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All Journal Jurnal Kesehatan Islam : Islamic Health Journal SURABAYA PHYSICAL MEDICINE AND REHABILITATION JOURNAL Journal of Pain, Vertigo and Headache
Lestari, Dwi Indriani
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Agriculture, Biological Sciences & Forestry Biochemistry, Genetics & Molecular Biology Chemical Engineering, Chemistry & Bioengineering Environmental Science Health Professions Medicine & Pharmacology Neuroscience Public Health

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SEVERE POSTURE AND GAIT DISTURBANCE IN LUMBAR SPINAL STENOSIS: A CASE REPORT Lestari, Dwi Indriani; Anggraini, Vivid Prety; Pringga, Gutama Arya; Kurniawan, Shahdevi Nandar; Misnasari, Putri Priela
Journal of Pain, Headache and Vertigo Vol. 5 No. 1 (2024): March
Publisher : PERDOSNI (Perhimpunan Dokter Spesialis Neurologi Indonesia Cabang Malang) - Indonesian Neurological Association Branch of Malang cooperated with Neurology Residency Program, Faculty of Medicine Brawijaya University, Malang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jphv.2024.005.01.4

Abstract

One of the causes of low back pain is lumbar spinal stenosis (LSS). LSS is defined as a disorder resulting from degenerative processes leading to narrowing of the spinal canal. The nature of pain in LSS—the neurogenic claudication—was aggravated by upright or extended trunk positions, such as during walking, descending stairs, or simply standing. Patient self-adjustments in response to pain can induce further muscle disturbance and worsen the condition. A 56-year-old male suffering from poor posture with antalgic and Trendelenburg gait. The MRI showed multiple spinal canal stenosis with compression of the L4-S1 nerve roots affected the gait and worsened posture. Physical medicine rehabilitation (PMR) program—including the use of ultrasound diathermy for severe muscle spasm followed by muscle stretching, Transcutaneous Electrical Stimulation (TENS) for pain relief, Neuromuscular Electrical Stimulation (NMES) for muscle strength improvement and several therapeutic exercises—has proven beneficial in reducing patient’s symptoms thus correcting the posture and gait. At this point spinal canal narrowing is not only causing pain with neurological deficit but may lead to posture and gait disturbance that increasing the patient's disability. The use of physical modalities combined with exercise has been shown to benefit patients similarly to surgery but without invasive approach.
COMPREHENSIVE REHABILITATION APPROACH FOR MEDIAN NERVE NEUROPATHY COMPLICATED BY CERVICAL RADICULOPATHY: CASE REPORT IN A YOUNG GAME Yudiansyah, Anggi Gilang; Kurniawan, Shahdevi Nandar; Lestari, Dwi Indriani; Pringga, Gutama Arya
Journal of Pain, Headache and Vertigo Vol. 6 No. 1 (2025): March
Publisher : PERDOSNI (Perhimpunan Dokter Spesialis Neurologi Indonesia Cabang Malang) - Indonesian Neurological Association Branch of Malang cooperated with Neurology Residency Program, Faculty of Medicine Brawijaya University, Malang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jphv.2025.006.01.02

Abstract

Background: Median nerve neuropathy, particularly associated with repetitive strain activities such as gaming, is increasingly recognized in clinical practice. This condition often necessitates a multidisciplinary and holistic approach for effective management, aiming to prevent long-term complications and improve functional outcomes. Case: A 21-year-old male presented with progressive weakness, paresthesia, and atrophy in the first three digits of both hands, attributed to excessive gaming, exceeding 12 hours daily. Neurological examination revealed marked weakness in muscles innervated by the median nerve, and electromyography (EMG) confirmed bilateral median nerve compression, compounded by cervical radiculopathy at the C6-7-8-T1 levels. Discussion: This case underscores the necessity of evaluating both peripheral nerve pathology and potential cervical radiculopathy in patients with extensive upper limb use. Intensive gaming, characterized by poor ergonomic practices, can exacerbate nerve compression, leading to significant neuropathic changes. The implemented multidisciplinary rehabilitation approach involved patient education on ergonomic modifications, targeted physical therapy to strengthen affected muscle groups, and strategies to optimize posture and reduce repetitive strain. This comprehensive intervention aimed to alleviate symptoms, restore function, and prevent further deterioration. Conclusion: The case highlights the complexities involved in managing median nerve neuropathy exacerbated by cervical radiculopathy in individuals engaged in repetitive, high-intensity activities. A comprehensive, evidence-based rehabilitation strategy is crucial for achieving optimal recovery, minimizing recurrence, and enhancing the patient’s quality of life. Further research is warranted to explore the long-term efficacy of such interventions and to develop tailored rehabilitation protocols for similar cases in the gaming community.
When a Massage Gone Wrong: Unveiling a Case of Post-Massage Brachial Plexopathy Anggi Gilang, Yudiansyah; Noor, Syeda Tazkia; Lestari, Dwi Indriani; Pringga, Gutama Arya
Surabaya Physical Medicine and Rehabilitation Journal Vol. 7 No. 1 (2025): SPMRJ, FEBRUARY 2025
Publisher : Faculty of Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/spmrj.v7i1.56484

Abstract

The brachial plexopathy associated with massage therapy is rarely reported. This case report describes an uncommon case of brachial plexopathy that developed after a session of massage therapy and revealed past published reports of peripheral nerve injury following massage therapy. A 54-year-old Javanese woman developed sudden unilateral paralysis of her left shoulder girdle after a session of massage therapy. The massage session was stopped due to pain. She could not move her left shoulder immediately after 5 minutes of massage. There was hypoesthesia from shoulder to forearm, and there was decreased MMT of the left deltoid muscle. She regularly participated in a twice-weekly rehabilitation program targeting the left shoulder. It included NMES, laser therapy, PROM, strengthening exercises, and a home exercise program. A diagnosis of acute brachial plexopathy was suspected due to her recent history and the results of several examinations. She had a gradual recovery of strength, resolution of limitations of ROM, and sensory function in her shoulder. Rehabilitation programs have a major role in helping the patient do her functional activities. This case report presents as a reminder to massage therapists or physical therapists that massage therapy of the neck and shoulder should be carefully performed to avoid any injury. Further studies will help improve the safety procedures and effectiveness of massage therapy in the future.
Evaluation of Wheelchair Fit and Its Impact on Physical Comfort in a Community-Based Program in Malang Firnanda, Sani Widya; Fajarningtyas, Mia; Yudiansyah, Anggi Gilang; Lestari, Dwi Indriani; Anggraini, Vivid Prety; Nugroho, Muhammad Barlian
Jurnal Kesehatan Islam : Islamic Health Journal Vol. 14 No. 1 (2025): Jurnal Kesehatan Islam : Islamic Health Journal
Publisher : Publikasi oleh Fakultas Kedokteran Universitas Islam Malang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33474/jki.v14i1.24164

Abstract

Background: Proper wheelchair fit is essential to ensure comfort, postural stability, and to prevent secondary health complications in individuals with disabilities. In community-based programs, mismatches between wheelchair dimensions and users' anthropometric characteristics often go unnoticed, potentially leading to long-term issues. Objective: This study aims to evaluate the alignment between users’ body dimensions and the wheelchairs distributed through a community-based program in Malang, and to examine the potential ergonomic and clinical implications of mismatched fit. Methods: A descriptive quantitative design was employed, involving 20 full-time wheelchair users selected purposively. Anthropometric measurements (seated height, popliteal length, hip width, elbow height) and wheelchair dimensions (seat height, seat depth, seat width, backrest height, armrest height) were directly measured. Normality was tested using the Shapiro–Wilk test, followed by Pearson correlation analysis. Outliers were identified using z-score thresholds. Results: Significant positive correlations were found between seat height and armrest height (r = 0.65, p < 0.01), and between backrest height and seat width (r = 0.58, p < 0.05). No correlation was found involving seat depth. Two participants showed notable mismatches requiring individual adjustments, highlighting risks such as discomfort, postural imbalance, and mobility limitation. Conclusion: Mismatch between wheelchair dimensions and user anthropometry can contribute to preventable discomfort and postural strain. Personalized assessments and ergonomic adjustments are crucial in community wheelchair programs. These findings support the implementation of anthropometric-based distribution strategies and training for service providers.
Prolotherapy as a Novel Adjunct in Post-Stroke Pain Management: A Pilot Study at RSUD Dr. Saiful Anwar Malang Lestari, Dwi Indriani; Rahmad; Pringga, Gutama Arya; Pambayun, Sheilla Elfira San; Musthafa, Ferdian; Puspitasari, Yuan Laura; Ichsan; Noor, Syeda Tazkia; Zulfikar, Dilloniar Bahny; Ariani, Maydah
Surabaya Physical Medicine and Rehabilitation Journal Vol. 7 No. 2 (2025): SPMRJ, AUGUST 2025
Publisher : Faculty of Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/spmrj.v7i2.65514

Abstract

Background: Post-stroke pain (PSP) and musculoskeletal complications significantly hinder recovery and quality of life in stroke survivors. Prolotherapy, a regenerative injection therapy, has shown promise in managing musculoskeletal disorders but remains underexplored for PSP. Aim(s): This study evaluates the effectiveness of prolotherapy in reducing pain, improving range of motion (ROM), and enhancing functional outcomes in PSP patients. Material and methods: This pilot study employed a pre-experimental design with pretest and posttest measurements. Conducted at RSUD Dr. Saiful Anwar Malang, the study included three stroke patients experiencing chronic musculoskeletal pain. Prolotherapy injections containing hypertonic dextrose were administered at regular intervals. Primary outcomes included pain (Numerical Rating Scale), ROM, and spasticity (Modified Ashworth Scale). Secondary outcomes were assessed using the Barthel Index, Short Form-36, and Fugl-Meyer Assessment. Statistical analyses were descriptive, with paired t-tests applied to outcome changes. Result: Significant improvements in pain levels (mean NRS reduction from 5.67±1.5 to 3.0±2.0) and ROM, particularly in shoulder flexion and wrist extension, were observed. Spasticity showed minor improvements in some muscle groups. Functional outcomes, including Barthel Index and SF-36 scores, demonstrated positive trends, with two participants improving from severe dependency to moderate independence. Conclusions: Prolotherapy shows promise as an adjunctive intervention for PSP, offering potential benefits in pain reduction and functional recovery. As the first study of its kind at RSUD Dr. Saiful Anwar Malang, it lays the groundwork for future large-scale research to validate these findings and refine clinical applications. Keywords: Stroke, Prolotherapy, Pain, Rehabilitation, post-stroke pain, functional performance
Co-Authors Anggi Gilang, Yudiansyah Anggraini, Vivid Prety Ariani, Maydah Fajarningtyas, Mia Firnanda, Sani Widya Ichsan Misnasari, Putri Priela Musthafa, Ferdian Noor, Syeda Tazkia Nugroho, Muhammad Barlian Pambayun, Sheilla Elfira San Pringga, Gutama Arya Puspitasari, Yuan Laura Rahmad Shahdevi Nandar Kurniawan, Shahdevi Nandar Yudiansyah, Anggi Gilang Zulfikar, Dilloniar Bahny