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Physical Medicine and Rehabilitation Management in Patients with Long COVID-19 and Thymoma-associated Myasthenia Gravis: A Case Report Tambunan, Tresia Fransiska Ulianna; Nathania, Eugene; Putryanti, Rimnauli Deasy Putryanti; Tifany, Elisabeth Pauline; Kurnain, Dave Nicander
Respiratory Science Vol. 5 No. 1 (2024): Respiratory Science
Publisher : Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/respirsci.v5i1.156

Abstract

Background: Myasthenia gravis is an autoimmune disease that causes muscle weakness and fatigue due to antibodies attacking the acetylcholine receptor. In patients with MG, fatigue can be worsened by concurrent long COVID, leading to further deterioration of cardiorespiratory function. Case: A 44-year-old woman with long COVID syndrome and thymoma-associated myasthenia was given an exercise program that aimed to overcome fatigue so that the patient could carry out her role as a housewife, and to prepare for thymectomy surgery. Before exercise, patients were educated to take pyridostigmine 1 hour earlier. During exercise, the patient was monitored to prevent excessive fatigue. At the end of the training session, the patient was asked to observe for signs of exacerbation until the next training session. Discussion: Pulmonary rehabilitation (PR) can be beneficial for patients with thymoma-associated MG and long COVID-19, but it requires special strategies. PR typically starts with light weights and gradually increases in intensity. It has been shown to improve fatigue and cardiorespiratory endurance, as indicated by a successful 6-minute walk test after 4 weeks of training intervention. Conclusion: Pulmonary rehabilitation plays an important role in increasing cardiorespiratory endurance and functional capacity for surgery preparation. The provision of pulmonary rehabilitation programs must be tailor-made according to the patient's functional ability and underlying disease to achieve optimal goals.
Rehabilitation Management of a Patient with Bilateral Pulmonary Bullae after Multiple Surgeries and Post-Tuberculosis Lung Disease Tifany, Elisabeth Pauline; Tambunan, Tresia Fransiska Ulianna
MAGNA MEDIKA Berkala Ilmiah Kedokteran dan Kesehatan Vol 12, No 1 (2025): FEBRUARY
Publisher : Universitas Muhammadiyah Semarang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26714/magnamed.12.1.2025.94-103

Abstract

Background:  Post-tuberculosis lung disease (PTLD) is a prevalent finding in TB survivors. PTLD has many clinical presentations, including structural damage in the form of pulmonary bullae. Pulmonary bullae, along with PTLD, lead to significant impairment and morbidity in the patient. In some cases, a surgical approach is indicated for pulmonary bullae.Objective: This case study aims to discuss the rehabilitation management in PTLD, including post-surgical cases.Case Presentation: A 27-year-old male underwent lung volume reduction surgery (LVRS) by wedge resection of the right superior lobe. The patient had a history of tuberculosis infection and a history of bilateral pneumothorax. The patient underwent pulmonary rehabilitation in ICU care as early as medically possible, and continued until the patient was transferred to the general ward. The patient tolerates the pulmonary rehabilitation program, and no adverse effects occurred due to pulmonary rehabilitation.Conclusion: Pulmonary rehabilitation is an essential part of cases involving PTLD, including post-surgical ones, and should be initiated as early as medically possible in inpatient and continued outpatient settings.
Telerehabilitasi pada Penyakit Paru Obstruktif Kronik Tifany, Elisabeth Pauline; Tambunan, Tresia Fransiska Ulianna
Cermin Dunia Kedokteran Vol 50 No 12 (2023): Penyakit Dalam
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v50i12.1042

Abstract

Chronic obstructive pulmonary disease (COPD) is one of the leading causes of death worldwide. Pulmonary rehabilitation is an essential component of COPD management and can be delivered through telerehabilitation programs. COPD telerehabilitation consists of exercise testing and training that can be performed at home with supervision from a physiotherapist or remotely using a smartphone application. Exercise training includes cardiorespiratory endurance, resistance, flexibility, and respiratory muscle training. COPD telerehabilitation is effective in improving exercise tolerance, reducing the incidence of acute exacerbations, and improving patients’ quality of life.