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SIX MINUTE WALKING DISTANCE CUT-OFF POINT IN INDONESIAN (MONGOLOID) POPULATION Nusdwinuringtyas, Nury
Majalah Kedokteran Indonesia Vol 68 No 8 (2018): Journal of the Indonesian Medical Association Majalah Kedokteran Indonesia Volum
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar

Introduction: Six-minute walk test has been a recommended valid and reliable tool used for functional capacity assessment. American Thoracic Society (ATS) had stated that there are no global standards in interpreting 6-minute walking distance (6MWD) as a one-time measurement of functional assessment, which may be caused by population differences and various 6MWT technique utilized in previous studies. Single time cut off is required to evaluate functional status at the start of a program as a baseline for further follow-up evaluations. It is then a necessity to determine these cut off points in every country/race. Methods: The study was performed on healthy subjects, sedentary lifestyle, age 18-50, Indonesian ethnicity (Mongoloid race). Recorded data were 6 minute walking distance,also body height and weight. Predicted walking distance based on gender is obtained by calculating walk distance, body weight, body height, gender and subject age in Nury?s predicted walk distance formula. Data is analysed with SPSS 20, utilizing independent T-test. Results: As much as 123 subjects (58 males, 65 females) were included in this study. Mean walking distance for males is 581,98 meters, while females are 516,80 meters, and these differences were statistically significant. Walking distance cut off point between gender were compared. In male subjects, actual walking distance were taken as normalif >483 meters, poor if 434-483 meters, and very poor <434 meters. As for female subjects, normal when >442 meters, poor when 405-442 meters, and very poor in distance <405 meters. General percentage cut off point in comparison to predicted walking distance was categorized into normal, poor and very poor subgroups. Normal percentage was >85%, poor when distance is 77-85%, and <77% categorized as very poor. Conclusion: There are varying cut off points for walking distance in both males and females. Percentage cut off point as compared to predicted walking distance were not differentiated between genders.

SIX MINUTE WALK TEST AS A MEASUREMENT TOOL FOR FUNCTIONAL CAPACITY Nusdwinuringtyas, Nury
Majalah Kedokteran Indonesia Vol 68 No 4 (2018): Journal of the Indonesian Medical Association Majalah Kedokteran Indonesia Volum
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar

Various scientific articles which include scientific writing, books or journals have been known to provide evidence based scientific facts. Thus, in order to achieve accurate evidence based results, a clear outcome measurement is required. Besides, the measurement should be based on precise measurements, both in methods and tools utilized during the measurement. This is a very essential matter, as the accuracy of an outcome measurement would correlate to intervention, program and prognosis of an individual.

Inspiratory Muscle Trainer Effectiveness in Chronic Obstructive Pulmonary Disease Rehabilitation Program Nusdwinuringtyas, Nury; Islamadina, Balqis; Rumende, Cleopas Martin; Kamelia, Telly
Majalah Kedokteran Bandung Vol 51, No 1 (2019)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Chronic obstructive pulmonary disease (COPD) is marked by persistent respiratory disturbance which results in altered health status as well as functional capacity. Pulmonary rehabilitation (PR) is a part of comprehensive therapy in patients suffering from respiratory disturbance. This study focused on inspiratory muscles exercise using the inspiratory muscle trainer(IMT), which is a form of a weight training exercise. This experiment was conducted at the COPD outpatient clinic of Dr. Cipto Mangunkusumo Hospital during the period of September 2017 until April 2018. Patients were recruited consecutively. The criteria for inclusion were stable COPD patient with GOLD criteria A-D and never received prior exercise for pulmonary rehabilitation. Patients underwent interview about their medical history followed by spirometry testing using CarefusionÂ® andÂ inspiratory muscle strength assessment using Micro RPM CarefusionÂ®. The St George Respiratory Questionnaire (SGRQ) was used to assess the health status and the 6-minute walking test (6MWT) was conducted to assess the functional capacity. Subject exercised using IMT (Philips RespironicÂ®) for eight weeks. Data were analyzed using paired t-test in statistical package for social sciences (SPSS) version 21. A total of 15 subjects with and average age of 65.6Â±8.40 years old were recruited. Pre-Post difference in inspiratory muscle strength was 11.31 cmH2O, showing a statistically significant impact. The significant impact was also shown clinically through the results of the Minimal Clinical Important Difference (MCID) on health status and functional capacity. The health status was evaluated using SGRQ with p exceeding 4%. A combined Pulmonary Rehabilitation (PR) and inspiratory muscles exercise program is proven to improve the health status and functional capacity.Key words: COPD, inspiratory muscle trainer, pulmonary rehabilitation, SGRQ, 6MWTÂ Keefektifan Inspiratory Muscle Trainer Pada Program Rehabilitasi Â Penyakit Paru Obstruktif KronikPenyakit paru obstruktif kronik (PPOK) ditandai dengan gangguan pernapasan yang persisten yang mengganggu status kesehatan dan kapasitas fungsional. Pulmonary rehabilitation (PR) merupakan bagian dari terapi komprehensif pasien dengan ganguan respirasi. Penelitian ini memfokuskan pada latihan otot inspirasi menggunakan inspiratory muscle trainer (IMT), suatu bentuk latihan otot pernapasan dengan pemberian beban. Eksperimen ini dilakukan di Rumah Sakit Cipto Mangunkusumo selama periode September 2017 hingga April 2018. Pasien direkrut secara consecutive sampling. Kriteria inklusi adalah pasien PPOK yang stabil dengan kriteria GOLD A-D yang belum pernah menerima latihan sebelumnya untuk rehabilitasi paru. Pasien menjalani wawancara, diuji dengan spirometri CarefusionÂ®, dan kekuatan otot inspirasi dinilai menggunakan Micro RPM CarefusionÂ®. St George Respiratory Questionnaire (SGRQ) digunakan untuk menilai status kesehatan dan 6-minute Walking Test (6MWT) dilakukan untuk menilai kapasitas fungsional. Subyek menggunakan alat IMT (Philips RespironicÂ®) selama 8 minggu. Data dianalisis menggunakan SPSS versi 21 dengan uji T berpasangan. Subjek penelitian berjumlah 15 orang dengan rerata usia 65,6 Â± 8,40 tahun. Kekuatan otot inspirasi awal didapatkan perubahan sebesar 11,31 cmH2O, yang memberikan dampak bermakna dilihat dengan pencapaian minimal clinical important difference (MCID) pada status kesehatan dan kapasitas fungsional. PR bersama dengan program latihanotot inspirasiterbukti memberikan hasil perbaikan status kesehatan dan kapasitas fungsional.Kata kunci: COPD, inspiratory muscle trainer, pulmonary rehabilitation, SGRQ, 6MWTÂ

Senam Asma Indonesia dalam Perspektif Rehabilitasi Medis Widjanantie, Siti Chandra; Laras, Sekar; Damayanti, Triya; Nusdwinuringtyas, Nury; Yunus, Faisal
Majalah Kedokteran Indonesia Vol 73 No 6 (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.73.6-2024-1186

“Senam Asma Indonesia” (SAI) is a series of medical knowledge-based structured physical exercises invented by a multidisciplinary team incorporated in the Indonesian Asthma Foundation (YAI) in 1994, taking into account the characteristics of asthma patients adjusted to the severity of the asthma diagnosis with different loads at each stage. The principles for treating asthma are avoidance of triggers, using medication, and maintaining physical fitness. The quality of life (QoL) of asthma patients decreases due to limited daily life activities caused by the respiratory symptoms they suffer. Multifactorial symptoms of asthma such as limited ventilation, gas transfer abnormalities, pulmonary and cardiac blood vessel dysfunction, and dysfunction of extremity muscles, will cause shortness of breath during physical activity or exercise, which is known as Exercise-induced Bronchoconstriction (EIB). Oral steroid therapy given to treat acute exacerbations can cause steroid-induced myopathy and skeletal muscle remodeling, resulting in decreased muscle endurance. SAI consists of a series of movements designed to improve lung function, strengthen respiratory muscles, and improve the quality of life of asthma patients. From a medical rehabilitation perspective, SAI can contribute to optimizing thoracic wall mobility, respiratory control with pursed-lip breathing, relaxation, and improving cardiorespiratory fitness.

Efek Program Telerehabilitasi Paru pada Penyintas COVID-19: Penilaian Status Fungsional Menggunakan 30-Second Sit-To-Stand Test Widjanantie, Siti Chandra; Maylani, Lina; Ilyas, Muhammad; Nusdwinuringtyas, Nury; Susanto, Agus Dwi
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.73.5-2023-1224

Introduction: Long COVID is a persistent symptom among COVID-19 survivors. Fatigue and other symptoms related to respiratory or non-respiratory cause disturbance of patient functional status. Pulmonary telerehabilitation program after hospitalization was needed to optimize patients’ functional status. Assessment of functional status using 30-Second Sit-To-Stand Test (30s-STST) was easily to apply. The aim of this study was to know the changes of functional status in COVID-19 survivors after pulmonary telerehabilitation program.Method: This study was analytic experimental with one group pre-test and post-test design, conducted in Persahabatan Hospital from August to September 2020. The COVID-19 patient’s discharge records were recruited consecutively, 24 patients were eligible for this study to get pulmonary telerehabilitation program for four weeks. The patients were evaluated with 30s-STST twice, at discharge (baseline) and four weeks after discharge.Result: Participants consist of 19 men (79,2%) and 5 women (20,8%). The result of thirty second-STST before and after four weeks pulmonary telerehabilitation program result was 7,75 ± 2,19 dan 13,70 ± 4,23 times. There was a strong positive correlation (significant) between 30s STST result before and after program (r = 0,757, p less than 0,01).Conclusion: There was functional status improvement in COVID-19 survivors after pulmonary telerehabilitation for four weeks, evaluated with 30s-STST.

Rehabilitation Management for Sarcopenia in Chronic Obstructive Pulmonary Disease: A Literature Review Widjanantie, Siti Chandra; Lestari, Fiona; Nusdwinuringtyas, Nury; Susanto, Agus Dwi
Respiratory Science Vol. 4 No. 3 (2024): Respiratory Science
Publisher : Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/respirsci.v4i3.136

Chronic obstructive pulmonary disease (COPD) is a prevalent and debilitating chronic respiratory condition that not only affects the lungs but has far-reaching systemic consequences; one such consequence is the heightened risk of developing sarcopenia, a condition characterized by progressive loss of skeletal muscle mass and strength. Recent studies have highlighted the significant prevalence of sarcopenia among COPD patients, with rates ranging from 7.9% to 66.7%. This association underscores the importance of early identification and intervention to mitigate the adverse outcomes related to both conditions. Managing COPD patients with sarcopenia is fraught with challenges, primarily due to the multifaceted nature of both conditions. Sarcopenia exacerbates the decline in respiratory function and physical performance in COPD patients, complicating treatment and management strategies. The complexity is further amplified by the need for personalized treatment plans that address these conditions' pulmonary and musculoskeletal aspects. Precise assessment and re-evaluation are essential to ensure optimal outcomes and enhance physical and functional well-being. Rehabilitation for COPD patients with sarcopenia involves a multidisciplinary approach, focusing on exercise training, nutritional support, and pulmonary interventions. Pulmonary rehabilitation programs, tailored to individual patient needs and capabilities, have shown promise in improving exercise capacity, functional performance, and overall health status, thereby enhancing the quality of life for these patients. In this literature review, we will discuss the elevated risk of sarcopenia in COPD patients, highlight the significance of rehabilitation management, and emphasize the pivotal role of precise assessment and re-evaluation in optimizing the care provided to this population.

Nilai Acuan Jarak Tempuh Uji Jalan Menit pada Populasi (Mongoloid) Nusdwinuringtyas, Nury
Majalah Kedokteran Indonesia Vol 68 No 8 (2018): 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.68.8-2018-48

Introduction: Six-minute walk test has been a recommended valid and reliable tool used for functional capacity assessment. American Thoracic Society (ATS) had stated that there are no global standards in interpreting 6-minute walking distance (6MWD) as a one-time measurement of functional assessment, which may be caused by population differences and various 6MWT technique utilized in previous studies. Single time cut off is required to evaluate functional status at the start of a program as a baseline for further follow-up evaluations. It is then a necessity to determine these cut off points in every country/race. Methods: The study was performed on healthy subjects, sedentary lifestyle, age 18-50, Indonesian ethnicity (Mongoloid race). Recorded data were 6 minute walking distance,also body height and weight. Predicted walking distance based on gender is obtained by calculating walk distance, body weight, body height, gender and subject age in Nury’s predicted walk distance formula. Data is analysed with SPSS 20, utilizing independent T-test. Results: As much as 123 subjects (58 males, 65 females) were included in this study. Mean walking distance for males is 581,98 meters, while females are 516,80 meters, and these differences were statistically significant. Walking distance cut off point between gender were compared. In male subjects, actual walking distance were taken as normalif greater-than sign 483 meters, poor if 434-483 meters, and very poor less-than sign 434 meters. As for female subjects, normal when greater-than sign 442 meters, poor when 405-442 meters, and very poor in distance less-than sign 405 meters. General percentage cut off point in comparison to predicted walking distance was categorized into normal, poor and very poor subgroups. Normal percentage was greater than sign 85%, poor when distance is 77-85%, and less-than sign 77% categorized as very poor. Conclusion: There are varying cut off points for walking distance in both males and females. Percentage cut off point as compared to predicted walking distance were not differentiated between genders.

Six Minute Walk Test as A Measurement Tool for Functional Capacity Nusdwinuringtyas, Nury
Majalah Kedokteran Indonesia Vol 68 No 4 (2018): 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.68.4-2018-78

Various scientific articles which include scientific writing, books or journals have been known to provide evidence based scientific facts. Thus, in order to achieve accurate evidence based results, a clear outcome measurement is required. Besides, the measurement should be based on precise measurements, both in methods and tools utilized during the measurement. This is a very essential matter, as the accuracy of an outcome measurement would correlate to intervention, program and prognosis of an individual.

Faktor-faktor yang Mempengaruhi Nilai Arus Puncak Batuk pada Dewasa Muda Sehat Indonesia (Mongoloid) Nusdwinuringtyas, Nury; Fauzan, Adri; Rumende, C Martin
Majalah Kedokteran Indonesia Vol 69 No 10 (2019): Journal of The Indonesian Medical Association - Majalah Kedokteran Indonesia, V
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47830/jinma-vol.69.10-2020-180

Introduction: Cough is one of the main human defense mechanisms against respiratory tract infection and aspiration. Until now, there has not been any Peak Cough Flow (PCF) standard value in Indonesia. The preexisting standard PCF values were measured in Brazil (2012) and New Zealand (Caucasian). There were anthropometric differences based on race, which affect PCF. The aim of this study is to determine the PCF of healthy Indonesian adults and affecting factors.Methods: This study used crossectional in design. A number of 30 healthy adult subjects were recruited and analyzed. Chi-Square and multivariate analyses. Screening subjects was measured using spirometry test and cough ability using peak flow meter.Results: The mean PCF was 477.17 (L/min). There was significant correlation between gender (p=0.000), age (p=0.012;r=-0.430), and height (p=0.000;r=0.741) to PCF. Height was the most contributing variable (p=0.003;IK95% 2.37-10.77).Conclusion: The mean PCF in healthy adults was 477.17(L/min). Height was the most contributing factor, followed by age and gender.

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.

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