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Journal : Indonesia Journal Physical Medicine and Rehabilitation

Post Surgical Neglected Idiopathic Triple Curve Scoliosis with Neuromuscular and Respiratory Disorders Rahmatika; Rudy Handoyo; Tanti Ajoe Kesoema
Indonesian Journal of Physical Medicine & Rehabilitation Vol 8 No 02 (2019): 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 (454.75 KB) | DOI: 10.36803/ijpmr.v8i02.247

Abstract

Introduction: About 75-85% of cases of scoliosis are idiopathic, with unknown cause whose ratio between men and women is 1: 8. In severe scoliosis, many disorders may occur such as muscle imbalance, pain, muscle weakness, degenerative joint disease, decreased cardiovascular capacity, and neurological disorders.Case Presentation: We reported a 14-year-old boy patient post posterior instrumentation and fusion surgery e.c neglected idiopathic triple curve scoliosis with neuromuscular complications such as weakness in upper and lower limbs causing disruption in hand functions and ambulation disorders, and respiration disorders such as shortness of breath, especially when walking in long-distance or running.The rehabilitation program consisting of exercise in the pool, fine motor exercise, activity of daily living (ADL) exercise, chest expansion exercise, and orthotic administration, which aims to support therecovery of patients to full function as early as possible.Conclusion: After 2 months, the patient showed slight improvement in functional, ambulation, and hand function due to non-routine exercise at the hospital.
Rehabilitation Program for Spinal Cord Injury Neurological Level C2 due to Foramen Magnum Meningioma Soracca Fellicita Sugiarto; Tanti Ajoe Kesoema
Indonesian Journal of Physical Medicine & Rehabilitation Vol 8 No 02 (2019): 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 (332.233 KB) | DOI: 10.36803/ijpmr.v8i02.248

Abstract

Introduction: Foramen magnum meningioma is a rare case. The incidence is 0.3% - 3.2% of all meningiomas. Clinical manifestations of foramen magnum meningioma are atypical and unpredictable. The main therapy for foramen magnum meningioma is surgery. The role of rehabilitation becomes important in the process after surgery. Case Presentation: A 46 years old female had weakness and loss of sensory of her upper and lower limbs, accompanied by urinary retention and constipation in the last 2 month, categorized by ASIAimpairment scale (AIS) C neurological level of injury at C2. Cervical MRI with contrast showed the impression of an extramedullary intradural mass as high as the inferior aspect of the pons to the corpusvertebrae cervical 1 supports the picture of meningiomas. The rehabilitation programs after surgery were active assistive range of motion exercise progressing to active range of motion, neuromuscular electrical stimulation, sensory stimulation and bladder and bowel training. Conclusion: The patient’s expectation for returning to independency is a long-term goal of the rehabilitation program. After definitive therapy (surgery) is conducted, medical rehabilitation management can be done as early as possible to achieve the optimum functional recovery. Muscle strengthening, sensory stimulation and bladder/bowel training improved motor , sensory and autonomic function.
Rehabilitation Program for Transverse Myelitis John Hartono; Tanti Ajoe Kesoema; Robby Tjandra Kartadinata
Indonesian Journal of Physical Medicine & Rehabilitation Vol 8 No 01 (2019): 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 (1062.251 KB) | DOI: 10.36803/ijpmr.v8i01.181

Abstract

Introduction: Transverse myelitis is a neurological disease involving inflammation or lesions on the spinal cord with rapid and progressive onset of symptomsMotor training, sensory stimulation, andrehabilitation of autonomic functions are needed, to restore the function, reduce disability, and improve the quality of life.Case Presentation: A 34 years old male had weakness and loss of sensoric of lower limbs, accompanied by low back pain (LBP), chronic cough, and micturition dysfunction for 1 month ago, categorized byASIA impairment scale (AIS) D, level of injury at T6. The MRI of Thoracolumbal showed myelitis lession at 6th – 7th of thoracal, effusion at facet joint of L2-L5, and lumbal spondylosis. The rehabilitationprograms were active range of motion exercise with walking exercise (3 session/week, 30 minutes/session), Transcutaneous Electrical Nerve Stimulation (2-10 pps, 2 session/week, 20 minutes/session),sensory stimulation (2 session/week, 20 minute/session), and bladder training for 3 weeks. After 16 days, there were lower limb’s strength improvement by Manual Muscle Testing (MMT) were average four atlevel L2-S1, sensory improvement to T9-10, LBP was reduced, and normal micturition. After 3 weeks, lower limb strength improved to 55445/55445 at level L2-S1. Pat ient able to walk without assisted.Conclusion: Muscle strengthening, sensory simulation and bladder training, combined with pharmacological treatment, improved motor, sensory and autonomic function in Transverse MyelitispatientKeywords: Motoric training, sensory stimulation, bladder training, Transcutaneous electrical nerve stimulation, transverse myelitis