gua-sha,' 'traditiona therapy,' and 'mechanism.' Studies were assessed using the Critical Appraisal Skills Programme qualitative checklist (CASP). Data will be analyzed using a thematic synthesis approach

Physical Medicine and Rehabilitation of Knee Osteoarthritis Grade 3-4 with Valgus Deformity

2025-02-17T09:30:04+07:00

Introduction: Osteoarthritis is an arthritic disease caused by joint cartilage damage that affects an estimated 302 million people worldwide. Factors that increase the risk of OA include being a woman, aged over 45, obesity, bone deformities, joint injuries, and repetitive strain on specific joints. Osteoarthritis is the leading cause of disability among older adults and needs a high health care and rehabilitation cost. The primary focus of treatment is symptom management and maintenance or restoration of functional capacity. The PMR programs include therapeutic exercises, modality uses, education and lifestyle modification (knee joint conservation). We aimed to determine the impact of PMR program combined with pharmacological therapy on 3rd-4th grade OA patients.

Methods: Case report of a woman, aged 62 years, diagnosed with right knee OA grade 3-4 with valgus deformity. Subject has chronic and progressive knee pain by visual analog scale (VAS) was 4-5, limited range of movement (ROM) in the right knee, and low back pain. The patient performed medical rehabilitation program combined with pharmacological therapy at Mitra Husada Pringsewu Hospital for 6 weeks and it was evaluated.

Results: Patient in comparison before and after treatment, pain was reduced from VAS score 4-5 to 3-4, ROM from extentiont-flexion angle 15-90o to 5-110o, Q angle remained the same, and The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score was decreased from 11-5-34 to 9-3-30.

Conclusion: A nonpharmacological and pharmacological therapy combination in medical rehabilitation programs is needed to reduce pain, improve ROM, and improve the patient's quaity of life.

Physical Medicine and Rehabilitation Role of Complete Recovery after Intracerebral Hemorrhage in Eclampsia with HELLP Syndrome: A Rare Case

2025-01-08T12:45:20+07:00

Cerebrovascular accident during hypertensive disorder of pregnancy is a rare condition, but carries high risk of mortality and morbidity due to its unpredictable onset. Intracerebral Hemorrhage (ICH) associated with eclampsia is responsible for 5–12% of maternal deaths during pregnancy. Eclampsia is defined as a convulsive episode occurring in the setting of preeclampsia. The hallmark presentation of eclampsia is characterized with generalized tonic-clonic seizures which typically lasted 60 to 90 second in duration, might be preceded with headaches, visual disturbance, abdominal pain, and increased blood pressure. HELLP syndrome frequently associated with severe preeclampsia-eclampsia and is characterized by three hallmark features of hemolysis, elevated liver enzymes, and low platelets. Here, we report an unusual case of 25-year-old primigravida with 38 weeks gestation, which developed sudden eclampsia and intracranial hemorrhage. A night before admission, she complained about headache and had projectile vomit in the morning that followed by generalized seizure. She had no history of seizure or high blood pressure during her antenatal care. Laboratory test shows elevated liver enzyme and low platelets count and CT-scan which showed hemorrhage in left intraparenchymal lobes. She was successfully managed by multidisciplinary approach including emergency cesarean section, conservative neurological treatment for intraventricular hemorrhage and rehabilitation ever since in intensive care unit until discharge from ward. Rehabilitation approach in eclampsia with superimposed intraparenchymal hemorrhages could start safely as early as possible by collaboration with other departments. This can help mother achieved independency of activity daily living and improvement of cardiorespiratory endurance as before.

Assessment of exercise re-training in chronic low back pain patients in Sub-Saharan Africa: an experimental cohort study using indirect measurement of VO2max

2024-09-05T08:48:56+07:00

Background: Exercise training is recommended for patients with chronic low back pain. The aim of this study was to evaluate exercise training in patients with chronic low back pain by indirect measurement of VO2max.

Patients and methods: This was an experimental cohort study involving 92 patients with chronic low back pain over a two-month period from 5 December 2023 to 5 February 2024. The patients underwent a four-week exercise training programme.

Results: The mean age of the patients was 49.37±12.72 years, with extremes of 26 and 70 years. There was a significant improvement in VAS pain intensity (m before=66.6 ± 1.4 ; m after =12 ± 10.9 p=0.0000) and also a significant improvement in VO2 max (m before=25.87 ± 10.15 m after = 28.25 ± 10.64 p= 0.000). The risk factors associated with low VO2max were age over 60 (p=0.000; RR=3), obesity (p=0.0002; RR=2.41) and sedentary lifestyle (p=0.0008; RR=8.39).

Conclusion: Indirect measurement of VO2max is effective for evaluating exercise training in patients with chronic low back pain. Our experimental exercise training protocol resulted in a significant improvement in patients' pain and VO2max.

Prolotherapy as a Novel Adjunct in Post-Stroke Pain Management: A Pilot Study at RSUD Dr. Saiful Anwar Malang

2025-05-08T10:02:40+07:00

Background: Post-stroke pain (PSP) and musculoskeletal complications significantly hinder recovery and quality of life in stroke survivors. Prolotherapy, a regenerative injection therapy, has shown promise in managing musculoskeletal disorders but remains underexplored for PSP.

Aim(s): This study evaluates the effectiveness of prolotherapy in reducing pain, improving range of motion (ROM), and enhancing functional outcomes in PSP patients.

Material and methods: This pilot study employed a pre-experimental design with pretest and posttest measurements. Conducted at RSUD Dr. Saiful Anwar Malang, the study included three stroke patients experiencing chronic musculoskeletal pain. Prolotherapy injections containing hypertonic dextrose were administered at regular intervals. Primary outcomes included pain (Numerical Rating Scale), ROM, and spasticity (Modified Ashworth Scale). Secondary outcomes were assessed using the Barthel Index, Short Form-36, and Fugl-Meyer Assessment. Statistical analyses were descriptive, with paired t-tests applied to outcome changes.

Result: Significant improvements in pain levels (mean NRS reduction from 5.67±1.5 to 3.0±2.0) and ROM, particularly in shoulder flexion and wrist extension, were observed. Spasticity showed minor improvements in some muscle groups. Functional outcomes, including Barthel Index and SF-36 scores, demonstrated positive trends, with two participants improving from severe dependency to moderate independence.

Conclusions: Prolotherapy shows promise as an adjunctive intervention for PSP, offering potential benefits in pain reduction and functional recovery. As the first study of its kind at RSUD Dr. Saiful Anwar Malang, it lays the groundwork for future large-scale research to validate these findings and refine clinical applications.

Keywords: Stroke, Prolotherapy, Pain, Rehabilitation, post-stroke pain, functional performance

Prevalence of Carpal Tunnel Syndrome and De-Quervain Tenosynovitis among PUBG Players

2025-03-05T10:46:52+07:00

Background: Portability and access to the internet are now the norm for everyone from school children to corporate business individuals allowing the playing of online games like Player Unknown’s Battlegrounds (PUBG) and other gaming. As for e-sports, there are some cognitive gains while game addiction especially among young people is on the rise. Excessive playing of games can cause musculoskeletal problems like strained neck muscles, and illnesses such as carpal tunnel syndrome, and de Quervain’s tenosynovitis.

Aim(s): This cross-sectional study sought to estimate the percentage prevalence of CTS and DQT in PUBG players and their addiction level to gaming.

Material and methods: The sample comprised 382 students with demographic data obtained using questionnaires completed independently by the participants. Gaming addiction was measured with a 21-item addiction scale while CTS was measured with the Boston Carpal Tunnel questionnaire; and DQT with the Finkelstein test.

Result: Thus, 42.1% of PUBG players were identified as players with GA. The calculated frequency for de Quervain’s tenosynovitis was 52.9% the mean symptom severity of patients was 17.53±6.00 and the functional status of patients was 11.19±4.41 showing mild pain and limitation to the function. However, the level of carpal tunnel syndrome was relatively low in the participants of the present study.

Conclusions: In this PUBG participants’ study, 52.9% had de Quervain’s tenosynovitis, largely with mild to moderate pain. However carpal tunnel syndrome was comparatively low in this instance. These findings indicate that musculoskeletal health is adversely affected by gaming and mostly the upper extremities are affected.

Keywords: Carpal tunnel syndrome, De Quervain’s tenosynovitis, PUBG, Gaming Addiction, Musculoskeletal disease

The Impact of Periodized Sit-to-Stand Exercises on Enhancing Gross Motor Skills and Balance in Children with Down Syndrome

2025-04-16T10:05:27+07:00

Background: Down syndrome (DS) is a congenital disorder with multiple chromosomal disorders. That causes growth disorders and changes the structure of the brain, like physical growth retardation, inability to learn, and other ailments of the cardiovascular system, thyroid glands, and blood cancer. The brain diminishes in size and maturation problems, and pathophysiological processes cause delayed motor development. Disorders often found in children with DS include hypotonia, ligamentous laxity, decreased muscle strength, postural control, proprioception, and cognitive disorders. Strengthening exercises in Down Syndrome children is thought to improve their motor and balance skills. The objective of this study was to assess the effect of periodic sit-to-stand strengthening exercises on Down Syndrome.
Material and Methods: Children aged 7-12 years with Down Syndrome from Perhimpunan Orang Tua Anak Down Syndrome (POTADS) in Bandung participated in a seven-week sit-to-stand exercise intervention using a quasi-experimental design with a Pretest-Posttest Group approach (n=16). The initial load was 30% of body weight at 1 RM, progressively increasing to 70% by the seventh week, with adjustments based on re-measurements at week four. The intervention incorporated unloading and overloading phases and was performed thrice weekly at participants' homes. GMFM dimensions D and E and PBS were used to assess outcomes.
Result: The result showed an increase in the D and E dimensions from the GMFM and PBS scores.
Conclusion: Standing, walking, running, jumping motor, and balance skills in children with DS administered sit-to-stand exercise intervention with increased periodization.

Demographic Influences on Sustainable Mobility Adoption in Rehabilitation

2025-04-16T10:39:20+07:00

Background: The integration of sustainable mobility within rehabilitation settings combines environmental and health-focused strategies to reduce the carbon footprint of healthcare and improve patient results. This approach addresses the need for environmentally friendly transport options, such as walking, cycling, public transport, and carpooling, within rehabilitation programs.

Aim(s) (including purpose setting): This study aimed to explore the influence of demographic factors - age, gender, and mobility restrictions on patients' willingness to adopt sustainable mobility options during rehabilitation.

Material and methods: A cross-sectional survey design was used, involving 85 participants undergoing rehabilitation. Data were collected using a structured electronic questionnaire, with demographic data and attitudes toward different sustainable transport methods. Statistical analyses included Chi-Square tests, ANOVA, Tukey’s HSD, t-tests, and Mann-Whitney U tests to identify significant demographic influences on mobility preferences.

Result: Younger participants (aged 18-30) and female participants demonstrated a higher willingness to use public transport compared to older age groups and male participants (ANOVA p = 0.008). Participants with mobility restrictions were less inclined toward active transport options, highlighting the need for customized support and accessible infrastructure.

Conclusions: Demographic factors significantly affect sustainable mobility preferences in rehabilitation, necessitating customized interventions to improve adoption. Programs should consider age, gender and mobility limitations to effectively promote sustainable transport. Addressing these factors can improve rehabilitation results and support broader environmental sustainability goals. Future research should investigate long-term impacts and the role of additional variables, such as socioeconomic status and infrastructure, in shaping mobility preferences.