JURNAL MEDIK DAN REHABILITASI

Medical Rehabilitation in Geriatric Patient with Post Right Total Knee Arthoplasty

Hendrik Kandamy — 2024-10-14

Abstract : Total knee arthroplasty (TKA) is a surgical procedure that is often performed in geriatric patients with
advanced osteoarthritis (OA). This action aims to reduce pain, improve knee joint function, and improve mobility.
However, post-TKA recovery in the elderly is often more complex, requiring integrated medical rehabilitation to
optimize clinical outcomes and quality of life. This study aims to evaluate the effectiveness of medical
rehabilitation programs in post-TKA geriatric patients in terms of functional recovery and improvement of quality
of life. This study uses a qualitative method with a case study approach on a 64-year-old male patient who has
undergone TKA on the right knee due to advanced OA. These patients also have comorbidities such as
hypertension and diabetes mellitus, which adds to the complexity of postoperative recovery. Data were collected
through clinical observations, interviews with patients and medical personnel, and reviews of patients' medical
records. The medical rehabilitation process includes several major interventions, such as Transcutaneous
Electrical Nerve Stimulation (TENS) for pain management, isometric exercises to increase quadriceps muscle
strength, as well as mobility training with the help of walkers. The results of the study showed that this medical
rehabilitation program provided a significant improvement in the patient's condition after a few weeks of therapy.
The patient's pain, which was initially measured by the Numerical Pain Scale (NPRS) at 5, decreased to 1 after
three weeks of therapy. In addition, the range of motion of the patient's knee joint increases from 20° to 110°,
allowing the patient to walk further and more stably without the help of tools. An increase in muscle strength is
also seen, where patients are able to perform daily activities independently, such as dressing, bathing, and walking
without the help of tools. The patient's Barthel Index score increased from 15 (mild dependence) to 20 (full
independence), which signified a significant increase in independence of daily activities. In addition to physical
improvements, patients also experience improvements in psychological aspects. There was a decrease in anxiety
and an improvement in sleep quality, which significantly contributed to an improvement in the overall quality of
life. The results of this study confirm that a comprehensive post-TKA medical rehabilitation approach, involving
a multidisciplinary team such as physiotherapists, nutritionists, and psychologists, is very effective in improving
the physical and mental functioning of geriatric patients. Medical rehabilitation in post-TKA geriatric patients is
effective in reducing pain, improving mobility, improving physical function, and overall quality of life.

MEDICAL REHABILITATION IN PATIENT WITH CONGENITAL MUSCULAR TORTICOLLIS

Hendrik Kandamy — 2024-10-14

ABSTRACT :. Torticollis is one of the most common types of head and neck posture abnormalities in
infants. The research method used is an observational study through observation of patients. The head tilted to
the right has been known by the patient's parents since the patient was 4 months old. Torticollis was first defined
by Tubby in 1912 as a deformity, either congenital or acquired, characterized by lateral tilt of the head to the
shoulder, with torsion in the neck and deviation of the face. The term congenital muscular torticollis (CMT)
indicates a neck deformity involving shortening of the sternocleidomastoid (SCM) muscle that is detected at birth
or shortly after birth. The term torticollis comes from Latin, from the word torquere meaning bent, and collum
meaning neck and is a clinical sign of a bent or twisted neck that can be acquired or congenital. Congenital
muscular torticollis (CMT) or also known as wry neck, fibromatosis colli and twisted neck ranks third as a
congenital musculoskeletal disorder in neonates after hip dislocation and clubfoot and is characterized by lateral
flexion of the head towards the affected side and cervical rotation to the opposite side due to unilateral shortening
of the sternocleidomastoid (SCM) muscle, which is detected at birth or soon after.

Medical Rehabilitation in Patient with Post Operative Total Hip Arthroplasty due to Femoral Neck Fracture

Natalia Nanlohy — 2024-10-14

ABSTRAK:. Fraktur hip merupakan salah satu patah tulang yang paling sering terjadi di unit gawat darurat dan
tim trauma ortopedi. Metode penelitian yang digunakan yaitu studi observasional ini melalui observasi pada
pasien. Rehabilitasi yang tepat setelah operasi total hip arthroplasty (THA) terbukti dapat memperpendek masa
rawat inap di rumah sakit, meningkatkan fungsi fisik, dan membantu pasien mempertahankan kehidupan sehari
hari yang mandiri, hasil yang mengurangi beban biaya med Lokasi persimpangan tersebut membuat leher femur
rentan terhadap fraktur. Pasokan darah ke kepala femur mengalir di sepanjang leher femur dan merupakan
pertimbangan penting dalam fraktur yang bergeser dan pada populasi yang lebih muda. Kami membalas mengenai
etiologi, presentasi, evaluasi, dan penanganan fraktur neck femur serta mengulas peran tim interprofesional dalam
mendengarkan, mendiagnosis, dan menangani kondisi ini. Untuk keterbatasan ADL, kami memberikan edukasi
tentang cara naik dan turun dari tempat tidur, duduk di kursi, bangkit dari kursi, naik ke atas, turun ke bawah,
tidak membungkuk terlalu jauh, tidak mencondongkan tubuh untuk berdiri, tidak berdiri dengan jari kaki
menghadap ke dalam, tidak menarik selimut ke atas, tidak menyilangkan kaki kiri, tidak duduk rendah di toilet
atau kursi. Kami juga memberikan edukasi tentang beberapa tindakan pencegahan setelah operasi THA.

Medical Rehabilitation in Patient with Cerebral Palsy Spastic Diplegic GMFCS II, MACS II, CFCS V, EDACS III

Natalia Nanlohy — 2024-10-14

Abstract : Cerebral Palsy (CP) is a group of permanent disorders of the development of movement and posture,
causing activity limitation, that are attributed to nonprogressive disturbances that occurred in the developing
fetal or infant brain. CP is the most common cause of childhood disability. The incidence is 2- 2.5/1000 live
births. Some affected children do not survive and the prevelance varies between 1-5/1000 babies in different
countries. In Indonesia, CP prevalence is 1- 5/1000 live births where as there are around 5.000-25.000 births
diagnosed with CP every 5 billion live births per year in Indonesia. The risk factors fall into the following
categories: preconception, concerning the broadly defined health and living conditions of the mother; prenatal,
which are related to the course of pregnancy; perinatal; as well as risk factors in the neonatal and infant period.
Children with CP present with three types of motor problems. The primary impairments of muscle tone,
balance, strength and selectivity are directly related to the damage in the CNS. CP may manifest itself
differently as the child ages. The modified neurologic classification system divides patients into three catagories
: spastic (pyramidal) CP, Dyskinetic (extrapyramidal) CP and mixed type (combination) CP. Early
identification of children who have CP allows for early therapeutic intervention and screening for associated
condition. The treatment of a child with CP requires a multidisciplinary approach. Once the diagnosis is made,
the infant or child should be evaluated by a comprehensive rehabilitation team. Rehabilitation of the children
with CP aims to reach and maintain optimal physical, sensory, intellectual, psychological and social function.
It includes providing the tools and individual needs to gain and maintain independence and self determination.
Children with CP often change overtime, due either to growth and development treatment. Various means of
determining change may be employed. Subjective evaluation that ask the child, parent or therapist his or her
opinion are most commonly used. Occasionally, more quantified techniques are employed, particularly in
research settings, although clinical use also occurs.

REHABILITASI MEDIS PADA PASIEN GERIATRI DENGAN EKSASERBASI AKUT

J.F. Lisa Kepel — 2024-10-14

ABSTRACT: COPD is one of the most important causes of death in the world. This disease is the fourth
leading cause of death in the United States and is expected to become the third leading cause of death in the world
by 2020. The prevalence of COPD increases dramatically with age, and COPD accompanied by chronic
respiratory failure can be considered a geriatric condition. Each year, this disease significantly burdens the
national health care system. The research method used is an observational study through observation of patients.
Because the patient is a geriatric patient, we conducted a CGA (Comprehensive Geriatric Assessment) and found
several things that lead patients to geriatric syndrome such as infection, Mild Frailty, insomnia and Malnutrition.
Rehabilitation carried out on patients is superficial heat modality therapy, namely infrared. Infrared is one of the
superficial heat therapy modalities used as a clinical physical therapy tool by utilizing the heat effects of infrared
radiation. Infrared light is an electromagnetic wave emission with a wavelength of 760 nm-1 mm which produces
heat when absorbed. Infrared light used in medical therapy is a type of infrared with a wavelength of 770-1500
nm (near-infrared). In occupational therapy, to reduce energy expenditure and oxygen consumption during
activities, so that patients are able to perform ADL independently (without dyspnea or fatigue) can be done with
the correct body position, adjustment of activities with breathing patterns, planning and prioritizing
activities/work. In the psychological subunit, psychologists provide mental support, motivation, and cognitive
behavioral therapy for patients and families to increase participation in rehabilitation programs, reduce anxiety,
depression, and increase physical activity of patients.