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All Journal SURABAYA PHYSICAL MEDICINE AND REHABILITATION JOURNAL
Arnengsih Nazir
Dr. Hasan Sadikin General Hospital?Faculty of Medicine Universitas Padjadjaran
Chemical Engineering, Chemistry & Bioengineering Health Professions Medicine & Pharmacology

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Role of exercise in severe COVID-19 case Arnengsih Nazir; Witri Septiani
Surabaya Physical Medicine and Rehabilitation Journal Vol. 5 No. 2 (2023): SPMRJ, AUGUST 2023
Publisher : Faculty of Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/spmrj.v5i2.30984

Abstract

Abstract Severe COVID-19 infection can lead to prolonged recovery and troublesome symptoms. The symptoms reported in those patients were dyspnea, fatigue, weakness, anxiety, and activity intolerance. Patients showed limited exercise capacity and interfered with daily activities, as well as the quality of life. We report the role of exercise in improving activity tolerance in a survivor of a COVID-19 severe case. A male patient, 51 years, came to outpatient pulmonary rehabilitation after hospitalization due to a severe case of COVID-19. The patient had a low activity tolerance presented as fatigue, dyspnea, activity-induced oxygen desaturation, and inability to perform exercise testing, in addition to mild anxiety. A set of exercises consisting of breathing, flexibility, muscular, and cardiorespiratory endurance were given for 4 weeks along with psychological counseling. Barthel Index, cardiorespiratory fitness, sit-to-stand test, Fatigue Severity Scale, Medical Research Council Dyspnea Scale, and maximum breathing capacity were recorded as outcome measures. A Zung Self-rating Anxiety Scale and insomnia severity index were also measured. After 4 weeks, the symptoms of activity intolerance decreased. There were improvements in all outcomes except for the insomnia severity scale. Experts recommend that COVID-19 patients should carry out regular daily activities and low to moderate-intensity exercise in the first 6-8 weeks after discharge. Resuming daily physical activities as early as possible can affect functional recovery. It is also beneficial for general fitness, fatigue, emotional disturbance, and lack of confidence. In this patient, low-intensity exercises as recommended by experts were given to improve activity tolerance.
Cardiovascular Diseases in Indonesia: Development, Barriers, and Future Challenges of Cardiac Rehabilitation Arnengsih Nazir; Henhen Heryaman; Cep Juli; Azizah Ugusman; Januar Wibawa Martha; Marina Annette Moeliono; Nur Atik
Surabaya Physical Medicine and Rehabilitation Journal Vol. 8 No. 2 (2026): SPMRJ, AUGUST 2026
Publisher : Faculty of Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/spmrj.v8i2.70300

Abstract

Introduction: Cardiovascular disease (CVD) remained the leading cause of morbidity and mortality in Indonesia, with a high prevalence posing challenges for medical and rehabilitation management. The unequal distribution of CVD and its risk factors hindered government efforts to allocate healthcare workers, limiting access to cardiac rehabilitation (CR) programs, particularly in underserved areas. Methods: This review analyzed various articles in English and Indonesian, retrieved through Google using relevant keywords, reference exploration, and communication with professional organizations. Results and Discussion: Despite being introduced over 40 years ago, hospital-based CR programs remained scarce, especially in rural regions. Barriers included comorbidities, socioeconomic status, limited accessibility, low referral rates, lack of patient motivation, insurance constraints, insufficient supervised CR facilities, and employment-related issues. Additionally, government challenges in coordination and staffing further restricted CR expansion. However, the high number of CVD patients and individuals at risk presented opportunities for improvement. Strategies such as strengthening referral systems, increasing facilities, regulating healthcare workforce distribution, implementing telerehabilitation, and enhancing government policies on service coverage were crucial to expanding CR access. Conclusion: Although CR in Indonesia has been developed for decades, its availability remains inadequate. Challenges mirrored those of other developing nations, yet the increasing burden of CVD underscored the urgent need to expand CR programs through improved infrastructure, policies, and workforce distribution.
Co-Authors Azizah Ugusman Cep Juli Henhen Heryaman Januar Wibawa Martha Marina Annette Moeliono Nur Atik Witri Septiani