Surabaya Physical Medicine and Rehabilitation Journal

Neurogenic Arthropathies of the Lower Limbs: About A Case Followed in Rehabilitation at the Chu-Bogodogo

Wed, 28 Aug 2024 00:00:00 +0700

Abstract

we report a case of pelvic limb neurogenic arthropathies (NA) in a young 25-year-old patient following severe cranioencephalic trauma in a road traffic accident. The aim of this clinical case was to report the contribution of physical medicine and rehabilitation in the management of neurogenic arthropathies. The patient was admitted to the Physical Medicine and Rehabilitation Department only six months after his trauma. Nervous system disorders were represented by a frontal syndrome and significant spasticity in the pelvic limbs. Deficiencies founds was pain, multiple joint stiffness of the pelvic limbs, induration of the thighs related to arthropathies objectified to the standard x-ray of the thighs. The rehabilitation approach consisted of postures associated with targeted cryotherapy of the muscles. The gait rehabilitation was done gradually between the parallel bars and then with a deanbulator Rehabilitation led to functional improvement, with the patient returning to independent walking using simple techniques. The presentation of this case study provided an overview of this pathology, its functional consequences and the role of Physical and Rehabilitation Medicine in the management of NA. The techniques we used have made it possible to limit the diffusion processes of neurogenic arthropathies by limiting inflammation through associated cryotherapy sessions. The presence of nervous system disorder such as frontal syndrome could have limited rehabilitation, but thanks to collaboration with psychiatrists the evolution was favorable and allowed the patient to actively participate in his rehabilitationThe case also underlined the importance of multidisciplinary patient management, which should be a goal for all practitioners.

Keywords: arthropathies ; cryotherapy ; neurogenic ; rehabilitation ; traumatic brain injury

Secondary Prevention Program through Hybrid Tele-Cardiac Rehabilitation using a Combination of Vigorous-intensity Interval Training and Low-Intensity Home-based Exercise in Patient with Refractory Angina Post-Percutaneous Coronary Intervention

Arnengsih Nazir, Gabriela Anggraini, Hana Athaya Nurhalizah — Wed, 28 Aug 2024 00:00:00 +0700

Background: Refractory angina (RA) refers to symptoms lasting >3 months due to reversible ischemia occurring with coronary artery disease, which cannot be controlled by increased medical therapy or revascularization including percutaneous coronary intervention (PCI). It may result in a significant impact on patient outcomes such as exercise limitation, biopsychosocial disorders, and decreased quality of life. Participation of patients with RA in cardiac rehabilitation (CR) reduces angina frequency and increases exercise capacity. Exercise-based CR also improves endothelial function, reduces oxidative stress and arterial stiffness, and improves myocardial perfusion. CR is also known as a secondary prevention program with the main goal to help patients return to their normal activities by increasing their functional capacity and preventing long-term complications.

Case illustration: A 64-year-old male has undergone PCI and experienced RA. This patient was given a CR program to increase his functional capacity as a secondary prevention of cardiovascular disease through a center-based combined with a home-based CR program. Aerobic exercise given was hospital-based vigorous-intensity interval training and low-intensity home-based exercise. Problems found were refractory angina that often appeared during activity, and low cardiorespiratory endurance or muscular fitness. Angina symptoms and hand grip strength improved after 2 weeks, even though muscular fitness classification was still poor. During the program, he could achieve the exercise heart rate target without any symptoms. After 4 weeks, hand grip strength and physical activity were improved, and an exercise test revealed no symptoms during the test, appropriate hemodynamic response, and good fitness classification. However, there were still frequent VES with couplet episodes, so the patient was still classified as high-risk stratification. Although risk stratification was still high, the patient was allowed to enter phase III CR, with the prescription of moderate-intensity aerobic, low-intensity resistance, flexibility, and breathing exercises. These exercises were given based on recommendations for the average adult to maintain his level of physical activity and promote lifelong healthy behavior.

Conclusion: Hybrid tele-cardiac rehabilitation through a combination of vigorous-intensity interval training and low-intensity home-based exercise in a patient with refractory angina post-PCI improved functional capacity as a key component for the prevention of long-term cardiac or non-cardiac complications.

Physical Medicine and Rehabilitation Approach of Elderly with Atypical COVID-19 Symptoms

Siti Chandra Widjanantie, Erlina Burhan, Agus Dwi Susanto — Wed, 28 Aug 2024 00:00:00 +0700

COVID-19 has affected the older population disproportionately. These patients are prone to have more severe COVID-19. Clinical manifestation of COVID-19 in the geriatric can be atypical and differs from the younger population. We report an 80-year-old male with atypical presentation of COVID-19. In this case report, we describe a COVID-19 patient with anorexia and gastrointestinal symptoms. We also describe the multidisciplinary aspect of physical medicine and rehabilitation management of the patient. Clinical manifestations in geriatric with COVID-19 can be atypical. Symptoms experienced may include anorexia and gastrointestinal tract symptoms. A multidisciplinary approach is needed to manage more seniors with COVID-19 and maximize their functional abilities.

Telerehabilitation for Geriatric with Dementia and Long Covid-19

Wed, 28 Aug 2024 00:00:00 +0700

Rehabilitation is crucial for individuals who have survived COVID-19, particularly those who are older and have pre-existing health conditions. These survivors may experience long covid symptoms up to four months after infection. Elderly individuals suffering from long covid face difficulties in undergoing conventional rehabilitation methods due to limitations in mobility, lack of social interaction, and inadequate healthcare accessibility. As a result, telerehabilitation has arisen as an alternate form of care. This case report intends to present empirical evidence on the enhancement of functional status in a geriatric long covid patient following telerehabilitation. We present a case of an elderly woman with underlying dementia who developed long covid. The symptoms included of dyspnea and mobility impairment. We provide a telerehabilitation program for three weeks with an active-assisted range of motion exercises. Following three sessions of telerehabilitation, we could see improvement in her Physical Mobility Scale (PMS). After 20 days, the patient's PMS score increased by 3 points.

Pregnancy Exercise Shorten the Duration of the Second Stage of Labor

Mahendra Eko Saputra — Wed, 28 Aug 2024 00:00:00 +0700

Background : There are several factors that contribute to duration of labor, which are power, passage, and passenger. Pregnancy exercise is one of many interventions that can be done in favor of increasing power during labor.

Aim : The purpose of this study was to investigate the correlation between pregnancy exercise and second stage of labor duration.

Material and Methods: This was an analytic observational study using cross sectional design conducted in Al-Irsyad Hospital in Surabaya. The total sample was 48 pregnant women who followed pregnancy exercise program and did not follow pregnancy exercise program that met sample criteria. Medical records data on duration of second stage of labor and pregnancy exercise program data were collected then analyzed by mann-whitney test.

Results: The mean second stage of labor in pregnancy exercise group was 25.88±13.21 minutes, while in non-pregnancy group was 11.46±4.77 minutes. The analysis using mann-whitney test showed a significant correlation between pregnancy exercise and second stage of labor (p=0.000).

Conclusion: There was a significant correlation between pregnancy exercise and second stage of labor. Pregnancy exercise shorten the duration of second stage of labor.

Event Profile of Ankle Sprain Injury at Athletes in East Java Puslatda

Pradana mahendra santoso — Wed, 28 Aug 2024 00:00:00 +0700

Background: Ankle injuries are the most common injuries in sports and often cause chronic pain, swelling, and functional instability. Ankle injuries (sprains) are acute injuries that athletes often experience. This acute injury is caused by a pressure force, for example, when making a sudden turning motion. Sprains can affect the ankle's side and damage the outside (lateral) ligament; ankle injuries were reported at the Sports Clinic RSUD Dr. Soetomo Surabaya .

Aims: To understand the profile of ankle injuries suffered by East Java Puslatda athletes and investigate the risk factors for these injuries.

Material and methods: The study was conducted using a retrospective approach with an analytic observational design in the form of a cross-sectional study because the researchers did not provide intervention to the research subjects and only made observations and secondary data profiling.

Result: The data collection and analysis found that ankle injuries in East Java Puslatda athletes most often occur in the late adolescent age range (17-23 years), which is as high as 35.8%. Conclusions: There is no relationship between extrinsic and intrinsic factors on the risk of ankle injury for Puslatda East Java athletes.

Acute Effects of Dynamic Stretching on Functional Performance in Non-Athlete Young Adults

Salsabila Zahroh, Arni Kusuma Dewi, Lydia Arfianti — Wed, 28 Aug 2024 00:00:00 +0700

Abstract
Background: Warming up is an activity carried out before exercise or competition to optimize performance. Dynamic stretching is a type of stretching that is applied as a part of warming up. Previous study showed that dynamic stretching had an acute effect on functional performance in athletes. But, acute effects on functional performance in non athletes have not been studied yet.
Aim: To prove that the addition of dynamic stretching during warming up has an acute effect on functional performance.
Material and Methods: This study uses an experimental method of randomized controlled trial post test design on 44 physically active young adults in non athlete level who were divided into two research groups. The intervention group completed 5 minute jogging and dynamic stretching whereas the control group completed 5 minute jogging without stretching then each group performed a modified 20-m sprint run test and triple hop for distance test.
Result: There is no statistical significant difference in comparison between groups. On speed showed that p values = 0.845 (p> 0.05) and on power showed that p values = 0.366 (p>0.05).
Conclusion: Addition of dynamic stretching during warming up has not been proven to have a better acute effect on speed and power in non-athlete young adults.
Keywords: Dynamic Stretching, Functional Performance, Warming Up

Profile of Sarcopenia in Elderly Patients at The Medical Rehabilitation Outpatient Department Dr. Soetomo General Academic Hospital

Wed, 28 Aug 2024 00:00:00 +0700

The elderly group is the age group that is most susceptible to geriatric syndromes, one of which is sarcopenia.
Sarcopenia is a syndrome characterized by a progressive and overall decrease in muscle mass and skeletal muscle strength
with an increased risk of disability, decreased quality of life, and death. Currently, research on sarcopenia profiles, particularly in Indonesia, is still limited. This research data is expected to help determine policies to improve the quality of services in the health sector. This study used the SARC-F questionnaire and the risk factor questionnaire for sarcopenia in elderly patients at the Medical Rehabilitation Outpatient Department RSUD Dr. Soetomo and has been permitted by the Penelitian dan Pengembangan (LitBang) section RSUD Dr. Soetomo, Surabaya. Several variables used in this study were gender, age, weight, height, body mass index (BMI), other diseases, physical activity, mood, and sarcopenia. There were 25 elderly patients at the Medical Rehabilitation Outpatient Department at RSUD Dr. Soetomo, Surabaya in November 2022”January 2023 which met the research inclusion criteria. The age of elderly patients at the Medical Rehabilitation Outpatient Department at RSUD Dr. Soetomo ranged from 60”81 years old, with an average of 60.48 years old. Female is the most common gender among the elderly patients at the Medical Rehabilitation Outpatient Department RSUD Dr. Soetomo, there are 17 (68%) female elderly patients. 80% of the elderly patients were in the young elderly group (60”69 years old), 16% in the middle elderly group (70”79 years old), and 4% in the old elderly group (â‰¥80 years old). Age, gender, other diseases, and physical activity are risk factors that have a significant correlation with
sarcopenia among elderly patients at the Medical Rehabilitation Outpatient Department RSUD Dr. Soetomo.