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"Tesis ini disusun untuk mengetahui gambaran kualitas hidup pasien adolescence idiopathic scoliosis (AIS). Desain penelitian merupakan studi potong pada 100 pasien AIS yang berusia di atas 13 tahun dengan menggunakan kuesioner Scoliosis Research Society 30 (SRS-30) sebagai alat ukur kualitas hidup. Dilakukan analisis faktor-faktor yang berhubungan yang meliputi faktor penyakit (usia terdiagnosis, derajat keparahan kurva, tipe kurva) faktor terapi (exercise, brace, operasi) dan faktor sosiodemografik (kelompok usia, jenis kelamin, body mass index). Hasil penelitian didapatkan skor total yaitu 3.42 ± 0.46. Didapatkan skor tertinggi pada domain nyeri yaitu 3.66 (2-5), serta skor terendah pada domain citra diri yaitu 3.33 ± 0,9. Pada faktor penyakit, didapatkan skor domain kepuasan terhadap manajemen yang lebih tinggi secara bermakna pada kurva derajat ringan. Pada faktor terapi, didapatkan skor total dan skor domain fungsi yang lebih tinggi secara bermakna pada kelompok exercise, skor domain citra diri dan kepuasan terhadap manajemen yang lebih rendah secara bermakna pada kelompok brace, serta skor domain citra diri yang lebih tinggi, tetapi skor domain fungsi dan kepuasan terhadap manajemen yang lebih rendah secara bermakna pada kelompok operasi. Tidak didapatkan perbedaan skor yang bermakna pada faktor sosiodemografi (usia, jenis kelamin, body mass index).

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This thesis aimed to determine the quality of life of patients with adolescent idiopathic scoliosis (AIS). The study design was a cross-sectional study of 100 AIS patients aged over 13 years using the Scoliosis Research Society 30 (SRS-30) questionnaire as a measurement tool of quality of life. Analysis of related factors including disease factors (age at diagnosis, degree of curve severity, type of curve), therapeutic factors (exercise, brace, surgery), and sociodemographic factors (age group, sex, body mass index) was performed. The results showed a total score of 3.42 ± 0.46. The highest score was in the pain domain (3.66 (2-5)), and the lowest score was in the self-image domain (3.33 ± 0.9). In the disease factors, a significantly higher score of satisfaction for management was found in mild degree curve. In the therapeutic factors, a significantly higher total score and function domain score was found in the exercise group, a significantly lower in self-image and satisfaction with management domain score in the brace group, and a significantly higher self-image domain score but lower in function and satisfaction with management domain score was found in the operating group. There were no significant differences in sociodemographic factors (age, gender, body mass index)."

"ABSTRAKLATAR BELAKANG. Skoliosis merupakan suatu bentuk deformitas tulang belakangyang berdampak pada banyak aspek kualitas hidup. Salah satu cara menilai patologi dasardan efektivitas intervensi adalah menggunakan kuesioner kualitas hidup terkait kesehatan,salah satunya Scoliosis Research Society 30 (SRS-30) Questionnaire dan Short Form-36(SF-36). Tujuan penelitian ini adalah untuk menguji kesahihan dan keandalan SRS-30versi Bahasa Indonesia.METODE. Dilakukan penerjemahan SRS-30 ke dalam Bahasa Indonesia melaluiprosedur forward-backward dan uji coba kuesioner. Pada 30 pasien skoliosis yangmemenuhi kriteria dan bersedia menjadi responden, dilakukan pengisian SRS-30 dan SF-36. Karakteristik data dasar dikumpulkan dan dicatat.HASIL. Nilai keseluruhan koefisien Cronbachs alpha adalah 0,679. Analisa kesahihanintratest didapatkan korelasi kuat antara domain fungsi per aktivitas, nyeri, citradiri per penampilan, dan kesehatan jiwa dengan skor subtotal (r=0,649-0,793), sedangkanuntuk koefisien korelasi domain kepuasan manajemen dengan skor total nilai korelasinyalemah (r=0,295). Skor SRS-30 versi Bahasa Indonesia dibandingkan dengan SF-36 untukmenilai kesahihan konvergen. Diperoleh korelasi bermakna pada empat domain SRS-30dengan domain SF-36, yaitu domain fungsi per aktivitas, nyeri, citra diri per penampilan, dankesehatan jiwa (r=0,260 hingga 0,673).KESIMPULAN. SRS-30 versi Bahasa Indonesia merupakan alat ukur kualitas hiduppenderita skoliosis yang sahih dan andal.

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ABSTRACTBackground Scoliosis is a spinal deformity which may affect many aspects of qualityof life. One way to measure the basic pathology and intervention effectiveness is usinghealth related quality of life questionnaire, one of them is Scoliosis Research Society 30(SRS-30) Questionnaire and Short Form-36 (SF-36). The purpose of this study is toassess the validity and reliability of SRS-30 in Indonesian version.Method Forward-backward translation approach, followed by trial of the questionnairewas done to develop Indonesian version of SRS-30. Thirty scoliosis patients that fulfillthe inclusion and exclusion criteria and willing to participate in this study filled the SRS-30 Indonesian version along with SF-36. The baseline characteristic was collected.Results The SRS-30 Indonesian version had an overall Cronbachs alpha was 0,679.Intratest validity showed strong correlation between function per activity, pain, bodyimage per appearance, and mental health domain with subtotal score (r=0,649-0,793), whilefor satisfaction with management domain with total score showed weak correlation(r=0,295). There were significant correlation between four domains of SRS-30 and SF-36, those are function per activity, pain, body image/appearance, and mental health domain(r=0,260-0,673).Conclusion The SRS-30 Indonesian version is a measuring tool of quality of life inscoliosis patient that is valid and reliable."

"Penelitian ini menggambarkan arti dan makna pengalaman psikososial remaja penyandang skoliosis, di wilayah karesidenan Surakarta, Jawa Tengah. Penelitian ini menggunakan pendekatan fenomenologi deskriptif dengan wawancara mendalam. Partisipan sebanyak 7 remaja putri (14-20 tahun) dan diperoleh melalui metode purposive sampling. Tujuh tema teridentifikasi dalam penelitian ini, yaitu pemahaman terhadap skoliosis, respon psikologis, kemampuan beradaptasi terhadap skoliosis, kemampuan beradaptasi terhadap terapi skoliosis, dukungan penyelesaian masalah, harapan kesehatan yang optimal, dan kekhawatiran terhadap masa depan. Support keluarga dan teman sebaya sangat dibutuhkan remaja untuk meminimalkan stress psikososial. Peningkatan pelayanan kesehatan melalui program pendidikan kesehatan dan skrining skoliosis di masyarakat sangat diharapkan skolioser remaja.

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This study describes the significance and meaning of adolescent psychosocial experience of people with scoliosis, in the residency of Surakarta, Central Java. This study used descriptive phenomenological approach with in-depth interviews. Participants were 7 girls (14-20 years) and obtained through purposive sampling. Seven themes identified in this study, namely an understanding of scoliosis, a psychological response, adaptability to the scoliosis, the ability to adapt to the treatment of scoliosis, support for problem solving, optimal health expectations, and concerns over the future. Family and peer support are needed to minimize adolescent psychosocial stress. Improved health care through health education and screening programs in the community is expected adolescents with."

"Tesis ini disusun untuk mengetahui gambaran kualitas hidup pasien adolescence idiopathic scoliosis (AIS). Desain penelitian merupakan studi potong pada 100 pasien AIS yang berusia di atas 13 tahun dengan menggunakan kuesioner Scoliosis Research Society 30 (SRS-30) sebagai alat ukur kualitas hidup. Dilakukan analisis faktor-faktor yang berhubungan yang meliputi faktor penyakit (usia terdiagnosis, derajat keparahan kurva, tipe kurva) faktor terapi (exercise, brace, operasi) dan faktor sosiodemografik (kelompok usia, jenis kelamin, body mass index). Hasil penelitian didapatkan skor total yaitu 3.42  0.46. Didapatkan skor tertinggi pada domain nyeri yaitu 3.66 (2-5), serta skor terendah pada domain citra diri yaitu 3.33  0,9. Pada faktor penyakit, didapatkan skor domain kepuasan terhadap manajemen yang lebih tinggi secara bermakna pada kurva derajat ringan. Pada faktor terapi, didapatkan skor total dan skor domain fungsi yang lebih tinggi secara bermakna pada kelompok exercise, skor domain citra diri dan kepuasan terhadap manajemen yang lebih rendah secara bermakna pada kelompok brace, serta skor domain citra diri yang lebih tinggi, tetapi skor domain fungsi dan kepuasan terhadap manajemen yang lebih rendah secara bermakna pada kelompok operasi. Tidak didapatkan perbedaan skor yang bermakna pada faktor sosiodemografi (usia, jenis kelamin, body mass index).

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This thesis aimed to determine the quality of life of patients with adolescent idiopathic scoliosis (AIS). The study design was a cross-sectional study of 100 AIS patients aged over 13 years using the Scoliosis Research Society 30 (SRS-30) questionnaire as a measurement tool of quality of life. Analysis of related factors including disease factors (age at diagnosis, degree of curve severity, type of curve), therapeutic factors (exercise,

brace, surgery), and sociodemographic factors (age group, sex, body mass index) was performed. The results showed a total score of 3.42  0.46. The highest score was in the

pain domain (3.66 (2-5)), and the lowest score was in the self-image domain (3.33  0.9). In the disease factors, a significantly higher score of satisfaction for management was found in mild degree curve. In the therapeutic factors, a significantly higher total score and function domain score was found in the exercise group, a significantly lower in selfimage and satisfaction with management domain score in the brace group, and a significantly higher self-image domain score but lower in function and satisfaction with management domain score was found in the operating group. There were no significant differences in sociodemographic factors (age, gender, body mass index)."

"Pendahuluan : Adolescent Idiopathic Scoliosis (AIS) adalah jenis skoliosis yang paling umum terjadi pada populasi pediatrik, mencakup 80% dari total kasus, dan seringkali mengakibatkan morbiditas serta hendaya kepada penderitanya. Parameter evaluasi Health Related Quality of Life (HRQL) menjadi penting karena AIS mempengaruhi kondisi klinis, sosial, dan psikologis penderitanya. Salah satu kuesioner evaluasi HRQL yang populer adalah Short Form-36 (SF-36), yang bersifat general dan telah diadaptasikan ke bahasa Indonesia. Namun, kuesioner ini tidak spesifik untuk skoliosis. Scoliosis Research Society (SRS) telah mengembangkan kuesioner HRQL spesifik untuk skoliosis, yaitu SRS-22r, yang terdiri dari 5 domain penilaian. Kuesioner ini telah diadaptasi ke berbagai bahasa, tetapi belum ada versi berbahasa Indonesia yang terdaftar di SRS. Oleh karena itu, peneliti berupaya melakukan adaptasi lintas budaya kuesioner SRS-22r agar dapat diaplikasikan pada praktik klinis di Indonesia.Metode : Penelitian ini merupakan studi potong lintang untuk adaptasi lintas budaya, uji validitas dan reliabilitas kuesioner SRS-22r berbahasa Indonesia (SRS-22r INA) pada pasien dengan Adolescence Idiopathic Scoliosis. Penelitian ini menggunakan metode consecutive sampling hingga terpenuhinya kuota sampel, berdasarkan perhitungan besar sampel untuk adaptasi kuesioner menggunakan sampel minimal untuk uji pra final, uji validitas dan uji reliabilitas.Hasil : Terdapat 50 responden perempuan (75.8%) dan 16 responden laki-laki (24.2%). Kurva utama yang paling umum adalah thorasic (75.8%), sedangkan yang paling jarang ditemukan adalah thoracolumbar (3.0%). Sebanyak 69.7% responden dikategorikan sebagai skoliosis dengan sudut berat (Cobb angle >450). Nilai rerata kurva utama adalah 57.33, dengan nilai minimum 10.7 dan maksimum 100.2. Standar deviasi yang relatif tinggi (22.73) menunjukkan besarnya variabilitas data. Kelima domain kuesioner SRS- 22r INA tidak terkena floor effect dan ceiling effect lebih dari 15%. Uji validitas konstruksi menunjukkan bahwa domain SRS-22r INA memiliki korelasi yang tinggi dengan domain SF-36 INA. Hasil Chronbach’s alpha menunjukkan bahwa butir pertanyaan pada domain SRS-22r INA sangat reliabel.Kesimpulan : Berdasarkan hasil adaptasi lintas budaya, uji validitas dan uji reliabilitas kuesioner, SRS-22r INA merupakan kuesioner yang valid dan reliabel. Kuesioner ini dapat digunakan sebagai parameter HRQL untuk evaluasi penderita AIS di Indonesia.

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Introduction : Adolescent Idiopathic Scoliosis (AIS) is the predominant form of scoliosis observed in the pediatric patient, constituting approximately 80% of all reported cases, this condition frequently leads to adverse health outcomes and functional impairments among affected patient. The assessment of Health Related Quality of Life (HRQL) is paramount due to the impact of AIS on the clinical, social, and psychological aspects of affected patient. The Short Form-36 (SF-36) is a widely used questionnaire for evaluating HRQL. It is a comprehensive tool that has been developed for use in various populations, including the Indonesian population. Nevertheless, this questionnaire lacks specificity in relation to scoliosis. The Scoliosis Research Society (SRS) has devised a dedicated HRQL survey for scoliosis, known as the SRS-22r. This questionnaire encompasses five distinct domains for evaluation. The present questionnaire has been modified and translated into other languages; nevertheless, it is worth noting that an Indonesian version is not yet included in the SRS. This study aims to conduct a cross-cultural adaptation of the SRS- 22r questionnaire to facilitate its implementation in therapeutic settings within Indonesia. Method : This study aims to achieve cultural adaptation, validity and reliability evaluation of the SRS-22r INA questionnaire in patients with Adolescence Idiopathic Scoliosis through a cross-sectional design. The present study employs the consecutive sampling technique to achieve the desired sample size, as determined by sample size calculations. The questionnaire is adapted through a preliminary testing phase followed by validity and reliability test. In addition, inclusion and exclusion criteria are established to choose participants for the study.

Result : There were 50 female respondents (75.8%) and 16 male respondents (24.2%). The most common main curve was thoracic (75.8%), while the least common was thoracolumbar (3.0%). A total of 69.7% of respondents were categorized as scoliosis with a severe angle. The average value of the main curve was 57.33, with a minimum value of 10.70 and a maximum value of 100.20. A relatively high standard deviation (22.73) indicates the amount of data variability. The five domains of the SRS-22r INA questionnaire were not affected by the floor effect and ceiling effect of more than 15%. The construct validity test showed that the SRS-22r INA domain had high correlation with the SF-36 INA domain. Chronbach’s alpha results showed that the question items in the SRS-22r INA domain were highly reliable.

Conclusion : Based cross cultural adaptation, validity testing and reliability testing, SRS- 22r INA questionnaire is valid and reliable. This questionnaire can be used as an HRQL parameter for AIS patient in Indonesia."

"Objectives: Osteoarthritis of the knee can caused by sosiolis. The Purpose of this study is to find out the influence of scoliosis caused secondary osteorthritis of the knee in athlete, based on cobbs degree, Scolisis curve. Materials and Method: This research use an analytic cross-sectional design. The total sample of 92 athletes scoliosis taken by simple random sampling technique. The data were analyzing with Chi-square test, fisher and prevalence rasio. Result: The result show that there were influences on the incidence of scoliosis towards secondary osteoarthritis of the knee in athletes at the national sports hopsital.Based on the cirteria in the cobbs angle had the results (p=0.022 (p<0.05)), moderate cobbs angle degree were 7.5 times more at risk of cousing secondary osteoarthritis on the knee than a mild degree. The other hand shape of the curve scoliosis had results (p=0.038(p<0.05)), the shape of the S cirve scoliosis 3.2 Times more at risk of causing secondary osteoarthritis on the knee than the curve C. Conclusion: It had to be concluded that there was influcence between cobbs degree scoliosis and shape curve towards incidence of secondary osteoarthritis on the knee"

"Pendahuluan: Skoliosis idiopatik remaja terbukti dapat menyebabkan masalah fisik, psikologis, dan sosial yang dapat mempengaruhi kualitas hidup setiap individu. Studi ini bertujuan untuk mengevaluasi factor faktor yang mempengaruhi kualitas hidup terkait kesehatan pada pasien skoliosis idiopatik.Metode: Studi potong lintang dilakukan pada dua rumah sakit tersier di Jakarta, Indonesia dengan menggunakan kuesioner Scoliosis Research Society-22 (SRS-22)dan Short Form (SF)-36. Subjek penelitian merupakan 80 pasien dengan skoliosis idiopatik remaja yang telah dioperasi dalam 5 tahun terakhir dengan minimum follow up selama 1 tahun. Data yang dianalis adalah jenis kelamin, usia, lokasi kurva, derajat keparahan (sudut Cobb), presentase koreksi, C7 plumb line, jumlah operasi, jumlah perdarahan, dan lama operasi.Hasil: Skor keseluruhan SF-36 adalah 94,5 (46,3-100) dan SRS-22 adalah 4,45 (3,58-4,84). Usia rata-rata subjek adalah 15 (10-26) tahun terdiridari 10% (n = 8) laki-laki dan 90% (n = 72) perempuan. Sembilan belas subjek (23,8%) memiliki skoliosis ringan (40°-60°), 41,3% sedang (60°-80°), dan 35% berat (> 80°). Presentase koreksi<50% ditemukan pada 30 (37,5%), 50-70% pada 39 (48,8%), dan> 70% pada 11 (13,8%) peserta. Lebih dari separuh peserta (57,5%, n = 46) berada dalam neutral balance dan 34 (42,5%) positive balance. Skor total SRS-22r memiliki perbedaan yang signifikan pada kelompok jenis kelamin (p = 0,026), C7 plumb line (p = 0,018) dan jumlah operasi (p =0,009). Skor total SF-36 memiliki perbedaan yang signifikan pada kelompok jenis kelamin (p = 0,019) dan C7 plumb line (p = 0,026). Selain itu, citra diri dan kepuasan yang merupakan sub-domain dari SRS 22 berkorelasi positif dengan C7 plumb line dan jumlah operasi.Pembahasan: Kualitas hidup terkait kesehatan pada pasien skoliosis idiopatik remaja yang dilakukan tindakan operasi menunjukan hasil yang baik. Pada studi ini, jenis kelamin, C7 plumb line, dan jumlah operasi berkaitan dengan kualitas hidup terkait kesehatan.Kualitas hidup terkait kesehatan pada skoliosis idiopatik remaja dipengaruhi oleh berbagai factor sehingga perlu dijadikan pertimbangan dalam target pengobatan setiap individu.

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Introduction: Adolescent Idiopathic Scoliosis (AIS) is a spinal deformity which may lead to physical and mental problems and can adversely affect patient satisfaction and the quality of life. The aim of this study is to evaluate the health related quality of life in scoliosis patients who had undergone surgical therapy.Methods: A cross sectional study was conducted in two tertiary hospital, Jakarta, Indonesia using Scoliosis Research Society-22 (SRS-22) and Short Form (SF)-36questionnaire. This study evaluated 80 AIS patients operated in our center over the past five years with a minimum follow up of one year. In addition, participant medical records were reviewed to collect data on gender, age, curve type, severity of scoliosis curve (Cobb Angle), the percentage of curve correction, C7 plumb line, number of operations, blood loss, and operative time.Results: The overall score of SF-36 is 94,5 (46,3-100) and SRS-22 is 4.45 (3.58-4.84). The median age of the participants was 15 (10-26) years. There were 10% (n=8) male and 90% (n=72) female. Nineteen participants (23.8%) had mild (40°-60°), 41.3 % moderate (60°-80°), and 35 % severe (>80°) scoliosis. The rates of curve correction<50% were found in 30 (37,5%), 50-70% in 39(48,8%), and>70% in 11 (13,8%) participants. More than half the participants (57,5 %, n=46) were in neutral balance and 34 ( 42,5 %) positive balance. The total score of the SRS-22r differed significantly between the groups of gender (p=0.026), C7 plumb line (p = 0.018) and number of operations(p = 0.009). The total score of the SF-36 differed significantly between gender (p=0.019) and C7 plumb line (p = 0.026). In addition, self-image and satisfaction, sub-domains of the SRS 22r, were positively correlated with C7 plumb line and number of operations.Discussion: The overall HRQoLof AIS patients who had undergone surgical therapy in scores in our population shows a good results. Gender, C7 plumb line, and number of operation were related to HRQoL scores of Indonesian adolescents with scoliosis. In addition, HRQoL in AIS patients can be affected by many factors which medical staff needs to consider in order to produce the best and most effective treatment outcomes."

"ABSTRAKLatar Belakang. Uji biomekanik konstruksi instrumentasi posterior untuk koreksiskoliosis diperlukan untuk menilai reliabilitas dan performa instrumentasi. Studibiomekanik terkini telah memvalidasi tulang buatan merupakan pengganti yangcocok. Densitas sekrup yang rendah dapat mencapai hasil koreksi yang baik tanpakomplikasi. Penelitian ini membandingkan biomekanik model konstruksi tigainstrumentasi posterior yaitu : Sekrup Pedikel Bilateral (SPB), sekrup pedikelpada ujung proksimal, apex, ujung distal end sisi konkaf (PAD), dan PADditambah kawat sublaminar pada sisi konkaf (PAD+SW).Metode. Tiga kelompok model tulang belakang scoliosis Lenke I Synbone®dipasang instrumentasi posterior konfigurasi SPB, PAD, PAD+SW denganmasing masing 5 buah sampel. Setiap kelompok dilakukan uji static test dengandiberikan gaya aksial secara gradual 50N, 100N, 150N, 200N dengan alatTensilon® AMD RTF-1310 buatan Jepang dengan pencatat dial indicatorMitutoyo buatan Jepang, lalu diukur pergeseran seluruh segmen yang terpasanginstrumentasi posterior secara keseluruhan. Kekakuan yang ditandai dengan loaddisplacmentdi ukur dan dianalisa.Hasil. Kelompok SPB sebagai standar emas menunjukan pergeseran paling kecil,diikuti dengan PAD+SW dan PAD. Didapatkan perbedaan yang bermakna dalamhal pergeseran antara kelompok SPB, PAD dan PAD+SW pada gaya 50N(p<0.001), 100N (p<0.001), dan 200N (p<0.001), dan tidak bermakna pad agaya150N (p=0.086). Didapatkan pula perbedaan yang bermakna dalam hal kekakuanantara kelompok SPB, PAD dan PAD+SW pada gaya 50N (p=0.002), 100N(p<0.001), dan 200N (p<0.001), dan gaya 150N (p<0.001).Simpulan. Pada uji biomekanik dengan static test menunjukan terdapat hubunganyang signifikan antara displacement dan kekakuan pada instrumentasi posterior.Kelompok SPB memberikan hasil paling kaku dibanding PAD+SW dan PAD.Densitas sekrup pedikel yang rendah berakibat berkurangnya kekakuan dariinstrumentasi posterior. Penambahan kawat sublaminar dapat secara signifikanmeningkatkan kekuatan.

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ABSTRACTIntroduction. Biomechanical construction test of posterior instrumentation forscoliosis correction is needed to evaluate the reliability and instrumentationperformance. Latest biomechanical testings have validated bone model as asuitable substitute. Low sekrup pedikel density can correct without significantcomplication. This study compared biomechanics of three posteriorinstrumentations: Bilateral pedicle screw (BPS), pedicle screw on proximal end,apex, distal end concave side (PAD), and PAD with sublaminar wire at theconcave side (PAD+SW).Method. Three groups of vertebral model of Scoliosis Lenke I Synbone® isequipped with configurations of 15 samples posterior instrumentations dividedinto three groups of BPS, PAD, PAD+SAW. Each of the static test is given axialforce gradually from 50N, 100N, 150N, and 200N using Tensilon® AMD RTF-1310 from Japan, with dial indicator Mitutoyo, Japan,. Total displacement weremeasured for each groups. Stiffness were also analyzed using load-displacementratio.Result. BPS as the current gold standard showed minimal displacement, followedby BPS, PAD and PAD+SAW for 50N (p<0.001), 100N (p<0.001), and 200N(p<0.001) force, and was not significant for 150N (p=0.086). There was alsosignificant difference between the stiffness of BPS, PAD and PAD+SW for 50N(p=0.002), 100N (p<0.001), 150N (p<0.001) and 200N (p<0.001)Consclusion. For biomechanical testing with static test, type of posteriorintrumentations showed significance relationship with displacement and stiffness.BPS groups were more rigid compared to PAD+SW and PAD. Low density ofsekrup pedikel resulted in the decrease of stiffness and posterior instrumentation.Kawat sublaminar addition significantly added the strength."