Surabaya Physical Medicine and Rehabilitation Journal

Airway Mucus Hypersecretion in Chronic Obstructive Pulmonary Disease Patients: From Basic Pathophysiology to Rehabilitation Approaches

Arnengsih Nazir — 2025-02-26

Objective: This narrative review aimed to describe the pathophysiology of mucus accumulation and mucus expectoration disorders, rehabilitation assessments, and airway clearance techniques in chronic obstructive pulmonary disease (COPD) patients.

Methods: Articles were searched using relevant keywords in PubMed, Google Scholar, and CINAHL databases. Article searches were carried out without limiting the article types or year of publication. Only full-text articles in English and Indonesian were included for data synthesis.

Results: COPD causes physiological and structural changes in the airway including stiffness of the airway wall, impaired mucociliary clearance, and decreased cough ability due to respiratory muscle dysfunction. These changes then lead to mucus hypersecretion and mucus accumulation problems resulting in impaired airway clearance and worsened lung function. A rehabilitation assessment is important to assess cough ability and its impact on daily activities and quality of life. Various airway clearance techniques are used to reduce or eliminate airway occlusion and increase expiratory airflow and lung volume. Successful airway clearance can be supported by knowledge of the mechanisms by which mucus accumulates so that appropriate management can be provided.

Conclusion: COPD causes airway stiffness, impaired mucociliary clearance, and weakened cough due to respiratory muscle dysfunction, leading to mucus accumulation and worsened lung function. Airway clearance techniques aim to remove obstructions, improve expiratory flow, and enhance lung volume. Understanding mucus accumulation mechanisms is crucial for optimizing airway clearance management based on patient needs.

Comparison of Hatha Yoga and Elderly Exercise in Quality of Life in Elderly

Rhevensa Santoso — 2025-02-26

Background: Aging-related physical changes impact Quality of Life (Qol). Even though it is a popular form of exercise for the elderly, few of them are aware of the many advantages of Hatha Yoga.

Aim: This study compares elderly exercise programs with Hatha Yoga in an effort to enhance quality of life in older adults.

Material and methods: This was a randomized controlled trial consisting of 26 participants split into two groups: 13 people did Hatha Yoga and 13 people did senior exercise. For six weeks, both groups participated in three-week exercises, and the EQ-5D-5L was used to measure quality of life both before and after the intervention.

Results: The elderly exercise group's delta post-test utility index score (0,15 ± 0,10) was lower than that of the Hatha Yoga group (0,46 ± 0,11); this difference was statistically significant (<0,001). The VAS score in the Hatha Yoga group (85,15 ± 7,38) was higher than that of the elderly exercise (74,15 ± 7,97) and the difference was significant (p=0.001). The difference in the score of Hatha Yoga (13,62 ± 5,47) compared to elderly exercise (2,46 ± 1,98) results in a significant p<0.001.

Conclusions: Hatha Yoga improves better EQ-5D-5L than elderly exercises to improve the QoL of elders.

Keywords: elderly, EQ-5D-5L, exercise, hatha yoga, quality of life

The Effectiveness of Kinesio Taping Application on the Balance of Recreational Futsal Players

Rudy Handoyo — 2025-02-26

Background: Futsal is a development of football which is the most popular sport in the world. In futsal there are many demands on individual technical and tactical skills that require a good balance. Kinesio taping stimulate mechanoreceptors, this stimulus can increase proprioception in normal tissue. Proprioception receptors are located in the skin, muscles and joints. For the distal extremities, receptors in the skin and joints become the most important factor. Increasing the ankle proprioception is important to improve balance that supports futsal players.

Objective: To determine the effectiveness of kinesio taping on balance, immediately after the application of kinesio taping.

Method: This study was a randomized control trial. The subjects were 44 recreational futsal players which were divided into 2 groups, control group (n=22) and treatment group (n=22). The control group performed the mCTSIB test without kinesio tapping application, the treatment group performed the mCTSIB test with kinesio tapping installed. Balance was measured before and after the intervention.

Results: The average mCTSIB results in the control group showed an improvement of 1.45±2.59 with p=0.016. The average mCTSIB results in the treatment group showed an improvement of 24.27±1.49 with p=0.000. The results for the difference between pre-test and post-test scores showed a greater increase in the treatment group, this increase was statistically significant, with a value of p=0.000

Conclusion: There is a significant improvement in balance after kinesio taping application.

Keywords: Ankle, Balance, Futsal, Kinesio taping, Mechanoreceptors, Proprioception

Bone Adaptation Process on Post-menopausal Women after Speed Play Walking Exercise with Medium & High Increased Cadence

Damayanti Tinduh — 2025-02-26

Background: Postmenopausal period is usually marked by dominancy of osteoclast activity, which leads to a decrease in bone mass. Speed Play Walking Exercise (SPWE) could be an important mechanical strategy for maintaining bone cell activity in postmenopausal women.

Aim(s): This study evaluated the rate of increased cadence in SPWE, which can reduce bone resorption and increase bone formation activities, associated with body mass index.

Material and methods: This was four group pre-post intervention design randomized clinical trial, included 32 postmenopausal women in normal-weight (NW) vs. overweight (OW) groups, divided into 2 groups of different walking speeds. The intervention is SPWE method with increased 15-35% or 50-80% from initial cadence as intervention target cadence, alternated with usual cadence, 3 times a week, for 4 weeks duration. Variables are baseline CTx and NMid osteocalcin serum taken on pre and post 4 weeks exercise.

Result: sNMid osteocalcin was increased in groups walked with 15-35% increased cadence compared to group walked with 50-80% increased cadence (p=0.002 for NW group and p=0.042 for OW group, respectively). NW group walked with 50-80% increased cadence showed the most decreased bone formation marker (p=0.019). CTx/NMid ratio is reduced in NW group walked with 15-35% increased cadence, on the other hand, OW group walked with 50-80% increased cadence showed the most increased trend of CTx/NMid ratio.

Conclusions: To maintain bone formation activity, SPWE with a rate of 15-35% increased from initial cadence is suggested for postmenopausal women, however the benefit is more visible in women with normal-weight.

Exploring Pain Distribution: Unveiling Lower Back Pain As The Prominent Player

Theresia Chandra Tania Novy — 2025-02-26

Background: Pain is a significant health issue affecting millions worldwide, with lower back pain being particularly prevalent. A comprehensive understanding of pain distribution across different body regions is essential for effective management, yet studies on this in clinical settings are limited.

Aim(s): This study aimed to evaluate the prevalence and distribution of pain among patients at a pain clinic, focusing on identifying the most affected body regions and the impact of chronic conditions and comorbidities.

Material and methods: A descriptive study conducted at Bandung Pain & Rehab Center from January 2019 to December 2022 included 5,103 subjects from 5,139 medical records. Demographic and clinical characteristics were analyzed using univariate analysis, revealing distinct chronic pain subgroups based on intensity, quality, clinical outcomes and comorbidities.

Result: The study included 435 patients, with a higher prevalence of pain observed in females (59.8%) compared to males (40.2%). Lower back pain was the most frequently reported issue, affecting 58.2% of patients, followed by neck pain (24.4%) and shoulder pain (17.4%). Chronic pain was reported in 76.1% of patients, with the majority experiencing pain for more than six months. Comorbidities, including diabetes and hypertension, were found in 38.4% of patients, significantly influencing pain severity and distribution.

Conclusions: Lower back pain emerges as the most prevalent pain condition among patients in this study, highlighting the need for focused interventions in this area. The association between chronic pain and comorbidities underscores the importance of comprehensive pain management strategies that consider the patient's overall health. These findings can guide clinicians in developing more effective treatment plans and improve patient outcomes in pain management.

The Effect of Resistance Training on Cardiorespiratory Fitness on Healthy Male in Surabaya

Muhammad Qashmal Ramadhan — 2025-02-26

Introduction: Low fitness levels have long been the cause of various diseases that are often experienced by humans. Although the process of a disease is something that is related to many factors, it cannot be denied that lack of physical fitness is one of the biggest factors. In theory, the results of the VO2Max test will increase due to several mechanisms including increased respiratory muscle strength and increased cardiac output. Aim: Based on this theory, this study was conducted to see the impact of resistance training on cardiorespiratory fitness. Method: This study used a Quasi-Experiment design with a pre-post test with a total sample of 16 people and was divided into 2 treatment and control groups. Treatment is the group that is given a resistance training regimen and control is the group that is not given. Data was obtained by testing the YMCA Ergometry Cycle Test, then processed with SPSS with the Shapiro-Wilk test and Levene test and then a paired t-test was carried out. Results: The results of this study indicate the effect of providing resistance training with a p value = 0.01 which shows significant results. Conclusion: Resistance training increases cardiorespiratory fitness with quite significant results and can improve fitness, but it is still recommended for each individual to balance this resistance training with endurance training for optimal body fitness.

When a Massage Gone Wrong: Unveiling a Case of Post-Massage Brachial Plexopathy

Yudiansyah Anggi Gilang — 2025-02-26

The brachial plexopathy associated with massage therapy is rarely reported. This case report describes an uncommon case of brachial plexopathy that developed after a session of massage therapy and revealed past published reports of peripheral nerve injury following massage therapy. A 54-year-old Javanese woman developed sudden unilateral paralysis of her left shoulder girdle after a session of massage therapy. The massage session was stopped due to pain. She could not move her left shoulder immediately after 5 minutes of massage. There was hypoesthesia from shoulder to forearm, and there was decreased MMT of the left deltoid muscle. She regularly participated in a twice-weekly rehabilitation program targeting the left shoulder. It included NMES, laser therapy, PROM, strengthening exercises, and a home exercise program. A diagnosis of acute brachial plexopathy was suspected due to her recent history and the results of several examinations. She had a gradual recovery of strength, resolution of limitations of ROM, and sensory function in her shoulder. Rehabilitation programs have a major role in helping the patient do her functional activities. This case report presents as a reminder to massage therapists or physical therapists that massage therapy of the neck and shoulder should be carefully performed to avoid any injury. Further studies will help improve the safety procedures and effectiveness of massage therapy in the future.

Unveiling the Potential of Perineural Injection Therapy in Trigeminal Neuralgia Management

Vivid Prety Anggraini — 2025-02-26

Trigeminal neuralgia is characterized by severe pain that is restricted to the trigeminal nerve and frequently causes abrupt, severe bouts in the face. About 80% of cases of classical trigeminal neuralgia are classed as idiopathic. With the use of the Numeric Rating Scale (NRS) and the SF-36 questionnaire, this case study aims to determine how perineural injection therapy (PIT) affects pain relief in early trigeminal neuralgia cases and how it can affect patient function. The patient presented with a history of 8 years persistent facial pain, localized to the right side of the face. Described as sharp and intermittent, the pain rated between 6 on the Numeric Rating Scale (NRS). It was exacerbated by activities such as chewing and combing, yet alleviated by rest and medication. Injections of a 5% dextrose solution in sterile water (D5W) are administered subcutaneously and intracutaneously at the trigeminal nerve point. The PIT has been performed three times. with an injection interval of 2-3 weeks. Injections are made at the trigeminal nerve point, based on the Lyftogt book. The NRS score on first injection was changed from 6 to 2, second injection was from 2 to 1, and third injection was 1 before and after injection. The quality of life is better than before. SF-36 questionnaire showed a change from 50-75% on first injection, 75-100% on second injection, and 100% on the third injection. This study showed that PIT can improve patient's pain and patient's quality of life.