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All Journal Juke Indonesia Journal of Physical Medicine and Rehabilitation
Aryadi Kurniawan Aryadi Kurniawan
Departemen Orthopedi Dan Traumatologi FK Universitas Indonesia-RS. Dr. Cipto Mangunkusumo
Decision Sciences, Operations Research & Management Health Professions Medicine & Pharmacology Neuroscience Physics

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Associations among the Degree of Hip Adductor Spasticity, the Level of Gross Motor Function Classification System (GMFCS) and the Migration Percentage in Children with Cerebral Palsy Lindrawati Tjuatja; Luh Karunia Wahyuni; Aryadi Kurniawan; Damayanti Sekarsari; Hamzah Shatri
Indonesian Journal of Physical Medicine & Rehabilitation Vol 5 No 01 (2016): Indonesian Journal Of Physical Medicine and Rehabilitation
Publisher : Indonesian Journal of Physical Medicine & Rehabilitation

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1387.708 KB) | DOI: 10.36803/ijpmr.v5i01.195

Abstract

Objectives : This study was aimed at detecting the occurrence of hip dislocation in children with cerebral palsy (CP) by seeking the association among the degree of hip adductor spasticity, level of Gross MotorFunction Classification System (GMFCS) and Migration Percentage (MP).Methods : It was a cross sectional study with inclusion criterias were children with cerebral palsy, both male and female aged 2-10 years old, and parent’s approval by signing informed consent. Exclusion criterias werecomorbidities of other neuromotor impairments, such as spina bifida; other neuromuscular or musculoskeletal diseases, etc; uncooperative; and presenting severe diseases at the day of assessment. Measurement methodsincluded the Modified Tardieu Scale (MTS) R2, R1 and R2-R1 components to measure hip adductor spasticity; Gross Motor Function Classification System (GMFCS) protocol to assess gross motor ability; andAnterior-Posterior (AP) pelvic plain radiograph to calculate the Migration Percentage (MP) value.Results : At the initial phase, 31 children were included, however only 57 legs were analyzed for hip adductor spasticity and MP. There were no correlation between the degree of hip adductor spasticity and MPboth the R2 with MP (r = -0.060; p = 0.658), and R1 with MP (r = -0.136; p = 0.314). Moreover, there was insignificant difference between level of GMFCS and MP (p = 0.831).Conclusion : This study indicates nill correlation between the degree of hip adductor spasticity and the MP, and insignificant difference between the level of GMFCS and MP to detect the occurence of hip dislocationin children with cerebral palsy.Keywords : Modified Tardieu Scale, R2, R1, level of GMFCS, AP pelvic plain radiograph, MP value.
APPLICATION OF PAVLIK HARNESS IN DEVELOPMENTAL DYSPLASIA OF THE HIP (DDH) Aryadi Kurniawan; Ahmad Fauzi
JUKE Unila Vol 4, No 8 (2014)
Publisher : Fakultas Kedokteran Universitas Lampung

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (2527.704 KB)

Abstract

Developmental dysplasia of the hip (DDH) is a spectrum of pathology ranging from acetabular dysplasia with minor instability until acetabular dysplasia with hip dislocation. The incidence of DDH that require treatment is 5.1 per 1000 live birth. Early detection is important to deliver good outcome and lessen complication. Careful history taking, physical examination and ultrasonography, have increased the sensitivity in establishing diagnose of DDH. Pavlik harness is the mainstay of treatment for infant who has not commenced crawling. Despite the fact of high success rate, the use of Pavlik harness is still uncommon in Indonesia. This paper reports a case of DDH treated with Pavlik harness and assessed regularly with ultrasonography. A 3 months girl with developmental dysplasia of the left hip. The initial ultrasound shows α angle 49.40 and β angle was 50.20, femoral head subluxated to superolateral aspect. The patient had Pavlik harness and followed up with serial ultrasound at 1st, 3rd and 4th month’s time. Having had 4 months of Pavlik harness, the α angle of the left hip became 630, and β angle 490 with good structure of ilium. Femoral head was smooth and no signs of avascular necrosis. The hip has full range of motion. Parents have no difficulty in taking care of their daughter daily activities such as taking a bath, changing napkin, and clothes. This implicates, patient treated using Pavlik harness showed good outcome clinically and ultrasonographically. Pavlik harness has been proven to be a safe, simple and user friendly method for treatment of DDH before crawling age. The good result obtained from this case could initiate application of pavlik harness in larger population of early detected DDH in Indonesia. [JuKe Unila 2014; 4(8):208-217]
Co-Authors Ahmad Fauzi Damayanti Sekarsari E. Mudjaddid A. Siswanto Deddy N.W.Achadiono Hamzah Shatri Lindrawati Tjuatja Nuryati C. Siregar Phedy Phedy S.Pd. M Kes I Ketut Sudiana .