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All Journal Majalah Kedokteran Bandung Medical Journal of Indonesia Journal of the Indonesian Medical Association : Majalah Kedokteran Indonesia
Nury Nusdwinuringtyas
Faculty of Medicine University of Indonesia/ Dr. Cipto Mangunkusumo Hospital, Jakarta,
Biochemistry, Genetics & Molecular Biology Education Health Professions Medicine & Pharmacology Public Health

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Healthy adults maximum oxygen uptake prediction from a six minute walking test Nusdwinuringtyas, Nury; Widjajalaksmi, Widjajalaksmi; Bachtiar, Adang
Medical Journal of Indonesia Vol 20, No 3 (2011): August
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (363.858 KB) | DOI: 10.13181/mji.v20i3.452

Abstract

Background: A parameter is needed in medical activities or services to determine functional capacity. This study is aimed to produce functional capacity parameter for Indonesian adult as maximum O2.Methods: This study used 123 Indonesian healthy adult subjects (58 males and 65 females) with a sedentary lifestyle, using a cross-sectional method.Results: Designed by using the followings: distance, body height, body weight, sex, age, maximum heart rate of six minute walking test and lung capacity (FEV and FVC), the study revealed a good correlation (except body weight) with maximum O2. Three new formulas were proposed, which consisted of eight, six, and five variable respectively. Test of the new formula gave result of maximum O2 that is relevant to the golden standard maximum O2 using Cosmed® C-Pex.Conclusion: The Nury formula is the appropriate predictor of maximum oxygen uptake for healthy Indonesians adult as it is designed using Indonesian subjects (Mongoloid) compared to the Cahalin’s formula (Caucasian). The Nury formula which consists of five variables is more applicable because it does not require any measurement tools neither specific competency. (Med J Indones 2011;20:195-200)Keywords: maximum O2, Nury’s formula, six minute walking test
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)

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Abstract

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)

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Abstract

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

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (625.998 KB) | DOI: 10.15395/mkb.v51n1.1600

Abstract

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 Carefusion® and  inspiratory muscle strength assessment using Micro RPM Carefusion®. 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 Respironic®) 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 65.6±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, 6MWT Keefektifan Inspiratory Muscle Trainer Pada Program Rehabilitasi  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 Carefusion®, dan kekuatan otot inspirasi dinilai menggunakan Micro RPM Carefusion®. 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 Respironic®) selama 8 minggu. Data dianalisis menggunakan SPSS versi 21 dengan uji T berpasangan. Subjek penelitian berjumlah 15 orang dengan rerata usia 65,6 ± 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, 6MWT 
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

Abstract

“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

Abstract

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.
Co-Authors Adang Bachtiar Agus Dwi Susanto Cleopas Martin Rumende Damayanti, Triya Faisal Yunus Idrus Alwi Islamadina, Balqis Laras, Sekar Maylani, Lina Muhammad Ilyas Telly Kamelia Widjajalaksmi Widjajalaksmi Widjanantie, Siti Chandra