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Widya Meiliana
Profil kualitas hidup ibu yang mengasuh anak palsi serebral dan hubungannya dengan kondisi palsi serebral anak, faktor sosial demografik dan kondisi mental ibu = Profile of mother's quality of life with cerebral palsy child and the correlation with cerebral palsy condition, social demographic factor, and mother's mental condition / Widya Meiliana
"ABSTRAK
Tesis ini disusun untuk mengetahui kondisi kualitas hidup ibu yang mengasuh anak dengan palsi serebral (PS), serta hubungannya dengan kondisi PS anak, faktor sosial demografik dan kondisi mental ibu. Penelitian menggunakan desain potong lintang. Subjek ibu diminta untuk mengisi kuesioner WHOQOL-BREF dan dilakukan wawancara untuk penilaian faktor sosial demografik dan kondisi mental ibu menggunakan MINI ICD-10, serta penilaian kondisi PS anak melalui pemeriksaan dan data rekam medis. Analisa statistik untuk menilai kualitas hidup ibu serta korelasinya dengan kondisi PS anak, faktor sosial demografik, dan kondisi mental ibu. Hasil penelitian menyatakan bahwa nilai tengah dari kualitas hidup ibu sebesar 50 (31-88), 63 (13-94), 62,5 (0-100), dan 50 (25-75) pada setiap domain. Faktor sosial demografik mempengaruhi kualitas hidup ibu pada faktor usia ibu, usia anak, pendapatan keluarga, jarak dari rumah ke pusat terapi, status tempat tinggal, jenis kelamin anak, pekerjaan ibu, dan pendidikan ibu. Tidak terdapat hubungan yang bermakna antara kondisi PS anak dan kondisi mental ibu terhadap kualitas hidup ibu. Maka, penelitian ini dapat menjadi pertimbangan untuk mulai memberikan pendampingan dan pelayanan yang komperhensif kepada para ibu yang mengasuh anak dengan PS ataupun kondisi disabilitas lainnya.
ABSTRACT
This thesis was aimed to determine the mother s quality of life (QoL) who caring for cerebral palsy (CP) child, also its relationship with CP child s condition, socio-demographic factors and mother s mental conditions. The design was cross-sectional. Mothers were asked to fill out the WHOQOL-BREF questionnaire and interviews to assess the social demographic factors and mental conditions using the MINI ICD-10, also assess the CP child s condition from examination and medical record data. Statistical analysis was conducted to assess the mother s QoL and its correlation with the CP child s condition, socio-demographic factors, and the mother s mental condition. The results stated that the mean value of mother s QoL were 50 (31-88), 63 (13-94), 62.5 (0-100), and 50 (25-75) in each domain. Social demographic factors affect the mother s QoL on the mother s age, child s age, family income, distance from home to the therapy center, residence state, child s sex, mother s occupation, and mother s education. There is no significant correlation between the CP child s condition and mother s mental condition to the mother s QoL. Thus, this research can be considered to start providing comprehensive assistance and services to mothers with CP child or other disability conditions. "
2019
SP-pdf
UI - Tugas Akhir  Universitas Indonesia Library
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Cut Nurul Hafifah, supervisor
Insidens dan faktor risiko pneumonia aspirasi pada anak dengan palsi serebral = Incidence and risk factors of aspiration pneumonia in children with cerebral palsy
"[ABSTRAK
Latar Belakang Masalah saluran napas yaitu pneumonia aspirasi merupakan masalah utama berkaitan dengan kualitas hidup morbiditas dan mortalitas pada anak palsi serebral PS Faktor yang berperan terhadap timbulnya pneumonia aspirasi antara lain adalah kelemahan otot napas gangguan koordinasi menelan refluks gastro esofagus status gizi dan imunitas yang kurang baik Namun hingga kini belum ada data seberapa besar insidens pneumonia aspirasi pada anak dengan PS di Indonesia dan faktor risiko yang berhubungan Tujuan Mengetahui insidens pneumonia aspirasi pada anak dengan PS dan hubungan faktor risiko dengan kejadian pneumonia aspirasi Metode Penelitian ini adalah studi kohort prospektif untuk menilai insidens pneumonia aspirasi dan studi potong lintang untuk menilai faktor risiko pneumonia aspirasi Penelitian ini dilakukan di Ruang Rawat Inap dan Klinik Neurologi Departemen Ilmu Kesehatan Anak Rumah Sakit Cipto Mangukusumo Waktu rekrutmen penelitian 1 Maret 31 Maret 2015 Waktu pengamatan tanggal 1 April 30 September 2015 Terhadap subyek dilakukan anamnesis termasuk penilaian faktor risiko dengan Dysphagia Disorder Survey pemeriksaan fisis dan R ntgen toraks sebagai data awal selanjutnya subyek diamati selama 6 bulan untuk mengevaluasi adanya pneumonia aspirasi Hubungan bivariat antara kejadian aspirasi dan faktor risiko dilakukan dengan uji Fisher dan Mann Whitney sedangkan analisis multivariat dilakukan dengan regresi logistik Hasil Total subjek penelitian adalah 40 anak dengan PS Dua subjek mengalami drop out karena meninggal dunia dan dua subjek loss to follow up sehingga terdapat 36 pasien yang berhasil diamati hingga enam bulan Sebanyak 8 dari 36 22 2 pasien pada penelitian ini mengalami kejadian aspirasi baik silent aspiration 5 5 maupun pneumonia aspirasi secara klinis 19 4 Derajat beratnya PS berhubungan dengan pneumonia dan silent aspiration p 0 040 sedangkan pneumonia dan silent aspiration tidak berhubungan dengan gangguan koordinasi menelan p 0 2 dan status gizi p 0 107 Simpulan Insidens pneumonia aspirasi pada anak PS adalah 22 2 dengan derajat beratnya PS sebagai faktor risiko terjadinya PS ABSTRACT Background Respiratory problems such as aspiration pneumonia are major morbidities and mortalities in children with cerebral palsy and play major role in the quality of life of these children Several risk factors may contribute to these problems including respiratory muscle weakness dysphagia gastro esophageal reflux disease nutrition and immune problem Nevertheless there are still no data on the incidence and risk factors of aspiration pneumonia in children with cerebral palsy in Indonesia Aim To determine the incidence and risk factors of aspiration pneumonia in children with cerebral palsy Method Incidence of pneumonia was studied prospectively and the prevalence of the risk factors was studied as cross sectional Subjects were recruited from March 1st ndash 31st 2015 through Neurology Clinic and Pediatric Ward Cipto Mangukusumo Hospital At baseline we evaluate history physical examination risk factors using Dysphagia Disorder Survey and chest X ray to evaluate the incidence of silent aspiration Subjects were followed up for six months to determine the incidence of aspiration pneumonia Analysis of the risk factors contributing to aspiration pneumonia were tested using Fisher rsquo s exact test and Mann Whitney Multivariate analysis was tested using logistic regression Result A total of 40 children with cerebral palsy were recruited Two subjects died during follow up and two subjects were loss to follow up giving a total of 36 subjects who completed the study Eight out of 36 subjects 22 2 had one or more episodes of aspiration consisting of silent aspiration 5 5 and clinically diagnosed aspiration pneumonia 19 4 Gross motor function was statistically signifant as risk factor of aspiration pneumonia p 0 040 while dysphagia p 0 2 and nutritional status p 0 107 were not associated with pneumonia and silent aspiration Conclusion Incidence of aspiration pneumonia and silent aspiration in children with cerebral palsy is 22 2 with gross motor function as a risk factor ;Background Respiratory problems such as aspiration pneumonia are major morbidities and mortalities in children with cerebral palsy and play major role in the quality of life of these children Several risk factors may contribute to these problems including respiratory muscle weakness dysphagia gastro esophageal reflux disease nutrition and immune problem Nevertheless there are still no data on the incidence and risk factors of aspiration pneumonia in children with cerebral palsy in Indonesia Aim To determine the incidence and risk factors of aspiration pneumonia in children with cerebral palsy Method Incidence of pneumonia was studied prospectively and the prevalence of the risk factors was studied as cross sectional Subjects were recruited from March 1st ndash 31st 2015 through Neurology Clinic and Pediatric Ward Cipto Mangukusumo Hospital At baseline we evaluate history physical examination risk factors using Dysphagia Disorder Survey and chest X ray to evaluate the incidence of silent aspiration Subjects were followed up for six months to determine the incidence of aspiration pneumonia Analysis of the risk factors contributing to aspiration pneumonia were tested using Fisher rsquo s exact test and Mann Whitney Multivariate analysis was tested using logistic regression Result A total of 40 children with cerebral palsy were recruited Two subjects died during follow up and two subjects were loss to follow up giving a total of 36 subjects who completed the study Eight out of 36 subjects 22 2 had one or more episodes of aspiration consisting of silent aspiration 5 5 and clinically diagnosed aspiration pneumonia 19 4 Gross motor function was statistically signifant as risk factor of aspiration pneumonia p 0 040 while dysphagia p 0 2 and nutritional status p 0 107 were not associated with pneumonia and silent aspiration Conclusion Incidence of aspiration pneumonia and silent aspiration in children with cerebral palsy is 22 2 with gross motor function as a risk factor ;Background Respiratory problems such as aspiration pneumonia are major morbidities and mortalities in children with cerebral palsy and play major role in the quality of life of these children Several risk factors may contribute to these problems including respiratory muscle weakness dysphagia gastro esophageal reflux disease nutrition and immune problem Nevertheless there are still no data on the incidence and risk factors of aspiration pneumonia in children with cerebral palsy in Indonesia Aim To determine the incidence and risk factors of aspiration pneumonia in children with cerebral palsy Method Incidence of pneumonia was studied prospectively and the prevalence of the risk factors was studied as cross sectional Subjects were recruited from March 1st ndash 31st 2015 through Neurology Clinic and Pediatric Ward Cipto Mangukusumo Hospital At baseline we evaluate history physical examination risk factors using Dysphagia Disorder Survey and chest X ray to evaluate the incidence of silent aspiration Subjects were followed up for six months to determine the incidence of aspiration pneumonia Analysis of the risk factors contributing to aspiration pneumonia were tested using Fisher rsquo s exact test and Mann Whitney Multivariate analysis was tested using logistic regression Result A total of 40 children with cerebral palsy were recruited Two subjects died during follow up and two subjects were loss to follow up giving a total of 36 subjects who completed the study Eight out of 36 subjects 22 2 had one or more episodes of aspiration consisting of silent aspiration 5 5 and clinically diagnosed aspiration pneumonia 19 4 Gross motor function was statistically signifant as risk factor of aspiration pneumonia p 0 040 while dysphagia p 0 2 and nutritional status p 0 107 were not associated with pneumonia and silent aspiration Conclusion Incidence of aspiration pneumonia and silent aspiration in children with cerebral palsy is 22 2 with gross motor function as a risk factor , Background Respiratory problems such as aspiration pneumonia are major morbidities and mortalities in children with cerebral palsy and play major role in the quality of life of these children Several risk factors may contribute to these problems including respiratory muscle weakness dysphagia gastro esophageal reflux disease nutrition and immune problem Nevertheless there are still no data on the incidence and risk factors of aspiration pneumonia in children with cerebral palsy in Indonesia Aim To determine the incidence and risk factors of aspiration pneumonia in children with cerebral palsy Method Incidence of pneumonia was studied prospectively and the prevalence of the risk factors was studied as cross sectional Subjects were recruited from March 1st ndash 31st 2015 through Neurology Clinic and Pediatric Ward Cipto Mangukusumo Hospital At baseline we evaluate history physical examination risk factors using Dysphagia Disorder Survey and chest X ray to evaluate the incidence of silent aspiration Subjects were followed up for six months to determine the incidence of aspiration pneumonia Analysis of the risk factors contributing to aspiration pneumonia were tested using Fisher rsquo s exact test and Mann Whitney Multivariate analysis was tested using logistic regression Result A total of 40 children with cerebral palsy were recruited Two subjects died during follow up and two subjects were loss to follow up giving a total of 36 subjects who completed the study Eight out of 36 subjects 22 2 had one or more episodes of aspiration consisting of silent aspiration 5 5 and clinically diagnosed aspiration pneumonia 19 4 Gross motor function was statistically signifant as risk factor of aspiration pneumonia p 0 040 while dysphagia p 0 2 and nutritional status p 0 107 were not associated with pneumonia and silent aspiration Conclusion Incidence of aspiration pneumonia and silent aspiration in children with cerebral palsy is 22 2 with gross motor function as a risk factor ]"
Fakultas Kedokteran Universitas Indonesia, 2015
SP-PDF
UI - Tugas Akhir  Universitas Indonesia Library
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Fadhilah Tia Nur
Kesulitan makan pada anak palsi serebral prevalensi faktor risiko dan pengaruh intervensi = Feeding difficulties in children with cerebral palsy prevalence risk factor and intervention
"Palsi serebral PS adalah gangguan fungsi motorik dan postur akibat gangguan perkembangan otak Anak PS sering mengalami kesulitan makan yang disebabkan gangguan tersebut Anak dengan gangguan fungsi motorik yang berat akan lebih besar kemungkinan mengalami kesulitan makan Kesulitan makan akan menyebabkan capaian kalori berkurang yang dapat mengakibatkan terjadinya malnutrisi Tujuan Mengetahui prevalensi faktor risiko skala GMFCS dengan kesulitan makan pada anak PS serta pengaruh intervensi Metode Penelitian ini merupakan studi potong lintang terhadap pasien palsi serebral yang datang di poliklinik neurologi anak RSUD Dr Moewardi pada Januari sampai September 2015 Anak PS akan diperiksa skala GMFCS status gizi dan kesulitan makan Skala GMFCS diukur menggunakan instrument pengukuran Gross Motor Function Measure 88 GMFM 88 Status gizi antropometri diukur menggunakan kurva CDC NCHS 2000 Pasien PS dengan tipe spastik kuadriplegi dilakukan pengukuran antropometri ulang menggunakan kurva Krick Penentuan status gizi berdasarkan kriteria klasifikasi Waterlow Capaian kalori diukur dengan analisis diet recall selama 3 hari dan dinilai cukup apabila memenuhi 13 9 kkal cm TB 10 Kesulitan makan dinilai dari anamnesis pemeriksaan fisik dan observasi kemampuan makan Hasil Didapatkan 80 anak PS pada penelitian ini sebagian besar subjek adalah PS tipe spastik 96 dengan tipe spastik kuadriplegi dan spastik diplegi dan mempunyai skala GMFCS V Prevalensi malnutrisi pada anak PS sebesar 68 Tujuh puluh delapan persen diantaranya mengalami kesulitan makan 30 dari yang menderita kesulitan makan adalah anak PS dengan skala GMFCS V Simpulan Prevalensi gizi kurang pada anak PS di RSUD Dr Moewardi sebesar 68 dan prevalensi gizi buruk sebesar 10 Skala GMFCS dan tipe PS spastik merupakan faktor risiko kesulitan makan pada anak PS Pemberian terapi oromotor dan postural berpengaruh secara signifikan memperbaiki kelainan oromotor dan kontrol postur.
Background Cerebral palsy CP is a motor and postural disorder due to an insult on the developing brain Children with CP often have feeding difficulties due to their disabilities Children with severe motor impairment are likely to experience greater feeding difficulties This results in inadequate calorie intake which finally leads to malnutrition Objective To determine the prevalence and the relationship between the GMFCS and feeding difficulties in CP Methods A cross sectional study was done from January to September 2015 in the neurology pediatric outpatient clinic of Dr Moewardi Hospital Children with CP underwent the GMFCS scale nutritional and feeding difficulties assessment The GMFCS was evaluated by Gross Motor Function Measure 88 GMFM 88 Nutritional status was determined by the ratio of body weight to body height standardized to CDC NCHS 2000 growth curve and were classified based on Waterlow Spastic quadriplegics CP patients were also compared to CP growth curve of Krick Calorie intake was evaluated by dietary analysis and defined as adequate if it reached 13 9 kcal cm BH 10 Feeding difficulties assessment included history taking physical examination and observation of feeding skill in the outpatient clinic Results Eighty children with CP were included in this study most of them were spastic type 96 mainly spastic quadriplegic and diplegic CP and were in GMFCS level V Malnutrition was found in 78 subject Feeding difficulties were found in 78 subject 30 with GMFCS level V Conclusion The prevalence of undernourished and severe malnutrition in children with CP is 68 and 10 respectively The GMFCS scale and CP with spastic type are risc factor for feeding difficulties in children with CP The effect of oromotor and postural theraphy on improvement of oromotor and postural control are significant."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2016
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UI - Tesis Membership  Universitas Indonesia Library
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Primo Parmato
Prevalens dan faktor prediktor dari kemampuan berjalan pasien palsi serebral pada masa anak di Rumah Sakit Umum Cipto Mangunkusumo dan Yayasan Pembinaan Anak Cacat = The prevalence and predicting factor of walking ability of cerebral palsy patient in childhood condition at Cipto Mangunkusumo Hospital and Yayasan Pembinaan Anak Cacat
"Latar belakang: Palsi serebral (PS) adalah salah satu gangguan fisis penyebab utama gangguan pertumbuhan dan perkembangan anak. Permasalahan PS yang menjadi perhatian bagi orangtua adalah keterlambatan perkembangan motorik terutama kemampuan berjalan. Sampai saat ini belum didapatkan data prevalens dan faktor prediktor pada masa anak apa saja yang berhubungan dengan kemampuan berkalan pasien PS.
Tujuan: Untuk mengetahui prevalens kemampuan berjalan pasien PS, dan mengetahui faktor prediktor apa saja yang berhubungan dan yang paling berperan terhadap kemampuan berjalan pasien PS pada masa anak.
Metode: 102 pasien PS yang berusia 6 tahun ke atas dilakukan pengambilan data melalui wawancara orang tua dan rekam medis mengenai kemampuan berjalan pasien PS dan faktor prediktor pada masa anak yang berhubungan dengan kemampuan berjalan pasien PS. Pengambilan data dilakukan di Rumah Sakit Cipto Mangunkusumo (RSCM) dan Yayasan Pembinaan Anak Cacat (YPAC).
Hasil: Sebanyak 27 pasien (26.5%) berjalan tanpa alat bantu, 13 pasien (12.7%) berjalan dengan alat bantu, dan 62 pasien (60.8%) tidak dapat berjalan walau dengan alat bantu. Faktor prediktor yang berhubungan dengan kemampuan berjalan pasien PS adalah kemampuan menahan posisi duduk tanpa topangan sebelum usia 2 tahun (P<0.001; OR=6.89; IK 95%=2.42-19.71) dan tipe PS spastik unilateral (OR=7.36; IK 95%=1.86-29.18).
Simpulan: Prevalens pasien PS yang dapat berjalan tanpa alat bantu adalah 26.5%, berjalan dengan alat bantu adalah 12.7%, dan tidak dapat berjalan walau dengan alat bantu 60.8%. Faktor prediktor yang berhubungan dengan kemampuan berjalan pasien PS adalah kemampuan menahan posisi duduk tanpa topangan sebelum usia 2 tahun dan spastik unilateral. Faktor prediktor yang paling berperan adalah kemampuan menahan posisi duduk tanpa topangan sebelum usia 2 tahun.
Background: Cerebral palsy (CP) is one of the main disorder of growth and development in child. The problem of CP often asked by parents is delayed of motoric development particularly about walking ability. There has been no data about prevalence and childhood predicting factor which has relationship with walking ability in CP patient.
Objectives: To determine the prevalence of walking ability in CP patient, to identify childhood predicting factor relating to walking ability in CP patient, and also to determine the most childhood predicting factor of walking ability in CP patient.
Methods: Data has been taken from 102 CP patients which has age above 6 years old, by interviewed to the parents or by medical record. The places of research are Cipto Mangunkusumo Hospital and Yayasan Pembinaan Anak Cacat (YPAC).
Results: 27 patients (26.5%) could walk without assistive device, 13 patients (12.7%) could walk with assistive device, and 62 patients (60.8%) could not walk even with assistive device. The childhood predicting factor of waking ability in CP patients is the ability to maintain sitting position before age 2 years old (P<0.001; OR=6.89; CI 95%=2.42-19.71) and the spastic unilateral CP type (OR = 7.36; CI 95% = 1.86-29.18).
Conclusions: The prevalence of walking ability in CP patient is 26.6% walk without assistive device, 12.7% walk with assistive device, and 60.8% could not walk even with assistive device. The predicting factor relating to walking ability in CP patients is the ability to maintain sitting position before age 2 years old and the spastic unilateral CP type. The most predicting factor of walking ability in CP patients is the ability to maintain sitting position before age 2 years old."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2013
T-Pdf
UI - Tesis Membership  Universitas Indonesia Library
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Anidar
Faktor risiko terjadinya epilepsi pada palsi serebral spastik = Risk factor for epilepsy in children with spastic cerebral palsy
"Latar belakang. Epilepsi dapat terjadi 34 - 94% pada pasien palsi serebral. Epilepsi pada anak palsi serebral akan sulit dikontrol, sehingga akan meningkatkan bertambah beratnya gangguan fungsi kognitif, gangguan fungsi motorik berjalan, gangguan prilaku, yang nantinya dapat menurunkan kulitas hidup anak di kemudian hari. Faktor risiko terjadinya epilepsi pada palsi serebral berbeda-beda antara satu peneliti dengan peneliti lainnya.
Tujuan. (1) mengetahui manifestasi klinis palsi serebral spastik, (2) mengetahui apakah faktor-faktor risiko seperti kejang neonatus, awitan kejang pertama < 1 tahun, riwayat keluarga epilepsi, subtipe palsi serebral spastik, proses persalinan, usia gestasi, berat badan lahir, ukuran lingkar kepala, riwayat infeksi susunan saraf pusat, gambaran EEG dan gambaran CT scan/MRI kepala berhubungan dengan kejadian epilepsi pada palsi serebral spastik
Metode penelitian. Desain penelitian adalah kasus kontrol dan dilakukan poliklinik rawat jalan Neurologi Anak di RSCM, RSUP Fatmawati dan RSAB Harapan Kita kurun waktu Januari 2010 sampai Agustus 2015 terhadap 250 anak palsi serebral spastik usia 1 sampai 18 tahun. Faktor risiko dianalisis bivariat dan multivariat.
Hasil. Manifestasi klinis palsi serebral spastik yang paling banyak ditemukan adalah tipe kuadriplegia 53,2% dan epilepsi lebih banyak terjadi pada tipe ini yaitu 52%. Pada analisis bivariat didapatkan faktor risiko yang bermakna yaitu awitan kejang pertama < 1 tahun (RO 5,49; IK 95% 2,98-10,10), EEG epileptik (RO 11,60; IK 95% 3,63-37,00), dan pencitraan abnormal (RO 2,96; IK 95% 1,07-8,13). Pada analisis multivariat didapatkan yaitu awitan kejang < 1 tahun dan EEG epileptik merupakan faktor risiko yang berperan untuk terjadinya epilepsi pada palsi serebral spastik.
Simpulan. Manifestasi klinis palsi serebral spastik yang paling banyak ditemukan adalah tipe kuadriplegia. Faktor risiko yang berperan untuk terjadinya epilepsi pada palsi serebral spastik adalah awitan kejang pertama < 1 tahun dan EEG epileptik.
Background. Epilepsy occurs in 34?94 percent of children with cerebral palsy. Epilepsies associated with cerebral palsy are difficult to control and associated with greater impairment of cognitive function, with lower probability of walking, with more severe behavioural problem, and a poorer quality of lifein compromising autonomy. Risk factors of epilepsy in children with cerebral palsy vary among studies.
Objective. (1) to identify clinical feature in spastis cerebral palsy, (2) to identify and analyze the association of risk factors including neonatal seizures, onset of first seizures before 1 year, family history of epilepsy, the type of cerebral palsy, delivery process, gestational age, birth weight, head circumference, history of central nervous system infection, the electroencephalogram (EEG) and magnetic resonance imaging (MRI)/computed tomography (CT) Scan findings with occure of epilepsy in spastic cerebral palsy.
Methods. Casus-control study was conducted in child neurology outpatient clinics in Cipto Mangunkusumo, Fatmawati, Harapan Kita Hospital Jakarta on January 2010 to August 2015 to 250 children of spastic cerebral palsy from 1 until 18 years old age. Data were analyzed using the IBM SPSS for Windowsv, 22 software.
Results. The most common type of spastic cerebral palsy is quadriplegia 53,2% and the occurance of epilepsy 52% in this type. Bivariate analysis showed that significantly onset of first seizures before 1 year (OR = 5.49; 95%CI 2.98-10.10), epileptiform EEG wave (OR = 11.60; 95%CI 3.63-37.00), and abnormal MRI/CT Scan (OR = 2.96; 95%CI 1.,07-8.13). Multivariate logistic regression analysis revealed that onset of first seizures before 1 year and epileptiform EEG wave were all found to be significant and independent risk factors for epilepsy in children with spastic cerebral palsy.
Conclusion. The most common type of spastic cerebral palsy is quadriplegia. The present study reveals that onset of first seizures before 1 year and epileptiform EEG wave are strongly associated with epilepsy in children with spastic cerebral palsy."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2015
T-Pdf
UI - Tesis Membership  Universitas Indonesia Library
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Lilis Diah Hendrawati
Hubungan antara fungsi motorik kasar dan kemampuan manual dengan kemampuan kognitif pada anak palsi serebral = The Relationship between gross motor function and manual ability with cognitive function in children with cerebral palsy
"Latar belakang. Pada anak Palsi Serebral terdapat hubungan antara motorik kasar (berdasarkan GMFCS) dan kemampuan manual (berdasarkan MACS) dengan kemampuan kognitif (berdasarkan tes IQ).Tujuan. Mengetahui hubungan antara skala GMFCS dan skala MACS dengan fungsi kognitif pada pasien Palsi Serebral (PS).
Metode penelitian. Penelitian dilakukan tanggal 17 Februari sampai 17 Mei 2018 pada pasien Palsi Serebral usai 5-18 tahun yang berobat di Poliklinik Neurologi Anak / Poliklinik Rehabilitasi Medik RSCM / YPAC Jakarta yang memenuhi kriteria penelitian.
Hasil penelitian. Pasien PS yang ikut serta dalam penelitian ini sejumlah 69 subyek, dengan karakteristik usia 4-6 tahun (26%), 6-12 tahun (57%), 12-18 tahun (17%) ; anak laki-laki (56,6%), perempuan (43.4%). Didapatkan tipe PS diplegi (68,1%), PS hemiplegi (2,9%), PS kuadriplegi (29%), dengan sebaran skala GMFCS I (14,5%), II (13%), III (27,5%), IV (17%), V (20,4%). Sebaran skala MACS: I (42%), II (13%), III (5,8%), IV (13%), V (26,2%). Sementara sebaran hasil tes IQ dengan skala WISC: 91-110 (3%), 80-90 (1%), 66-79 (4%), 52-65 (17%), 36-51 (25%), 20-35 (25%), <19 (25%).
Simpulan. Pada pasien PS, makin buruk kemampuan motorik kasar (GMFCS) maka makin buruk pula kemampuan manual (MACS) dan makin rendah pula IQ nya. Makin buruk kemampuan manual (MACS) makin rendah pula IQ nya. Tipe PS kuadriplegi memiliki nilai IQ yang paling rendah dibandingkan tipe PS diplegi/hemiplegi.
Objective.To determine the relationship between GMFCS and MACS with cognitive function in children with Cerebral Palsy. The study was conducted from February 17 to May 17, 2018. Children with Cerebral Palsy,  5-18 years old, were treated  at Pediatric Neurology Cipto Mangunkusumo Hospital/Medical Rehabilitation Cipto Mangunkusumo Hospital / YPAC Jakarta as outpatient, who met the research criteria.
Results. Children with Cerebral Palsy who participated in this study were 69 subjects, with characteristics of 4-6 years (26%), 6-12 years (57%), 12-18 years (17%); boys (56.6%), girls (43.4%). Cerebral Palsy type was obtained: diplegia (68.1%), hemiplegia (2.9%), quadriplegia (29%). Distribution scale of GMFCS: I  (14.5%), II (13%), III (27.5 %), IV (17%), V (20.4%). Distribution scale of MACS: I (42%), II (13%), III (5.8%), IV (13%), V (26.2%), while the distribution scale of IQ test with the WISC method: 91-110 (3%), 80-90 (1%), 66-79 (4%), 52-65 (17%), 36-51 (25%), 20 -35 (25%), <19 (25%).
Conclusions. Children with Cerebral Palsy, the worse gross motor function (GMFCS) then the worse manual ability (MACS) and the worse cognitive function (IQ). The worse manual ability (MACS) the lower the IQ. Quadriplegia type of Cerebral Palsy has the lowest IQ score compared to diplegia/ hemiplegia type of Cerebral Palsy."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2018
SP-Pdf
UI - Tugas Akhir  Universitas Indonesia Library
cover
Dian Eka Putri
Pengaruh laserpunktur terhadap spastisitas pada anak dengan palsi serebral tipe spastik = The effect of laserpuncture on spasticity in children with spastic cerebral palsy
"Spastisitas pada palsi serebral merupakan penyebab disabilitas terbesar pada anak-anak 80 . Akupunktur sebagai terapi tambahan diketahui dapat membantu mengurangi spastisitas pada anak dengan palsi serebral. Salah satu modalitas akupunktur dengan efek samping minimal dan aman untuk anak-anak adalah laserpunktur. Penelitian ini bertujuan mengetahui pengaruh laserpunktur pada titik GV20, GV14, LI4, GB34 dan LR3 terhadap spastisitas pada palsi serebral tipe spastik. Desain penelitian ini adalah uji klinis acak tersamar tunggal dengan kontrol. Melibatkan 60 pasien palsi serebral tipe spastik usia 2-10 tahun yang dibagi menjadi dua kelompok. Pasien yang menyelesaikan terapi hingga akhir penelitian adalah 52 orang, 8 pasien dinyatakan dropout. Kelompok perlakuan sebanyak 26 pasien mendapatkan terapi laserpunktur dan kelompok kontrol sebanyak 26 pasien mendapatkan terapi laserpunktur plasebo, masing-masing sebanyak 12 kali terapi dengan frekuensi 3 kali seminggu. Kemudian pada kedua kelompok dilakukan penilaian spastisitas menggunakan Modified Ashworth Scale MAS sebelum dan setelah mendapatkan perlakuan. Hasil penelitian menunjukkan terdapat penurunan nilai MAS setelah perlakuan pada kelompok laserpunktur dibandingkan kelompok laserpunktur plasebo p < 0,05; 95 IK = 2,616 - 15,230 , terdapat penurunan nilai MAS pada kelompok laserpunktur setelah perlakuan dibandingkan sebelum perlakuan p < 0,05; 95 IK = 2,354 - 11,030 , tidak terdapat penurunan nilai MAS pada kelompok laserpunktur plasebo setelah perlakuan dibandingkan sebelum perlakuan p > 0,05; 95 IK = -7,027 - 2,565 , dan terdapat penurunan nilai MAS 3,6 kali lebih besar pada kelompok laserpunktur dibandingkan kelompok laserpunktur plasebo OR = 3,6, p < 0,05 . Dapat disimpulkan bahwa laserpunktur pada titik akupunktur GV20, GV14, LI4, GB34 dan LR3 terbukti efektif terhadap penurunan nilai MAS dibandingkan dengan laserpunktur plasebo pada anak dengan palsi serebral tipe spastik.
Spasticity is a common feature of cerebral palsy 80 and the most common cause of disability in children. Acupuncture as an adjunctive therapy is known to help reduce spasticity in children with cerebral palsy. One of the acupuncture modalities with minimal side effects and safe for children is laser acupuncture or laserpuncture. This study aims is to determine the laserpuncture effects on GV20, GV14, LI4, GB34 and LR3 to spasticity on spastic cerebral palsy patients. The study design is a randomized single blinded clinical trial, involving 60 patients aged 2 to 10 years, divided into two groups. Only 52 patients who completed therapy until the end of the study, 8 patients stated dropout. The treatment group 26 patients received laserpuncture therapy, and the control group 26 patients received laserpuncture plasebo, each patient get 12 times therapy with frequency 3 times a week. Both of groups evaluated for spasticity using Modified Ashworth Scale MAS before and after treatment. The results showed a decrease in MAS score after treatment p 0,05 95 CI 2,616 15,230 in the laserpuncture group compared to the placebo group, a decrease in MAS score in the laserpuncture group after treatment p 0,05 95 CI 2,354 11,030 compared to before treatment, there is no improvement in the placebo group after treatment p 0,05 95 CI 7,027 2,565 compared to before treatment, and there was a decrease in MAS score 3,6 time greater in the laserpuncture group compared to the placebo group OR 3,6, p 0,05 . It can be concluded that laserpuncture therapy more effectively reduce MAS score in patients with spastic cerebral palsy compared to laserpuncture placebo. "
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2017
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Gendis Ayu Ardias
Faktor-faktor risiko terjadinya epilepsi pada anak dengan Palsi Serebral Tipe Spastik: studi kasus kontrol = Risk factors of epilepsy in children with Spastic Cerebral Palsy: a case control study
"Latar belakang: Palsi serebral (PS) merupakan gangguan permanen pada perkembangan gerakan dan postur tubuh, bersifat non-progresif, dan dapat menyebabkan keterbatasan aktivitas. Gangguan motorik pada PS dapat disertai dengan gangguan fungsi sensasi, persepsi, kognisi, komunikasi dan tingkah laku, masalah muskuloskeletal sekunder, dan berisiko untuk terjadinya epilepsi di kemudian hari. Jenis PS yang diyakini berhubungan erat dengan kejadian epilepsi adalah PS tipe spastik dengan topografi kuadriplegia. Meskipun terdapat beberapa teori yang diyakini menjadi etiologi spesifik epilepsi pada PS spastik, masih sekitar 70% kasus belum diketahui penyebabnya.
Metode: Penelitian ini merupakan studi observasional analitik dengan desain kasus kontrol yang bertujuan untuk menelaah faktor-faktor risiko epilepsi pada PS spastik. Faktor risiko yang terkait kejadian epilepsi pada PS tipe spastik yang akan diteliti adalah mikrosefal, topografi PS spastik, usia pertama kejang < 1 tahun, riwayat kejang periode neonatal, riwayat infeksi SSP di usia < 2 tahun, temuan abnormal CT scan/ MRI, dan temuan abnormal EEG.
Hasil: Sebanyak 103 subjek populasi kasus (PS spastik dengan epilepsi) dan 103 subjek populasi kontrol (PS spastik tanpa epilepsi) diikutsertakan dalam penelitian ini. Analisis univariat hingga multivariat dilakukan menggunakan program statistical package for the social sciences versi 27 (SPSS 27). Faktor risiko dianggap bermakna apabila nilai p<0,05. Penelitian ini menunjukkan bahwa faktor-faktor risiko PS tipe spastik yang paling berperan untuk terjadinya epilepsi pada penelitian ini adalah mikrosefal (p=0,003; OR 3,577; IK 95% 1,559–8,209), topografi PS spastik kuadriplegia dan hemiplegia (p=0,005; OR 6,636; IK 95% 1,797–24,509; dan p=0,006; OR 7,888; IK 95% 1,782–34,914), temuan abnormal CT scan/ MRI (nilai p=0,002; OR 4,153; IK 95% 1,715–10,058), dan temuan abnormal EEG berupa gambaran hipofungsi (p < 0,0001; OR 219,338; IK 95% 40,103–1199,63). Kesimpulan: Mikrosefal, topografi PS spastik kuadriplegia, temuan abnormal CT scan/ MRI, dan temuan abnormal EEG terbukti meningkatkan risiko terjadinya epilepsi pada PS spastik, sedangkan usia kejang pertama < 1 tahun, riwayat kejang neonatal, dan infeksi SSP usia < 2 tahun tidak terbukti meningkatkan risiko terjadinya epilepsi pada PS spastik.
Background: Cerebral palsy (CP) is a permanent and non-progressive disturbance in the development of movement and posture, and causes activity limitations. Motor disturbances in PS can be accompanied by impaired function of sensation, perception, cognition, communication and behaviour, secondary musculoskeletal problems, and the risk of developing epilepsy later in life. The type of CP that is believed to be closely related to the incidence of epilepsy is the spastic type with a quadriplegic topography. Although there are several theories that are believed to be the specific aetiology of epilepsy in spastic PS, the cause is still unknown in about 70% of cases.
Method: This is a case-control study design that aims to examine the risk factors of epilepsi in spastic CP. The risk factors associated with the occurrence of epilepsy that will be involved are microcephaly, topography of spastic CP, age at first seizure <1 year, history of neonatal seizures, history of CNS infection at the age < 2 years, abnormal CT scan/ MRI findings, and abnormal EEG findings.
Result: A total of 103 case population subjects (spastic CP with epilepsy) and 103 control population subjects (spastic CP without epilepsy) were included in this study. Univariate to multivariate analysis was performed using the statistical package for the social sciences version 27 (SPSS 27). Risk factors are considered significant if the p value <0.05. This study showed that the risk factors for epilepsy in spastic CP which were most significant for the occurrence of epilepsy were microcephaly (p=0.003; OR 3.577; 95% CI 1.559 – 8.209), quadriplegia and hemiplegia topography (p=0.005; OR 6.636; 95% CI 1.797- 24.509 and p=0.006; OR 7.888; 95% CI 1.782-34.914), abnormal CT scan/MRI findings (p=0.002; OR 4.153; 95% CI 1.715– 10.058), and hypofunction form of EEG findings (p<0,0001; OR 219.338; 95% CI 40.103–1199.63).
Conclusion: Microcephaly, quadriplegia topography, abnormal CT scan/MRI findings, and abnormal EEG findings have been shown to increase the risk of developing epilepsy in spastic CP. Whereas age of first seizure <1 year, history of neonatal seizures, and CNS infection at age <2 years old were not proven to increase the risk of epilepsy in spastic CP."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2023
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UI - Tugas Akhir  Universitas Indonesia Library
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Fenny Lovitha Dewi
Hubungan antara gross motor function classification system gmfcs dan manual ability classification system macs pada anak dengan palsi serebral = Relationship among the gross motor function classification system gmfcs and the manual ability classification system macs in children with cerebral palsy
"Latar Belakang : Fungsi motorik kasar pada seorang anak berkaitan erat dengan kemampuan untuk menggunakan tangannya. Pada anak dengan Palsi Serebral, Gross Motor Function Classification System (GMFCS) dan Manual Ability Classification System (MACS) merupakan sistem klasifikasi yang digunakan untuk menentukan tingkat fungsi motorik kasar dan tingkat kemampuan manual, sehingga perlu diketahui apakah kedua sistem klasifikasi ini juga saling berhubungan dalam menggambarkan kemampuan fungsional pada anak dengan Palsi Serebral. Penilaian tingkat GMFCS dan MACS dapat melengkapi gambaran tentang keterbatasan aktifitas dan restriksi partisipasi anak dengan Palsi Serebral menurut International Classification of Functioning, Disability and Health (ICF).
Tujuan : Penelitian ini bertujuan untuk mengetahui hubungan antara GMFCS dan MACS pada anak dengan Palsi Serebral.
Metode: Penelitian ini merupakan studi potong lintang analitik yang melibatkan 14 orang anak (8 orang laki-laki dan 6 orang perempuan) dengan rerata usia 6,21 tahun. Seluruh subjek merupakan Palsi Serebral tipe spastik dan 7 orang diantaranya adalah spastik kuadriplegik. Tingkat kemampuan motorik kasar diklasifikasikan berdasarkan GMFCS dan tingkat kemampuan manual berdasarkan MACS. Hubungan antara GMFCS dan MACS ditentukan dengan uji korelasi non parametrik Spearman's.
Hasil: Didapatkan 57,1% anak mempunyai GMFCS tingkat V dan 35,7% dengan MACS tingkat V. Satu orang subjek dengan Palsi Serebral spastik hemiplegik berada pada GMFCS tingkat V dan MACS tingkat IV dan 1 orang subjek dengan Palsi Serebral spastik triplegik mempunyai GMFCS dan MACS tingkat IV. Lima orang subjek dengan Palsi Serebral spastik diplegik mempunyai tingkat GMFCS yang bervariasi dari tingkat I hingga tingkat V dan 60% mempunyai MACS tingkat II. Pada Palsi Serebral spastik kuadriplegik, 85,7% subjek mempunyai GMFCS tingkat V dan 71,4% dengan MACS tingkat V.
Kesimpulan: GMFCS dan MACS saling berhubungan dalam menggambarkan tingkat fungsi motorik kasar dan tingkat kemampuan manual pada seluruh jenis Palsi Serebral.
Background : Gross motor function correlates strongly with the children's ability to use their hands. The Gross Motor Function Classification System (GMFCS) and the Manual Ability Classification System (MACS) was designed to determine the level of gross motor function and manual ability, and we need to know the relationship between these classifications to describe the functional ability for the children with Cerebral Palsy. GMFCS and MACS will give the complete description about the activity limitation and participation restriction in children with Cerebral Palsy, according to the International Classification of Functioning, Disability and Health (ICF).
The aim : To investigate the relationship among the GMFCS and MACS in children with Cerebral Palsy.
Methods: This is was the analytic cross sectional study which involving 14 children with the average age 6,21 years old (8 males and 6 females). All of the children was diagnosed as spastic Cerebral Palsy with 1 hemiplegic, 5 diplegic, 1 triplegic and 7 quadriplegic. The children were classified by researcher according to the GMFCS for their motor function and according to the MACS for the functioning of their hands when handling objects in daily activities. The relationship among the GMFCS and MACS was analyzed with the Spearman correlation test.
Results: From all of the children, 57,1% was the children with GMFCS level V and 35,7% with MACS level V. One subject with spastic hemiplegic was the child with level V in GMFCS and level IV in MACS and 1 subject with spastic triplegic have the GMFCS and MACS level IV. Five subjects with spastic diplegic were have varying distribution in all of GMFCS levels and 60% from all of spastic diplegic children have the MACS level II. In spastic quadriplegic, 85,7% were the subjects with level V in GMFCS and 71,4% with level V in MACS.
Conclusion: The GMFCS and MACS correlate each other for describing the level of gross motor function and manual ability in all of the types of Cerebral Palsy. "
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2013
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Maimanati Aina Rusdi
Korelasi sudut inklinasi femur dengan spastisitas otot aduktor panggul dan persentasi migrasi panggul pada penyandang palsi serebral = Correlation of femoral inclinnation angle with hip adductor muscle spasticity and pelvic migration percentage of people with cerebral palsy
"Pendahuluan : Sudut inklinasi femur penting untuk dinilai pada penyandang palsi serebral karena dipengaruhi oleh spastisitas dan meningkat pada penyandang palsi serebral yang mempunyai risiko terjadi subluksasi. Sudut inklinasi femur juga merupakan parameter yang digunakan untuk melihat progresivitas penyakit maupun respons terapi. Penelitian ini bertujuan Mengetahui korelasi sudut inklinasi femur dengan spastisitas otot adduktor panggul dan persentasi migrasi panggul pada penyandang palsi serebral.
Metode : Penelitian analitik potong lintang menggunakan data sekunder radiografi pelvis dari 30 orang penyandang palsi serebral yang berobat ke poliklinik Kedokteran Fisik dan Rehabilitasi RS Ciptomangunkusumo. Dari data radiografi tersebut diukur nilai sudut inklinasi femur dan dihubungkan dengan nilai spastisitas otot adduktor serta persentasi migrasi panggul yang sudah tercatat sebelumnya. Dilakukan uji korelasi Spearman untuk menentukan ada tidaknya hubungan antara sudut inklinasi femur dengan spastisitas otot adduktor panggul dan persentasi migrasi panggul.
Hasil : Tidak didapatkan korelasi bermakna antara sudut inklinasi femur dengan spastisitas otot adduktor panggul. Didapatkan kecenderungan peningkatan sudut inklinasi femur yang diikuti dengan peningkatan nilai persentasi migrasi panggul akan tetapi tidak didapatkan pula korelasi bermakna antara sudut inklinasi femur dengan persentasi migrasi panggul.
Kesimpulan : Tidak didapatkan korelasi secara statistik antara spastisitas otot adduktor panggul dengan sudut inklinasi femur. Hal ini dapat terjadi karena sudut inklinasi femur dipengaruhi oleh beberapa faktor salah satunya spastisitas yang dapat terjadi pada kelompok otot yang lain seperti hamstring dan iliopsoas, tidak hanya terjadi pada otot aduktor Didapatkan kecenderungan peningkatan sudut inklinasi femur diikuti dengan peningkatan nilai persentasi migrasi panggul akan tetapi tidak didapatkan korelasi yang bermakna secara statistik. Hal ini dapat terjadi karena persentasi migrasi panggul juga dipengaruhi oleh faktor lain seperti mobilisasi pasien.
Introduction: Femoral inclination angle is important to assess in people with cerebral palsy as affected by spasticity and increased in people with cerebral palsy who have a risk of subluxation. The femoral inclination angle is also a parameter that is used to see the progression of the disease and therapeutic response. This study aims to investigate the correlation of femoral inclination angle with hip adductor muscle spasticity and pelvic migration percentage of people with cerebral palsy.
Methods: A cross-sectional analytic study used secondary data pelvic radiographs of 30 people with cerebral palsy who went to the clinic of Physical Medicine and Rehabilitation Hospital Ciptomangunkusumo. From the measured value of the data radiographic pelvic inclination angle and the value associated with the adductor muscle spasticity as well as the percentage of migration of the pelvis that has been recorded previously. Spearman correlation test was done to determine whether there is a relationship between the angle of inclination of the femur to the pelvis and the adductor muscle spasticity migration percentage pelvis.
Results: There were no significant correlation between the inclination angle of the femur to the pelvis adductor muscle spasticity. Obtained trend of increasing the angle of inclination of the femur, followed by the percentage increase in the value of pelvic migration but not found also significant correlation between the inclination angle of the femur to the pelvis migration percentage.
Conclusion: There were no statistically significant correlation between the adductor muscle spasticity pelvis at an inclination angle of the femur. This can happen because of the angle of inclination of the femur is affected by several factors, one of which spasticity that may occur in other muscle groups such as the hamstring and iliopsoas, not only in the adductor muscle Obtained trend of increasing inclination angle of the femur followed by the percentage increase in the value of pelvic migration but not correlations were statistically significant. This can happen because the percentage of pelvic migration is also influenced by other factors such as the mobilization of the patient."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2014
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UI - Tesis Membership  Universitas Indonesia Library
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