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"ABSTRAKICS merekomendasikan latihan Kegel, sebagai terapi konservatif untuk mengatasi inkontinensia urin tekanan untuk dilakukan selama 12 minggu. Namun, beberapa penelitian menunjukkan bahwa latihan kegel selama 4, dan 8 minggu dapat memperbaiki gejala inkontinensia, kualitas hidup, dan meningkatkan kekuatan otot dasar panggul. Tujuan : Mengetahui gambaran perbaikan gejala subjektif dan objektif, peningkatan kekuatan otot dasar panggul, perbaikan derajat keparahan dan perbaikan kualitas hidup wanita penderita inkontinensia urin tekanan yang menjalani antara latihan Kegel yang 4, 8, dan 12 mingguMetode: 55 subjek terdiagnosis inkontinensia urin tekanan (berdasarkan nilai (QUID >4) dan tes pembalut positif 60 menit) diberikan latihan Kegel di Poliklinik Rehabilitasi Medik RSCM selama 12 minggu. Pengumpulan data, seperti kuesioner UDI-6; tes pembalut 60 menit; dan kuesioner IIQ-7 akan dicatat oleh subjek penelitian dalam buku kegiatan 4, 8, dan 12 minggu. Selain itu, evaluasi biofeedback(Myomed 932) dari kekuatan serat otot lambat dan serat otot cepat dilakukan setiap 2 minggu untuk menilai perbaikan. Hasil: Hasil penelitian menunjukkan bahwa adanya perbedaan bermakna antara skor UDI-6 dan IIQ-7 subjek sebelum latihan dan setelah latihan 4, 8, dan 12 minggu (uji Wilcoxon; p<0.05). Selain itu, adanya perbedaan yang signifikan pada kekuatan serat otot lambat dan serat cepat antara sebelum latihan dengan pasca latihan 8 minggu dan sebelum latihan dengan pasca 12 minggu. (dengan uji Wilcoxon; p <0.05).Kesimpulan : Latihan Kegel yang dilakukan dengan durasi minimal 8 minggu dapat memperbaiki gejala, kekuatan otot dasar pangul dan kualitas hidup wanita dengan inkontinensia urin tekanan.

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ABSTRACTKegel exercise is recommended by ICS, as a conservative therapy to improve stress urinary incontinence for 12 weeks. However, several studies have shown that Kegel exercise for 4 and 8 weeks can improve symptoms of incontinence, quality of life and increase pelvic floor muscle strength. Objective: To identify the improvement subjective and objective symptoms, increasing pelvic floor muscle strength, and improvement quality of life among women with stress urinary incontinence who performed kegel exercise 4, 8, and 12 weeks.Method: 55 subjects were diagnosed with stress urinary incontinence (based on (QUID score >4) and positive result of pad test 60 minutes) and were given the Kegel exercise at RSCM for 12 weeks. Datas such as UDI-6, pad test 60 minutes, and IIQ-7 will be documented by each subject in the book for 4, 8, and 12 weeks. In addition, Pelvic floor muscle (slow and fast fibers twitch) were assessed by biofeedback (myomed 932) every 2 weeks. Result: The results show that there is a significant difference between the UDI-6 and IIQ-7 scores before, after 4, 8, and 12 weeks Kegel exercise. (Wilcoxon testp < 0.05).In addition, there is a significant difference in the pelvic floor muscle strength (slow and fast fibers twitch) between before with after exercise for 8 weeks Kegel exercise and between before and after 12 weeks Kegel exercise. (Wilcoxon test; p <0.05).Conclusion: Performing Kegel exercise with a minimum duration of 8 weeks can improve symptoms, pelvic floor muscle strength and quality of life for women with stress urinary incontinence"

"Latar Belakang : ICS merekomendasikan latihan Kegel, sebagai terapi konservatif untuk mengatasi inkontinensia urin tekanan untuk dilakukan selama 12 minggu. Namun, beberapa penelitian menunjukkan bahwa latihan kegel selama 4, dan 8 minggu dapat memperbaiki gejala inkontinensia, kualitas hidup, dan meningkatkan kekuatan otot dasar panggul. Tujuan : Mengetahui gambaran perbaikan gejala subjektif dan objektif, peningkatan kekuatan otot dasar panggul, perbaikan derajat keparahan dan perbaikan kualitas hidup wanita penderita inkontinensia urin tekanan yang menjalani antara latihan Kegel yang 4, 8, dan 12 mingguMetode:55 subjek terdiagnosis inkontinensia urin tekanan (berdasarkan nilai (QUID >4) dan tes pembalut positif 60 menit) diberikan latihan Kegel di Poliklinik Rehabilitasi Medik RSCM selama 12 minggu. Pengumpulan data, seperti kuesioner UDI-6; tes pembalut 60 menit; dan kuesioner IIQ-7 akan dicatat oleh subjek penelitian dalam buku kegiatan 4, 8, dan 12 minggu. Selain itu, evaluasi biofeedback(Myomed 932) dari kekuatan serat otot lambat dan serat otot cepat dilakukan setiap 2 minggu untuk menilai perbaikan. Hasil:Hasil penelitian menunjukkan bahwa adanya perbedaan bermakna antara skor UDI-6 dan IIQ-7 subjek sebelum latihan dan setelah latihan 4, 8, dan 12 minggu (uji Wilcoxon; p<0.05). Selain itu, adanya perbedaan yang signifikan pada kekuatan serat otot lambat dan serat cepat antara sebelum latihan dengan pasca latihan 8 minggu dan sebelum latihan dengan pasca 12 minggu. (dengan uji Wilcoxon; p <0.05).Kesimpulan :Latihan Kegel yang dilakukan dengan durasi minimal 8 minggu dapat memperbaiki gejala, kekuatan otot dasar pangul dan kualitas hidup wanita dengan inkontinensia urin tekanan.

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Introduction :

Kegel exercise is recommended by ICS, as a conservative therapy to improve stress urinary incontinence for 12 weeks. However, several studies have shown that Kegel exercise for 4 and 8 weeks can improve symptoms of incontinence, quality of life and increase pelvic floor muscle strength.

Objective:

To identify the improvement subjective and objective symptoms, increasing pelvic floor muscle strength, and improvement quality of life among women with stress urinary incontinence who performed kegel exercise 4, 8, and 12 weeks.

Method:

55 subjects were diagnosed with stress urinary incontinence (based on (QUID score >4) and positive result of pad test 60 minutes) and were given the Kegel exercise at RSCM for 12 weeks. Datas such as UDI-6, pad test 60 minutes, and IIQ-7 will be documented by each subject in the book for 4, 8, and 12 weeks. In addition, Pelvic floor muscle (slow and fast fibers twitch) were assessed by biofeedback (myomed 932) every 2 weeks.

Result:

The results show that there is a significant difference between the UDI-6 and IIQ-7 scores before, after 4, 8, and 12 weeks Kegel exercise. (Wilcoxon testp < 0.05).

In addition, there is a significant difference in the pelvic floor muscle strength (slow and fast fibers twitch) between before with after exercise for 8 weeks Kegel exercise and between before and after 12 weeks Kegel exercise. (Wilcoxon test; p <0.05).

Conclusion:

Performing Kegel exercise with a minimum duration of 8 weeks can improve symptoms, pelvic floor muscle strength and quality of life for women with stress urinary incontinence."

"Latar Belakang : Inkontinensia urin menyebabkan dampak morbiditas yang cukup bermakna bagi penderitanya. Kondisi ini banyak terjadi pada wanita dan dipengaruhi oleh keadaan defisiensi estrogen. Stigma yang kurang tepat dan kurangnya pemahaman tentang pilihan intervensi menyebabkan kurang tepatnya terapi. Latihan otot dasar panggul dengan menggunakan alat bantu (biofeedback) diharapkan akan dapat mengatasi hal tersebut.Tujuan: Mengetahui pengaruh biofeedback pada latihan otot dasar panggul untuk meningkatkan kekuatan otot dasar panggul agar dapat memperbaiki kondisi stres inkontinensia urin pada wanita pascamenopause.Desain : Kuasi eksperimental acak lengkapTempat : Poli Rehabilitasi Medik Bagian Ilmu Kedokteran Fisik dan Rehabilitasi Perjan. RS. dr. Hasan Sadikin BandungSubyek : Tiga puluh lima orang wanita pascamenopause yang menderita inkontinensia urin di lingkungan Panti Wredha Pakutandang - CiparayIntervensi : Antara bulan Mei - Agustus 2004, 24 wanita dengan stres inkontinensia pascamenopause yang masuk dalam kriteria inklusi dibagi dalam dua kelompok (kontrol dan latih) melakukan latihan otot dasar panggul setiap hari dengan dan tanpa alat bantu biofeedback disertai pengawasan selama 8 minggu. Hasil peningkatan kekuatan kontraksi otot dasar panggul antara kedua kelompok dibandingkan pada akhir penelitian.Hasil : Terjadi peningkatan kekuatan kontraksi maksimal otot dasar panggul yang sangat bermakna (<.001) pada kedua kelompok naracoba dengan perbedaan yang bermakna (<.05) antara kedua kelompok. Peningkatan kekuatan kontraksi otot dasar panggul berdampak pada berkurang atau hilangnya keluhan stres inkontinensia urin yang dibuktikan dengan stres test yang menjadi negatif (100%).Kesimpulan : Latihan otot dasar panggul dengan biofeedback meningkatkan kekuatan otot dasar panggul lebih baik sehingga dapat mengurangi gejala stres inkontinensia urin pascamenopause

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Background : Urinary incontinence can cause a significant morbidity. This condition occurs commonly in women with estrogens deficient. Inappropriate stigma and less comprehension to the intervention choices caused inaccurate therapy. Pelvic floor exercise with biofeedback will prevent that to be happened.

Objective : To evaluate the usefulness of biofeedback in pelvic floor exercise to increase the strength of the muscles to treat urinary stress incontinence on postmenopausal women.

Design : Quasi experimental complete randomized

Setting : At Department of Physical Medicine and Rehabilitation Perjan. dr. Masan Sadikin Hospital Bandung

Subject : Thirty five postmenopausal women with stress urinary incontinence from Panti Wredha Pakutandang-Ciparay

Intervention : From May -- August 2004. 24 postmenopausal women with stress urinary incontinence who were divided in two groups (exercise and control) did the pelvic floor muscle exercise daily supervised, with and without biofeedback for 8 weeks. The strength of the muscles was compared in the end of the study.

Result : There was a very significant increase of maximal pelvic floor muscles contraction (<.001) within all two groups with significant differences (<.05) between two groups. Increasing strength of pelvic floor muscles within both groups (control and exercise) relieve urinary stress incontinence (stress test negative forl00°%).

Conclusion : Pelvic floor muscles exercise with biofeedback increase the strength of the pelvic floor on postmenopausal women with stress urinary incontinence."

"Disfungsi ereksi (DE) merupakan disfungsi seksual pada laki-laki yang paling sering ditemukan dan prevalensinya mencapai 76% pada pasien LUTS. Penyebab DE dihubungkan dengan kelemahan otot dasar panggul. Salah satu terapi yang dapat diberikan adalah latihan otot dasar panggul, yang bertujuan untuk meningkatkan aktivitas otot ischiocavernosus dan bulbocavernosus. Biofeedback otot dasar panggul dapat memberikan informasi visual dan auditorik sehingga otot dapat melakukan kontraksi dengan tepat. Penelitian bertujuan untuk mengetahui pengaruh pemberian biofeedback otot dasar panggul terhadap perbaikan fungsi ereksi pada pasien dengan lower urinary tract symptoms (LUTS). Perbaikan fungsi ereksi dinilai dengan skor IIEF (International Index of Erectile Function), EHS (Erectile Hardness Score), dan kekuatan otot dasar panggul. Perbaikan gejala LUTS juga dinilai dengan skor IPSS (International Index of Prostat Symptoms). Penelitian ini merupakan studi randomized controlled trial pada pasien rawat jalan di RSUPN Cipto Mangunkusumo. Subjek pada penelitian ini dibagi menjadi 2 kelompok, pada kelompok perlakuan mendapatkan biofeedback otot dasar panggul sebanyak 10 sesi, 2 kali seminggu dan latihan otot dasar panggul dirumah. Kelompok kontrol hanya mendapatkan latihan otot dasar panggul dirumah. Terdapat 21 pasien LUTS yang mengalami disfungsi ereksi (DE). Sebanyak 10 subjek (50%) termasuk dalam kategori DE ringan, 4 subjek (20%) termasuk dalam kategori DE sedang, dan 6 subjek (30%) termasuk dalam kategori DE berat. Dari hasil penelitian didapatkan perbaikan skor IIEF, IPSS, EHS, slow twitch dan fast twitch pada kelompok perlakuan (p-value <0,05), sedangkan pada kelompok kontrol hanya didapatkan perbaikan pada skor IIEF dan IPSS (p-value <0,05). Kesimpulan penelitian ini adalah terdapat perbaikan fungsi ereksi (peningkatan skor IIEF, skor EHS, penurunan skor IPSS dan peningkatan kekuatan otot dasar panggul) setelah pemberian biofeedback otot dasar panggul pada pasien DE dengan LUTS selama 10 sesi.

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Erectile dysfunction (ED) is the most common male sexual dysfunction, and its prevalence reaches 76% in LUTS patients. The cause of ED is associated with weakness of the pelvic floor muscles. One of the therapies that can be given is pelvic floor muscle exercises, which aim to increase the activity of the ischiocavernosus and bulbocavernosus muscles. Pelvic floor muscle biofeedback can provide visual and auditory information so that the muscles can contract properly. This research aims to determine the effect of pelvic floor muscle biofeedback on improving erectile function in patients with lower urinary tract symptoms (LUTS). Improvement in erectile function was assessed by scores of IIEF (International Index of Erectile Function), EHS (Erectile Hardness Score), and pelvic floor muscle strength. Improvement in LUTS symptoms was also assessed by an IPSS (International Index of Prostate Symptoms) score. This research was a randomized controlled trial study on outpatients at Cipto Mangunkusumo General Hospital. Subjects in this study were divided into 2 groups, the treatment group received 10 sessions of pelvic floor muscle biofeedback, 2 times a week and pelvic floor muscle exercises at home. The control group only got pelvic floor muscle exercises at home. There were 21 LUTS patients who experienced erectile dysfunction (ED). A total of 10 subjects (50%) were included in the mild ED category, 4 subjects (20%) were included in the moderate ED category, and 6 subjects (30%) were included in the severe ED category. From the results of the study, it was found that the scores for IIEF, IPSS, EHS, slow twitch and fast twitch were improved in the treatment group (p-value <0.05), whereas in the control group there were only improved in IIEF and IPSS scores (p-value <0.05 ). The conclusion of this study was that there was an improvement in erectile function (increased IIEF score, EHS score, decreased IPSS score and increased pelvic floor muscle strength) after administering pelvic floor muscle biofeedback to patients ED with LUTS for 10 sessions."

"Pendahuluan: Kejadian fraktur menjadi urutan ketiga di dunia dan ekstremitas bawah sebagai angka tertinggi di Indonesia. Open Reduction Internal Fixation (ORIF) merupakan tindakan fraktur ekstremitas bawah yang sering digunakan. Salah satu latihan yang dapat mencegah komplikasi imobilisasi yaitu isometrik quadricep dengan pressure biofeedback. Dalam penelitian ini pressure biofeedback diberikan pada pasien post ORIF ekstremitas bawah hari I sampai III. Tujuan: Tujuan penelitian ini untuk mengidentifikasi efektivitas pressure biofeedback terhadap kekuatan otot quadricep dan nyeri post ORIF ekstremitas bawah.Metode: Penelitian ini merupakan Randomized Controlled Trial dengan pre and posttest pada pengukuran skala nyeri dan posttest only pada skor kekuatan otot quadricep. Teknik pengambilan sampel menggunakan teknik simple random sampling dengan kriteria inklusi diantaranya post ORIF ekstremitas bawah hari pertama sampai ketiga dan berusia 18-64 tahun. Responden dengan multipel fraktur, fraktur bilateral, neglected, riwayat DM, kelainan neuromuskular, cacat fisik dan penurunan kesadaran dieksklusikan. Perhitungan sampel dengan menggunakan standar deviasi dan derajat kemaknaan diperoleh 30 responden di RSD Idaman Banjarbaru dan Ratu Zalecha Martapura yang terbagi menjadi 2 kelompok perlakuan. Double blind diterapkan pada responden dan pengambil data. Instrumen yang digunakan untuk mengukur kecemasan (APAIS), nyeri (VAS), dan kekuatan otot quadricep (MMT).Hasil: Penelitian ini melaporkan bahwa pressure biofeedback secara signifikan meningkatkan kekuatan otot quadricep (p value 0,01; α < 0,05). Namun, berdasarkan hasil uji statistik Paired T-test baik pada responden dengan latihan pressure biofeedback maupun tanpa pressure biofeedback, didapatkan hasil yang signifikan dalam penurunan nyeri (p value 0,00; α < 0,05). Meskipun demikian, dapat dikatakan bahwa pressure biofeedback tidak efektif dalam menurunkan nyeri pasien post ORIF ekstremitas bawah. Begitu pula hasil uji Mann Whitney pada selisih rerata skala nyeri yang menunjukkan bahwa penurunan nyeri yang terjadi tidak dipengaruhi oleh pressure biofeedback.Kesimpulan: Penelitian ini menunjukkan bahwa latihan isometrik kombinasi pressure biofeedback secara signifikan dapat meningkatkan skor kekuatan otot quadricep pada pasien post ORIF ekstrimtas bawah.

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Introduction: The incidence of fractures is third in the world and lower extremities are the highest in Indonesia. Open Reduction Internal Fixation (ORIF) is a frequently used procedure for lower extremity fractures. One exercise that can prevent immobilization complications is quadriceps isometrics with pressure biofeedback. In this study, pressure biofeedback was given to post ORIF lower extremity patients on days I to III.

Objective: The aim of this study was to identify the effectiveness of pressure biofeedback on quadricep muscle strength and post-ORIF lower extremity pain. Methods: This study was a Randomized Controlled Trial with pre and posttest on pain scale measurements and posttest only on quadricep muscle strength scores. The sampling technique used simple random sampling technique with inclusion criteria including post ORIF lower extremities first to third day and aged 18-64 years. Respondents with multiple fractures, bilateral fractures, neglected, history of DM, neuromuscular disorders, physical disabilities and decreased consciousness were excluded. Sample calculations using standard deviation and degree of significance obtained 30 respondents at RSD Idaman Banjarbaru and Ratu Zalecha Martapura who were divided into 2 treatment groups. Double blind is applied to respondents and data takers. Instruments used to measure anxiety (APAIS), pain (VAS), and quadricep muscle strength (MMT).

Results: This study reported that pressure biofeedback significantly increased quadricep muscle strength (p value 0.01; α < 0.05). However, based on the results of the Paired T-test statistical test for both respondents with pressure biofeedback training and without pressure biofeedback training, significant results were obtained in reducing pain (p value 0.00; α < 0.05). However, it can be said that pressure biofeedback is not effective in reducing pain in post-ORIF lower extremity patients. Likewise, the results of the Mann Whitney test on the mean difference on the pain scale showed that the reduction in pain that occurred was not influenced by pressure biofeedback.

Conclusion: This study shows that isometric training combined with pressure biofeedback can significantly increase quadricep muscle strength scores in lower extremity post ORIF patients."

"The book reports on advanced topics in the areas of neurorehabilitation research and practice. It focuses on new methods for interfacing the human nervous system with electronic and mechatronic systems to restore or compensate impaired neural functions. Importantly, the book merges different perspectives, such as the clinical, neurophysiological, and bioengineering ones, to promote, feed and encourage collaborations between clinicians, neuroscientists and engineers. Based on the 2018 International Conference on Neurorehabilitation (ICNR 2018) held on October 16-20, 2018, in Pisa, Italy,, this book covers various aspects of neurorehabilitation research and practice, including new insights into biomechanics, brain physiology, neuroplasticity, and brain damages and diseases, as well as innovative methods and technologies for studying and/or recovering brain function, from data mining to interface technologies and neuroprosthetics. In this way, it offers a concise, yet comprehensive reference guide to neurosurgeons, rehabilitation physicians, neurologists, and bioengineers. Moreover, by highlighting current challenges in understanding brain diseases as well as in the available technologies and their implementation, the book is also expected to foster new collaborations between the different groups, thus stimulating new ideas and research directions."