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All Journal SURABAYA PHYSICAL MEDICINE AND REHABILITATION JOURNAL Respiratory Science eJournal Kedokteran Indonesia
Kurnain, Dave Nicander
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Biochemistry, Genetics & Molecular Biology Chemical Engineering, Chemistry & Bioengineering Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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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.
Physical Medicine and Rehabilitation Role of Complete Recovery after Intracerebral Hemorrhage in Eclampsia with HELLP Syndrome: A Rare Case Tambunan, Tresia Fransiska Ulianna; Putri, Yoan Utami; Utami, Diniah; Chandra Kasih, Siti Aminah; Ulfa, Meryta; Kurnain, Dave Nicander
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.v7i2.56155

Abstract

Cerebrovascular accident during hypertensive disorder of pregnancy is a rare condition, but carries high risk of mortality and morbidity due to its unpredictable onset. Intracerebral Hemorrhage (ICH) associated with eclampsia is responsible for 5–12% of maternal deaths during pregnancy. Eclampsia is defined as a convulsive episode occurring in the setting of preeclampsia. The hallmark presentation of eclampsia is characterized with generalized tonic-clonic seizures which typically lasted 60 to 90 second in duration, might be preceded with headaches, visual disturbance, abdominal pain, and increased blood pressure. HELLP syndrome frequently associated with severe preeclampsia-eclampsia and is characterized by three hallmark features of hemolysis, elevated liver enzymes, and low platelets. Here, we report an unusual case of 25-year-old primigravida with 38 weeks gestation, which developed sudden eclampsia and intracranial hemorrhage. A night before admission, she complained about headache and had projectile vomit in the morning that followed by generalized seizure. She had no history of seizure or high blood pressure during her antenatal care. Laboratory test shows elevated liver enzyme and low platelets count and CT-scan which showed hemorrhage in left intraparenchymal lobes. She was successfully managed by multidisciplinary approach including emergency cesarean section, conservative neurological treatment for intraventricular hemorrhage and rehabilitation ever since in intensive care unit until discharge from ward. Rehabilitation approach in eclampsia with superimposed intraparenchymal hemorrhages could start safely as early as possible by collaboration with other departments. This can help mother achieved independency of activity daily living and improvement of cardiorespiratory endurance as before.
Return to Work in Post-Revascularization Patients with Acute Coronary Syndrome Undergoing Phase II Cardiac Rehabilitation Tambunan, Tresia Fransiska Ulianna; Wulandari, Najwa; Kurnain, Dave Nicander; Sianipar, Helisa Rachel Patricie
eJournal Kedokteran Indonesia Vol. 13 No. 3 (2025): Vol. 13 No. 3 - Desember 2025
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.23886/ejki.13.1129.1

Abstract

Returning to work is an essential indicator of functional and psychosocial recovery in post-revascularization patients with acute coronary syndrome (ACS). Participation in Phase II cardiac rehabilitation (CR) is believed to facilitate this process through structured exercise, education, and psychological support. This study aimed to evaluate the effect of Phase II CR on return-to-work outcomes among post-revascularization ACS patients. An evidence-based case report was conducted through a systematic search of PubMed, Scopus, ProQuest, ScienceDirect, and SpringerLink databases from 2013 to 2023. Eligible studies included randomized controlled trials, cohort studies, and systematic reviews that assessed return-to-work outcomes in patients undergoing coronary artery bypass grafting or percutaneous coronary intervention who participated in Phase II CR. Articles not available in full text, published before 2013, or unrelated to return-to-work outcomes were excluded. Three studies met the inclusion criteria: two systematic reviews and one prospective cohort study encompassing approximately 68,000 patients. All reported that CR participation improved physical function, quality of life, and the likelihood of returning to work. The average time to return ranged from 9 to 32 weeks, with higher rates among younger males with white-collar occupations and preserved ejection fraction. Phase II CR significantly enhances recovery and expedites return to work, underscoring its essential role in post-ACS care.
Co-Authors Chandra Kasih, Siti Aminah Nathania, Eugene Putri, Yoan Utami Putryanti, Rimnauli Deasy Putryanti Sianipar, Helisa Rachel Patricie Tambunan, Tresia Fransiska Ulianna Tifany, Elisabeth Pauline Ulfa, Meryta Utami, Diniah Wulandari, Najwa