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All Journal Journal of the Indonesian Medical Association : Majalah Kedokteran Indonesia SURABAYA PHYSICAL MEDICINE AND REHABILITATION JOURNAL Indian Journal of Forensic Medicine & Toxicology Narra J

Poerwandari, Dewi

Departemen Ilmu Kedokteran Fisik Dan Rehabilitasi Medik, Fakultas Kedokteran, Universitas Airlangga, Surabaya

Author-ID : 2456722

Biochemistry, Genetics & Molecular Biology Chemical Engineering, Chemistry & Bioengineering Education Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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Articles

Correlation of Cardiorespiratory Fitness Levels with Functional Mobility Abilitiy in Post Thrombotic Infarction Stroke Patient Eny Susilowati1, Reni Hendrarati Kusharyaningsih2, Dewi Poerwandari2
Indian Journal of Forensic Medicine & Toxicology Vol. 14 No. 2 (2020): Indian Journal of Forensic Medicine & Toxicology
Publisher : Institute of Medico-legal Publications Pvt Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37506/ijfmt.v14i2.3145

Background: Stroke patients often experience functional ambulation difficulties and lack ability to walk independently due to the reduction cardiorespiratory fitness so that an understanding of the relationship between fitness levels cardiorespiratory with functional mobility ability is needed, especially for thrombotic infarction stroke patients.. Objectives: This study aims to assess the relationship between cardiorespiratory fitness levels with functional mobility ability in the first three months after thrombotic infarction stroke. Method: Subjects are 38 post trombotic infarction stroke. Functional mobility is measured by the Timed Up and Go test. Subjects were asked to stand up from a chair whose seat is ± 46cm and the height of its back is 65cm, walk as far as 3 m, turn 1800, walk back and sit back. Data were analyzed and performed statistical test using SPSS 17. Results: The study showed the average TUG test was 15.56-7.79 seconds with the longest travel time was 37.38 seconds and the fastest travel time was 8.16 seconds. The average of VO2max was 10.62 ± 2.31mL / kg / min, with the lowest VO2max yield of 5.78mL / kg / min and the highest was 14.54mL / kg / minute. The TUG test had a negative correlation with VO2max the 6 minute walk test result. Conclusion: There is a significant relationship between cardiorespiratory fitness level and functional mobility abilities in post thrombotic infarction stroke patient

Effect of Neuromuscular Electrical Stimulation Addition in Exercise with Expiratory Muscle Trainer on FEV1 And FVC in Untrained Healthy Subjects Langgeng Gunariadi; Imam Subadi; Dewi Poerwandari
Indian Journal of Forensic Medicine & Toxicology Vol. 15 No. 3 (2021): Indian Journal of Forensic Medicine & Toxicology
Publisher : Institute of Medico-legal Publications Pvt Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37506/ijfmt.v15i3.15841

Coughing is a mechanism for expelling foreign particles or excess mucus in the airway by increasinghigh expiratory pressure. When coughing, the respiratory muscles that control cough production are theinspiratory and expiratory muscles. Weakness of the expiratory muscle can affect to the ability to generatesufficient pressure to cough. In generally, a decrease in respiratory muscle’s strength can occur in patientswho have experience of prolonged immobilization, elderly people who suffer from sarcopenia, to strokepatients. The untrained healthy persons were not realizing the effects of their lifestyle which can reduce therectus abdominis muscle as an additional expiratory muscle. If it occurred in long time, it will reduce thelung function capacity of force expiratory volume (FEV1) and force vital capacity (FVC). The subjects ofthis study were 16 untrained healthy males with aged 18-40 years. Furthermore, they divided into 2 groups,the intervention group with Expiratory Muscle Trainer (EMT) training plus of Neuromuscular ElectricalStimulation (NMES) on the rectus abdominis muscle and the control group with exercise with ExpiratoryMuscle Trainer only. The outcome was measured for FEV1 and FVC by spirometry. The results of this studywere indicating an increase in FEV1 and FVC in each group however. The intervention group was increaseof FEV1 0.22+0.22 (p value=0.18) and the control group was 0.01+0.39 (p value=0.92). The interventiongroup was increase of FVC 0.50+0.48 (p value=0.02) and the control group was 0.32+0.51 (p value=0.12).The FEV1 results between the two groups were not significant difference (p value=0.21) and as well as FVCresults after 4 weeks of training. In summary, this study concluded that EMT training with NMES increasedFVC even though the difference between the two was not significant.

The Effect Of Hand Exercise On Grip Strength, Forearm Circumference, Diameter Of Vein, Blood Flow Volume And Velocity In Patient Who Underwent Arteriovenous Fistula Surgery And On Routine Haemodialysis Jufri Febriyanto Poetra; Andriati Andriati; Dewi Poerwandari
Surabaya Physical Medicine and Rehabilitation Journal Vol. 1 No. 1 (2019): SPMRJ, Februari 2019
Publisher : Faculty of Medicine, Universitas Airlangga

Background: The arteriovenous fistula (AVF) is considered the gold standard for haemodialysis access. The fistula needs time to be mature and functional. Maturation process respond to increases in blood flow. Exercise stimulates vascular response as such an increase of blood flow. Aims: The purpose of this study is to determine the effectiveness of hand exercise in increasing grip muscle performance, and its effectiveness in supporting maturation process of fistula.Methods: This experimental study done on 14 patients underwent AVF procedure and on routine haemodialysis. Randomly, 7 subjects allocated on intervention group by doing hand exercise using hand gripper (HG) for 5 weeks, and 7 subjects allocated as control group without introduction to hand gripper. Grip strength and forearm circumference were measured before and after 5 weeks of intervention. Cephalic vein diameter, blood flow volume and velocity were measured using Doppler USG on AVF arm. The comparison of intervention effects between groups treatment were analyzed based on effect size (ES).Results: Grip strength and forearm circumference increased significantly on intervention group before and after exercise intervention (p<.001, p=.001). Cephalic vein diameter and blood flow were increased significantly in this group (p=.027, p=.033). Blood flow velocity showed no difference before and after exercise intervention. Significant results were found on increased grip strength, forearm circumference, cephalic vein diameter and blood flow volume in comparison between treated group (p<.001; ES=.94, p<.001; ES=.4, p=.046; ES=.84, p=.035; ES=.53). There were no differences on cephalic vein blood flow velocity between these two groups.Conclusion: Five weeks hand exercise were effective to increase grip strength, forearm circumference, cephalic vein diameter and blood flow volume, nonetheless ineffective to increase cephalic vein blood flow velocity in post AVF procedure patients with routine haemodialysis.

Elastic Taping’s Effect on Exercise Capacity in Recreational Runner with Inspiratory Muscle Training Asriningrum Asriningrum; Dewi Poerwandari; Andriati Andriati; Soenarnatalina Soenarnatalina
Surabaya Physical Medicine and Rehabilitation Journal Vol. 1 No. 1 (2019): SPMRJ, Februari 2019
Publisher : Faculty of Medicine, Universitas Airlangga

Background: Running is a new trend of recreational sports in Indonesia. About 70% of recreational runners have difficulty in improving exercise capacity due to exercise-related transient abdominal pain (ETAP), caused by fatigue of the diaphragmatic muscles. Previous studies have shown that various training methods may increase diaphragmatic muscle strength and endurance, for example, inspiratory muscle training (IMT). Unfortunately, improvement of inspiratory muscle strength and endurance after exercise and IMT are still varies. Therefore, other methods are needed to optimize the effect of IMT. Application of the elastic taping on thoracic wall during exercise allows the inspiratory muscles to contract optimally which might improve functional capacity.Aim: To assess the effect of elastic taping on inspiratory muscle training using the pressure threshold IMT, in increasing the functional exercise capacity of recreational runners. Functional capacity was measured based on VO2max value, rating of perceived breathlessness (RPB) and rating of perceived exertion (RPE).Methods: an experimental study involved 14 nonsmoker recreational runners, ages 20-40 years, at Outpatient Clinic of Physical Medicine and Rehabilitation Department of Dr. Soetomo Hospital Surabaya. Subjects were divided into two groups (pressure threshold IMT with and without elastic taping groups), which were observed for four weeks. IMT was done five times a week, twice a day, with 30 repetitions, and 60% resistance 30 RM using Respironics®. Elastic taping Leukotape® was applied on the first until fifth day in each IMT sessions. The running exercises were done three times a week with EnMill® Treadmill ETB-03195 with a speed of 4.5 mph and 0% inclination. RBP, RPE and VO2max were measured using Borg Dyspneu scale, Borg Scale, and Bruce Treadmill Protocol test, respectively, before the first exercise and after 4 weeks of exercise.Results: There were an improvement of functional exercise capacity in both groups which were marked with a decline of RPB and RPE and increase of VO2max (p values < 0.05). However, there were no significant differences in the decrease of RPB and RPE and an increase of VO2max between groups (p values of were 0.31, 0.83, and 0.13, respectively). The effect of the elastic taping (r2 = 0.99) was not reflected in the differences of RPB, RPE and increasing VO2max.Conclusion: Inspiratory muscle training using pressure threshold IMT with or without the elastic taping for four weeks can improve exercise capacity of recreational runners.

Drop foot Post Mitral Valve Replacement and Total correction of Tetralogy of Fallot: A Two Case Report Dewi Poerwandari; Daisy F Lapasi; Bayu Aji M
Surabaya Physical Medicine and Rehabilitation Journal Vol. 1 No. 2 (2019): SPMRJ, Agustus 2019
Publisher : Faculty of Medicine, Universitas Airlangga

Background: Peripheral nerve lesion after heart surgery was reported on brachial plexus, phrenic nerve, laryngeal recurrent nerve facial nerve, lumbosacral root and spinal cord. Incidence of peroneal communis nerve lesion after heart surgery was not much reported (0,19%). Diagnostic procedure of peripheral nerve lesion are including clinical sign and symptom, electrophysiology studies and MRI. Rehabilitation management of peripheral nerve lesion are not only management of pain and nerve stimulation, but also walking aid beside cardiac rehabilitation due to cardiac problem.Methods: Reporting two case of peripheral nerve lesion after heart surgery. First case is a female, 37 years old suffered from drop foot two days after mitral valve replacement with mechanic valve. She got pain management, electrical nerve stimulation and therapeutic exercise beside cardiac rehabilitation program. Second case is a female, 9 years old, after total correction of Tetralogy of Fallot, got drop foot at day two. She also got pain management, electrical nerve stimulation and therapeutic exercise beside cardiac rehabilitation.Results: First case result was the drop foot getting better after she entered phase two of cardiac rehabilitation. In the second case, the drop foot was relieved at phase two cardiac rehabilitation and back to normal condition after one year after surgery.Conclusion: In these two case of drop foot after heart surgery, the drop foot was relieved after pain and rehabilitation management beside cardiac rehabilitation.

Low-intensity aerobic cycle ergometer effects on lung function of myasthenia gravis patients: A randomized controlled trial Amalina, Nabila; Poerwandari, Dewi; Handajani, Noor I.; Sudibyo, Devi A.; Melaniani, Soenarnatalina
Narra J Vol. 4 No. 3 (2024): December 2024
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v4i3.844

Patients with generalized myasthenia gravis (MG) often show restrictive spirometry results. Although regular exercise and physical fitness are linked to better respiratory function, there is limited research assessing the effects of aerobic exercise on lung function in MG patients. The aim of this study was to analyze the effect of low-intensity aerobic exercise using a cycle ergometer on lung function parameters in MG patients. A randomized controlled trial with pre- and post-test was conducted at the Medical Rehabilitation Outpatient Clinic of Dr. Soetomo General Academic Hospital in Surabaya, Indonesia, in 2023. MG patients classified as I−IIb based on the Myasthenia Gravis Foundation of America (MGFA) classification were recruited and randomly divided into treatment and control groups. The treatment group was given low-intensity aerobic exercise using a cycle ergometer, education on lifestyle changes, and breathing exercises (deep and pursed lip breathing). Lung function parameters, including forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), and forced expiratory volume ratio (FEVR), were then measured. Measurements were conducted before and after eight weeks of low-intensity aerobic cycle ergometer exercise and compared with those of a control group. A total of 17 MG patients were included in this study. The results showed a significant increase in FVC in the treatment group (p=0.003), whereas no significant change in the control group (p=0.068). A significant increase in FEV1 was observed both in the treatment (p=0.029) and the control group (p=0.016). There was no improvement in FEVR in either group. After the intervention, significant differences were observed in FVC (p=0.009) and FEV1 (p=0.029) between the treatment and control groups. There was no significant difference in FEVR values after the intervention between both groups (p=0.491). In conclusion, eight weeks of low-intensity aerobic cycle ergometer exercise led to significant improvements in FVC and FEV1 among MG patients.

Comparison of Lower Extremities Physical Performance on Male Young Adult Athletes with Normal Foot and Flatfoot Kumala, Mira Saraswita; Tinduh, Damayanti; Poerwandari, Dewi
Surabaya Physical Medicine and Rehabilitation Journal Vol. 1 No. 1 (2019): SPMRJ, Februari 2019
Publisher : Faculty of Medicine, Universitas Airlangga

Background: Motor tasks involving the lower legs activate a closed kinetic chain, with the foot being the terminal part of that chain. It is known that when a part of this chain is disturbed, it will affect other parts of the chain, including the effect on the motor performance of lower extremities.Aims: To see the difference of physical performance on athlete age 14 – 17 years with flatfoot and normal foot on strength, balance and agility factors.Methods: Male athletes age 14 – 17 years enrolled in Sport Senior High School at Sidoarjo who underwent athletes screening at Sport Clinic of dr. Soetomo General Hospital and fulfill the inclusion criteria. The subject were 29 boys, the normal foot were 22 boys and the flatfoot were 7 boys. Subjects were examined for Clarke's angle and Chippaux-Smirak index to diagnose flatfoot and did Single-leg Hop for Distance, One Leg Test, Star Excursion Balance Test, and Hexagon Hop Test.Result: The statistical analysis showed no difference of lower extremities' physical performance in strength using Single-leg Hop for Distance (p>0.05), balance using One Leg Test and Star Excursion Balance Test (p>0.05), and agility using Hexagon Hop Test (p>0.05) on male athletes age 14-17 years with normal foot and flatfoot.Conclusion: There are no difference of lower extremities' physical performance in strength, balance and agility on male athlete age 14-17 years with normal foot and flatfoot.

Mobilisasi Dini di Intensive Care Unit (ICU): Tinjauan Pustaka Sari, Dian Marta; Widjanantie, Siti Chandra; Poerwandari, Dewi; Paulus, Anitta Florence Stans; Tedjasukmana, Deddy; Nusdwinuringtyas, Nury; Ratnawati, Anita; Putra, Hening Laswati
Majalah Kedokteran Indonesia Vol 72 No 1 (2022): 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.72.1-2022-315

Patients in the intensive care unit (ICU) usually have muscle weakness problems that are not related to their primary diseases when admitted ICU. This problem may become a clinical syndrome that we called ICU-Acquired Weakness (ICU-AW). There is currently no specific treatment for ICU-AW, therefore preventing patients from ICU-AW by controlling associated risk factors such as immobility, becoming a critical approach. Early mobilization (EM) has many benefits in the ICU setting for patients with or without mechanical ventilation. Besides that, the realization of EM needs consider the safety criteria and the barriers to their application. Thus, there are guidelines for the realization of EM to give the best outcomes while minimalizing the adverse events.

Co-Authors Andriati Andriati Anita Ratnawati Asriningrum Asriningrum Bayu Aji M Daisy F Lapasi Damayanti Tinduh Dian Marta Sari Handajani, Noor I. Hening Laswati Putra Imam Subadi Jufri Febriyanto Poetra Kumala, Mira Saraswita Langgeng Gunariadi Nabila Amalina Nury Nusdwinuringtyas Paulus, Anitta Florence Stans Soenarnatalina Melaniani Soenarnatalina Soenarnatalina Sudibyo, Devi A. Tedjasukmana, Deddy Widjanantie, Siti Chandra

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