JURNAL MEDIK DAN REHABILITASI

PENGARUH LATIHAN AEROBIK INTRADIALITIK BERBASIS VIRTUAL REALITY DENGAN SATU ANGGOTA GERAK ATAS TERHADAP KEKUATAN GENGGAMAN DAN HEART RATE RECOVERY PASIEN HEMODIALISIS RUTIN

Devan Perwira, Lidwina Sengkey, Masrianti, Stella Palar — Wed, 15 Jan 2025 00:00:00 +0800

ABSTRACT: Background : Limited physical activity and sedentary behavior are common in patients with chronic kidney disease (CKD). CKD patients often face limitations in work, walking, and cognition, leading to difficulties in performing activities of daily living (ADL). Additionally, CKD patients tend to experience a decline in muscle mass and strength, as well as impaired exercise capacity. Materials and Methods: Participants were instructed to perform virtual reality games for 40 minutes during the first 2 hours of the dialysis session, engaging in table tennis, canoeing, and basketball games which were conducted twice a week for one month. During the games, vital signs were monitored, and assessments were made using the Borg scale. Grip strength was evaluated before the first and after the final session, while heart rate recovery was assessed during the first and last sessions. Results: The study included 31 subjects (22 males, 9 females) aged 18–65 years. Data analysis using SPSS version 26 revealed no significant difference in the mean grip strength before and after the exercise (t = -0.333, p = 0.370). For heart rate post-exercise, there was no significant difference in the mean heart rate increase between the first and last sessions. Regarding heart rate recovery, the results showed a significant difference in the mean at the 10th second, no significant difference at the 20th second, a significant difference at the 30th second, and no significant differences at the 60th second or the 120th second. Conclusion: Virtual reality game exercises using Nintendo Wii as a training method for CKD patients during hemodialysis sessions are safe and can serve as a cardiovascular rehabilitation tool. They also help maintain quality of life and reduce the progression of complications associated with kidney damage.

PENGARUH LATIHAN AEROBIK INTRADIALITIK BERBASIS VIRTUAL REALITY DENGAN SATU ANGGOTA GERAK ATAS TERHADAP DAYA TAHAN KARDIORESPIRASI DAN KUALITAS HIDUP PASIEN HEMODIALISIS KRONIK

Patrick Muljono, Joudy Gessal, Masrianti, Stella Palar — Wed, 15 Jan 2025 00:00:00 +0800

ABSTRACT : Background Chronic Kidney Disease (CKD) is a highly urgent global health problem. The number of hemodialysis patients in developing and middle-income countries such as Indonesia is estimated to increase exponentially by 2030. Chronic kidney disease (CKD) patients, particularly those on hemodialysis, can experience reduced functional capacity, levels of physical activity, and quality of life, which correlate with elevated morbidity among this patient population. Morbidities risk was 62% higher for sedentary compared to active classified HD patients. The low level of compliance is one major issue physicians experience with increasing the physical activity of HD patients. Studies indicated that regular physical exercise may sufficiently enhance dialysis adequacy in chronic hemodialysis patients, as well as cardiorespiratory endurance and quality of life; thus, as a part of a complementary therapy for chronic hemodialysis patients. Recent studies indicate that not only can VR-based exercise programs improve patient compliance among dialysis patients, but can also further enhance patients' muscle strength, balance, flexibility, and BIA (bioelectrical impedance analysis) results while minimizing fatigue [7,8]. Less than 10% of hemodialysis clinics worldwide are using new intra-dialytic exercise programs for CKD Patients on Chronic HD. Purpose: To assess the effect of one upper limb virtual reality based intradialytic aerobic exercise on hemodialysis patients/ cardiorespiratory endurance and quality of life. Methods: This study uses an experimental, pre-test- post-test one-group design. The virtual exercise program was performed on one upper limb. Participants included in the study were all subjects satisfying the inclusion and exclusion criteria who were undergoing hemodialysis. Intervention setting: Hemodialysis Unit, Prof. Dr. R.D. Kandou Hospital, Manado, Indonesia (May 2024 to August 2024) Results: Statistically significant improvement on cardiorespiratory endurance, general quality of life and mental quality of life was found after Supreme VR based intradialytic aerobic exercise with the application of one upper limb. The fact that a higher quality of life means more self-sufficiency, social participation and less mobility and hospitalization restrictions means a virtual reality-based exercise significantly swim the cardiorespiratory endurance and quality of life in chronic hemodialysis patients. One-sided upper limb strengthening exercises are a safe and feasible exercise program for chronic hemodialysis patients.

Perbandingan Pengaruh Latihan Penguatan Moderate Intensity Dengan Latihan Penguatan Konvensional Terhadap Fungsi Keseimbangan Pasca Hip Hemiarthroplasty

Jenisa Reivana Symons, Theresia Isye Mogi, Joudy Gessal — Wed, 15 Jan 2025 00:00:00 +0800

ABSTRACT :. Hip hemiarthroplasty is a surgical procedure in which the femoral head is replaced with a prosthesis. Pelvic muscle strength, particularly the gluteus medius muscle, plays a crucial role in stability post-hip hemiarthroplasty but often decreases due to immobilization and pain. The Wii Balance Board is used to measure static balance through the Center of Pressure (COP), while the Timed Up and Go (TUG) test measures dynamic balance with high reliability. Moderate-intensity strengthening exercises (60–80% 1RM) are effective in improving muscle strength, joint stability, and patient functional ability, supporting optimal recovery post-surgery.

This study aims to analyze the comparative effects of moderate-intensity strengthening exercises versus conventional strengthening exercises on balance function post-hip hemiarthroplasty. The study used a randomized control trial design and divided participants into two groups: the moderate-intensity strengthening group and the conventional exercise group. The subjects were post-hip hemiarthroplasty patients at the Medical Rehabilitation Unit of Prof. Dr. R.D. Kandou General Hospital, Manado, who met the inclusion criteria. Subjects were selected using consecutive sampling. The results concluded that moderate-intensity strengthening exercises as a supplementary therapy alongside conventional therapy were proven effective in improving balance function post-hip hemiarthroplasty, with 12 sessions of therapy. Moderate-intensity strengthening exercises are safe for post-hip hemiarthroplasty patients and can be utilized as a non-pharmacological modality to enhance balance function.

Perbedaan Pengaruh Latihan Penguatan Moderate Intensity Dengan Latihan Penguatan Konvensional Terhadap Gait Speed Dan Performa Fungsional Pasca Hip Hemiarthroplasty

Ixora Fabiola, Joudy Gessal , Theresia Isye Mogi — Wed, 15 Jan 2025 00:00:00 +0800

ABSTRACT :. Hip hemiarthroplasty is an orthopedic procedure that involves replacing the femoral head with a prosthesis while preserving the acetabulum and acetabular cartilage. The goals of post-hip hemiarthroplasty rehabilitation are to restore maximum range of motion (ROM), minimize pain, increase muscle strength, initiate ambulation, and facilitate functional independence. The research method used was a randomized control trial. The subjects were post-hip hemiarthroplasty patients at the Medical Rehabilitation Installation of Prof. Dr. R.D. Kandou Manado Hospital who met the inclusion criteria. The method of selecting subjects was by consecutive sampling. The results of this study were: In this study, it can be concluded: Moderate intensity strengthening exercises are superior to conventional strengthening exercises in increasing gait speed in post-hip hemiarthroplasty patients as measured by 4MWT. Moderate intensity strengthening exercises are superior to conventional strengthening exercises in improving functional performance in post-hip hemiarthroplasty patients as assessed by FJS-12. Moderate intensity strengthening exercises are safe for post-hip hemiarthroplasty patients.

PENGARUH LATIHAN VIRTUAL REALITY TERHADAP KETAHANAN KARDIORESPIRASI DAN QUALITY OF LIFE PADA PENDERITA KANKER PAYUDARA PASCA MASTEKTOMI

Dippo Fitri Haratua Siahaan , Joudy Gessal , Elfrida Marpaung — Wed, 15 Jan 2025 00:00:00 +0800

ABSTRACT: Background: Breast cancer is the most commonly diagnosed cancer in women worldwide and a leading cause of cancer-related death. Mastectomy is one of the medical procedures used to treat breast cancer. Mastectomy can cause several side effects and it has been reported that there is a decrease in cardiorespiratory endurance post-surgery, leading to limitations in activities of daily living. Virtual reality (VR) therapy has shown results as effective as conventional therapy for the development of upper extremity function and provides the capacity to perform activities of daily living. Kinect-based VR rehabilitation programs have been used to improve upper extremity function in various disease groups. This study is an experimental research using a one-group pre-test-post-test design conducted at the Medical Rehabilitation Installation of Prof. Dr. R. D Kandou Manado General Hospital from January to February 2024. Twenty breast cancer subjects participated in this study for 8 sessions conducted over 4 weeks. This research analyzes the effect of Virtual Reality Exercise on cardiorespiratory endurance measured by the Six Minutes Pegboard and Ringtest (6-PBRT) and the improvement of Quality of Life measured by the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) in Breast Cancer Patients Post-Mastectomy. Results: Cardiorespiratory endurance showed a significant improvement after the treatment, and Quality of Life showed a very significant improvement after the treatment. Conclusion: Virtual Reality game exercises using the Xbox 360 and Kinect^TM sensor as supplementary therapy have proven to be effective in improving cardiorespiratory endurance and Quality of Life in post-mastectomy breast cancer patients with 8 sessions of exercise therapy.

PENGARUH HIGH INTENSITY LASER THERAPY TERHADAP PENINGKATAN KEKUATAN OTOT EKSTREMITAS BAWAH PADA ULKUS KAKI DIABETIK

Arifin Siahaan, Theresia Isye Mogi, Lidwina Sengkey — Wed, 15 Jan 2025 00:00:00 +0800

ABSTRACT :. Diabetic foot ulcer (DFU) is the most common and serious complication of diabetes mellitus (DM). DFU is one of the wound complications of DM that is difficult to heal and often gets worse. The most common cause of DM is macrovascular and microvascular disease that causes impaired blood circulation in the lower extremities. This study is a quantitative analytical study with a pre-experimental design approach of one group pretest-post test type. The subjects of the study were patients with diabetic foot ulcers on the Wagner scale I - III who were treated at Prof. Dr. R. D. Kandou Manado General Hospital and met the research criteria that met the inclusion criteria. The results of this study are In this study it can be concluded that high-intensity laser therapy has been proven effective as an adjuvant to conventional therapy to help increase muscle strength in DFU Wagner Scale I to III with therapy given three times a week for four consecutive weeks, and significant improvements began to appear at the end of the fourth week. High-intensity laser therapy can be included in the protocol/clinical practice guideline in diabetic foot ulcer services at the Medical Rehabilitation Installation of Kandou General Hospital. For further research with similar topics, it can apply a comparison between high intensity laser therapy and other therapies. For further research with similar topics, it can consider the homogeneity and number of subjects to be studied.

EFEK REPETITIVE PERIPHERAL MAGNETIC STIMULATION TERHADAP KETANGKASAN FUNGSI TANGAN PASIEN PASCASTROKE SUBAKUT DI INSTALASI REHABILITASI MEDIK RSUP PROF. DR. R. D. KANDOU MANADO YANG DIUKUR DENGAN BOX AND BLOCK TEST

Wiwin Lestari Selawa, Theresia Isye Mogi, Lidwina Sengkey, Julius H. Lolombulan — Wed, 15 Jan 2025 00:00:00 +0800

ABTRACT: Stroke is a leading cause of disability in adults, with upper limb motor impairments being one of the most common complications. These impairments can result in decreased hand dexterity, significantly affecting patients' ability to perform daily activities such as eating, dressing, and completing other tasks. This study aimed to evaluate the effectiveness of Repetitive Peripheral Magnetic Stimulation (rPMS) in improving hand dexterity in subacute post-stroke patients compared to standard rehabilitation. A randomized controlled experimental design with a pre-post method was employed in two groups under a single-blind protocol. Twenty-six subacute post-stroke patients meeting the inclusion criteria were divided into two groups: a treatment group receiving rPMS alongside standard rehabilitation and a control group undergoing standard rehabilitation only. rPMS was administered in 10 sessions over 30 days, with a frequency of 2–3 sessions per week. Hand dexterity was assessed using the Box and Block Test (BBT) before and after the intervention. Results revealed that both groups demonstrated significant improvements in hand dexterity following the interventions. In the treatment group, the median BBT score increased from 34 to 40 blocks per minute, while in the control group, it rose from 23 to 30 blocks per minute. Statistical analysis using the Wilcoxon Signed Ranks test and paired t-tests indicated a significant positive effect of rPMS. However, comparative analysis between the groups did not reveal a statistically significant difference in hand dexterity improvement. This study highlights the potential of rPMS as an effective adjunct modality in rehabilitating subacute post-stroke patients, particularly for motor recovery of the upper limbs