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All Journal Majalah Kedokteran Bandung Journal of the Indonesian Medical Association : Majalah Kedokteran Indonesia Respiratory Science
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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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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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 
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

Abstract

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.
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

Abstract

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.
Co-Authors Adang Bachtiar Agus Dwi Susanto C Martin Rumende Cleopas Martin Rumende Faisal Yunus Fauzan, Adri Fiona Lestari, Fiona Idrus Alwi Islamadina, Balqis Telly Kamelia Widjajalaksmi Widjajalaksmi Widjanantie, Siti Chandra