Penerapan Latihan Range Of Motion (ROM) aktif pada pasien pasca stroke di Desa Sampangan Pekalongan

Stroke is a brain functional disorder characterized by nerve paralysis due to obstruction of blood flow to the brain. The frequent impact if a post-stroke client is not carried out with rehabilitation immediately will result in mobility disorder that can impede daily physical activity. One pratice in the rehabilitation process is to prevent disability in a client with post-stroke physical mobility disorder that is, by performing a Range Of Motion rope. The case study is intended to illustrate application of roma exercises to boost muscle strength. The method of writing the case study USES a descriptive design and case studies reported in narration. The instrumrnts used are observation sheets and structured observation sheets covering the assessment of muscle strength. The resulth of the case study have been after the six-meeting application of roma that the roma can increase muscle strength in subject. I the average muscle strength 3.31 to 3.50 and subject II average muscle strength 3.68 to 3,93. The conclusion of the case study increased muscle strength after the practice of roma. Suggestions for the family in order to train ROM for family members who had suffered stroke. Keywords: Stroke, muscle strength, ROM AbstrakStroke adalah penyakit nerulogis terbanyak yang dapat mengakibatkan disfungsi motorik dan sensorik.Dampak yang sering muncul jika klien pasca stroke tidak dilakukan rehabiltasi dengan segera maka akan mengalami gangguan mobilitas yang dapat menghambat aktivitas fisik sehari-hari. Saalah satu bentuk latihan dalam proses rehabilitasi untuk mencegah terjadinya kecacatan pada klien dengan gangguan mobilitas fisik pasca stroke yaitu dengan melakukan latihan Range Of Motion ROM. Studi kasus ini bertujuan untuk menggambarkan penerapan latihan ROM untuk meningkatkan kekuatan otot. Metode penulisan studi kasus ini menggunakan rancangan deskriptif dan hasil studi kasus dilaporkan dalam bentuk narasi. Instrumen yang digunakan yaitu lembar pengkajian dan lembar observasi terstruktur meliputi penilaian kekuatan otot. Hasil studi kasus setelah dilakukan penerapan ROM selama 6 pertemuan bahwa ROM dapat meningkatkan kekuatan otot pada Subyek I nilai rata-rata kekuatan otot 3,31 menjadi 3,50 dan Subyek II nilai rata-rata kekuatan otot 3,68 menjadi 3,93. Simpulan studi kasus ini terjadi peningkatan kekuatan otot setelah dilakukan latihan ROM. Saran bagi keluarga agar dapat melatih ROM pada anggota keluarga yang mengalmi stroke. Kata kunci: Stroke, kekuatan otot, ROM

Literature Review: Pengaruh Latihan Rom (Range Of Motion) Terhadap Peningkatan Kekuatan Otot Pada Pasien Stroke

Muscle weakenss is the biggest impact on stroke patients, so that Range Of Motion (ROM) exercises are needed to maintain muscle strength and join mobility. The incidence of stroke and disability tends to increase if Range Of Motion (ROM) exercises are not carried out. This is due to a decrease in muscle strength. The purpose of this study was to describe the effect of Range Of Motion therapy on improving motor function in stroke patients. The method was literature review used the keywords “stroke”, “Range Of Motion(ROM)”, “Muscle strength”. The study was conducted by searching for serval articles from a predetermined database, namely the last 10 years. The three articles showed the strength of the muscle scale, after being given the Range Of Motion (ROM) intervention. The t-test of statistic test shows p valued <0,01 wich means there was a effect. It can be concluded there is the effect of Range Of Motion (ROM)training on muscle strength in stroke patients. Therefore, it is expected for the health workers, especially nurses to be able to apply ROM intervention more intensively in stroke patients as an additional therapy.Keywords: Stroke, Range Of Motion (ROM), Muscle strength AbstrakKelemahan otot merupakan dampak terbesar pada pasien stroke, untuk itu diperlukan latiham Range Of Motion (ROM) bertujuan untuk mempertahankan atau memelihara kekuatan otot, mobilitas persendian. Peningkatan angka kejadian stroke dan kecacatan tersebut apabila latiham Range Of Motion (ROM) tidak dilaksanakan maka akan terjadi penurunan kekuatan otot.Tujuan dari Karya Tulis Ilmiah ini adalah untuk mengetahui bagaimana gambaran pengaruh terapi ROM terhadap peningkatan fungsi motorik pada pasien stroke. Metode yang dilakukan adalah Literature Review dengan menggunakan kata kunci “Stroke”, “Range Of Motion (ROM)”, “kekuatan otot”. Penelitian dilakukan dengan cara mencari beberapa artikel dari database yang telah ditentukan yaitu 10 tahun terakhir. Pada ketiga artikel menunjukkan kekuatan skala otot, setelah diberikan intervensi Range Of Motion (ROM). Uji statistik t-test menunjukkan p value < 001 menyatakan ada pengaruh. Kesimpulan Karya Tulis Ilmiah ini terdapat pengaruh latihan Range Of Motion (ROM) terhadap kekuatan otot pada pasien stroke, sehingga sangat di harapkan agar tenaga kesehatan khususnya perawat dapat lebih intensif memberikan intervensi ROM pada pasien stroke sebagai terapi tambahan untuk pasien stroke.Kata kunci:Stroke, Range Of Motion (ROM), kekuatan otot

PRE-HOSPITAL ASSESSMENT OF SUCCESS AND VALIDITY OF SCALES OF STROKE AND TIA

Introduction: cerebrovascular disease is the most frequent cause of death in argentin in 2004, it cause 7.5% of total deaths. The American Heart Association proposes using Cincinnati Prehospital Stroke Scale (CPSS) and Los Angeles Prehospital Stroke Screen (LAPSS) to evaluate cerebrovascular cases. Objective: is to evaluate the awareness of knowledge of these scales between doctors working in emergency rooms and prehospital consultation and range of usefulness of these scales. Material and Method: Observational and prospective survey of 569 doctors from the Argentinian provinces of Santa Fe, Rios, and Chaco from December 2008 to March 2009. Results: One third of doctors declared to know the scales, but 8.4% could enumerate CPSS points, while 1.9% could enumerate LAPSS points with 0.7% remembered both CPSS and LAPSS points. Those who remembered either one or both scales felt safer evaluating a possible stroke (p= 0.02) .Those who felt more hesitant where the doctors who a described more benefits to the scales (p= 0.0003). Non specialists considered scales more useful Conclusion: Both scales were valued by doctors to diagnose patients with possible stroke. We try to stress the need of a widespread coverage of these scales to improve the initial approach for managing these patients. Keywords: stroke, Los Angeles Prehospital Stroke Screen, Pre-hospital Stroke Scale, emergency room, doctors on call.

PELATIHAN DETEKSI DINI MENCEGAH TERJADINYA STROKE PADA LANSIA PIMPINAN RANTING ‘AISYIYAH ALUN-ALUN UTARA KOTAGEDE YOGYAKARTA

ABSTRAK Latar belakang :Stroke adalah gejala-gejala defisitfungsi saraf yang diakibatkan oleh penyakit pembuluh darah otak, bukan oleh sebab yang lain (WHO). Gangguan fungsi syaraf pada stroke disebabkan oleh gangguan peredaran darah otak non traumatik. Gangguan syaraf tersebut menimbulkan gejala antara lain: kelumpuhan wajah atau anggota badan, bicara tidak lancar, bicara tidak jelas (pelo), perubahan kesadaran, gangguan penglihatan, dan lain-lain. Stroke merupakan penyebab disabilitas nomor satu dan penyebab kematian nomor dua di dunia setelah penyakit jantung iskemik baik di negara maju maupun berkembang. Metode : pelatihan ini dilakukan dengan metode ceramah dan apllikasi kepada kader dan lansia di PRA Alun-alun Utara kotagede Tujuan: Bertambahnya pengetahuan kader posyandu dan ibu ‘Aisyiyah Alun-Alun Utara tentang gangguan pembuluh darah otak, tentang deteksi dini terjadinya stroke serta pelatihan dalam mencegah terjadinya stroke. Hasil para Kader lansia mampu melakukan cara bagaimana deteksi dini stroke dengan melakukan pengukuran tensi darah serta mampu mengetahui batas normal dari nilai kadar kolesterol dan gula darah, Rekomendasi kegiatan ini bisa dilakukan secara rutin dengan diadakannya posyandu lansia Kata Kunci: Stroke, Deteksi Dini stroke, pencegahan stroke ABSTRACT Background: Stroke is a symptom of nerve deficit function caused by cerebral vascular disease, not by other causes (WHO). Nerve function disorders in stroke are caused by non-traumatic brain circulatory disorders. This nerve disorder causes symptoms, including: paralysis of the face or limbs, speech is not fluent, speech is not clear (pelo), Stroke is the number one cause of disability and the number two cause of death in the world after ischemic heart disease in both developed and developing countries. Methods: This training was conducted by lecturing and applying to cadres and the elderly at PRA Alun-alun Utara, Kotagede. Objectives: Increasing the knowledge of posyandu cadres and 'Aisyiyah Alun-Alun Utara' about brain blood vessel disorders, early detection of stroke and training in preventing the occurrence of a stroke. The results of the elderly cadres are able to do how to detect stroke early by measuring blood pressure and being able to know the normal limit of the value of cholesterol and blood sugar levels. Recommendations for this activity can be done regularly by holding posyandu for the elderly Keywords: Stroke, Stroke Early Detection, Stroke Prevention

SISTEM MEKANIK DAN ELEKTRIK PADA PROTOTIPE ROBOT REHABILITASI KAKI

Stroke patients need rehabilitation to repair diseased parts of the body. Patients have limitations on therapists who have limitations and intensity to accompany the patient's rehabilitation process. The development of modern robotics technology provides solutions for independent consultations. This research has made a prototype of a rehabilitation robot with a mechanical design based on the foot rehabilitation movement reference as upper leg movement and lower leg movement. The movement is to bend and straighten the knee, and the movement of lifting and lowering the thigh. Mechanical adjustments to the movements applied make the prototype divided into several parts, namely asking the body, approving the legs and packing the actuator. The leg frame on the prototype has two free joints. The power system legs are built to complement the workings of the prototype and support the user's independent movement effort. The results of system testing that have been applied to this prototype are actuators that serve to assist users, provide user movement and provide additional power PWM motor used. Keywords— Stroke Patients, Rehabilitation Robot, Sistem Power Legs.

Justification of a New Solution in the Field of Stroke Rehabilitation

This research consists in the creation of a hardware-software complex for the rehabilitation of stroke patients. The device is designed for rehabilitation of patients after acute disorders of cerebral blood circulation with severe neurotraumas. The device is based on two existing rehabilitation technologies: the method of transcranial brain stimulation with the help of a magnetic neurostimulator, and the development of hand motility with the help of gloves. The combination of these two methods will allow patients to recover effectively, even at home, after they was suffering from neurotrauma. Keywords: stroke, ischemic, rehabilitation, biofeedback, paresis, brain, computer, mechanized glove, hardware, and software complex, CNS diseases, integration, TMS, magnetic neurostimulator

Hubungan antara Waktu Tindakan Intubasi dengan Outcome Pasien Stroke di RSUP Prof. Dr. R. D. Kandou Manado: Kajian terhadap Glasgow Coma Scale, Ventilator Associated Pneumonia, Length of Stay, dan Angka Kematian

Stroke patients with decreased consciousness, airway disorders, hypoxia, apnea or therapeutic initiation of hyperventilation must be intubated. The delay in intubation time in stroke patients with a deteriorating general condition is very dangerous because it is related to higher mortality within the first 24 to 48 hours and will affect the length of stay (LOS). One of the indications for intubation in stroke patients is the decrease in consciousness, namely the Glasgow Coma Scale (GCS) score <9. Albeit, intubation and mechanical ventilation can cause a person 6 to 21 times more likely to develop pneumonia, commonly referred to as ventilator associated pneumonia (VAP). This study was conducted at Prof. Dr. R. D. Kandou Hospital Manado and was aimed to obtain the correlation between time of intubation and stroke patient’s outcome based on GCS, VAP, LOS, and mortality. The results showed that there was no relationship between time of intubation <48 hours or ≥48 hours after stroke and improvement of GCS (0%); between time of intubation <48 hours or ≥48 hours after stroke and the occurence of VAP (P=0.698); and between time of intubation <48 hours or ≥48 hours after stroke and LOS (r=0.265; P=0.054); as well as between time of intubation <48 hours or ≥48 hours after stroke and mortality in the first two days after intubation (P=0.313).Keywords: stroke, time of intubation, outcome. Abstrak: Pasien stroke dengan penurunan kesadaran, gangguan jalan napas, hipoksia, apnea atau inisiasi terapetik hiperventilasi harus diintubasi. Penundaan waktu tindakan intubasi pada pasien stroke dengan keadaan umum yang memburuk sangat berisiko karena berkaitan dengan mortalitas dalam waktu 24-48 jam pertama dan akan memengaruhi length of stay (LOS). Indikasi dilakukannya intubasi terhadap pasien stroke salah satunya ialah penurunan kesadaran yang dinilai dengan skor Glasgow Coma Scale (GCS) <9. Intubasi dan ventilasi mekanik dapat menyebabkan seseorang 6 sampai 21 kali lipat cenderung terkena pneumonia (ventilator associated pneumonia/VAP). Penelitian ini bertujuan untuk mendapatkan hubungan antara waktu tindakan intubasi dengan outcome pasien stroke di RSUP Prof. Dr. R. D. Kandou Manado dengan menggunakan kajian terhadap GCS, VAP, LOS, dan angka kematian. Hasil penelitian memperlihatkan tidak terdapat hubungan antara waktu tindakan intubasi <48 jam atau ≥48 jam setelah serangan stroke dengan perbaikan GCS (0%); dengan kejadian VAP (P=0,698); dengan LOS (r=0,265; P=0,054); dan dengan angka kematian pada 2 hari pertama setelah diintubasi (P=0,313).Kata kunci: stroke, waktu tindakan intubasi, outcome

Gambaran pemberian terapi pada pasien stroke dengan hemiparesis dekstra atau sinistra di Instalasi Rehabilitasi Medik RSUP Prof. Dr. R. D. Kandou Manado periode Januari-Maret tahun 2016

Stroke is one of the important problems in public health due to its morbidity, mortality, and high cost. In many countries in the world, stroke is the third leading cause of death after coronary heart disease and cancer. This study aimed to obtain the profile of medical rehabilitation treatment for stroke patients with hemipharesis. This was a retrospective descriptive study. Subjects were medical records of stroke patients with hemiparesis at Installation of Medical Rehabilitation at Prof. Dr. R. D. Kandou Hosipital Manado. The results showed that the medical rehabilitation treatment for stroke patients with hemiparesis in the period January-March 2016 in the Installation of Medical Rehabilitation at RSUP Prof. Dr. R. D. Kandou Manado was as follows: physiotherapy with infrared (31.402%), classis physical exercise (27.744%), active creative exercise (18.293%), daily activity adaptation (13.415%), therapeutic USD (2.449%), breathing exercise (2.134%), language exercise 0.610%), psychology rehabilitation (1.829%), proper body mechanisms (1.829%), and therapeutic medical social (0.305%). Keywords: stroke, hemiparesis, therapy Abstrak: Stroke adalah salah satu masalah penting bagi kesehatan masyarakat karena memiliki angka kesakitan, angka kematian, dan biaya yang tinggi. Di banyak negara di dunia, stroke menduduki peringkat ketiga penyebab kematian sesudah penyakit jantung koroner dan kanker. Penelitian ini bertujuan untuk mendapatkan jenis-jenis penanganan rehabilitasi medik pada pasien stroke dengan hemiparesis. Jenis penelitian ini ialah deskriptif retrospektif. Subjek penelitian ialah data rekam medik pasien stroke dengan hemiparesis di Instalasi Rehabilitasi Medik RSUP. Prof. Dr. R. D. Kandou Manado. Hasail penelitian memperlihatkan pemberian terapi yang paling sering diberikan kepada pasien stroke dengan hemiparesis pada periode Januari-Maret 2016 di Instalasi Rehabilitasi Medik RSUP Prof. Dr. R. D. Kandou Manado ialah fisioterapi dengan pemberian infra merah (31,402%), latihan fisik klasik (27,744%), latihan aktif kreatif (18,293%), adaptasi AKS (13,415%), terapi USD (2,449%), latihan pernapasan (2,134%), latihan berbahasa (0,610%), rehabilitasi psikologi (1,829%), proper body mechanism (1,829%), dan terapi sosial medik (0,305%).Kata kunci: stroke, hemiparesis, terapi