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Effects of Inspiratory Muscle Training with Incentive Spirometry to Maximum Inspiratory Capacity and Quality of Life on Chronic Obstructive Pulmonary Disease Patients Tresia Fransiska Ulianna Tambunan; Moerdjajati Angka; Anita Ratnawati; Zulkifi Amin
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

Objectives: to determine whether the incentive spirometry respiratory muscle training can increase the maximum inspiratory capacity, decrease difficulty of breathing, functional lung capacity and quality oflife according to St. George’s Respiratory Questionnaire on Chronic Obstructive Pulmonary Disease patients.Methods: an intervention pre-post and case control group of twenty subjects with mild COPD who came to Medical Rehabilitation Department. They divided into two groups: control group (10 subjects)and study group (10 subjects). All subjects underwent pre interventional test which are : maximum inspiratory capacity, dyspnoea rating scale, pulmonary functional test (PFT) and questionnaire forquality of life. The study group were given respiratory muscle training with incentive spirometry and breathing control exercise while the control group only given the breathing control exercise. After 8weeks, all participant underwent post interventional test. Every subject still using the basic medication.Results: There are statistically improvement of maximum inspiratory capacity, dyspnoea rating scale and quality of life in study group compare with the control group (p<0,05). Mean difference of SGRQbetween pre and post intervention shows significant results in activity, impact and total component (p<0,05) and there is no significant results on symptoms components (p>0,05). No changes were foundin FEV1% value with the study or control group (p>0,05).Conclusions: Combination between incentive spirometry respiratory muscle training and breathing control exercise can improve maximum inspiratory capacity, dyspnoea rating scale and quality of life inCOPD patients within 8 weeks.Keywords: COPD, Incentive spirometry muscle training, Maximum inspiratory capacity, Quality of life.

Value of Peak Cough Flow (PCF) in Healthy Middle Adulthood and Late Adulthood and the Affecting Factors Nury Nusdwinuringtyas; Roy Dwi Indra; Tresia Fransiska Ulianna Tambunan; Aria Kekalih
Indonesian Journal of Physical Medicine & Rehabilitation Vol 9 No 01 (2020): Indonesian Journal Of Physical Medicine and Rehabilitation
Publisher : Indonesian Journal of Physical Medicine & Rehabilitation

ABSTRACTIntroduction: Cough is a symptom that is felt by all humans and it is important for the protection which maintains mucus secretion, foreign substances, and infections of the larynx, trachea and bronchi. Thepurpose of this study is to find out the PCF value in healthy middle adulthood and late adulthood and the factors that influence it.Methods: This study is a cross-sectional study involving 99 subjects. Subjects were patients in the clinic for medical rehabilitation of middle adulthood and late adulthood healthy respiration. Subjects whofulfilled the inclusion and exclusion criteria were examined with spirometry to ensure healthy respiration and after that, the PCF examination was carried out with a peakflowmeter device and the correlation wasobserved with age, gender and, height. Results: The PCF value in healthy middle adulthood is 190-540 L / minute (41-50 years 465 L / minute, ages 51-60 years 405 L / minute) and healthy late adulthood is 245-520 L / minute with median 352.5L / minute. Men have a greater PCF value than women, but at the age of 61 years and over there not significantly different. The higher age, the lower the PCF value obtained and there was a statisticallysignificant decrease in the PCF value at 61-70 years of age compared to 41-50 years of age. Subjects with high height have a tendency for a lar ger PCF value and height will af fect the PCF value. Conclusion: Obtained PCF values in middle adulthood and late adulthood with healthy respiration and there is a relationship between sex, age and height factors for the PCF value. Keywords: Age, height, Peak Cough Flow, peakflow meter, sex.

Effects of Inspiratory Muscle Training with Incentive Spirometry to Maximum Inspiratory Capacity and Quality of Life on Chronic Obstructive Pulmonary Disease Patients Tresia Fransiska Ulianna Tambunan; Moerdjajati Angka; Anita Ratnawati; Zulkifi Amin
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

Objectives: to determine whether the incentive spirometry respiratory muscle training can increase the maximum inspiratory capacity, decrease difficulty of breathing, functional lung capacity and quality oflife according to St. George’s Respiratory Questionnaire on Chronic Obstructive Pulmonary Disease patients.Methods: an intervention pre-post and case control group of twenty subjects with mild COPD who came to Medical Rehabilitation Department. They divided into two groups: control group (10 subjects)and study group (10 subjects). All subjects underwent pre interventional test which are : maximum inspiratory capacity, dyspnoea rating scale, pulmonary functional test (PFT) and questionnaire forquality of life. The study group were given respiratory muscle training with incentive spirometry and breathing control exercise while the control group only given the breathing control exercise. After 8weeks, all participant underwent post interventional test. Every subject still using the basic medication.Results: There are statistically improvement of maximum inspiratory capacity, dyspnoea rating scale and quality of life in study group compare with the control group (p<0,05). Mean difference of SGRQbetween pre and post intervention shows significant results in activity, impact and total component (p<0,05) and there is no significant results on symptoms components (p>0,05). No changes were foundin FEV1% value with the study or control group (p>0,05).Conclusions: Combination between incentive spirometry respiratory muscle training and breathing control exercise can improve maximum inspiratory capacity, dyspnoea rating scale and quality of life inCOPD patients within 8 weeks.Keywords: COPD, Incentive spirometry muscle training, Maximum inspiratory capacity, Quality of life.

Value of Peak Cough Flow (PCF) in Healthy Middle Adulthood and Late Adulthood and the Affecting Factors Nury Nusdwinuringtyas; Roy Dwi Indra; Tresia Fransiska Ulianna Tambunan; Aria Kekalih
Indonesian Journal of Physical Medicine & Rehabilitation Vol 9 No 01 (2020): Indonesian Journal Of Physical Medicine and Rehabilitation
Publisher : Indonesian Journal of Physical Medicine & Rehabilitation

ABSTRACTIntroduction: Cough is a symptom that is felt by all humans and it is important for the protection which maintains mucus secretion, foreign substances, and infections of the larynx, trachea and bronchi. Thepurpose of this study is to find out the PCF value in healthy middle adulthood and late adulthood and the factors that influence it.Methods: This study is a cross-sectional study involving 99 subjects. Subjects were patients in the clinic for medical rehabilitation of middle adulthood and late adulthood healthy respiration. Subjects whofulfilled the inclusion and exclusion criteria were examined with spirometry to ensure healthy respiration and after that, the PCF examination was carried out with a peakflowmeter device and the correlation wasobserved with age, gender and, height. Results: The PCF value in healthy middle adulthood is 190-540 L / minute (41-50 years 465 L / minute, ages 51-60 years 405 L / minute) and healthy late adulthood is 245-520 L / minute with median 352.5L / minute. Men have a greater PCF value than women, but at the age of 61 years and over there not significantly different. The higher age, the lower the PCF value obtained and there was a statisticallysignificant decrease in the PCF value at 61-70 years of age compared to 41-50 years of age. Subjects with high height have a tendency for a lar ger PCF value and height will af fect the PCF value. Conclusion: Obtained PCF values in middle adulthood and late adulthood with healthy respiration and there is a relationship between sex, age and height factors for the PCF value. Keywords: Age, height, Peak Cough Flow, peakflow meter, sex.

The Effectivity of Telerehabilitation for Post Stroke Patients Glenis, Gabrielle; Setiawan, Regina Caecilia; Tambunan, Tresia Fransiska Ulianna
Cermin Dunia Kedokteran Vol 48, No 11 (2021): Kardio-SerebroVaskular
Publisher : PT. Kalbe Farma Tbk.

Stroke rehabilitation is an essential component of post-stroke care and is more effective if started sooner. Stroke rehabilitation therapy aims to improve motor function, psychological well-being, cognitively, emotionally, and in terms of social well-being. Telerehabilitation allows communication between medical staff and patients and can be a suitable alternative to usual rehabilitation care in poststroke patients. This method may have potential implications for patients, especially in remote or underserved areas. Future trials are needed on telerehabilitation's feasibility, efficacy, and cost-effectiveness in other low and middle-income countries where the stroke burden is burgeoning.Â Rehabilitasi stroke merupakan komponen penting dalam tatalaksana pasca-stroke dan lebih efektif untuk dimulai lebih awal. Tujuan terapi rehabilitasi stroke adalah untuk meningkatkan fungsi motorik, kognitif, emosional, kesejahteraan psikologis dan sosial. Telerehabilitasi memungkinkan komunikasi antara staf medis dan pasien dan dapat sebagai alternatif yang sesuai untuk perawatan rehabilitasi biasa pada pasien pasca-stroke. Metode ini mungkin memiliki implikasi potensial bagi pasien, terutama di daerah terpencil atau kurang terlayani. Penelitian masih diperlukan untuk kelayakan, kemanjuran, dan keefektifan biaya telerehabilitasi di negara berpenghasilan rendah dan menengah dengan beban stroke meningkat.

The Effectiveness of Telerehabilitation for Post Stroke Patients Gabrielle Glenis; Regina Caecilia Setiawan; Tresia Fransiska Ulianna Tambunan
Cermin Dunia Kedokteran Vol 48 No 11 (2021): Penyakit Dalam - COVID-19
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v48i11.143

Stroke rehabilitation is an essential component of post-stroke care and is more effective if started sooner. Stroke rehabilitation therapy aims to improve motor function, psychological well-being, cognitively, emotionally, and in terms of social well-being. Telerehabilitation allows communication between medical staff and patients and can be a suitable alternative to usual rehabilitation care in poststroke patients. This method may have potential implications for patients, especially in remote or underserved areas. Future trials are needed on telerehabilitation’s feasibility, efficacy, and cost-effectiveness in other low and middle-income countries where the stroke burden is burgeoning. Rehabilitasi stroke merupakan komponen penting dalam tatalaksana pasca-stroke dan lebih efektif untuk dimulai lebih awal. Tujuan terapi rehabilitasi stroke adalah untuk meningkatkan fungsi motorik, kognitif, emosional, kesejahteraan psikologis dan sosial. Telerehabilitasi memungkinkan komunikasi antara staf medis dan pasien dan dapat sebagai alternatif yang sesuai untuk perawatan rehabilitasi biasa pada pasien pasca-stroke. Metode ini mungkin memiliki implikasi potensial bagi pasien, terutama di daerah terpencil atau kurang terlayani. Penelitian masih diperlukan untuk kelayakan, kemanjuran, dan keefektifan biaya telerehabilitasi di negara berpenghasilan rendah dan menengah dengan beban stroke meningkat.

Physical Medicine and Rehabilitation Management in Patients with Long COVID-19 and Thymoma-associated Myasthenia Gravis: A Case Report Tambunan, Tresia Fransiska Ulianna; Nathania, Eugene; Putryanti, Rimnauli Deasy Putryanti; Tifany, Elisabeth Pauline; Kurnain, Dave Nicander
Respiratory Science Vol. 5 No. 1 (2024): Respiratory Science
Publisher : Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/respirsci.v5i1.156

Background: Myasthenia gravis is an autoimmune disease that causes muscle weakness and fatigue due to antibodies attacking the acetylcholine receptor. In patients with MG, fatigue can be worsened by concurrent long COVID, leading to further deterioration of cardiorespiratory function. Case: A 44-year-old woman with long COVID syndrome and thymoma-associated myasthenia was given an exercise program that aimed to overcome fatigue so that the patient could carry out her role as a housewife, and to prepare for thymectomy surgery. Before exercise, patients were educated to take pyridostigmine 1 hour earlier. During exercise, the patient was monitored to prevent excessive fatigue. At the end of the training session, the patient was asked to observe for signs of exacerbation until the next training session. Discussion: Pulmonary rehabilitation (PR) can be beneficial for patients with thymoma-associated MG and long COVID-19, but it requires special strategies. PR typically starts with light weights and gradually increases in intensity. It has been shown to improve fatigue and cardiorespiratory endurance, as indicated by a successful 6-minute walk test after 4 weeks of training intervention. Conclusion: Pulmonary rehabilitation plays an important role in increasing cardiorespiratory endurance and functional capacity for surgery preparation. The provision of pulmonary rehabilitation programs must be tailor-made according to the patient's functional ability and underlying disease to achieve optimal goals.

Protokol Latihan BEST yang Disesuaikan dalam Rehabilitasi Gagal Jantung Triangto, Kevin; Radi, Basuni; Siswanto, Bambang Budi; Tambunan, Tresia Fransiska Ulianna; Heriansyah, Teuku; Harahap, Alida Rosita; Kekalih, Aria; Ambari, Ade Meidian; Dwiputra, Bambang; Desandri, Dwita Rian; Katsukawa, Hajime; Santoso, Anwar
Jurnal Kardiologi Indonesia Vol 45 No 3 (2024): July - September, 2024
Publisher : The Indonesian Heart Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30701/ijc.1738

Introduction Heart failure with a reduced ejection fraction (HFrEF) significantly contributes to global morbidity and mortality, necessitating effective rehabilitation programs. Exercise-based rehabilitation improves functional capacity and quality of life in HFrEF patients, though responses vary. The tailored BEST (Breathing, Endurance, and Strengthening) exercise protocol addresses both cardiac and extracardiac rehabilitation, benefiting all patients regardless of response status. This study evaluated the protocol's effects on HFrEF patients and classified responses based on VO2max changes. Methods In this etiologic study with prospective cohort design, all participants underwent a three-month cardiac rehabilitation program using the BEST Exercise Protocol. Assessments included the 6-minute walk test (6MWT), short physical performance battery (SPPB), handgrip strength, chest expansion, ultrasonographic measurements, and NT-proBNP levels before and after the intervention, with statistical comparisons made within and between groups. Groupings of responder level will be reliant on 6MWT distance achievement at the end of the program, with ≥6% improvement classified as good responders. Results Out of 107 HFrEF patients (median age 55 years, ejection fraction 29.50±7.34%), 63.56% were good responders and 36.44% were poor responders (<6% improvement). Good responders showed significant improvements in most extracardiac parameters, including a 20% increase in 6MWT distance (470.96±69.21 meters post-rehabilitation), chest expansion, handgrip strength, and SPPB scores (p<0.001 for all). Poor responders also improved in chest expansion, sit-to-stand time, and postural balance, with minor 6MWT gains (407.33±72.50 meters). NT-proBNP levels decreased in both groups but were not statistically significant (p=0.288 and 0.368 for good and poor responders, respectively). Conclusion The tailored BEST Exercise Protocol offers substantial cardiac and extracardiac benefits for HFrEF patients by enhancing functional capacity and muscle strength. Both good and poor responders exhibited significant improvements, indicating the protocol's broad applicability. However, the lack of statistically significant NT-proBNP reduction suggests further studies on cardiac biomarkers are needed. The 6MWT provides accessible rehabilitation insights, though more precise evaluations like Cardiopulmonary Exercise Testing (CPET) can offer clearer insights into cardiopulmonary adaptations.

The Effectiveness of Telerehabilitation for Post Stroke Patients Gabrielle Glenis; Regina Caecilia Setiawan; Tresia Fransiska Ulianna Tambunan
Cermin Dunia Kedokteran Vol 48 No 11 (2021): Penyakit Dalam - COVID-19
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v48i11.143

Stroke rehabilitation is an essential component of post-stroke care and is more effective if started sooner. Stroke rehabilitation therapy aims to improve motor function, psychological well-being, cognitively, emotionally, and in terms of social well-being. Telerehabilitation allows communication between medical staff and patients and can be a suitable alternative to usual rehabilitation care in poststroke patients. This method may have potential implications for patients, especially in remote or underserved areas. Future trials are needed on telerehabilitation’s feasibility, efficacy, and cost-effectiveness in other low and middle-income countries where the stroke burden is burgeoning. Rehabilitasi stroke merupakan komponen penting dalam tatalaksana pasca-stroke dan lebih efektif untuk dimulai lebih awal. Tujuan terapi rehabilitasi stroke adalah untuk meningkatkan fungsi motorik, kognitif, emosional, kesejahteraan psikologis dan sosial. Telerehabilitasi memungkinkan komunikasi antara staf medis dan pasien dan dapat sebagai alternatif yang sesuai untuk perawatan rehabilitasi biasa pada pasien pasca-stroke. Metode ini mungkin memiliki implikasi potensial bagi pasien, terutama di daerah terpencil atau kurang terlayani. Penelitian masih diperlukan untuk kelayakan, kemanjuran, dan keefektifan biaya telerehabilitasi di negara berpenghasilan rendah dan menengah dengan beban stroke meningkat.

Physical Medicine and Rehabilitation Role of Complete Recovery after Intracerebral Hemorrhage in Eclampsia with HELLP Syndrome: A Rare Case Tambunan, Tresia Fransiska Ulianna; Putri, Yoan Utami; Utami, Diniah; Chandra Kasih, Siti Aminah; Ulfa, Meryta; Kurnain, Dave Nicander
Surabaya Physical Medicine and Rehabilitation Journal Vol. 7 No. 2 (2025): SPMRJ, AUGUST 2025
Publisher : Faculty of Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/spmrj.v7i2.56155

Cerebrovascular accident during hypertensive disorder of pregnancy is a rare condition, but carries high risk of mortality and morbidity due to its unpredictable onset. Intracerebral Hemorrhage (ICH) associated with eclampsia is responsible for 5–12% of maternal deaths during pregnancy. Eclampsia is defined as a convulsive episode occurring in the setting of preeclampsia. The hallmark presentation of eclampsia is characterized with generalized tonic-clonic seizures which typically lasted 60 to 90 second in duration, might be preceded with headaches, visual disturbance, abdominal pain, and increased blood pressure. HELLP syndrome frequently associated with severe preeclampsia-eclampsia and is characterized by three hallmark features of hemolysis, elevated liver enzymes, and low platelets. Here, we report an unusual case of 25-year-old primigravida with 38 weeks gestation, which developed sudden eclampsia and intracranial hemorrhage. A night before admission, she complained about headache and had projectile vomit in the morning that followed by generalized seizure. She had no history of seizure or high blood pressure during her antenatal care. Laboratory test shows elevated liver enzyme and low platelets count and CT-scan which showed hemorrhage in left intraparenchymal lobes. She was successfully managed by multidisciplinary approach including emergency cesarean section, conservative neurological treatment for intraventricular hemorrhage and rehabilitation ever since in intensive care unit until discharge from ward. Rehabilitation approach in eclampsia with superimposed intraparenchymal hemorrhages could start safely as early as possible by collaboration with other departments. This can help mother achieved independency of activity daily living and improvement of cardiorespiratory endurance as before.

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