Surabaya Physical Medicine and Rehabilitation Journal

Traditional Massage-Induced Iliotibial Band Syndrome: A Case Report

Nunung Nugroho — 2024-02-29

Iliotibial Band (ITB) Syndrome is common among athletes, such as runners and cyclists. There are several theories regarding the etiology of ITB Syndrome, including friction, compression, and chronic inflammation. We report a rare case of ITB Syndrome induced by traditional massage after a history of chronic knee pain. A 63-year-old female visited our Pysical Medicine and Rehabilitation Department with the pain of the lateral side of the right knee for four months after traditional massage. The physical examination showed a positive Ober test and Noble compression test. We performed an ultrasonography on the lateral right knee and found fluid effusion beneath the ITB confirming the diagnosis of ITB Syndrome. A pain intervention was performed with ultrasound-guided aspiration and injection of steroid beneath the ITB. After the procedure and rehabilitation program of cryotherapy and ultrasound therapy, the pain was reduced greatly and there was no need for further management.

Improving Quality of Life in Geriatric with Pain due to Scoliosis and Old Compression Fracture: A Case Report

Easy Orient Dewantari — 2024-02-29

Scoliosis frequently causes problems in geriatrics, particularly pain. Pain that persists for a long time can result in a decreased quality of life and disability. Thus, pain management is needed in patients with scoliosis. We report the case of a 71-year-old man referred from the Neurology Department with pain due to scoliosis and an old compression fracture, making him incapable of walking, became dependent, and had a high risk of falling, thus resulting in a decreased quality of life. Physical examination revealed hyperkyphotic thoracal, tenderness and spasms on the paralumbar muscles, with no weakness in the extremities but decreased sensory function on both dorsum of the feet. The patient also had decreased chest expansion. The patient was conservatively managed. The goals of this treatment are to relieve pain, improve sensory function, and improve the quality of life. He underwent a staged rehabilitation program, starting from a combination of Transcutaneous Electrical Nerve Stimulation (TENS) and microwave diathermy, breathing, and core muscle strengthening exercises. After 10 weeks, there was an improvement in pain, risk of falls, chest expansion, and quality of life. Improving the quality of life of geriatric patients requires a multi-dimensional approach. Relieving pain, enhancing cardiorespiratory endurance and preventing falls were the main goals of this patient. Each exercise must be safe considering the patient's age, health condition, and vertebral fractures. Family support is important to monitor and encourage patient during the program.

The Effect of Therapeutic Exercise in Postural Low Back Pain: A Case Report

Vivid Prety Anggraini — 2024-02-29

Postural low back pain (LBP) is a non-specific LBP defined as pain or discomfort in low back areas caused by incorrect posture for ages. Most patients only experience mild and moderate pain from low back pain, however, it can cause chronic pain and disability for several groups. This case report aims to investigate the effect of therapeutic exercise on posture and pain in postural LBP.

A 37-year-old male presented with LBP for 4 months with Numeric Rating Scale (NRS) 7. Physical examination showed impaired posture, wide base gait, limitation ROM of trunk, reduced breathing count test, muscle spasm at upper and lower back areas, positive in Thomas test, Ely test, and hamstring tightness test. The back pain functional scale (BPFS) was 7. The therapeutic exercise program consisted stretching exercises (neck, upper and lower back, hamstring, rectus femoris, iliopsoas muscle), core strengthening, William's flexion, McKenzie's, breathing and chest expansion exercise, alongside proprioceptive exercise. One cycle (eight times) of physical modalities, TENS at paralumbal and USD at paracervical, upper and middle trapezius, rhomboid, sternocleidomastoideus, paralumbal, and insertion of hamstring were given. We evaluated the patient's condition for about 4 months, and the patient showed a good compliance with improvement in pain score, ROM of the trunk, reduced muscle spasm and tightness, improved posture, gait, breathing, and BPFS. The patient can return to do his job again.

This case report is able to demonstrate that therapeutic exercise improves clinical and functional conditions. These findings suggest the clinical implications of therapeutic exercise in patients with postural LBP are beneficial.

Home Based Cardiac Rehabilitation in Cardiovocal Syndrome

Ida Ayu Wulan Kartika Dewi Manuaba — 2024-02-29

Cardiovascular disease is one of the highest causes of death and disability in the world. Cardiac Rehabilitation has an important role in the management of patients with heart diseases. This article reported a Cardiac Rehabilitation for a 22-year-old male patient with Cardiovocal Syndrome, a rare condition characterized by heart failure accompanied by hoarseness. The Cardiac Rehabilitation in this case was a phase 2 Cardiac Rehabilitation that carried out as Home based Cardiac Rehabilitation. We performed the 6MWT for the patient to assess his physical endurance. After 3 months of Cardiac Rehabilitation program, patient has physical endurance was improved, his voice was back to normal and he was able to return to work.

Rehabilitation Management of Intensive Care Unit-acquired Weakness (ICU-AW): A Narrative Review

Arnengsih Nazir — 2024-02-29

Background: Intensive Care Unit-acquired weakness (ICU-AW) is one of the most common neuromuscular disorders affecting intensive care unit (ICU) patients' outcomes and clinical course. ICU-AW is found in 30-50% of patients and increases to 67% in sepsis-critically ill patients. Prolonged ICU stay, the difficulty of weaning from the ventilator, higher hospitalization costs, and an increase in mortality, as well as long-term morbidity, are associated with ICU-AW. ICU-AW causes skeletal muscle weakness, including respiratory muscles, which results in complications that continue even years after being discharged from the hospital.

Aim: To describe the rehabilitation management of ICU-AW and provide the information needed clinically to manage these patients.

Methods: The authors reviewed all types of articles without time filtering using PubMed and Google Scholar databases with "ICU-AW”, "ICU-related weakness”, "rehabilitation”, and "early mobilization” used as keywords.

Results: Rehabilitation management can be done as early as possible, beginning while the patient is still in the ICU. Early mobilization programs require teamwork consisting of doctors, therapists, and nurses. Physical activity and early mobilization in the ICU must be carried out with consideration for safety. Monitoring patient safety before and during mobilization is an essential factor to be considered. Any mobilization program should be the decision of the ICU care team. Implementation of rehabilitation programs and early mobilization improves outcomes for patients with ICU-AW and should be continued until the follow-up period.

Conclusion: The rehabilitation management aiming at preventing and treating ICU-AW should be done since the patient was still in the ICU and under careful consideration of safety aspects.

Musculoskeletal Pain Description in Adolescence with Internet Addiction: Community Engagement in Senior High School

Peggy Sunarjo — 2024-02-28

Background: Some bad postures resulting from bad habits that had lasted since childhood, especially posture while accessing internet using gadget, might lead to some complications in adolescence.

Aim: In this community engagement program, we tried to explore internet addiction and musculoskeletal pain proportions in some students.

Material and methods: This is a cross-sectional study conducted in a senior high school at Jonggol, West Java, in February 2023. Students were gathered to have an education class about good posture. Before the education session, we asked the students to explore whether they had internet addiction and musculoskeletal pain by filling out the Indonesian Internet Addiction Diagnostic Questionnaire and Cornell Musculoskeletal Discomfort Questionnaire.

Results: Thirty-nine students were involved in this study. As many as 19 (48.7%) students have an internet addiction. More than 50% of the addicted students often have moderate-severe pain in their neck, back and right wrist and reported that the pain interferes with their daily activities.

Conclusions: Almost half of students attending posture education class had internet addiction and musculoskeletal pain. A further study with a larger sample size needs to be conducted to show the correlation between internet addiction and musculoskeletal pain in adolescence and other factors that correlate with them.

Factors Predictive of the Level Of Physical Activity (PA) in Patients with Gonarthrosis in Sub-Saharan Africa

Yirozounlomian TIAHO — 2024-02-29

Background: Our aim was to determine the predictive factors of the level of physical activity (PA) in patients with gonarthrosis in the city of Ouagadougou (Burkina Faso).

Methods: This was a cross-sectional, descriptive and analytical study based on clinical records, conducted from January 9 to 27, 2023. Using the International Physical Activity Questionnaire (IPAQ), we assessed the level of PA in patients followed at CHU-Bogodogo for gonarthrosis. The significance threshold p<0.05 was retained.

Results: Sixty-seven patients were included. Fifty-six were women (83.58%). The mean age was 59.87± 12.53 years. Hypertension was noted in 34 patients (50.75%), diabetes in 16 (23.88%). The mean BMI was 28.70kg/m2± 6.73. Gonarthrosis was bilateral in 49 patients (73.13%). Gonarthrosis patients had a moderate level of PA, with a mean IPAQ score equal to 635.24±135 MET-minutes/week.

45 patients (67.16%) had a low level of physical activity (Ë‚ 600 MET-minutes/week). In bivariate analysis, low PA was associated with age over 65 [OR=5.62, (CI=1.45-21.73), p<0.001], hypertension [OR=2.83, (CI=1.27-6.31), p<0.001], diabetes [OR=2.14, (CI=1.13-5.89), p<0.031], and overweight [OR=2.43, (CI=1.17-6.12), p<0.026]. Moderate PA was associated with age under 65 [OR=1.71, (CI=1.25-2.34), p<0.005] and absence of hypertension [OR=1.86, (CI=1.19-2.89), p<0.012].

Conclusion : Gonarthrosis patients have a moderate level of PA. Factors associated with low PA were advanced age and sedentary comorbidities.

Key words: Gonarthrosis, physical activity, Ouagadougou/Burkina Faso

The Effect of Virtual Reality Game Training on Improving Walking Speed and Dynamic Balance Function After Stroke

Christopher Lampah — 2024-02-29

Background: Stroke is a serious health condition that can cause physical and cognitive impairment, affecting a person's ability to perform daily activities. Important factor that affect the quality of life of stroke patients is the ability to mobilize, especially walking. Virtual Reality is expected to increase walking speed and dynamic balance which are important to improve patient mobility and independence.

Aim(s) : Analyse the effect of Virtual Reality (VR) game training using Xbox 360° and Kinect^TM devices on post-stroke walking speed and balance

Material and methods: An experimental study involving 18 ischemic post-stroke patients at the Rehabilitation Installation of Prof. Dr. R. D. Kandou Hospital Manado (from June to July 2023). The intervention was a 30 minutes VR game exercises with three sessions per week (a total of 8 sessions for each subject). This subject was assessed using the 10-meter Walk Test (10 MWT) and the Berg Balance Scale (BBS).

Result: There were significant improvements in both walking speed and dynamic balance. Wilcoxon Signed Ranks test results on Walking Speed (10 MWT) obtained a value of Z = -3,754 with a value of (p = 0.000 <0.05). Similar results were obtained in testing the dynamic balance function where the paired t test results were obtained at t = -14.750. The results indicate significant differences in the mean value of Subacute Post-Stroke BBS before and after training (p < 0.05).

Conclusions: Virtual Reality (VR) game training using Xbox 360° and Kinect^TM devices significantly increased walking speed and balance in post-stroke patients.