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Medical Rehabilitation in Patient with Post ORIF et causa Neglected Epiphyseal Fracture Distal Radius-Ulna Sinistra: A Case Report Christina A. Damopolii; Joudy Gessal; Jonathan P. Suyono
e-CliniC Vol. 11 No. 2 (2023): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v11i2.44765

Distal radius-ulna fracture is one of the most common human osseous injuries, with incidence rate increasing worldwide. There are two peaks of prevalence: the first around the 10th and the second around the 60th year of life. During childhood, they are among the most common pediatric fractures accounting for 19.9 to 35.8% of all pediatric fractures. We reported a case of a boy 13 years old diagnosed as post open reduction internal fixation distal radius ulna et causa epiphyseal fracture. He came to rehabilitation outpatient clinic with chief complaint pain on his left forearm. He underwent a surgery two weeks ago at the distal radius ulna. The surgeon did osteotomy on ulna and then fixated with plate and screw. On physical examination, there were pain and range of motion limitation mainly on the forearm and wrist joint. The patient was treated with low level laser therapy at the surgical wound to promote healing and decrease edema, initial digital motion exercise along with active range of motion of the uninvolved joints. He was also educated about icing and medicamentation if pain still persisted. Once adequate bony healing had occurred, active, active-assisted, progressive passive wrist motion, and strengthening exercise using resistance were performed to maximize the result. At the end of rehabilitation program, there was great improvement on pain and also range of motion improvement. Albeit, there was still a slight range of motion limitation on ulnar deviation and wrist extension by 5 degrees. In conclusion, rehabilitation program is very beneficial in treating post-surgery patient using modalities and exercises to improve functional function. Keywords: epiphyseal fracture; radius-ulna; medical rehabilitation

Penanganan Rehabilitasi Medik pada Pasca Artrodesis Kaki Charcot Tanpa Komplikasi Christina A. Damopolii; Joudy Gessal; Devan Perwira
e-CliniC Vol. 11 No. 3 (2023): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v11i3.44762

Impact of diabetes on the occurrence of Charcot's foot provides conservative treatment to the benefits of arthrodesis. Charcot foot is a debilitating joint disease characterized by progressive multiple bone destruction, dislocations, and severe deformities of the foot and ankle. Its prevalence may increase in the general high-risk population. Initial treatment of Charcot foot is often conservative and involves the use of bracing, casting, and special orthopedic shoes. This intervention allows the patient to functionally ambulate without resorting to more invasive interventions. Arthrodesis is an effective limb-saving method for patients with Charcot neuroarthropathy who have severe deformity and instability. This technique is usually used for chronic cases with irreversible deformity and/or joint instability to increase plantar pressure and balance of the foot and to minimize the risk of foot ulceration and amputation. In conclusion, non-weight bearing treatment dan immobilisation are the most effective rehabilitation management for active-phase Charcot foot accompanied by surgery consideration to maximize the functional of the foot. Keywords: Charcot foot; diabetes; arthrodesis; rehabilitation management Abstrak: Diabetes berdampak terhadap terjadinya kaki Charcot dengan penanganan secara konservatif hingga tindakan artrodesis. Kaki Charcot merupakan salah satu penyakit sendi yang merusak dan ditandai dengan progresifitas kerusakan tulang multipel, dislokasi dan deformitas parah pada kaki dan pergelangan kaki dengan prevalensi yang meningkat pada populasi dengan risiko tinggi. Perawatan awal kaki Charcot seringkali konservatif dan melibatkan penggunaan bracing, casting, dan sepatu ortopedi khusus. Intervensi ini memungkinkan pasien untuk ambulasi secara fungsional tanpa menggunakan intervensi yang lebih invasif. Artrodesis merupakan metode penyelamatan anggota tubuh yang efektif untuk pasien dengan neuropati Charcot yang memiliki deformitas parah dan ketidakstabilan. Teknik ini biasanya digunakan untuk kasus kronis dengan deformitas ireversibel dan/atau ketidakstabilan sendi untuk meningkatkan tekanan dan keseimbangan plantar kaki dan untuk meminimalkan risiko ulserasi dan amputasi kaki. Simpulan studi ini ialah penanganan non-weight bearing dan imobilisasi merupakan penanganan rehabilitasi untuk kaki Charcot fase aktif dengan pertimbangan tindakan pembedahan untuk memaksimalkan fungsi kaki. Kata kunci: kaki Charcot; diabetes; arthrodesis; penanganan rehabilitasi

Rehabilitasi Medik pada Nyeri Bahu Hemiplegia Pasca Stroke Joshua Manurung; Christopher Lampah; Joudy Gessal
e-CliniC Vol. 11 No. 3 (2023): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/ecl.v11i3.45280

Abstract: According to WHO 2019, stroke is the second leading cause of death worldwide and a significant cause of long-term disability. One of the complications that often occurs after a stroke is hemiplegic shoulder pain that affects the patient with decreased functional use of the arm, decreased quality of life, higher rates of depression, prolonged hospitalization, and impaired rehabilitation. This study aimed to discuss about rehabilitation efforts in post stroke patients with hemiplegic shoulder pain. This was a literature review study by searching three databases (Google Scholar, Pubmed, and Clinical Key) to determine medical rehabilitation for hemiplegic shoulder pain. The results obtained 13 literatures that matched the criteria. Hemiplegic shoulder pain in many ways, such as reducing the functional use of the arm, reducing quality of life, increasing levels of depression, prolonged hospitalization, is to the point of interfering with the recovery process, namely rehabilitation. In conclusion, medical rehabilitation for hemiplegic shoulder pain has shown quite successful efforts in treating or restoring the condition of patient with hemiplegic shoulder pain. It is possible to carry out more extensive research regarding the underlying causes, examinations to diagnose hemiplegic shoulder pain, and more effective rehabilitation in the future. Keywords: medical rehabilitation; hemiplegic shoulder pain; post stroke; quality of life Abstrak: Menurut WHO 2019, stroke merupakan penyebab kematian kedua di dunia dan salah satu penyebab yang bermakna bagi disabilitas jangka panjang. Salah satu komplikasi yang sering terjadi setelah kejadian stroke ialah nyeri bahu hemiplegia yang memengaruhi penderita dengan penurunan penggunaan fungsional lengan, penurunan kualitas hidup, tingkat depresi yang lebih tinggi, rawat inap yang berkepanjangan, gangguan rehabilitasi. Penelitian ini bertujuan untuk mengetahui rehabilitasi medik pada nyeri bahu hemiplegia pada pasien pasca stroke menggunakan metode literature review dengan penelusuran pada tiga database (Google Scholar, Pubmed, dan Clinical Key). Hasil penelitian mendapatkan 13 literatur yang sesuai dengan kriteria. Nyeri bahu hemiplegia dalam banyak hal, seperti penurunan penggunaan fungsional lengan, penurunan kualitas hidup, tingkat depresi yang bertambah, rawat inap yang berkepanjangan, sampai mengganggu proses pemulihan membutuhkan rehabilitasi. Simpulan penelitian ini ialah penanganan rehabilitasi medik pada pasien pasca stroke dengan nyeri bahu hemiplegia telah menunjukkan upaya yang cukup berhasil dalam mengobati atau memulihkan kondisi tersebut Tidak menutup kemungkinan dilakukan penelitian yang lebih luas mengenai penyebab yang mendasari, pemeriksaan untuk mendiagnosis keadaan nyeri bahu hemiplegia maupun rehabilitasi yang lebih efektif di masa mendatang. Kata kunci: penanganan rehabilitasi medik; nyeri bahu hemiplegia; pasca stroke; kuallitas hidup

Rehabilitasi Medik pada Gangguan Mobilisasi Pasca Stroke Keith J. Legoh; Christopher Lampah; Joudy Gessal
Medical Scope Journal Vol. 5 No. 2 (2023): Medical Scope Journal
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/msj.v5i2.45275

Abstract: Care and assistance in post-stroke patients require special handling that is often not mastered by caregivers, causing an increase in the number of patients readmitted to the hospital, especially the elderly. This study aimed to find out the available current rehabilitation for patients with post-stroke mobility impairment. This was a literature review study using literatures published and accredited in the last five years based on three databases, namely: PubMed, ClinicalKey, and Google Scholar. The results obtained 10 literatures to be reviewed. Comparisons of conventional and modern therapies, as well as the focus of therapy on impaired mobility of post-stroke patients proved that the design of an appropriate therapy program would provide a better prognosis, but for now, most therapies still focused on gait, balance, and risk of falling. Therapy supported by appropriate and qualified technology would produce a better prognosis compared to therapy with physical activity or with the help of conventional technology. In conclusion, patients with post-stroke mobility impairment need an accurate diagnosis of existing pathologies and manifestations to receive the best medical rehabilitation therapy program. Modernization of technology supported rehabilitation has quite an influence on the prognosis of patients with post-stroke mobility impairment and combination of various types of therapy can be used to solve this problem. Keywords: rehabilitaion; post-stroke; mobility impairment; gait; balance; fall risks Abstrak: Perawatan dan bantuan pada pasien pasca stroke membutuhkan penanganan khusus yang sering kali belum dikuasai oleh pengasuh sehingga menyebabkan meningkatnya jumlah pasien yang dirawat kembali di rumah sakit, khususnya lanjut usia (lansia). Penelitian ini bertujuan untuk mengetahui modalitas rehabilitasi yang tersedia bagi pasien dengan gangguan mobilisasi pasca stroke berdasarkan perkembangan teknologi yang tersedia saat ini. Metode yang digunakan ialah literature review. Proses pencarian pustaka-pustaka yang diteliti ialah sudah terpublikasi dan terakreditasi selama lima tahun terakhir dan berbasis tiga database, yakni: PubMed, ClinicalKey, dan Google Scholar. Hasil penelitian mendapatkan 10 literatur untuk ditinjau. Perbandingan terapi konvensional dan modern, serta fokus terapi terhadap gangguan mobilisasi pasien pasca stroke membuktikan bahwa rancangan program terapi yang tepat akan memberikan prognosis yang lebih baik, namun untuk saat ini, terapi umumnya lebih berfokus pada gait, balance, dan fall risks. Terapi yang disokong dengan teknologi yang tepat dan mumpuni akan menghasilkan prognosis yang lebih baik dibandingkan dengan terapi aktifitas fisik saja ataupun dengan bantuan teknologi konvensional. Simpulan penelitian ini ialah pasien dengan gangguan mobilisasi pasca stroke memerlukan diagnosis yang tepat terhadap patologi dan manifestasi yang ada untuk menerima program terapi rehabilitasi medik terbaik. Modernisasi dari teknologi penyokong rehabilitasi cukup berpengaruh terhadap prognosis dari pasien dengan gangguan mobilisasi pasca stroke dan dapat dilakukan terapi kombinasi dari beragam jenis terapi untuk menyelesaikan permasalahan ini. Kata kunci: rehabilitasi; pasca stroke; gangguan mobilisasi; gait; balance; fall risks

Physical Medicine and Rehabilitation Management in Pediatric Patient with Postural (Positional) Clubfoot: A Case Report Gloria Rondonuwu; Joudy Gessal; Patricia Kalangi
Medical Scope Journal Vol. 5 No. 2 (2023): Medical Scope Journal
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/msj.v5i2.46886

Abstract: Clubfoot, talipes equinovarus, is a common term used to describe several kinds of ankle or foot deformities present at birth. This condition is one of the most treatable birth defects, often leading to normal or near-normal athletic activities later in life. We reported a patient with positional clubfoot treated with serial casting, passive manipulation, and stimulation. Male, 6 days old, lived in Sonder, with a chief complaint of right foot that bent inward since birth. Patient was consulted by pediatrician to physiatrist since the birth day. The bent inward foot was not accompanied by swelling and redness, and patient was seen calm when the foot being moved. Patient was treated by physiatrist with passive manipulation, four times weekly with serial casting, and everyday stimulation for feet. During treatment session, patient’s deformity was getting improved. After treatment, the deformity was corrected and patient’s foot was in normal position without any complication. The aim of medical rehabilitation of clubfoot was to reduce the deformity with the success criteria that foot could be functional, free of pain, good mobility, and did not require correction shoes, therefore, the patient could carry out normal activities after growing up. In conclusion, to produce the maximum correction results, good cooperation is required with the patient’s parents. Even though correction is optimal and done as soon as possible, if bone growth has not stopped, the clubfoot problem can reappear. The first element of management is correction of the cavus deformity by positioning the forefoot in proper alignment with the hindfoot. Keywords: postural clubfoot; physical medicine and rehabilitation; children; passive manipulation; serial casting; everyday stimulation for feet

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