Angela BM Tulaar
Department Of Physical Medicine And Rehabilitation, Faculty Of Medicine, Universitas Indonesia, Jakarta

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Validity and reliability of Preschool Language Scale 4 for measuring language development in children 48-59 months of age Sidarta, Nuryani; Tulaar, Angela BM; Nasution, Amendi; Suryanto, Suryanto
Universa Medicina Vol 27, No 4 (2008)
Publisher : Faculty of Medicine, Trisakti University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2008.v27.174-182

Abstract

Prevalence rates for speech and language delay have been reported across wide ranges. Speech and language delay affects 5% to 8% of preschool children, often persisting into the school years.  A cross-sectional study was conducted in 208 children aged 48-59 months to determine the validity and reliability of the Indonesian edition of the Preschool Language Scale version 4 (PLS4) as a screening tool for the identification of language development disorders. Construct validity was examined by using Pearson correlation coefficient. Internal consistency was tested and repeated measurements were taken to establish the stability coefficient and intraclass correlation coefficients (ICC) for test-retest reliability. For construct validity, the Pearson correlation coefficient ranged from 0.151-0.526, indicating that all questions in this instrument were valid for measuring auditory comprehension (AC) and expressive communication skills (EC). Cronbach’s alpha level ranged from 0.81-0.95 with standard error of measurement (SEM) ranging from 3.1-3.3. Stability coefficients ranged from 0.98-.0.99 with ICC coefficient ranging from 0.97-0.99 both of which showed an excellent reliability. This study found that PLS-4 is a valid and reliable instrument. It is easy to handle and can be recommended for assessing language development in children aged 48-59 months.
Effect of range of motion and isometric strengthening exercises on grip strength and hand function in rheumatoid arthritis patients Bastiana, Yefta Daniel; Tulaar, Angela BM; Hartono, Surjanto; Albar, Zuljasri
Universa Medicina Vol 27, No 4 (2008)
Publisher : Faculty of Medicine, Trisakti University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2008.v27.157-164

Abstract

In previous studies, duration of hand exercises in patients with rheumatoid arthritis (RA) had widely varying ranges, from 3 weeks to 4 months. An experimental study was conducted to evaluate the effect of range of motion (ROM) and muscle strengthening exercises for 6 weeks on grip strength and hand function in RA patients. Seventeen patients with chronic RA were randomly assigned to a treatment group and a control group. The treatment group (n=8) was given muscle strengthening exercises and heat therapy using paraffin baths 3 times a week at the hospital and ROM exercises once a day at home for 6 weeks. The control group (n=9) was given only paraffin baths 3 times a week. After 6 weeks, there were significant differences in hand function (p=0.003), right and left grip strength (p=0.000 and p=0.001) and ROM in the interventional group only. ROM and isometric strengthening exercises significantly improved grip strength and hand function in patients with RA, while no impact was found when the patients were given paraffin baths only. In view of the small size of the study population, there is a need for further studies with larger populations.
Effectiveness of Taping for the Short-Term Treatment of Pain and Walking Speed in Patients with Plantar Fasciitis Mira Muhammad; Angela BM Tulaar; Rosiana Pradanasari; Saptawati Bardosono
Indonesian Journal of Physical Medicine & Rehabilitation Vol 5 No 01 (2016): Indonesian Journal Of Physical Medicine and Rehabilitation
Publisher : Indonesian Journal of Physical Medicine & Rehabilitation

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1867.596 KB) | DOI: 10.36803/ijpmr.v5i01.198

Abstract

Plantar fasciitis causes pain in the heel and medial arch of the foot can interfere daily activities. Taping theplantar fasciitis will reduce pain by reducing strain on the plantar fascia during standing and ambulation.Objective: to see the effect of taping on pain and walking speed.Methods: fifteen subjects received taping and ultrasound diathermy therapy for one week. Fifteen othersubjects received ultrasound therapy alone. Pain measured by Visual Analogue Scale (VAS) and the walkingspeed is measured in meters / sec.Results: VAS score started to differ significantly on the first day after treatment (p = 0.008) and continuesuntil the last day of evaluation. On the first day, the VAS score changes differs significantly (p = 0.002). Butin the evaluation of the days, the change of VAS scores were not significantly different. VAS score changes onthe seventh day compared to the initial evaluation found significant (p <0.001). With multivariate analysis ofrepeated measurements, VAS scores in each group decreased significantly (p <0.001), but the decrease in VASscore taping group were significantly better compared with non-taping group (p = 0.004).Conclusion: combination of taping and ultrasound diathermy for people with plantar fasciitis can be used asa modality to reduce pain more quickly.Keywords:plantar fasciitis, taping, ultrasound diathermy, visual analog scale, walking speed.
The Effect of Nuhonni-Tulaar Rheumatic Exercise on Pain Reduction of Knee Osteoarthritis Patients Ferius Soewito; Siti Annisa Nuhonni; Elida Ilyas; Muchtaruddin Mansyur; Angela BM Tulaar
Indonesian Journal of Physical Medicine & Rehabilitation Vol 2 No 01 (2013): Indonesian Journal Of Physical Medicine and Rehabilitation
Publisher : Indonesian Journal of Physical Medicine & Rehabilitation

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (244.514 KB) | DOI: 10.36803/ijpmr.v2i01.223

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Objectives: Knee osteoarthritis patient has the risk for ambulation disability as a result of knee pain. Nuhonni-Tulaar rheumatic exercise was designed to prevent complications of rheumatic diseasesincluding knee osteoarthritis. The purpose of this study is to investigate the effectivity of Nuhonni-Tulaar rheumatic exercise to reduce pain of knee osteoarthritis patient.Methods: Twenty two subjects did the rheumatic exercise thrice a week in the gymnasium of medicalrehabilitation department Cipto Mangunkusumo hospital. Twenty other subjects, the control group, didthe standard hamstring stretching exercise at home. Each group performed the exercise for 8 weeks.Pain was measured using Visual Analog Scale (VAS) each week and analyzed before and after theintervention.Results: After 8 weeks VAS was reduced 1.5 in the intervention group while in the control group the reduction was 0.9. VAS was then transformed into no pain, mild pain, moderate pain and severepain. VAS was significantly reduced in the intervention group (p=0.002) but not in the control group (p=0.059). VAS changes between the two groups was significantly different (p=0.004).Conclusions: Rheumatic exercise has greater benefit in reducing pain than standard stretching exercise.Warming up, core exercise II and cooling down is safe and comfortable for knee osteoarthritis patientwith grade I-II Kellgren Lawrence radiographic grading.Keywords: Nuhonni-Tulaar Rheumatic exercise, Knee osteoarthritis, Visual Analog Scale
Efficacy of McConnell’s Medial Patellar Taping Application for Pain Management and Walking Velocity of Osteoarthritis Patients Wahju Hidajati1,; Angela BM Tulaar; Yoga Iwanoff Kasjmir; Sumariyono; Surjanto M.A
Indonesian Journal of Physical Medicine & Rehabilitation Vol 2 No 01 (2013): Indonesian Journal Of Physical Medicine and Rehabilitation
Publisher : Indonesian Journal of Physical Medicine & Rehabilitation

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1282.443 KB) | DOI: 10.36803/ijpmr.v2i01.224

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Objectives: to evaluate the efficacy of medial patellar taping in addition to exercise for pain relief and 15 meters walking time, and to find any correlation between the pain improvement and functional outcome.Methods: This study was a randomized controlled trial of knee patellar taping in combination with the isometric and stretching exercise in comparison to taping free- exercise. The inclusion criteria includesknee osteoarthritis patients with VAS score ranges four to eight of each knee, with or without tolerable pain on the other knee. The treatment group received knee tapping and isometric and stretching exercise of thequadriceps, iliotibial band, hamstring and gastrocnemius muscles. Both treatment and control group were assessed for about three weeks (day 1/week 0, day 2, day 28/week 4, and day 49/week 7). A visual analoguescale (VAS) was used to assess knee pain severity whereas 15 m walking time assessed to measure functional gait performance. On day 2, both measurements were done for study group only, with assumption the resultwould be the same with 1 day exercise only. A Lequesne index measured functional outcome.Results: There were 24 participants, twelve patients were in the tapped group while the remaining twelve were in the control group. Significant pain differences were visible during the treatment period at day 1, day2 and at the beginning of week 7. At day 2 and week 4, the study group showed significant pain reduction in comparison to the control group (p < 0.007).The walking time also showed significant improvement in the study group at day 2 (p < 0.000) but there were no significant difference at week 4 and week 7. At week 7, the study group experienced pain (p < 0.037) andoutcome improvement significantly. In addition, for about 75% of them had none to moderate disability post intervention. Meanwhile, from the total of eight patients in the control group who had severe to very severedisability, four of them had moderate (50%) and the rest had mild disability (50%). There was significant correlation between the pain and functional outcome on day two.Conclusions: Medial Patellar Taping in addition to isometric and stretching exercise of quadriceps, iliotibial band, hamstrings and gastrocnemius muscles showed significant improvement of disability superior to theuntapped group. Benefits of Medial Patellar Taping remained three weeks after removal.Keywords: Osteoarthritis, Knee Pain Severity, exercise, Medial Patellar Taping, Visual Analogue Scale, 15 Meter Walking Time, Functional Gait Performance, Lequesne Index.
Development of ‘16-Holes Manual Dexterity Pegboard’ and the Normal Value of 6 Years Old Children Fanny Aliwarga; Ferial Hadipoetro; Angela BM Tulaar; Surjanto H
Indonesian Journal of Physical Medicine & Rehabilitation Vol 2 No 01 (2013): Indonesian Journal Of Physical Medicine and Rehabilitation
Publisher : Indonesian Journal of Physical Medicine & Rehabilitation

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (352.506 KB) | DOI: 10.36803/ijpmr.v2i01.225

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Objectives: Obtaining the standard normal value of 6 years old children aged six year, and testing our hypothesis if girls’ dexterity is higher than boys.Methods: The design of this study was a cross sectional study of six years old students of public elementary school in South Jakarta. Inclusion criteria included age six years old, no neurological andorthopedic problem, normal nutritional status and right handed. Location based-random sampling was performed. Dependent variables comprised of age, sex and nutritional status. Independent variable wasthe result of ‘16-Holes Three-Jaw Chuck Manual Dexterity Pegboard’ test. Statistical analysis was done by descriptive analysis and Mann Whitney Test.Results: There were 191 girls and 191 boys who fulfilled the criteria. The ‘16-Holes Three-Jaw Chuck Manual Dexterity Pegboard’ test allowed subjects to be assessed for their ability to put numbers of pegwithin 15 seconds. The mean number of pegs placed for girls was 6.92 pegs (CI 95% 6.76 – 7.08) and boys was 6.49 pegs (CI 95% 6.33 – 6,65)Conclusions: Girls are able to place more pegs than boys in a given time. Furthermore, girls’ manual dexterity is superior to boys (p 0,000).Keywords: Manual dexterity, standard normal value, pegboard, sex differences.
The 400-Meter Walk Test to Evaluate Walking Performance between Diabetics and Healthy Females Ronald Pakasi; Angela BM Tulaar; Sarwono Waspadji; Corrie Wawolumaya
Indonesian Journal of Physical Medicine & Rehabilitation Vol 2 No 01 (2013): Indonesian Journal Of Physical Medicine and Rehabilitation
Publisher : Indonesian Journal of Physical Medicine & Rehabilitation

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (391.799 KB) | DOI: 10.36803/ijpmr.v2i01.230

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Objective: to evaluate walking performance in female with type 2 diabetes mellitus (DM2) with the 400-meters walk test (400-MWT) compared to healthy individuals.Methods: two groups of female subjects with DM2 and healthy individuals were matched by the age. The 400-MWT parameters to be compared were walking speed (WS) and predicted maximum oxygenconsumption (pVO2max). Baseline examination included body mass index (BMI), random blood glucose (RBG), and ankle-brachial index (ABI). All subjects performed 2 minutes warm up before thetest. Heart rate (HR) was recorded every 30 seconds, and blood pressure (BP) was measured before warm up and within 60 seconds after test. The test was performed twice on a different day.Results: Nineteen subjects on each group participated in the study. The mean WS was significantly different (p<0.0001) between the study group (1.26 + 0.19 and 1.31 + 0.17 m/s) and the control group(1.70 + 0.20 and 1.78 + 0.24 m/s) for the first and second tests respectively. There was a significant difference of mean pVO2max (p<0.0001) between the study group (17.22 + 2.94 and 17.99 + 2.36 ml/kg/min) and the control group (23.68 + 3.79 and 24.44 + 3.74 ml/kg/min).Conclusion: the 400-MWT demonstrated lower walking performance in female subjects with DM2 compared to healthy individuals.Keywords: Type 2 DM, healthy individuals, 400 meter walk test, walking speed, VO2max.
Massage Therapy Can Prevent the Risk of Autism Spectrum Disorders in Children Aged 18-36 Months Andy Martahan Andreas; Ratna Djuwita; Helda Helda; Rini Sekartini; Sri Hartati R. Suradijono; Thjin Wiguna; Angela B. M. Tulaar; Jusuf Kristianto
Health Notions Vol 5, No 11 (2021): November
Publisher : Humanistic Network for Science and Technology (HNST)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33846/hn51102

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 Background: Research on massage therapy for children with autism spectrum disorders conducted over a period of 10-15 years is mostly aimed at children who have been diagnosed with autism spectrum disorders with the average age of children being between 3-6 years. Meanwhile, research on massage therapy in children at risk for autism spectrum disorders, especially in Indonesia, has not been widely published. Aims:  This study aims to provide an overview of the results of massage therapy in an effort to prevent the risk of autism spectrum disorders in children aged 18-36 months. Methods: The study was conducted from May 2019 to March 2020 at three community health centers in Jakarta, 10 children aged 18-36 months who were previously screened with M-Chat were then given massage therapy for 40 times to see the effect on changes in status risk of autism spectrum disorderThe results of therapy were then assessed by modifying the M-Chat score through the receiver operating characteristic (ROC) in order to obtain a new cut off point to determine the risk status of autism spectrum disorders. Results: The results of massage therapy showed that there was a decrease in M-Chat scores and changes in the risk status of autism spectrum disorders starting in the third period of 30 days of massage therapy. Conclusion: The conclusion of this study is that massage therapy can change the risk status of ASD children from autism risk to normal to prevent the risk of autism spectrum disorders.Keywords: massage therapy; autism spectrum disorder risk; modified check list for autism in toddler
Foot Arch and Plantar Pressure in the Age of 17-21 Years Arif Wicaksono; Sasanthy Kusumaningtyas; Angela BM Tulaar
Mutiara Medika: Jurnal Kedokteran dan Kesehatan Vol 21, No 2 (2021): July
Publisher : Universitas Muhammadiyah Yogyakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18196/mmjkk.v21i2.10799

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Research on the plantar segment has not been widely carried out in Indonesia’s population, even though the plantar segment data will be essential in further research and therapy of plantar-related problems. Therefore, this research intends to describe the plantar profile: the foot arch and the plantar pressure difference between the right and left foot. This research applied a cross-sectional study. Subjects were recruited from the Faculty of Medicine students, Universitas Indonesia, class 2012, with inclusion criteria aged 17-21 years and normal gait. Meanwhile, the exclusion criteria consisted of having postural abnormalities, a history of neuromusculoskeletal disorders in the lower limbs, a history of fractures in the spine and legs, a history of surgery on the spine and legs, and refusing to participate in the study. Research subjects stood on a plantar scanner, conducted at the Anatomy Laboratory, the Faculty of Medicine, Universitas Indonesia. The Mann-Whitney test was then used to analyze the difference in plantar pressure between the right and left foot. The results revealed that a hundred research subjects had a proportion of a low foot arch of 4%, a normal foot arch of 89%, and a high foot arch of 7%. The median right plantar pressure was 273.5 KPa, while the median left plantar pressure was 253.5 KPa. The Mann-Whitney test showed a p-value of 0.954 for the pressure difference between right and left foot. There was no plantar pressure difference between the right and left foot.
Foot orthoses improve kinematic measurement in young women with biomechanical abnormality Maria Regina Rachmawati; Angela BM Tulaar; Muctarudin Mansyur; Ferial Hadipoetro Idris; Ismail Ismail; Ratna Darjanti Haryadi
Universa Medicina Vol. 32 No. 3 (2013)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2013.v32.187-196

Abstract

BACKGROUNDFoot pronation causes biomechanical abnormalities in the form of functional leg-length disparity. Foot orthoses are often used in the treatment of abnormal pronation. The aim of the study was to evaluate the effect of foot orthoses on abnormal kinematic chain the differences of pelvic height, step length, and walking distance on walking test in young women with biomechanical abnormality.METHODS A randomized double blind controlled clinical trial was conducted on 27 young adult women having abnormal biomechanical abnormalities. By random allocation the subjects were divided into the intervention group (14 subjects) receiving correction of foot pronation using foot orthoses, and the control group (13 subjects) receiving no orthoses. Before and during use of foot orthoses, we determined pelvic height difference (mm), step length difference (cm), and walking distance at maximal walking speed for 15 minutes. RESULTS Correction of foot pronation resulted in decreased pelvic height difference from 4.7 ± 2.1 mm to 1.7 ± 1.3 mm (p<0.001) and in a reduction in step length difference, from 4.9 ± 2.9 cm to 2.1 ± 1.5 cm (p=0.002). Walking test distance of the intervention group was 1318.5 ± 46.3 m, as compared with that of the control group of 1233 ± 114.7 m (p = 0.05). Walking distance of the intervention group rose steadily in the second test to 1369.3 ± 27 m, and in the third test to 1382.14 ± 10.5 m (p<0.001). CONCLUSIONS Foot orthoses improved the kinematic chain, resulting in a more symmetrical pelvic height, reduced step length difference, and increased functional walking ability.