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Physiological Effects and Prescription of Exercise in Patients with Peripheral Artery Disease Arnengsih Nazir
Indonesian Journal of Physical Medicine & Rehabilitation Vol 10 No 01 (2021): Indonesian Journal Of Physical Medicine and Rehabilitation
Publisher : Indonesian Journal of Physical Medicine & Rehabilitation

ABSTRACTIntroduction: Peripheral artery disease (PAD) is a disease with atherosclerotic process in blood vessels which results in impairment of blood flow to the lower limbs. The prevalence escalates with advancing age and resulting in typical symptoms of intermittent claudication, ischemic pain at rest, non-healingwound, and atypical symptoms associated with PAD. These symptoms can lead to impaired walking, activity restrictions, and low quality of life. Regular exercise has been known as an effective intervention to reduce symptoms and improve exercise performance.Methods: Literature published from 2011-2021 was searched using the PubMed and Google Scholar as the search engine. The keywords used were exercise, physiological effect, recommendation, peripheral artery disease, and intermittent claudication.Results: Forty-four literature matched with the topic and 1 1 were used to explain sub-topics.Conclusion: The physiological effects of regular exercise include increased of oxygen extraction from blood vessels and muscle enzyme activity, as well as decreased of inflammatory mediators associated with endothelial damage. The recommended form of exercise for PAD is walking both under supervisionand without supervision at home and community. Prescription of aerobic exercise vary based on intensity targeted. Another forms of exercise recommended for PAD patients are resistance and flexibility exercises.Keywords: exercise, peripheral artery disease, physiological ef fects, supervised-exercise.

Monitored Home-based Exercise Rehabilitation for Patient with Chronic Respiratory and Cardiovascular Diseases During Covid-19 Pandemic: A Case Report Arnengsih Nazir; Marina Annette Moeliono
Indonesian Journal of Physical Medicine & Rehabilitation Vol 9 No 02 (2020): Indonesian Journal Of Physical Medicine and Rehabilitation
Publisher : Indonesian Journal of Physical Medicine & Rehabilitation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36803/ijpmr.v9i2.300

ABSTRACTIntroduction: In patients with Chronic Obstructive Pulmonary Disease (COPD), due to shared-riskfactors, concomitant chronic cardiovascular diseases include Congestive Heart Failure (CHF) arecommon and resulting in increase overall morbidity and mortalit y.Case Report: A female patient, 52 years, came for pulmonary rehabilitation 2 weeks after hospitalizationdue to acute exacerbation of COPD. One week before the exacerbation, she showed symptoms of CHF.Physical examination showed signs of right and left heart failure, oxygen desaturation, and limitedchest expansion. Functional assessment showed disability in self-care, instrumental activities ofdaily living (ADL), deconditioning, depression, and anxiety. Supporting examination confirmed verysevere restriction and obstruction, bronchopneumonia, cardiomegaly, and pulmonary hypertension.Rehabilitation problems include cardiorespiratory, ADL, and psychological problems. The Covid-19pandemic causing prohibition of supervised cardiorespiratory rehabilitation. Home-based exerciseprogram was given for 5 months. Monitoring was done via video call before and after each exercise andthrough analysis of exercise diary. Psychological counseling also given at the beginning of the program.Patient did all of prescribed exercises. At the end, symptoms decreased, patient can do ADL and hobbies,no exacerbation or exercise intolerance, patient does not look anxious and consents to leisure activities.Conclusion: Monitored-home based exercise programs can be used as safely alternative to hospitalbased,if done according to the prescription. However , monitoring by physician is mandatory.Keywords: chronic obstructive pulmonary disease, congestive heart failure, covid-19 pandemic, homebasedexercise, rehabilitation

Pre-Operative Depression and Anxiety in Patients Undergoing Open-Heart Surgery Arnengsih Nazir; Lynna Lidyana; Faresha Nadia Amanda; M. Maulana Efry
Indonesian Journal of Physical Medicine & Rehabilitation Vol 11 No 01 (2022): Indonesian Journal Of Physical Medicine and Rehabilitation
Publisher : Indonesian Journal of Physical Medicine & Rehabilitation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36803/ijpmr.v11i01.325

ABSTRACT Introduction: Cardiac disease and mental health are two related disorders and often co-exist together. As one of the interventions to manage patients with cardiac diseases, the heart surgical procedure also correlated with depression and anxiety which will interfere with the prognosis. This study aimed to know the incidence of depression and anxiety in patients before undergoing open-heart surgery at Dr. Hasan Sadikin General Hospital (RSHS) Bandung. Methods: This study was a case series using primary data from patients and secondary data from medical records. Subjects were adult patients who will undergo open-heart surgery at RSHS Bandung. Data collection was started from November to December 2019. Variables assessed were depression and anxiety. Demographic profiles (age, gender, occupation, education, and marital status), as well as medical profiles (underlying disease, comorbidity, and type of surgical procedure), were also obtained. Results: Seven subjects will undergo open-heart surgery during the study period. One subject was excluded for returning an incomplete questionnaire. Subjects’ age was ranged from 28–58 years with a 1:1 male to female ratio. Subjects were dominated by those who will undergo mitral valve replacement(4 of 6). No subject had depression and anxiety in this study. Discussion: In this study, no incidence of depression and anxiety were found among subjects. The possible explanation for this result was the dominant underlying disease of valvular heart disease which was known to have a lower incidence of psychological disorders compared to coronary artery disease. Conclusion: Depression and anxiety were not found among the subjects of th is study.Keywords: anxiety, coronary artery disease, depression, heart disease, open-hear t surgery

Physiological Effects and Prescription of Exercise in Patients with Peripheral Artery Disease Arnengsih Nazir
Indonesian Journal of Physical Medicine & Rehabilitation Vol 10 No 01 (2021): Indonesian Journal Of Physical Medicine and Rehabilitation
Publisher : Indonesian Journal of Physical Medicine & Rehabilitation

ABSTRACTIntroduction: Peripheral artery disease (PAD) is a disease with atherosclerotic process in blood vessels which results in impairment of blood flow to the lower limbs. The prevalence escalates with advancing age and resulting in typical symptoms of intermittent claudication, ischemic pain at rest, non-healingwound, and atypical symptoms associated with PAD. These symptoms can lead to impaired walking, activity restrictions, and low quality of life. Regular exercise has been known as an effective intervention to reduce symptoms and improve exercise performance.Methods: Literature published from 2011-2021 was searched using the PubMed and Google Scholar as the search engine. The keywords used were exercise, physiological effect, recommendation, peripheral artery disease, and intermittent claudication.Results: Forty-four literature matched with the topic and 1 1 were used to explain sub-topics.Conclusion: The physiological effects of regular exercise include increased of oxygen extraction from blood vessels and muscle enzyme activity, as well as decreased of inflammatory mediators associated with endothelial damage. The recommended form of exercise for PAD is walking both under supervisionand without supervision at home and community. Prescription of aerobic exercise vary based on intensity targeted. Another forms of exercise recommended for PAD patients are resistance and flexibility exercises.Keywords: exercise, peripheral artery disease, physiological ef fects, supervised-exercise.

Monitored Home-based Exercise Rehabilitation for Patient with Chronic Respiratory and Cardiovascular Diseases During Covid-19 Pandemic: A Case Report Arnengsih Nazir; Marina Annette Moeliono
Indonesian Journal of Physical Medicine & Rehabilitation Vol 9 No 02 (2020): Indonesian Journal Of Physical Medicine and Rehabilitation
Publisher : Indonesian Journal of Physical Medicine & Rehabilitation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36803/ijpmr.v9i2.300

ABSTRACTIntroduction: In patients with Chronic Obstructive Pulmonary Disease (COPD), due to shared-riskfactors, concomitant chronic cardiovascular diseases include Congestive Heart Failure (CHF) arecommon and resulting in increase overall morbidity and mortalit y.Case Report: A female patient, 52 years, came for pulmonary rehabilitation 2 weeks after hospitalizationdue to acute exacerbation of COPD. One week before the exacerbation, she showed symptoms of CHF.Physical examination showed signs of right and left heart failure, oxygen desaturation, and limitedchest expansion. Functional assessment showed disability in self-care, instrumental activities ofdaily living (ADL), deconditioning, depression, and anxiety. Supporting examination confirmed verysevere restriction and obstruction, bronchopneumonia, cardiomegaly, and pulmonary hypertension.Rehabilitation problems include cardiorespiratory, ADL, and psychological problems. The Covid-19pandemic causing prohibition of supervised cardiorespiratory rehabilitation. Home-based exerciseprogram was given for 5 months. Monitoring was done via video call before and after each exercise andthrough analysis of exercise diary. Psychological counseling also given at the beginning of the program.Patient did all of prescribed exercises. At the end, symptoms decreased, patient can do ADL and hobbies,no exacerbation or exercise intolerance, patient does not look anxious and consents to leisure activities.Conclusion: Monitored-home based exercise programs can be used as safely alternative to hospitalbased,if done according to the prescription. However , monitoring by physician is mandatory.Keywords: chronic obstructive pulmonary disease, congestive heart failure, covid-19 pandemic, homebasedexercise, rehabilitation

Pre-Operative Depression and Anxiety in Patients Undergoing Open-Heart Surgery Arnengsih Nazir; Lynna Lidyana; Faresha Nadia Amanda; M. Maulana Efry
Indonesian Journal of Physical Medicine & Rehabilitation Vol 11 No 01 (2022): Indonesian Journal Of Physical Medicine and Rehabilitation
Publisher : Indonesian Journal of Physical Medicine & Rehabilitation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36803/ijpmr.v11i01.325

ABSTRACT Introduction: Cardiac disease and mental health are two related disorders and often co-exist together. As one of the interventions to manage patients with cardiac diseases, the heart surgical procedure also correlated with depression and anxiety which will interfere with the prognosis. This study aimed to know the incidence of depression and anxiety in patients before undergoing open-heart surgery at Dr. Hasan Sadikin General Hospital (RSHS) Bandung. Methods: This study was a case series using primary data from patients and secondary data from medical records. Subjects were adult patients who will undergo open-heart surgery at RSHS Bandung. Data collection was started from November to December 2019. Variables assessed were depression and anxiety. Demographic profiles (age, gender, occupation, education, and marital status), as well as medical profiles (underlying disease, comorbidity, and type of surgical procedure), were also obtained. Results: Seven subjects will undergo open-heart surgery during the study period. One subject was excluded for returning an incomplete questionnaire. Subjects’ age was ranged from 28–58 years with a 1:1 male to female ratio. Subjects were dominated by those who will undergo mitral valve replacement(4 of 6). No subject had depression and anxiety in this study. Discussion: In this study, no incidence of depression and anxiety were found among subjects. The possible explanation for this result was the dominant underlying disease of valvular heart disease which was known to have a lower incidence of psychological disorders compared to coronary artery disease. Conclusion: Depression and anxiety were not found among the subjects of th is study.Keywords: anxiety, coronary artery disease, depression, heart disease, open-hear t surgery

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