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All Journal Indonesian Journal of Cardiology MAGNA MEDICA: Berkala Ilmiah Kedokteran dan Kesehatan Journal of the Indonesian Medical Association : Majalah Kedokteran Indonesia SURABAYA PHYSICAL MEDICINE AND REHABILITATION JOURNAL Respiratory Science Cermin Dunia Kedokteran Cermin Dunia Kedokteran
Tambunan, Tresia Fransiska Ulianna
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Biochemistry, Genetics & Molecular Biology Chemical Engineering, Chemistry & Bioengineering Education Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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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.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (100.989 KB) | DOI: 10.55175/cdk.v48i11.1551

Abstract

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

Abstract

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

Abstract

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.
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

Abstract

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.
Rehabilitation Management of a Patient with Bilateral Pulmonary Bullae after Multiple Surgeries and Post-Tuberculosis Lung Disease Tifany, Elisabeth Pauline; Tambunan, Tresia Fransiska Ulianna
MAGNA MEDIKA Berkala Ilmiah Kedokteran dan Kesehatan Vol 12, No 1 (2025): FEBRUARY
Publisher : Universitas Muhammadiyah Semarang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26714/magnamed.12.1.2025.94-103

Abstract

Background:  Post-tuberculosis lung disease (PTLD) is a prevalent finding in TB survivors. PTLD has many clinical presentations, including structural damage in the form of pulmonary bullae. Pulmonary bullae, along with PTLD, lead to significant impairment and morbidity in the patient. In some cases, a surgical approach is indicated for pulmonary bullae.Objective: This case study aims to discuss the rehabilitation management in PTLD, including post-surgical cases.Case Presentation: A 27-year-old male underwent lung volume reduction surgery (LVRS) by wedge resection of the right superior lobe. The patient had a history of tuberculosis infection and a history of bilateral pneumothorax. The patient underwent pulmonary rehabilitation in ICU care as early as medically possible, and continued until the patient was transferred to the general ward. The patient tolerates the pulmonary rehabilitation program, and no adverse effects occurred due to pulmonary rehabilitation.Conclusion: Pulmonary rehabilitation is an essential part of cases involving PTLD, including post-surgical ones, and should be initiated as early as medically possible in inpatient and continued outpatient settings.
Penerapan Perhitungan Langkah Harian Pada Pasien Penyakit Paru Obstruktif Kroni Tambunan, Tresia Fransiska Ulianna; Nathania, Eugene; Tifany, Elisabeth Pauline
Majalah Kedokteran Indonesia Vol 73 No 5 (2023): Journal of The Indonesian Medical Association - Majalah Kedokteran Indonesia, Vo
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47830/jinma-vol.73.5-2023-1054

Abstract

Chronic Obstructive Pulmonary Disease (COPD) is a condition which airflow limitation occurs due to an abnormality of the airways. The cause of COPD is usually exposure to noxious particles or gases. COPD is often accompanied by metabolic syndrome and leads to impaired physical activity, leading to increased morbidity and mortality. According to the international recommendation, COPD patients should receive a 30-minute daily step program. Pulmonary rehabilitation program with daily step count could be prescribed to all COPD patients who have no exacerbations within 4 weeks and able to ambulate. The pedometer can be used for ≥ 8 hours/day, ≥ 3 days/week, and a minimum of ≥ 100 steps/day. Increasing activity that can be assessed by calculating daily steps in patients with COPD can reduce the number of exacerbations, reduces the risk of death, increases exercise capacity, and improves the quality of life.
Telerehabilitasi pada Penyakit Paru Obstruktif Kronik Tifany, Elisabeth Pauline; Tambunan, Tresia Fransiska Ulianna
Cermin Dunia Kedokteran Vol 50 No 12 (2023): Penyakit Dalam
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v50i12.1042

Abstract

Chronic obstructive pulmonary disease (COPD) is one of the leading causes of death worldwide. Pulmonary rehabilitation is an essential component of COPD management and can be delivered through telerehabilitation programs. COPD telerehabilitation consists of exercise testing and training that can be performed at home with supervision from a physiotherapist or remotely using a smartphone application. Exercise training includes cardiorespiratory endurance, resistance, flexibility, and respiratory muscle training. COPD telerehabilitation is effective in improving exercise tolerance, reducing the incidence of acute exacerbations, and improving patients’ quality of life.
Co-Authors Ambari, Ade Meidian Anwar Santoso Aria Kekalih Bambang Budi Siswanto Basuni Radi Chandra Kasih, Siti Aminah Desandri, Dwita Rian Dwiputra, Bambang Glenis, Gabrielle Harahap, Alida Rosita Katsukawa, Hajime Kurnain, Dave Nicander Nathania, Eugene Putri, Yoan Utami Putryanti, Rimnauli Deasy Putryanti Setiawan, Regina Caecilia Teuku Heriansyah, Teuku Tifany, Elisabeth Pauline Triangto, Kevin Ulfa, Meryta Utami, Diniah