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"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."

"Penelitian terhadap 56 orang anggota Persadia Unit RSU Dr. Soetomo Surabaya bertujuan untuk mengetahui pengaruh latihan active lower range of motion terhadap tanda dan gejala neuropati diabetikum pada penderita Diabetes Mellitus tipe II. Penelitian ini menggunakan quasy experimental pre-post test design dengan teknik consecutive sampling.Hasil penelitian menunjukkan bahwa terdapat perbedaan yang bermakna rerata kekuatan otot antara kedua kelompok (p value=0,047), namun tidak untuk rerata reflek tendon, sensasi proteksi, ankle brachial index dan proporsi keluhan polineuropati perifer. Simpulan dari penelitian ini adalah latihan active lower range of motion berpengaruh terhadap kekuatan otot pada penderita DM tipe II dengan komplikasi mikrovaskuler.

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The aimed of this study for the 56 members of Persadia Surabaya was to determine the effect of the active lower range of motion exercise on the signs and symptoms of diabetic neuropathy in type II Diabetes Mellitus?s patients. A quasy experimental pre-post test design with a consecutive sampling technique was used in this study.The results showed that there was a significant differences between control and treatment groups for muscle strength with p value 0.047 but not for tendon reflexes, protective sensation, ankle brachial index and diabetic polyneuropathy complaints. Therefore, it can be concluded that active lower range of motion exercise has an effect on muscle strength in patients with type II DM with microvascular complications."

"Latar belakang: Kehamilan dan persalinan merupakan faktor risiko utama terjadinya disfungsi dasar panggul. Manifestasi utama pada kelainan tersebut adalah gejala saluran kemih bagian bawah dan inkontinensia urin. Studi mengenai prevalensi dan faktor risiko kondisi-kondisi tersebut sangat penting untuk diagnosis dini dan tata laksana yang komprehensif. Namun, hingga saat ini belum terdapat studi mengenai prevalensi dan faktor-faktor risiko tersebut secara komprehensif pada ibu hamil di Indonesia.Tujuan: Mengetahui prevalensi inkontinensia urin dan gejala saluran kemih bagian bawah serta faktor-faktor yang memengaruhi.Metode: Penelitian ini merupakan penelitian analitik observasional dengan metode potong lintang (cross sectional). Subjek dari penelitian ini adalah ibu hamil yang datang untuk pemeriksaan rutin di Puskesmas Kecamatan Jakarta pada April 2021-Maret 2022. Pasien dengan riwayat inkontinensia, kehamilan ganda, diabetes tidak terkontrol, gangguan neurologis, atau riwayat operasi sebelumnya dieksklusi dari penelitian. Faktor risiko yang dinilai adalah usia ibu, usia kehamilan, paritas, indeks massa tubuh, dan riwayat obstetrik sebelumnya.Hasil: Didapatkan sebanyak 236 subjek yang diikutsertakan dalam penelitian. Didapatkan inkontinensia urin tekanan 8,5%, inkontinensia urin desakan 14%, dan inkontinensia urin campuran 1,6%. Didapatkan keluhan berkemih berupa frekuensi (59,3%), nokturia (87,3%), urgensi (33,1%), hesitansi (8,9%), dan straining (0,8%). Hanya terdapat 5,1% subjek yang tidak memiliki keluhan berkemih sama sekali. Faktor risiko yang berpengaruh dengan keluhan berkemih dan inkontinensia urin adalah usia ibu dan trimester kehamilan.Kesimpulan: Didapatkan prevalensi inkontinensia urin dan gejala saluran kemih bagian bawah yang tinggi pada ibu hamil di Indonesia. Faktor risiko terjadinya gangguan saluran kemih dan inkontinensia urin pada ibu hamil adalah usia ibu dan trimester kehamilan.

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Background: Pregnancy and childbirth are the main risk factors for pelvic floor dysfunction. The main manifestations of this disorder are lower urinary tract symptoms and urinary incontinence. Studies on the prevalence and risk factors of these conditions are essential for early diagnosis and comprehensive management. However, until now there has been no comprehensive study of the prevalence and risk factors for pregnant women in Indonesia.

Objective: To determine the prevalence of urinary incontinence and lower urinary tract symptoms and the factors that influencing.

Methods: This research was an observational analytic study with cross sectional method. The subjects of this study were pregnant women who came for routine check-ups at the Jakarta Publics Health Center in April 2021-March 2022. Patients with a history of incontinence, multiple pregnancy, uncontrolled diabetes, neurological disorders, or a history of previous surgery were excluded from the study. The risk factors assessed were maternal age, gestational age, parity, body mass index, and previous obstetric history.

Results: There were 236 subjects who were included in the study. We found stress urinary incontinence 8.5%, urgency urinary incontinence 14%, and mixed urinary incontinence 1.6%. There were urinary complaints in the form of frequency (59.3%), nocturia (87.3%), urgency (33.1%), hesitancy (8.9%), and straining (0.8%). There were only 5.1% of subjects who did not have urinary complaints at all. The risk factors that influence lower urinary tract symptoms and urinary incontinence are maternal age and trimester of pregnancy.

Conclusions: We found a high prevalence of urinary incontinence and lower urinary tract symptoms in pregnant women in Indonesia. Risk factors for urinary tract disorders and urinary incontinence in pregnant women are maternal age and trimester of pregnancy."

"Gejala saluran kemih bawah LUTS pada laki laki seringkali dikaitkan dengan pembesaran prostat jinak BPH yang menyebabkan obstruksi infravesika yang sering diikuti oleh trabekulasi sehingga terjadi gangguan fungsi kandung kemih Reseksi prostat transuretra TURP adalah tindak baku emas yang bertujuan untuk menghilangkan obstruksi ini Namun gejala LUTS masih banyak dikeluhkan setelah dilakukan TURP Penelitian cross sectional ini dilakukan untuk mencari hubungan antara gejala LUTS pasca TURP dengan derajat trabekulasi dan volume kandung kemih di RSUP H Adam Malik Medan Selama tahun 2013 didapatkan 39 pasien BPH rata rata umur 68 36 7 638 tahun dengan retensi urin berulang yang dilakukan tindakan TURP Dari keseluruhan sampel kelompok yang terbanyak ditemukan adalah derajat trabekulasi sedang 35 9 dan volume kandung kemih 200 cc 46 2 Dua puluh dua sampel 56 4 mengeluhkan LUTS ringan dengan rerata IPSS total 6 28 3 986 Derajat trabekulasi dan volume mempunyai korelasi positif kuat 0 661 dan 0 723 p value.

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Lower urinary tract symptoms LUTS in older male is often associated with benign prostate hyperplasia BPH and caused bladder outlet obstruction BOO with the consequential trabeculation that impair bladder contractility and viscoelasticity Transurethral resection of the prostate TURP is the gold standard for relieving BPH caused BOO Nevertheless many still complained of persisting symptoms even after undergoing TURP This cross sectional study was conducted to analyze the correlation between bladder volume and trabeculation in determining LUTS after TURP in BPH patient In 2013 bladder trabeculation and volume was measured during TURP from 39 BPH patients with recurrent urinary retention and were re evaluated 6 months after The most common findings were moderate trabeculation 35 9 bladder volume 200cc 46 2 and mild degree LUTS 56 4 after TURP with mean IPSS 6 28 3 986 Bladder trabeculation and volume are positively and strongly correlated with LUTS after TURP 0 661 and 0 723 respectively p value 0 01 Analytical linear regression found that these two variables are significant factors in determining LUTS after TURP with positive predictive value of 62 In conclusion bladder trabeculation and volume had strong significant correlation with LUTS after TURP although there are other possible determining factors that are not included in the study"

"Keterbatasan fungsi motorik kasar merupakan salah satu masalah yang sering terjadi pada anak dengan tuna grahita sedang. Upaya yang dapat dilakukan untuk meminimalkan gangguan ini diantaranya adalah dengan melakukan latihan rentang gerak sendi. Penelitian ini bertujuan untuk mengetahui hubungan antara latihan rentang gerak sendi pada ekstremitas bawah terhadap kekuatan otot dan luas gerak sendi anak dengan tuna grahita sedang. Desain yang digunakan adalah quasi-experimental dengan control group pretest-postest design. Sampel berjumlah 30 anak di dua sekolah luar biasa di Bogor. Hasilnya menunjukkan ada peningkatan kekuatan otot dan luas gerak sendi lutut dan panggul pada kelompok intervensi. Latihan ini dapat membantu anak tuna grahita meningkatkan fungsi motoriknya dan dapat dikembangkan di sekolah.

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Limitations of gross motor function is one problem that often occurs in children with mental retardation. Joint range of motion exercises are one of the efforts that can be done to deal with clients with limited motor function. This study aims to determine the relationship between joint range of motion exercises on lower limb muscle strength and extent of joint motion children with moderate mental retardation. The design used was quasi-experimental with the control group pretest-postest design. Sample are 30 children at two SLB in Bogor. The results showed increase in muscle strength and extent of knee and hip joint motion in the intervention group. This exercise can be used to help children with limited motor function improving their motor function and can be developed into one of the programs in SLB."

"Tujuan Mengetahui hubungan antara nilai glukosa darah puasa, disfungsi ereksi DE, dan lower urinary tract symptoms LUTS pada pasien dengan pembesaran prostate jinak.Metode Terdapat 42 pasien berusia lebih dari 50 tahun dengan pembesaran prostat jinak. LUTS dan DE dievaluasi dengan menggunakan International Prostate Symptom Score IPSS and International Index of Erectile Function-5 IIEF-5. Diabetes mellitus ditegakkan jika gula darah puasa lebih dari 126 mg/dL. LUTS dikategorikan menjadi 3 grup; ringan, sedang, dan berat dimana DE dikategorikan menjadi 2; positif dan negative. Semua data dianalisa menggunakan SPSS ver. 22.Hasil Usia rata-rata pasien adalah 68,83 8,56 tahun dengan mayoritas menderita DE 83.33 dan LUTS 80.96. Diabetes mellitus ditemukan pada 26,19 pasien dengan rata-rata nilai gula darah puasa 108.3 21.1 mg/dL. Nilai IPSS didapati berhubungan signifikan dengan nilai gula darah puasa r = 0.879, p

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Aims To discover the correlation between fasting glucose level, erectile dysfunction, and lower urinary tract symptoms LUTS in patients diagnosed with benign prostatic hyperplasia BPH .Methods There were 42 patients with BPH related LUTS aged over 50 years old enrolled in this study. LUTS and erectile dysfunction ED were evaluated using International Prostate Symptom Score IPSS and International Index of Erectile Function 5 IIEF 5 . Diabetes mellitus was established if fasting glucose level was above 126 mg dL. LUTS was classified into 3 groups mild, moderate, and severe LUTS while ED was classified into 2 groups ED positive and ED negative. Data were analyzed using SPSS ver. 22Results Patients rsquo mean age was 68.83 8.56 years old with most of them had ED 83.33 and also suffered from severe LUTS 80.96 . Diabetes mellitus was observed in 26.19 subjects with mean fasting glucose level was 108.3 21.1 mg dL. IPSS score were significantly correlated with fasting glucose level r 0.879, p "

"Penelitian ini membandingkan kuesioner Visual Prostate Symptom Score VPSS yang jarang digunakan dengan kuesioner International Prostate Symptom Score IPSS dan parameter uroflowmetri di Indonesia pada pasien laki-laki yang berobat di Rumah Sakit Umum Nasional Cipto Mangunkusumo. Evaluasi menggunakan IPSS dalam bahasa Indonesia, VPSS, uroflowmetri dan ultrasonografi transabdominal dikerjakan pada pasien pria berusia lebih dari 45 tahun yang berobat ke Rumah Sakit Umum Nasional Cipto Mangunkusumo antara Februari 2014 dan Agustus 2015. Dari seluruh subyek, 24,2 dan 11,1 membutuhkan bantuan ketika menjawab kuesioner IPSS dan VPSS. Usia rata-rata, skor total IPSS, skor total VPSS, Q-max, volume berkemih, dan volume residu pasca berkemih masing-masing adalah 67,4 8,9 tahun, 13,4 7,8, 10,8 2,7, 13,6 8,6 mL / detik, 248 136 ml, dan 54,9 68,3 ml. Skor total, IPSS kualitas hidup QoL, IPSS pertanyaan Q 2, IPSS Q7, dan IPSS Q5, secara signifikan berkorelasi dengan skor total VPSS, VPSS QoL, VPSS Q1, VPSS Q2, dan VPSS Q3 koefisien korelasi r, nilai P masing-masing: 0,57.

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This study aims to compare and correlate the novel Visual Prostate Symptom Score VPSS with International Prostate Symptom Score IPSS questionnaire and uroflowmetry parameters in Indonesian men who visited Dr. Cipto Mangunkusumo National General Hospital. Male patients older than 45 years who visited Dr. Cipto Mangunkusumo National General Hospital between February 2014 and August 2015 with LUTS were evaluated with Indonesian version of the IPSS, VPSS, uroflowmetry and transabdominal ultrasound. Appropriate statistical analysis was employed. Of all subjects, 24.2 and 11.1 require assistance when answering IPSS and VPSS questionnaires respectfully. The mean age, IPSS total score, VPSS total score, Q max, voided volume, and post void residual volume were 67.4 8.9 years, 13.4 7.8, 10.8 2.7, 13.6 8.6 mL sec, 248 136 ml, and 54.9 68.3 ml respectively. Total IPSS, IPSS quality of life QoL, IPSS question Q 2, IPSS Q7, and IPSS Q5, were significantly correlated with total VPSS, VPSS QoL, VPSS Q1, VPSS Q2, and VPSS Q3 correlation coefficient r P value 0.57."

"The southern coast of the North Sea is mainly protected by a single line of defence against flooding. The traditional means for heightening and strengthening the existing coastal barriers are limited due to the increased enormous resource costs, i.e. building materials, funding and space. On the other hand, further interests and needs such as tourism, nature conservation and agriculture demand an integrated planning process according to the principle of a sustainable coastal development. The spatial protection concepts discussed in the book provide new options for sustainable coastal development in line with the integration of several types of land use. Furthermore, the multifunctional coastal protection zones offer new opportunities for the application of different options for coastal protection, i.e. holding the line, accommodation or retreat. This book also provides a sound basis for an integrated planning process in coastal zones combining participatory methods with adapted --tools from socio-economic and ecologic evaluation"