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Comparison of functional outcome after early and delayed anterior cruciate ligament reconstruction: A systematic review I Putu Dharma Kresna; Kukuh Dwiputra Hernugrahanto; Rr. Indrayuni Lukitra Wardhani; Dwikora Novembri Utomo
Qanun Medika - Jurnal Kedokteran FK UMSurabaya Vol 6, No 2 (2022): Journal Qanun Medika Vol 6 No 02
Publisher : Universitas Muhammadiyah Surabaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30651/jqm.v6i2.11315

This study aims to find the optimal timing for Anterior Cruciate Ligament (ACL) reconstruction by comparing the outcome of early versus delayed ACL reconstruction, meniscus, and chondral damage. A systematic literature search was performed from February to March 2021 from 4 databases. Inclusion criteria were English language Randomized Control Trial (RCT) and observational studies published in 2000-2020, 20-50 years old patients with an isolated ACL tear with/without meniscal injury underwent ACL reconstruction. Early ACL reconstruction was estimated at less than six weeks post-injury, and delayed ACL reconstruction was estimated at more than six weeks. Tegner and Lysholm were the functional outcomes to compare early and delayed ACL reconstruction with a meniscus tear and chondral damage. The search yielded 3094 studies. After removing duplicates, titles and abstracts were screened, leaving 154 potential studies. The studies were selected, and eight studies were eligible. No statistically significant difference between early and delayed ACL reconstruction in Lysholm and Tegner score (p>0,05) was found. Both scores were similar regarding whether the patient performs early/delayed ACL reconstruction. Therefore, early ACL reconstruction could be an optimal timing for the patient who will undergo ACL reconstruction.

Sun Bathing Affects Overweight-Obese Subjects Vitamin D Deficiency Rio yudistira christanto; Andriati; Dwikora Novembri Utomo; Indrayuni Lukitra Wardhani
Surabaya Physical Medicine and Rehabilitation Journal Vol. 4 No. 2 (2022): SPMRJ, AUGUST 2022
Publisher : Faculty of Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/spmrj.v4i2.23815

Background: There are increasing number of studies that discuss the effect of sun exposure to overweight and obese individuals with vitamin D deficiency (which is UVB exposure can increase serum 25-Hydroxyvitamin D levels). However, until now there is no a literature review about these studies. This shows a weak correlation between sun bathing and serum 25-Hydroxyvitamin D elevation in overweight and obese people. Aim: Describe the effect of the sun bathing for overweight-obese patient with vitamin D deficiency. Material and Methods: Electronic searching tools (ScienceDirect, Pubmed, and Google Scholar) were conducted from the 1990s until the recent literature. A sensitive search strategy uses specific terms. Studies were included if the population with BMI > 25 Kg/m2; Sun Exposure intervention, the studies provided the comparison of implementation method, the studies provided 25-Hydroxyvitamin D status as the outcome. For the exclusion criteria: studies that included subjects metabolics syndrome. MMAT was used for eliminating biased research. Results: Two studies were fulfilled our inclusion criteria. The studies, were excluded, mainly because they lacked data, biased reseach, and failure to answer any authors questions. Conclusion: The sun exposure method has a positive corellation for increasing serum 25-Hydroxyvitamin D level in overweight and obese subjects with vitamin D deficiency, but internal factors (age and skin color) and external factors (season, temperature, dose, and duration) need to be considered to get effective result. Keywords: Obese, Overweight, Sun bathing, Vitamin D deficiency, 25-Hydroxyvitamin D.

Immediate Effect of Kinesiotaping on Non-dominant Wrist Extensor Muscles:an Alteration in Handgrip Strength of Healthy Individuals M. Rasyidin Alamsyah Siregar; Indrayuni Lukitra Wardhani; Nuniek Nugraheni Sulistiawaty; R A Meisy Andriana
Surabaya Physical Medicine and Rehabilitation Journal Vol. 4 No. 2 (2022): SPMRJ, AUGUST 2022
Publisher : Faculty of Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/spmrj.v4i2.25137

Background: Adequate function of wrist extensor muscles is essential for handgrip strength. Handgrip strength can be used as a health problem predictor in the future. Maintaining and increasing handgrip strength to reduce the risk of future mortality is noteworthy. Aim: To investigate the immediate effect of the kinesiotaping facilitation technique on the non-dominant wrist extensor muscles on handgrip strength of healthy individuals. Material and Methods: This study was conducted in August – September 2020. Twenty-two healthy men, aged 25 – 40 years and willing to participate in this study by signing the research agreement form was recruited from Medical Rehabilitation Departement RSUD Dr. Soetomo Surabaya, and randomized into kinesiotaping group and placebo taping group. The kinesiotaping group received kinesiotaping facilitation technique Y strip 50% stretched on the non-dominant wrist extensor muscles. The placebo taping group received non-elastic adhesive tape Y strip on the non-dominant wrist extensor muscles. Handgrip strength was measured using hydraulic handgrip dynamometer before and 30 minutes after kinesiotaping facilitation technique and placebo taping applied. Results: Alteration of handgrip strength is significant increase in kinesiotaping group compared to placebo taping group (p=0.036). Conclusion: Kinesiotaping facilitation technique on non-dominant wrist extensor muscles can immediately increase handgrip strength of healthy individuals.

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

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v45i3.807

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. Pendahuluan: Penggunaan gelombang ultrasonik untuk memperbaiki penyembuhan tulang umumnya menggunakan alat stimulasi khusus yang tidak tersedia di Indonesia. Frekuensi dan durasi terapi penelitian sebelumnya sulit diterapkan dalam praktik klinis. Tujuan penelitian ini adalah untuk membandingkan efek stimulasi gelombang ultrasonik menggunakan alat terapi konvensional ultrasound diathermy (USD) antara kelompok kontrol, kelompok perlakuan USD 5x/minggu dan 3x/minggu terhadap jumlah osteoblas, kadar alkali fosfatase, dan kalsium serum. Metode: Sejumlah 36 ekor tikus putih jantan dibagi tiga kelompok (kontrol, USD 5x/minggu, dan USD 3x/minggu). Fraktur tibia pada kelompok ultrasound diterapi 3x/minggu dan 5x/minggu dengan gelombang ultrasonik (1 MHz, pulsed-mode, 20% duty cycle, intensitas 0,2 W/cm2, durasi 10 menit, stasioner) selama 3 minggu. Jaringan kalus dan darah semua hewan dinilai secara kuantitatif dengan analisis histologi dan biokimia. Hasil: Ada perbedaan signifikan (p <0,05) jumlah rata-rata osteoblas, kadar alkali fosfatase, dan kalsium serum antara ketiga kelompok. Simpulan: Terapi konvensional dengan pulsed-ultrasound intensitas rendah frekuensi 5x/minggu ataupun 3x/minggu memperbaiki proses penyembuhan tulang.

The Impact of COVID-19 Pandemic on the Epidemiology of Hip and Knee Arthroplasty: A Two-Year Look into the Pandemic from A Single Tertiary Referral General Hospital in Indonesia Hanif, Hanan; Wardhani, Indrayuni Lukitra; Widhiyanto, Lukas; Chilmi, Mohammad Zaim
JUXTA: Jurnal Ilmiah Mahasiswa Kedokteran Universitas Airlangga Vol. 15 No. 1 (2024): Jurnal Ilmiah Mahasiswa Kedokteran Universitas Airlangga
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/juxta.V15I12024.44-50

Highlights: Arthroplasty surgeries were reduced significantly during the COVID-19 pandemic. The number of operations gradually increased between the first and second year of the pandemic. Patients' median age and hospital stays were reduced during the pandemic. Abstract Introduction: The COVID-19 pandemic has had significant effects on arthroplasty surgeries worldwide. Various studies have described decreased arthroplasty procedures among the most common orthopedic surgeries. This study aimed to analyze the effects of the pandemic on the epidemiology and demography of hip and knee arthroplasty in a tertiary referral general hospital in Indonesia. Methods: This was a retrospective study of medical records data conducted on hip and knee arthroplasty cases from the pre-pandemic (April 2019–March 2020), first-year pandemic (April 2020–March 2021), and second-year pandemic (April 2021–March 2022) periods. Each period was compared for epidemiology and demography data, which included the annual number of arthroplasties, female-to-male ratio, age, duration of hospitalization, and in-hospital post-operative rehabilitation participation. All statistical data calculations were performed using the International Business Machines Corporation (IBM) Statistical Package for Social Sciences (SPSS) version 26. Results: This study observed a statistically significant decrease of 232.00% for hip and 371.43% for knee arthroplasty performed during the first-year pandemic and an increase of 41.86% for hip and 74.07% for knee arthroplasty in the second-year pandemic. A decrease in median age and fluctuation of the female-to-male ratio were observed. The median duration of hospitalization was 80.00% shorter between the pre-pandemic and first-year pandemics and 11.11% shorter between the first and second-year pandemics. Participation in rehabilitation fluctuated during each period. There were four positive cases of COVID-19 and two cases of mortality during the first- and second-year pandemics. Conclusion: The COVID-19 pandemic caused a significant reduction in arthroplasties performed during the first year and a slight increase during the second year. Several changes to the demographics of the patients were also observed between the pre-pandemic and the pandemic periods.

Flat Foot based on Clarke's Angle Method and Overweight among Medical Students of Universitas Airlangga Putri, Nelsya Safira Aulia; Arfianti, Lydia; Desnantyo, Andre Triadi; Wardhani, Indrayuni Lukitra
JUXTA: Jurnal Ilmiah Mahasiswa Kedokteran Universitas Airlangga Vol. 15 No. 2 (2024): Jurnal Ilmiah Mahasiswa Kedokteran Universitas Airlangga
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/juxta.V15I22024.113-118

Highlights: Being overweight can be one of the causes of flat foot. A person with flat feet may experience pain in the medial malleolus area and discomfort when tiptoeing. Abstract Introduction: A flat foot is an arch deformity, and being overweight is one of the risk factors. It can cause problems such as fatigue, pain in the ankle and back, foot pain (especially during long walks or sports), and disturbances in balance and walking patterns. This study examined the relationship between flat feet (measured using Clarke's angle) and overweight students at the Faculty of Medicine, Universitas Airlangga. Methods: This study used an observational analytic design with a cross-sectional method, gathering primary data directly from the research sample. The data were analyzed using the International Business Machines Corporation (IBM) Statistical Package for the Social Sciences (SPSS) version 26 with a p<0.05 considered statistically significant. Results: Of the 56 samples meeting inclusion criteria, most flat foot cases occurred in males. A total of 36 research subjects were overweight or obese, evenly split between females and males. Among the 112 samples, 19 had flat feet, and 93 did not. Chi-square test analysis indicated a highly significant (p=0.001), suggesting a significant relationship between flat feet and overweight. Conclusion: Flat feet (measured using Clarke's angle) had a significant relationship with overweight. Most subjects in this study were overweight based on body mass index (BMI), and most had a non-flat foot arch type. All cases of flat foot were found in subjects with overweight BMI.

HUBUNGAN ANTARA INFEKSI DAN LAMA PERAWATAN PASIEN LUKA BAKAR BERDASARKAN JENIS KUMAN DI RSUD DR SOETOMO SURABAYA Samiyah; Wardhani, Rr. Indrayuni Lukitra; Iswinarno Doso Saputro
Jurnal Rekonstruksi dan Estetik Vol. 7 No. 1 (2022): Jurnal Rekonstruksi dan Estetik, Juni 2022
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jre.v7i1.36369

Highlights: Rata-rata waktu tersingkat lama perawatan pasien luka bakar yang mengalami infeksi yaitu selama 11 hari dan paling lama yaitu 53 hari. Acinetobacter baumanii, Staphylococcus haemolyticus, dan Pseudomonas aeruginosa merupakan jenis bakteri yang sering menginfeksi pasien luka bakar di RSUD Dr. Soetomo Surabaya. Lama masa perawatan dengan jenis bakteri yang menginfeksi pasien luka bakar memiliki hubungan yang signifikan. ABSTRAK: Latar Belakang: Luka bakar merupakan salah satu masalah global di Indonesia. Infeksi pada pasien luka bakar merupakan salah satu faktor yang mempengaruhi lama masa perawatan berkaitan dengan tingkat patogenisitas bakteri penyebab infeksi. Tujuan penelitian ini adalah untuk mengetahui hubungan antara lama masa perawatan dengan jenis kuman penyebab infeksi pada pasien luka bakar yang dirawat di RSUD Dr. Soetomo Surabaya periode Januari-Desember 2019. Metode: Penelitian ini merupakan studi deskriptif analitik dengan desain kohort retrospektif. Data mengenai karakteristik pasien, derajat keparahan luka bakar, penyakit penyerta, jenis bakteri yang menginfeksi pasien luka bakar, serta lama masa perawatan didapatkan dari rekam medis pasien. Data mengenai jenis bakteri yang menginfeksi pasien luka bakar dan lama perawatan pasien luka bakar ditentukan korelasinya dengan menggunakan uji statistik Rank Spearman-Rho. Hasil: Penelitian diperoleh sebanyak 42 data pasien luka bakar yang mengalami infeksi dan didominasi pasien berjenis kelamin laki-laki yaitu sebesar 61,9%. Persentase rentang usia terbanyak adalah 26-35 tahun yakni 23,8%. Persentase derajat keparahan luka bakar terbanyak adalah derajat II yang didominasi derajat IIB yakni 38,1%. Gangguan metabolik merupakan kondisi penyerta tersering yang dialami pasien luka bakar yakni sebanyak 50%. Rerata lama perawatan pasien luka bakar yang mengalami infeksi adalah 28,21±10,17 hari dengan waktu paling lama adalah 53 hari. Jenis bakteri yang menginfeksi pasien luka bakar pada penelitian ini didominasi oleh Acinetobacter baumanii (31%), Staphylococcus haemolyticus (23,8%), dan Pseudomonas aeruginosa (16,7%). Uji korelasi antara lama masa perawatan pada pasien luka bakar dan jenis bakteri yang menginfeksi pasien luka bakar menunjukkan hasil yang signifikan (p = 0,012). Kesimpulan: Terdapat korelasi yang signifikan antara lama masa perawatan dengan jenis bakteri yang menginfeksi pasien luka bakar.

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

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v45i3.807

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. Pendahuluan: Penggunaan gelombang ultrasonik untuk memperbaiki penyembuhan tulang umumnya menggunakan alat stimulasi khusus yang tidak tersedia di Indonesia. Frekuensi dan durasi terapi penelitian sebelumnya sulit diterapkan dalam praktik klinis. Tujuan penelitian ini adalah untuk membandingkan efek stimulasi gelombang ultrasonik menggunakan alat terapi konvensional ultrasound diathermy (USD) antara kelompok kontrol, kelompok perlakuan USD 5x/minggu dan 3x/minggu terhadap jumlah osteoblas, kadar alkali fosfatase, dan kalsium serum. Metode: Sejumlah 36 ekor tikus putih jantan dibagi tiga kelompok (kontrol, USD 5x/minggu, dan USD 3x/minggu). Fraktur tibia pada kelompok ultrasound diterapi 3x/minggu dan 5x/minggu dengan gelombang ultrasonik (1 MHz, pulsed-mode, 20% duty cycle, intensitas 0,2 W/cm2, durasi 10 menit, stasioner) selama 3 minggu. Jaringan kalus dan darah semua hewan dinilai secara kuantitatif dengan analisis histologi dan biokimia. Hasil: Ada perbedaan signifikan (p <0,05) jumlah rata-rata osteoblas, kadar alkali fosfatase, dan kalsium serum antara ketiga kelompok. Simpulan: Terapi konvensional dengan pulsed-ultrasound intensitas rendah frekuensi 5x/minggu ataupun 3x/minggu memperbaiki proses penyembuhan tulang.

The Relationship Between Quadriceps Muscle Atrophy and Proprioception Function in Knee Osteoarthritis Patients Susanti, Ayu; Wardhani, Rr. Indrayuni Lukitra; Pawana, I Putu Alit
Surabaya Physical Medicine and Rehabilitation Journal Vol. 1 No. 2 (2019): SPMRJ, Agustus 2019
Publisher : Faculty of Medicine, Universitas Airlangga

Background: Osteoarthritis of the knee (OA) patients can experience impaired proprioceptive function which causes instability, balance disorder and limited activity. Further analysis is needed to detect changes that occur. There are two methods to evaluate the speed and angle of a particular motion as an analysis of the function of proprioception, Time to Detect Passive Movements (TTDPM) and Joint Position Sense (JPS).Aim: To analyze the relationship between quadriceps muscle atrophy with proprioception in knee osteoarthritis patients.Methods: The design of this research is cross sectional analysis done in Dr. Soetomo General Hospital Surabaya, Indonesia. There were 25 knee OA patients (2 men and 23 women) with each subject had proprioception (JPS and TTDPM) function measured using isokinetics dynamometer on both sides of the knee.Results: This study shows the atrophic side had greater pain intensity and greater disturbance of proprioception. In addition, there were significant differences in JPS measurements at angle of 30â°, and 60â° and TTDPM (p <0.05). No difference obtained at 45â° measurements angle.Conclusion: In this study, there was no association between quadriceps atrophy and function of proprioception in knee osteoarthritis patients. This was due to a number of confounding factors that cannot be controlled such as duration, difference in pain intensity, OA severity, physical activity before measurement, and fatigue which can affect proprioception function and bring misinterpretation on measurements.

Impact of cycle ergometer based low-intensity aerobic exercise on quadriceps femoris strength in breast cancer patients receiving chemotherapy Perdana, Difitasari Cipta; Wardhani, Indrayuni Lukitra; Utami, Ditaruni Asrina; Suprabawati, Desak Agung Gede
Physical Therapy Journal of Indonesia Vol. 6 No. 2 (2025): July-December 2025
Publisher : Universitas Udayana dan Diaspora Taipei Medical University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/ptji.v6i2.332

Background: Breast cancer and chemotherapy can reduce muscle strength through systemic and neuromusculoskeletal effects. This study aimed to evaluate the effect of low-intensity cycle ergometer exercise on quadriceps femoris strength in patients receiving chemotherapy. Methods: A randomized controlled trial was conducted at the medical rehabilitation outpatient clinic, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia, from May to November 2024. Twenty female patients aged 18–59 years with stage II–III breast cancer who had completed at least three chemotherapy cycles were enrolled. Eligible participants had normal echocardiography findings (left ventricular ejection fraction ≥ 50%) and oncologist approval. Exclusion criteria included hemodynamic instability, hematologic abnormalities, arrhythmia, pulmonary disease exacerbations, recent surgery or radiotherapy, severe pain, or cognitive disorders. Participants were randomly assigned to either an intervention group or a control group. The intervention group performed low-intensity cycle ergometer training twice weekly for eight, while the control group performed breathing exercises only. Quadriceps femoris strength was measured before and after the intervention using a handheld dynamometer. Data were analyzed using paired and independent t-tests, with significance set at p-value < 0.05. Results: After eight weeks, the intervention group showed significantly greater increases in quadriceps femoris strength compared with the control group (right leg: p = 0.006; left leg: p= 0.020). Mean strength gains were 4.38 ± 2.3 kg (right) and 3.22 ± 1.9 kg (left), whereas the control group showed significant declines. Large effect sizes (Cohen’s d > 1) indicated clinically meaningful improvements in the exercise group. Conclusion: The intervention group showed significantly greater preservation and improvement of quadriceps femoris strength than the control group. Low-intensity cycle ergometer exercise appears to be a safe and effective rehabilitation strategy for maintaining muscle strength, functional capacity, and quality of life in breast cancer patients undergoing chemotherapy.

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