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All Journal TELKOMNIKA (Telecommunication Computing Electronics and Control) Indonesian Journal of Electrical Engineering and Informatics (IJEEI) JUXTA: Jurnal Ilmiah Mahasiswa Kedokteran Universitas Airlangga SURABAYA PHYSICAL MEDICINE AND REHABILITATION JOURNAL Indonesia Journal of Physical Medicine and Rehabilitation Indonesia Journal Physical Medicine and Rehabilitation Cermin Dunia Kedokteran Jurnal Ilmu Medis Indonesia Jurnal Widya Medika Cermin Dunia Kedokteran
Pawana, I Putu Alit
Department Of Physical Medicine And Rehabilitation, Faculty Of Medicine, Universitas Airlangga, Dr. Soetomo Academic General Hospital, Surabaya, East Java, Indonesia
Biochemistry, Genetics & Molecular Biology Chemical Engineering, Chemistry & Bioengineering Computer Science & IT Decision Sciences, Operations Research & Management Electrical & Electronics Engineering Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Physics Public Health

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Conventional Low Intensity Pulsed-Ultrasound Therapy Increase Osteoblast, Serum Alkaline Phosphatase and Serum Calcium Levels in Fracture Healing Process Wardhani, Indrayuni Lukitra; Agus Budi Wirawan, I Ketut Gede; Pawana, I Putu Alit; -, Andriati; Maria, Patricia
Cermin Dunia Kedokteran Vol 45, No 3 (2018): Muskuloskeletal
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (411.148 KB) | DOI: 10.55175/cdk.v45i3.179

Abstract

Introduction: Application of ultrasound waves to improve bone healing generally use specific bone stimulator equipment not available in Indonesia. Frequency and duration of therapy from previous studies are very difficult to apply in clinical practice. This study aims to observe the therapeutic effect of conventional low-intensity pulsed-ultrasound to osteoblast, alkaline phosphatase and serum calcium levels. Method: Thirty six male white rats were divided into three groups (control, USD 5x/week, and USD 3x/week). Tibial fracture in ultrasound groups were treated 3x/week and 5x/week with ultrasound waves (1 MHz, pulsed mode, 20% of duty cycle, intensity of 0.2 W/cm2, duration 10 minutes, stationary) for 3 weeks. Callus tissue and blood from all animals were assessed quantitatively using histological and biochemical analyses. Result: Significant differences (p<0.05) in the average number of osteoblasts, level of alkaline phosphatase and serum calcium among all three groups. Conclusion: Conventional low intensity pulsed-ultrasound either 5x/week or 3x/week improve bone healing process.
Low-cost and open-source anthropomorphic prosthetics hand using linear actuators Triwiyanto Triwiyanto; I Putu Alit Pawana; Torib Hamzah; Sari Luthfiyah
TELKOMNIKA (Telecommunication Computing Electronics and Control) Vol 18, No 2: April 2020
Publisher : Universitas Ahmad Dahlan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.12928/telkomnika.v18i2.14799

Abstract

A robust, low cost, open-source, and low power consumption in the research of prosthetics hand is essential. The purpose of this study is to develop a low-cost, open-source anthropomorphic prosthetics hand using linear actuator based on electromyography (EMG) signal control. The main advantages of this proposed method are the low-cost, lightweight and simplicity of controlling the prosthetic hand using only single channel. This is achieved by evaluating the DC motor and exploring number of locations of the EMG signal. The development of prosthetics hand consists of 3D anthropomorphic hand design, active electrodes, microcontroller, and linear actuator. The active electrodes recorded the EMG signal from extensor carpi radialis longus. The built-in EMG amplifier on the electrode amplified the EMG signal. Further, the A/D converter in the Arduino microcontroller converted the analog signal into digital. A filtering process consisted of bandpass and notch filter was performed before it used as a control signal. The linear actuator controlled each finger for flexion and extension motion. In the assessment of the design, the prosthetic hand capable of grasping ten objects. In this study, the cost and weight of the prosthetics hand are 471.99 US$ and 0.531 kg, respectively. This study has demonstrated the design of low cost and open-source of prosthetics hand with reasonable cost and lightweight. Furthermore, this development could be applied to amputee subjects.
Embedded system for upper-limb exoskeleton based on electromyography control Triwiyanto Triwiyanto; I Putu Alit Pawana; Bambang Guruh Irianto; Tri Bowo Indrato; I Dewa Gede Hari Wisana
TELKOMNIKA (Telecommunication Computing Electronics and Control) Vol 17, No 6: December 2019
Publisher : Universitas Ahmad Dahlan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.12928/telkomnika.v17i6.11670

Abstract

A major problem in an exoskeleton based on electromyography (EMG) control with pattern recognition-based is the need for more time to train and to calibrate the system in order able to adapt for different subjects and variable. Unfortunately, the implementation of the joint prediction on an embedded system for the exoskeleton based on the EMG control with non-pattern recognition-based is very rare. Therefore, this study presents an implementation of elbow-joint angle prediction on an embedded system to control an upper limb exoskeleton based on the EMG signal. The architecture of the system consisted of a bio-amplifier, an embedded ARMSTM32F429 microcontroller, and an exoskeleton unit driven by a servo motor. The elbow joint angle was predicted based on the EMG signal that is generated from biceps. The predicted angle was obtained by extracting the EMG signal using a zero-crossing feature and filtering the EMG feature using a Butterworth low pass filter. This study found that the range of root mean square error and correlation coefficients are 8°-16° and 0.94-0.99, respectively which suggest that the predicted angle is close to the desired angle and there is a high relationship between the predicted angle and the desired angle.
Feature and muscle selection for an effective hand motion classifier based on electromyography Triwiyanto Triwiyanto; Triana Rahmawati; I Putu Alit Pawana
Indonesian Journal of Electrical Engineering and Informatics (IJEEI) Vol 7, No 2: June 2019
Publisher : IAES Indonesian Section

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (23.257 KB) | DOI: 10.52549/ijeei.v7i2.867

Abstract

An issue that arises in the hand motion classification based on the electromyography (EMG) system is the failure of choosing the right features and number of muscles. These parameters are fundamental in determining the accuracy and effectiveness of the classifier system. Therefore, the objective of this study is to develop and evaluate an effective hand motion classifier based on the EMG signal. The three-channel of EMG was collected by placing three pairs of electrodes on the surface of the skin. Six statistic features (mean, variance, standard deviation, kurtosis, skewness, and entropy) were selected to extract the EMG signal using a window length of 100 samples. A muscle and features selection is applied to the classifier machine (linear discriminant analysis (LDA), support vector machine (SVM) and K nearest neighborhood (KNN)) to retrieve the most useful feature and muscle. In this study, we found that there was no significant difference in accuracy among a number of muscles (p-value>0.05). LDA and SVM showed the best accuracy and no significant difference in accuracy between both were found. This study concluded that EMG signal from a single muscle can classify the hand motion (hand close, open, wrist flexion, and extension) effectively. 
Effect of Power-Assisted Functional Electrical Stimulation (PAFES) and Occupational Exercise on Motor Unit Activity of Extensor Digitorum Communis and Hand Dexterity in Post-stroke Patient Yusuf Roni; Sri Mardjiati Mei Wulan; I Putu Alit Pawana
Surabaya Physical Medicine and Rehabilitation Journal Vol. 2 No. 2 (2020): SPMRJ, AGUSTUS 2020
Publisher : Faculty of Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/spmrj.v2i2.17602

Abstract

Background: Weakness of upper extremity can affect the ability to perform daily activities in post-stroke patients. Power-Assisted Functional Electrical Stimulation (PAFES) may give motor reeducation and sensory feedback to improve motor recovery through neuroplasticity.Aim: To evaluate the effect of PAFES and occupational exercise on post-stroke patient hand dexterity and motor unit activity of extensor digitorum communis muscle.Material and methods: Twenty post-stroke patients enrolled in the study were divided intervention group whom received PAFES and occupational exercise, and control group whom received occupational exercise only. Each group underwent 30 minutes per session of treatment, 5 times a week, for 3 weeks. The Root Mean Square (RMS) for measuring motor unit activity of extensor digitorum communis muscle; Box and Block Test (BBT) and Nine Hole Peg Test (NHPT) for measuring hand dexterity were evaluated before and after intervention.Result: There were significant improvements of RMS (p<0.001), BBT (p<0.001) and NHPT (p=0.002) in intervention group after receiving PAFES and occupational exercise. The improvement of BBT in intervention group was significant compared with control group (p=0.028), however, no significant improvement of NHPT was found between groups.Conclusion: PAFES and occupational exercise could improve motor unit activity of the extensor digitorum communis muscle and hand dexterity in post-stroke patient.
The Influence of Elastic Taping on Dynamic Muscular Control (Dynamic Control Ratio) Evertor-Invertor Ankle in Type 2 Diabetes Mellitus Male with Complications of Peripheral Neuropathy Yuli Indah Kurnia; Imam Subadi; I Putu Alit Pawana; Sony Wibisono
Surabaya Physical Medicine and Rehabilitation Journal Vol. 2 No. 2 (2020): SPMRJ, AGUSTUS 2020
Publisher : Faculty of Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/spmrj.v2i2.17673

Abstract

Background: Type 2 Diabetes Mellitus (DM) with Peripheral Neuropathy often have impared control of muscle strength that increases the risk of fall. Elastic taping (ET) is a special elastic band that can stretch up to 140% and could facilitate muscle contraction.Aim: To prove the influence of ET on the dynamic muscular control balance between evertor and invertor muscles of the ankle in type 2 DM male with peripheral neuropathy.Material and methods: This study used a pre-post one grup study, with10 type 2 DM male with peripheral neuropathy. All subjects were examined for ankle evertor-invertor dynamic control ratio (DCR) with isokinetic dynamometer at 600/sec and 1200/sec before elastic taping (ET), 30 minutes after ET, at the third day of ET aplication and 3 days after ET was released. Elastic taping was applied with functional tehniques on the both ankles.Result: There were no significant differences between with and without the application of KT in the ankle evertor-invertor DCR in both side. The p value were same in both sides, at 600/sec after 30 minute ET (p=0.72), at the third day of ET aplication (p=0,24), 3 days after released ET (p= 0,88) and at 1200/sec after 30 minute ET (p=0,17).Conclusion: Elastic taping did not improve the ankle evertor-invertor DCR in type 2 DM male patients with peripheral neuropathy.
Effect of Short Period Simultaneous Stimulation of Transcranial Direct Current Stimulation (tDCS) on Occupational Therapy to Motor Function of Upper Extremity in Stroke Subject Adrian Utomo; I Lukitra Wardhani; I Putu Alit Pawana
Surabaya Physical Medicine and Rehabilitation Journal Vol. 2 No. 2 (2020): SPMRJ, AGUSTUS 2020
Publisher : Faculty of Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/spmrj.v2i2.20623

Abstract

ABSTRACTObjective: Stroke could cause upper extremity motor function disturbances that may affect to quality of life. The affected brain has an ability to get recovery by neuroplasticity process. Transcranial direct current stimulation (tDCS) is a non-invasive modality that could induce brain neuroplasticity Goal: To determine the effect of tDCS stimulation on recovery of upper extremity motor function in subacute ischaemic stroke patient. Methods: 22 stroke patients included in inclusion criteria, divided into 2 groups, control group and intervention group. Control group had occupational therapy for 5 days consecutively and intervention group had occupational therapy and tDCS stimulation simultaneously for 5 days consecutively. Upper extremity motor function was evaluated with Fugl-Meyer Assessment (FMA) before and after the treatment. Results: Significant improvement of FMA score on control group (p=0,018) and intervention group (p=0,000). Comparison of the result after the treatment revealed that the intervention group showed more significant improvement in FMA score than the control group (p=0,000). Conclusion: Application of tDCS stimulation on occupational therapy simultaneously showed improvement of upper extremity motor function in subacute ischaemic stroke patient better than only occupational therapy. Key Words: Transcranial direct current stimulation, occupational therapy, Fugl-Meyer Assessment, upper extremity motor function, subacute ischemic stroke.
Effect of Agonist-Antagonist Paired Set and Traditional Set Strengthening Exercise Methodson Single-Leg Hop Performance Gadiza Raiznintha Permatasari; RA Meisy Andriana; I Putu Alit Pawana
Surabaya Physical Medicine and Rehabilitation Journal Vol. 3 No. 1 (2021): SPMRJ, FEBRUARY 2021
Publisher : Faculty of Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/spmrj.v3i1.20670

Abstract

Background: Functional activities mostly done in daily life such as jumping, walking, running, and stairs ascending-descending require dynamic stability of the knee. The knee joint dynamic stability is required to have effective and efficient functional activities and to avoid injury when performing them. It can be achieved by increasing muscle strength through strengthening exercises with the aim of balancing the agonist muscles (quadriceps femoris) and antagonist muscles (hamstring) using the agonist- antagonist paired set (APS) method.Aim: The aim of this study is to find out the effect of strengthening exercise using APS method, compared to traditional set (TS) method, on single-leg hop performance.Material and Methods: The subjects of this study were 14 untrained healthy men aged 18-40 years old divided into 2 intervention groups, APS group and TS group. The variable evaluated was the distance of single-leg hop (SLH).Results: The results of this study showed a significant increase in SLH distance in APS group (p=0.005) and TS group (p<0.001) with no significant difference between the two groups (p = 0.933).Conclusion: Quadriceps femoris and hamstring muscle strengthening exercises in both APS and TS methods increase SLH distance although there is no difference between them. The APS method has an advantage compared to the TS method in terms of a relatively shorter time with comparable results.
Risk Factors for Lower Extremity Amputation in Diabetic Foot Ulcer Patients: A Case-Control Study Gusti Agung Ayu Ira Kencana Dewi; Sony Wibisono; I Putu Alit Pawana
JUXTA: Jurnal Ilmiah Mahasiswa Kedokteran Universitas Airlangga Vol. 11 No. 2 (2020): Jurnal Ilmiah Mahasiswa Kedokteran Universitas Airlangga
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/juxta.V11I22020.83-85

Abstract

Introduction: Diabetes mellitus is a metabolic syndrome that is marked by higher blood glucose. The uncontrolled high blood glucose can lead to complication, such as diabetic foot. Diabetic foot is the most reason why diabetic patients are hospitalized. Diabetic foot that cannot heal may lead to lower extremity amputation. The purpose of this study was to describe the risk factors of lower extremity amputation in diabetic foot ulcer patients.Methods: This study used a case-control study of diabetic foot patients in Dr. Soetomo General Hospital from January 2015 to December 2017. This study used the data from medical records in Inpatient Installation Department of Internal Medicine. Patients with diabetic foot ulcer and lower extremity amputation due to diabetes were included in this study. Incomplete medical records were excluded. Data of samples were divided to two groups, i.e. the amputation group and the non-amputation group with a ratio of 1:1. Risk factors of amputation that were analyzed were male, old age, and the history of ulcer/lower extremity amputation.Results: Based on the data of 36 samples, there were 11 male patients (61.1%) and 7 female patients (38.9%) who experienced lower extremity amputation. The average age of amputation group was 59.61 years old with a range of ages from 39 to 72 years old. This study found the risk factors for lower extremity amputation in diabetic foot ulcer patients was the history of ulcer/amputation due to diabetes (OR 5.0, 95% CI 1.065-23.464, p = 0.034). Conclusion: The risk factor for lower extremity amputation in diabetic foot ulcer patients was the history of ulcer/amputation due to diabetes. 
Comparison of Neutrophyl Lymphocyte Ratio and Nerve Conduction Study Between Male Type 2 Diabetes Mellitus With or Without Peripheral Neuropathy Complication Martha Kurnia Kusumawardani; Surdiana; I Putu Alit Pawana; Sony Wibisono
Indonesian Journal of Physical Medicine & Rehabilitation Vol 11 No 01 (2022): Indonesian Journal Of Physical Medicine and Rehabilitation
Publisher : Indonesian Journal of Physical Medicine & Rehabilitation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36803/ijpmr.v11i01.326

Abstract

ABSTRACT Background: Diabetic Peripheral Neuropathy (DPN) is one of the type 2 Diabetes Melitus (T2DM) complication, which may lead to diabetic foot ulcer and lower extremity amputation. Inflammation plays a role in the pathogenesis of this type 2 DM complication. Recent studies showed neutrophyl-lymphocyte ratio (NLR) is a potential inflammation marker. Early screening for neuropathy is an important part of the medical rehabilitation management of this condition. Material and methods: This study uses data analysis independent sample T-2 test with a significant (p<0.05). This study is a analytic observation cross-sectional study with type 2 diabetic male subjects, screened with Michigan Neuropathy Screening Instrument then divided into 2 groups, with DPN group (11 subjects) and without DPN group (7 subjects). This was followed with complete blood count laboratory testing (neutrophyl and lymphocyte level) and NCS to measure distal latency, amplitudo, and NCV of the tibial, peroneal, and suralnerve on both lower extremities. Result: There were 18 subjects in this study. Independent T-2 test showed that there was no significant difference in neutrophils (p=0.679), lymphocytes (p=0.127), and NLR (p=0.190) in the DM group without or with neuropathy. NCS showed that there were significant differences on the amplitude of the three nerves peroneal (p=0.003), tibial (p=0.017), sural (p=0.033), also in NCV of peroneal (p=0.001) and tibial (p=0.008). There were no significant differences found on the three distal latency of peroneal (p=0.074), tibial (p=0.151), sural(p=0.294), and NCV of sural (p=0.262). Conclusions: This study shows that there is no significant difference in NLR on both groups. There were significant differences in the amplitude of the three peroneal, tibial, and sural nerves and the conduction velocity of the peroneal and tibial nerves. However, there was no significant difference in the distal latency of the threeperoneal, tibial, sural, and the NCV of the sural nerves.Keywords: diabetes melitus, diabetic peripheral neuropathy, nerve conduction studies, neutrophyl-lymphocyte ratio, rehabilitation management.
Co-Authors -, Andriati Adrian Utomo Agus Budi Wirawan, I Ketut Gede Andriati Andriati Ayu Susanti, Ayu Bambang Guruh Irianto Damayanti Tinduh Devi Ariani Sudibyo Florentina Sustini Gadiza Raiznintha Permatasari Gusti Agung Ayu Ira Kencana Dewi Hermina Novida, Hermina I Dewa Gede Hari Wisana I Ketut Gede Agus Budi Wirawan I Lukitra Wardhani Imam Subadi Indrato, Tri Bowo Inez Anabela Suprijadi Suprijadi Luthfiyah, Sari Lydia Arfianti Maria, Patricia Martha Kurnia Kusumawardani Masduchi, Reni Hendrarati Meisy Andriana, Meisy Nurul Bashirah Aminy Patricia Maria Putra, Bayu Aji Mayogya Rahmawati, Triana Soenarnatalina Melaniani Sony Wibisono Sri Mardjiati Mei Wulan Subagyo Subagyo Surdiana Torib Hamzah Tri Nurhayati, Yeni Tri Rahayu Septyaningrum Triwiyanto Triwiyanto Wardana, Farid Aditya Wardhani, Indrayuni Lukitra Wardhani, Rr. Indrayuni Lukitra Yuli Indah Kurnia Yusuf Roni