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Program fisioterapi dalam pencegahan kecacatan fungsional pada pasien kusta dengan xerosis: Studi kasus Andini, Rizqi Mutia; Fatmarizka, Tiara; Pristianto, Arif; Prihastomo, Teguh
Journal Physical Therapy UNISA Vol. 2 No. 1 (2022): April
Publisher : Universitas 'Aisyiyah Yogyakarta

Kusta disebut juga penyakit Morbus Hansen atau Lepra disebabkan adanya bakteri Mycobacterium Leprae. Penyakit ini menyerang kulit serta menyebabkan luka terhadap kulit, mati rasa, kerusakan saraf (sistem saraf perifer), melemahnya otot, melemahnya selaput lendir pada saluran pernafasan atas, serta melemahnya fungsi mata. Kusta terbagi menjadi dua yaitu Kusta Pausi Basiler atau Kusta tipe kering dan Kusta Multi Basiler atau Kusta tipe basah. Masing-masing memiliki klasifikasi tanda dan gejala yang berbeda. Ciri menonjol dari kusta adalah adanya xerosis yang merupakan suatu kondisi kekeringan pada lapisan epidermis kulit. Pada kondisi ini kulit mengalami bersisik, mengelupas, dan gatal. Studi Kasus ini dilakukan untuk mengetahui keefektifan modalitas fisioterapi dalam memperbaiki kerusakan kulit dan mencegah kecacatan fungsional. Metode studi kasus ini berupa analitik eksperimental. Sampel penelitian dengan seorang penderita Kusta dengan xerosis di Unit Rehabilitasi Kusta Donorojo. Program fisioterapi berupa scrubbing, Virgin Coconut Oil (VCO), passive dan active movement exercise serta Ambulasi. Pengukuran menggunakan Prevention of Disability (POD) sebagai alat ukur kecacatan, Overal Dry Skin Score (ODSS) sebagai alat ukur tingkat Xerosis, Goniometer sebagai alat ukur lingkup gerak sendi, dan Foot and Ankle Disability Index (FADI) sebagai alat ukur kemampuan fungsional. Hasil program menunjukkan modalitas fisioterapi yang diberikan terprogram efektif memperbaiki kerusakan kulit dan mencegah kecacatan fungsional.

FISIOTERAPI PADA KASUS DROP FOOT DI RS KELET DONOROJO JEPARA: STUDI KASUS Ratnasari, Eka Febri; Herawati, Isnaini; Prihastomo, Teguh
JURNAL PROFESIONAL FISIOTERAPI Vol. 2 No. 2 (2023): July
Publisher : Universitas Muhammadiyah Metro

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24127/fisioterapi.v2i2.2722

Drop Foot adalah kondisi umum di mana seseorang kehilangan kendali atas dorsofleksi pergelangan kaki. Seringkali, disfungsi saraf peroneal umum (Common Peroneal Nerve) menyebabkan kelumpuhan otot dorsofleksi pergelangan kaki termasuk; tibialis anterior, dorsi flexors jari kaki, ekstensor digitorum brevis, dan ekstensor hallucis longus. Kusta adalah penyakit menular kronis yang disebabkan oleh Mycobacterium Lepra. Deformitas fungsional yang umum ditemukan pada kasus kusta adalah ulkus tangan, ulkus kaki, drop hand, drop foot dan juga claw hand. Drop foot ditemukan pada 2% hingga 5% pasien yang baru didiagnosis dengan kusta. Tujuan dari penelitian ini adalah untuk mengetahui apakah modalitas fisioterapi berupa TENS, Streching, dan Strengthening efektif digunakan dalam penanganan kasus drop foot. Dengan metode penelitian berupa case study yang dilakukan di RS KELET DONOROJO pada bulan Desember 2021. Hasil penelitian di dapatkan bahwa intervensi fisioterapi yang dilakukan selama 6 kali pertemuan menunjukkan hasil akhir berupa penurunan nyeri, peningkatan lingkup gerak sendi dan peningkatan kemampuan fungsional pasien. Drop Foot is a common condition in which a person loses control of the dorsiflexion of the foot. Occasionally, generalized peroneal nerve dysfunction causes paralysis of the dorsiflexion muscles of the foot including; tibialis anterior, dorsi flexor toes, extensor digitorum brevis, and extensor hallucis longus. Leprosy is an infectious disease caused by Mycobacterium leprosy. Functional deformities commonly found in cases of leprosy are hand ulcers, foot ulcers, drop hands, drop feet and claw hands. Foot fall in 2% to 5% of patients newly diagnosed with leprosy is found. The purpose of this study was to determine whether physiotherapy modalities such as TENS, stretching, and stretching are effective in treating drop foot cases. With a research method in the form of a case study conducted at RS KELET DONOROJO in December 2021. The results showed that the physiotherapy intervention carried out for 6 meetings showed the final result in the form of decreasing pain, increasing joint ability and increasing the patient's functional ability.

Management Fisioterapi pada Kasus Drop Foot e.c. Morbus Hansen Multi Basiler dengan Xerosis dan Ulcus Zahra, Arifah Az; Wijianto, W; Prihastomo, Teguh
Academic Physiotherapy Conference Proceeding 2024: Academic Physiotherapy Conference Proceeding
Publisher : Universitas Muhammadiyah Surakarta

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Introduction: Morbus Hansen atau biasa dikenal Kusta adalah penyakit menular kronis yang disebabkan oleh sejenis bakteri yang disebut Mycobacterium leprae dan menyerang kulit, saraf perifer, mukosa saluran pernapasan bagian atas, dan mata. Kusta dapat mengganggu kelembapan kulit yang menyebabkan xerosis. kusta biasanya dapat disembuhkan dan jarang menyebabkan kematian, tetapi dapat menyebabkan cacat. Salah satu masalah yang timbul akibat penyakit kusta ini adalah kelemahan atau lesi saraf peroneus, yang merupakan kelumpuhan otot anterior dan lateral pada kaki karena cedera atau kerusakan saraf peroneus. Ini juga dikenal sebagai istilah drop foot. Case Presentation: Penelitian ini dilakukan dengan meneliti seorang pasien jenis kelamin laki-laki usia 42 tahun yang didiagnosa Drop Foot Bilateral et causa Morbus Hansen Multi Basiler dengan Xerosis dan Ulcus. Dengan tujuan untuk mengetahui manfaat dari modalitas fisioterapi berupa Electrical stimulation, Stretching exercise, Terapi Latihan, dan Oiling. Management and Outcome: setelah dilakukan Tindakan fisioterapi sebanyak 3 kali pertemuan selama 3 dengan durasi 45 menit setiap pertemuan. didapatkan peningkatkan kekuatan otot pada dorsi fleksi, eversi dan inversi ankle dextra 1 poin, dan peningkatan lingkup gerak dextra dan sinistra sebanyak 5 derajat. Namun belum mengalami peningkatan pada kelembapan kulit dan belum mengalami perubahan pada kemampuan fungsional. Discussion: Belum adanya peningkatan yang signifikan dalam aspek-aspek pemeriksaan secara keseluruhan. Hal ini dikarenakan kerusakan pada saraf membutuhkan waktu yang lebih lama untuk sembuh dari pada otot. Karena fungsi saraf mengirimkan impuls listrik ke otot, ketika otot mengalami kerusakan, implus listrik yang dikirim ke otot akan terganggu dan berkurang, yang berarti otot tidak dapat melakukan fungsinya dengan baik. Oleh karena itu, sangat memungkinkan terjadinya peningkatan apabila waktu pertemuan untuk evaluasi diperpanjang. Total dari dilakukan terapi hingga evaluasi yaitu 3 kali pertemuan selama 2 minggu dengan durassi 45 menit setiap pertemuan. Conclusion: berdasarkan penelitian pada studi kasus ini menunjukkan bahwa modalitas fisioterapi pada kasus Drop Foot e.c morbus hansen multi basiler dengan xerosis dan ulcus berupa Electrical Stimulation, Stretching exercise, Terapi Latihan, dan Oiling dapat meningkatkan kekuatan otot dan peningkatan lingkup gerak sendi meskipun belum signifikan.

PHYSIOTHERAPY MANAGEMENT IN INDIVIDUAL WITH WRIST DROP AFFECTED BY LEPROSY: A CASE REPORT Endrawati, Mira Yuga; Sari, Dwi Rosella Komala; Prihastomo, Teguh
Academic Physiotherapy Conference Proceeding 2021: Academic Physiotherapy Conference Proceeding
Publisher : Universitas Muhammadiyah Surakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (413.228 KB)

Introduction: Leprosy is a skin disease caused by Mycobacterium leprae, which is an intracytoplasmic parasite on macrophages and Schwann cells. This bacterium attacks the peripheral nerves, especially the Schwann cells. Mycobacterium leprae was first discovered by a Norwegian named Gerhard Armauer Hansen. One of the consequences of peripheral nerve disorders in people with leprosy is drophand/wrist drop/finger drop caused by damage in radial nerve. Case Presentation: A male patient aged 29 years, at the Kelet’s Hospital, Jepara, Central Java, on January 11, 2021 in a bed rest phase, had a fever of 37.8 C. His diagnose was wrist drop affected by leprosy. The condition of the skin was dry and peeled and indicated wrist drop. Previously, the patient had treated at one of the health centers in Juwana city, Central Java, and received the 4th MDT, the haemoglobin was 7 and already received a blood transfusion. Thus, the patient was referred to Kelet’s Hospital to get better treatments and the doctor suggested to do physiotherapy treatment. Management and Outcome: The interventions used the virgin coconut oil (VCO) Oil, passive, active assisted and stretching for 3 sessions. The impairments were limitation movement for wrist flexion and extension. The evaluation carried out the Manual Muscle Testing (MMT) to measure the muscle strength of wrist flexion and extension and the xerosis problem value applied by Overall Dry Skin Score (ODSS). Discussion: After 3 sessions, the physical examination declaired muscle strength for wrist flexion and extension had the same pattern was 3 of 5 and xerosis problem had not decreased yet. The second treatment reported muscle strength was not increasing, however the skin condition was more moist. The third evaluation found a reduction of xerosis condition, as well as increased muscle strength for wrist flexion and extension were 4 of 5. Conclusion: A management of physiotherapy used VCO Oil and exercise therapy applied passive, active assisted and stretching in patients with wrist drop affected by leprosy, reported giving positive effects to xerosis condition and able increase muscle strength of flexion and extension of wrist joint.

Physiotherapy Program on Claw Hand Condition at Leprosy Hospital Kelet Donorejo: a Case Study Hawari, Dadang; Naufal, Adnan Faris; Prihastomo, Teguh
Academic Physiotherapy Conference Proceeding 2022: Academic Physiotherapy Conference Proceeding
Publisher : Universitas Muhammadiyah Surakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (405.492 KB)

Introduction: Leprosy or known as Morbus Hansen's disease is a bacterium that attacks skin tissue, peripheral nerves, and respiratory tract in humans under the name Mycobacterium leprae. Fourteen countries including Indonesia conducted data collection on cases of leprosy in the world with a total of 199,992 people in 2015 and 17,202 people in Indonesia. Most people with leprosy experience ulnar nerve paralysis which causes partial disruption of the fingers.Case Presentation: Patient S, 21 years old, complains of swelling of the hands and itching and fever. The patient reported numbness in the left hand and difficulty moving the 4th and 5th fingers of the left arm. In January 2021 the doctor recommended taking multi drug therapy (MDT), after taking it the patient had a severe reaction with nodules appearing in several areas.Management and Outcome: Physiotherapy performed an IPPA examination (inspection, palpation, percussion, auscultation), the results were thickening of the left ulnar nerve, the skin surface felt dry and rough. physiotherapy also performs pain assessment using a numerical rating scale (NRS), muscle strength examination using manual muscle testing (MMT), examination of joint range of motion with a goniometer, examination of motor nerve function and nerve palpation with POD, and examination of functional ability of the hand using a wrist hand. disability index (WHDI).Discussion: The physiotherapy program carried out for claw hand patients aims to increase the range of motion of the joints, increase muscle strength, and increase the patient's functional activities.Conclusion: The physiotherapy program for 7 meetings on claw hand conditions at the Leprosy Hospital Kelet Donorojo, Jepara in the form of stretching, strengthning, and functional exercises can increase the range of motion of the joints, there has not been an increase in muscle strength and functional in the patient, although in the range of joint motion which increases, the results are not significant.

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