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"ABSTRAKPasien stroke akut sering mengalami hemiparese dan hemiplegi khususnya pada ekstremitas atas. Menimbulkan kelemahan motorik dan penurunan rentang gerak bahu, yang beresiko menyebabkan nyeri bahu dan kontraktur. Pencegahan dapat dilakukan dengan pemberian posisi yang tepat. Tujuan penelitian adalah untuk mengetahui efektifitas pemberian posisi bahu selama 30 menit dan 45 menit terhadap rentang gerak bahu. Penelitian ini merupakan penelitian quasi eksperiment yang melibatkan 32 responden. Hasil penelitian menunjukan tidak ada perbedaan rerata rentang gerak bahu pada pemberian posisi 30 menit dan 45 menit p=0,334 . Peningkatan lama pemberian posisi pada bahu selama 45 menit, dapat mempertahankan rentang gerak bahu.

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ABSTRACTAcute stroke patients frequently experienced hemiparese and hemiplegi especially in the upper limbs, that cause motor weakness and decreases in ROM of the shoulders, risk of shoulders pain and contractures. Prevention can be performed by assigning the right position. The research objective was to determine the effectiveness of the position of the shoulders for 30 minutes and 45 minutes to the ROM of the shoulders. This research is a quasi experiment with pre post test design involving 32 respondents. The results showed that there were no differences between the mean ROM of the shoulders in the delivery position 30 minutes and 45 minutes p 0.334 . This study suggested that increased in the duration of the position of the shoulders for 45 minutes, can to maintain the ROM of the shoulders."

"[ABSTRAKTujuan penelitian ini yaitu mengembangkan intervensi model adaptasi paska stroke serta mengidentifikasi efektifitasnya terhadap perilaku adaptasi dan kualitas hidup pasien paska stroke. Penelitian ini secara keseluruhan dilakukan dalam dua tahap. Tahap satu yaitu pengembangan model intervensi yang diawali dengan penelitian kualitatif menggunakan pendekatan fenomenologi deskriptif tentang pengalaman pasien beradaptasi paska stroke. Model intervensi kemudian dikembangkan dengan cara mengintegrasikan tema hasil penelitian kualitatif, studi literatur, dan konsultasi pakar. Tahap kedua yaitu uji coba intervensi model untuk menentukan efektifitasnya terhadap respon adaptasi dan kualitas hidup pasien paska stroke. Penelitian tahap dua merupakan penelitian kuasi eksperimen menggunakan desain post test control group. Metode sampling yang digunakan dalam penelitian tahap dua yaitu consecutive sampling dengan jumlah sampel 65 orang (32 orang kelompok intervensi dan 33 orang kelompok kontrol). Pembagian sampel ke dalam kelompok intervensi dan kontrol dilakukan dengan matching rumah sakit. Hasil penelitian tahap satu teridentifikasi 9 tema yang dinyatakan partisipan dan dihasilkan intervensi model adaptasi paska stroke (IMAPS) beserta perangkatnya meliputi buku panduan intervensi model, modul untuk perawat pelaksana, dan booklet untuk pasien dan keluarga. Hasil penelitian tahap dua membuktikan adanya perbedaan respon adaptasi fisiologis, adaptasi psikososial, dan kualitas hidup yang bermakna antara pengukuran 3 bulan dengan 4 bulan sesudah intervensi diantara kelompok intervensi dan kontrol. Kesimpulan hasil penelitian yaitu intervensi model adaptasi paska stroke efektif meningkatkan respon adaptasi fisiologis, adaptasi psikososial dan kualitas hidup paska stroke.;

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ABSTRACTThe purpose of this research was to develop intervention adaptation model for post-stroke (IMAPS) and identify its effectiveness on adaptation response and quality of life after stroke. This study conducted in two stages. The first stage was the development of intervention model that begins with a qualitative research using a descriptive phenomenological approach. Intervention model was then developed by integrating the results of qualitative research, literature review, and expert review. The second stage was examination the intervention model to identified its effectiveness on adaptation response and quality of life after stroke. This study was quasi-experimental research using post test control group design. The sampling method used in this study was consecutive sampling with a sample of 65 stroke patient (32 samples in intervention group and 33 samples in control group). Samples were allocated to intervention and control group by matching the hospital. The qualitative study identified nine theme stated by the participants. Qualitative themes serve as guidelines for developing intervention model. The first stage resulted in intervention model and its devices include intervention manual, module for nurses, and booklet for patients and their families. The second stage of research proves the significant difference in physiological and psychosocial adaptation response, and quality of life between measurements 3 months to 4 months after the intervention between groups. We conclude that IMAPS effectively improve the response of physiological and psychosocial adaptation, and quality of life after stroke;The purpose of this research was to develop intervention adaptation model for post-stroke (IMAPS) and identify its effectiveness on adaptation response and quality of life after stroke. This study conducted in two stages. The first stage was the development of intervention model that begins with a qualitative research using a descriptive phenomenological approach. Intervention model was then developed by integrating the results of qualitative research, literature review, and expert review. The second stage was examination the intervention model to identified its effectiveness on adaptation response and quality of life after stroke. This study was quasi-experimental research using post test control group design. The sampling method used in this study was consecutive sampling with a sample of 65 stroke patient (32 samples in intervention group and 33 samples in control group). Samples were allocated to intervention and control group by matching the hospital. The qualitative study identified nine theme stated by the participants. Qualitative themes serve as guidelines for developing intervention model. The first stage resulted in intervention model and its devices include intervention manual, module for nurses, and booklet for patients and their families. The second stage of research proves the significant difference in physiological and psychosocial adaptation response, and quality of life between measurements 3 months to 4 months after the intervention between groups. We conclude that IMAPS effectively improve the response of physiological and psychosocial adaptation, and quality of life after stroke, The purpose of this research was to develop intervention adaptation model for post-stroke (IMAPS) and identify its effectiveness on adaptation response and quality of life after stroke. This study conducted in two stages. The first stage was the development of intervention model that begins with a qualitative research using a descriptive phenomenological approach. Intervention model was then developed by integrating the results of qualitative research, literature review, and expert review. The second stage was examination the intervention model to identified its effectiveness on adaptation response and quality of life after stroke. This study was quasi-experimental research using post test control group design. The sampling method used in this study was consecutive sampling with a sample of 65 stroke patient (32 samples in intervention group and 33 samples in control group). Samples were allocated to intervention and control group by matching the hospital. The qualitative study identified nine theme stated by the participants. Qualitative themes serve as guidelines for developing intervention model. The first stage resulted in intervention model and its devices include intervention manual, module for nurses, and booklet for patients and their families. The second stage of research proves the significant difference in physiological and psychosocial adaptation response, and quality of life between measurements 3 months to 4 months after the intervention between groups. We conclude that IMAPS effectively improve the response of physiological and psychosocial adaptation, and quality of life after stroke]"

"Merokok merupakan masalah kesehatan masyarakat di dunia, menurut World Health Organization (WHO 1988), kebiasaan merokok cenderung meningkat akhir-akhiir ini yaitu 50% pada laki-laki dan 8% pada wanita. Rokok adalah faktor risiko dari strok yang dapat dicegah (klasifikasi serebro vascular diasease III 1990), akan tetapi mekanisme rokok sebagai penyebab strok masih kontroversi. Barigarımenteria (1993) pada penelitianya menganggap rokok sebagai faktor risiko strok yang dapat menurunkan kadar protein S. Penelitian ini bertujuan untuk melihat pengaruh rokok terhadap penurunan kadar protein S pada strok iskemik fase akut. Penelitian dilakukan di Bagian Penyakit Saraf RSUPN-CM sejak bulan Mei 1996 sampai dengan Februari 1997 dengan disain kanıs kontrol pada 45 penderita strok iskemik akut perokok dan 45 penderita strok iskemik akut non perokok yang memenuhi kriteria inklusi. Semua penderita Paki-laki dengan rentang usia seluruh penderita 40 74 tahun. Pemeriksaan protein S dilakukan pada fase akut selambat-lambatnya hari keenam setelah serangan, menggunakan metode koagulometrik. Nilai standard protein 3 untuk orang Indonesia 76% 121,2%. Penilaian hasil aktifitas kadar protein S menurun bila nilai kurang dari 76%. Rerata usia pada kasus 57,2 ± 7,5, tahun dan rerata usia kontrol 56,9 ± 7,9 tidak terdapat perbedaan yang bermakna antara usia kasus dan kontrol (p=0,421). Rerata lama merokok 15,6 ± 8 talaan, 71% (32 orang) merokok lebih dari 10 tahun dan 28,8% (13 orang), merokok kurang dari 10 tahun, didapatkan perbedaan yang bermakna penurunan aktifitas protein S antara kasus dan kontrol (X 11,37, p- 0,0018; Ratio Odds 11,2). Rerata jumlah rokok yang dikonnanai perhari 15 ± 8 batang perhari, 35,5% (16 orang) merokok lebih dari 20 batang perhari, 64,4% (29 orang) merokok kurang dari 20 batang perhari (X²-4,45; p 0,0349, Ratio Odds-7,89). Semua penderita perokok kretek, 26,78% (12 orang) perokok kretek filter dan 73,3% (33 orang) perokok kretek non filter. Tidak didapatkan perbedaan bermakna perokok kretek filter dan non kretek filter (X=0,72; p = 0,403). Didapatkan penurunan aktifitas kadar protein S yang bermakna pada kasus dibanding dengan kontrol (Ratio Odds 14,3). Rata-rata aktifitas kadar protein S pada kasus 50,6% dan rata-rata pada kontrol 85,5%, terlihat perbedaan yang bermakna dengan uji t-test 7,5; p 0,0001. Tujub puluh lima persentil aktifitas kadar protein S menurun dibawah nilai standard normal pada kasus dan hanya lima belas persentil pada kontrol. Lama merokok dan jumlah rokok yang dikonsumsi setiap hari mempunyai pengaruh yang bermakna terhadap penurunan aktifitas kadar protein S (t-test-4,25; p- 0,0001; 95% CI 15,5-45,7) dan (t-test = 2,65; p=0,011; 95% CT 4,1-30,2.

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Smoking is a public health problem in the world, according to the World Health Organization (WHO 1988), smoking habits tend to increase recently, namely 50% in men and 8% in women. Cigarettes are a risk factor for preventable stroke (cerebro vascular disease classification III 1990), however the mechanism of smoking as a cause of stroke is still controversial. Barigarımenteria (1993) in his research considered smoking as a risk factor for stroke which can reduce protein S levels. This study aims to see the effect of smoking on reducing protein S levels in the acute phase of ischemic stroke. The research was conducted in the Neurological Diseases Department of RSUPN-CM from May 1996 to February 1997 with a control design on 45 acute ischemic stroke sufferers who were smokers and 45 sufferers of acute ischemic stroke who were non-smokers who met the inclusion criteria. All Paki sufferers were male with an age range of 40 to 74 years. Protein S examination is carried out in the acute phase no later than the sixth day after the attack, using the coagulometric method. The standard value of protein 3 for Indonesians is 76% 121.2%. Assessment of activity results means S protein levels decrease if the value is less than 76%. The mean age of cases was 57.2 ± 7.5 years and the mean age of controls was 56.9 ± 7.9. There was no significant difference between the ages of cases and controls (p=0.421). The average number of cigarettes consumed per day was 15 ± 8 cigarettes per day, 35.5% (16 people) smoked more than 20 cigarettes per day, 64.4% (29 people) smoked less than 20 cigarettes per day (X²-4.45; p 0.0349, Odds Ratio-7.89). All sufferers were kretek smokers, 26.78% (12 people) were filter kretek smokers and 73.3% (33 people) were non-filter kretek smokers. There was no significant difference between filtered kretek and non-filtered kretek smokers (X=0.72; p = 0.403). There was a significant decrease in the activity of protein S levels in cases compared to controls (Odds Ratio 14.3). The average activity level of protein S in cases was 50.6% and the average in controls was 85.5%, showing a significant difference using the t-test of 7.5; p 0.0001. Seventy-fifth percentile activity levels of protein S decreased below normal standard values ​​in cases and only fifteen percentiles in controls. Length of smoking and the number of cigarettes consumed each day had a significant influence on reducing the activity of protein S levels (t-test-4.25; p-0.0001; 95% CI 15.5-45.7) and (t-test = 2.65; p=0.011; 95% CT 4.1-30.2."

"Latar Belakang: Stroke merupakan penyakit yang memiliki perbedaan karakteristik antara pria dan wanita. Tujuan: Penelitian bertujuan untuk mengetahui hubungan jenis kelamin dengan fungsi kognitif yang dinilai menggunakan uji Montreal Cognitive Assesment versi Indonesia MoCA-Ina pada pasien stroke fase subakut dan kronik di Departemen Rehabilitasi Medik RSCM, dengan melakukan kontrol terhadap variabel perancu berupa tingkat pendidikan dan usia. Metode: Penelitian merupakan studi observasional analitik dengan desain potong lintang. Sampel penelitian sebanyak 34 subjek, diperoleh melalui teknik consecutive sampling. Analisis bivariat uji Mann-Whitney dan uji korelasi Pearson dilakukan untuk melihat hubungan antarvariabel, dan dilanjutkan dengan analisis multivariat regresi linier. Hasil: Berdasarkan uji Mann-Whitney diperoleh nilai p hubungan jenis kelamin dan tingkat pendidikan dengan skor MoCA-Ina sebesar 0,103 dan 0,076. Nilai korelasi hubungan usia dengan skor MoCA-Ina berdasarkan uji korelasi Pearson sebesar r=0,135 p=0,447 . Persamaan regresi skor MoCA-Ina=21,268-3,620 Wanita 3,762 Pendidikan Tinggi R2=8,6 . Perbedaan rerata skor MoCA-Ina antara pria dan wanita setelah dilakukan kontrol variabel tingkat pendidikan adalah sebesar -3,620 IK95 =-8,928-1,058 , namun secara statistik tidak bermakna p=0,125. Diskusi: Tidak ada perbedaan signifikan pada fungsi kognitif yang dinilai menggunakan MoCA-Ina antara pasien stroke sub-akut dan kronik pria dan wanita.

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Background: Stroke is a disease with different characteristics between men and women.

Objective: This study aims to determine the age and level of education adjusted relationship between gender and cognitive function which is assessed by Montreal Cognitive Assessment in sub acute and chronic stroke patients in the Department of Rehabilitation Medicine RSCM.

Methods: This study is an analytic observational study with a cross sectional design. 34 subjects were selected as samples with consecutive sampling method. Mann Whitney test and Pearson's correlation test were used in to determine the bivariate relationships between the variables, proceeded by a multivariate linear regression analysis.

Results: Based on the Mann Whitney test, the p value of the relationship between gender and the level of education and MoCA Ina score were p 0,103 and p 0,076 respectively. Correlation value between age and MoCA Ina score was r 0,135 p 0,447. The regression equation generated was MoCA Ina score 21,268 3,620 Women 3,762 Higher Education R2 8,6. The mean difference of MoCA Ina score between men and women stroke patients after adjusting for age and level of education was 3,620 CI 95 8,928 1,058, but it was statistically insignificant p 0,125.

Discussion: There was no significant difference in the cognitive function which is assessed by MoCA Ina between the male and female sub acute and chronic stroke patients."

"LATAR EELAKANGKejadian stroke menimbulkan kerusakan sel otak. Berbagai faktor risiko telah dikenal meliputi faktor risiko mayor dan minor. Kadar magnesium endogen sebagai salah satu faktor risiko kerusakan set otak masih belum banyak dianalisa dengan berbagai hasil penelitian yang masih kontroversial.METODEPenelitian ini merupakan penelitian prospektif longitudinal (retreated measurement design) dengan data printer diperoleh dari penderita stroke iskemik yang berobat ke RSCM yang memenuhi kriteria inklusi dan eksklusi. Diagnosis stroke iskemik dilakukan melalui pemeriksaan klinis dan CT Scan atau MRI kepala. Dilakukan pemeriksaan laboratorium darah, analisa urin, EKG, dan foto thoraks pada saat masuk. Dilakukan pemeriksaan magnesium serum, plasma, eritrosit pada hari ke-2, ke-4 dan ke-7 dan skor NIHSS pada hari dan saat yang sama.HASILJumlah objek penelitian 53 orang. Sebagian besar rerata magnesium serum dan plasma dalam batas normal (1,4-2,0 mmEq/l) pada tiap hari pengambilan (Mg serum 67,9% - 90,6%, Mg plasma 75-5% - 88,7%) sedangkan ditemukan hipoMg eritrosit pada hari ke-4 dan ke-7 onset stroke (81,1 % dan 73,6%). Ditemukan hubungan sangat bermakna antara Mg serum dengan Mg plasma pada tiap hari pengambilan (p=0,000) dan hubungan bermakna antara Mg serum dengan Mg eritrosit (p=0,02) dan Mg plasma dan Mg eritrosit (p=0,033) pada hari ke-4. Ditemukan hubungan bermakna independen antara Mg plasma hari ke-4 dengan NIHSS hari ke-4 (p=0,005) di samping faktor risiko riwayat stroke /TIA, aritmia jantung dan hiperkoleslerolemia dengan NIHSS.KESIMPULANPenderita iskemik serebral menunjukkan perubahan kadar Mg serum, plasma, eritrosit yang dipengaruhi berbagai faktor risiko lain dan hubungan bermakna antara kadar Mg plasma dan skor NIHSS hari ke-4.KATA KUNCI: Stroke iskemik, hipertensi, magnesium serum, plasma, eritrosit, NIHSS.

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PREFACE

Stroke causes damage to brain cells. Many risk factors of stroke are known like mayor and minor risk factors. Endogen magnesium level as one of risk factor of brain cell damage is analyzed rarely with the controversially results of its studies.

METHOD

The design of this study was repeated measurement with its primary data were collected from ischemic stroke patients in Cipto Mangunkusumo hospital who fulfilled inclusion and exclusion criteria. Diagnosis of stroke was made by physical exam, CT scan or head MRI and completed by blood and urine analysis, echocardiography and chest photo. Serum, plasma and erythrocyte Mg were collected on the 2nd, 4th, aid 7th days after onset and compared with NIHSS scores at the same times.

RESULT

There are 53 persons of subjects studied. Almost all means of the serum Mg and plasma Mg were in normal limits (1,4-2,0 mEq/l) on every days of data collection (serum Mg : 67,6%-90,6%, plasma Mg : 75,5%-88,7%), but there were erythrocyte hipoMg on the 4th and 7th days of stroke onset (81,1% and 73,6%). There were very significant relationship between serum Mg with plasma Mg (p=0,000) on every days of data collection and significant relationship between serum Mg with erythrocyte Mg (p=0,02) and plasma Mg with erythrocyte Mg (p 1,033) on the 4th day onset. There were significant independent relationship between plasma Mg on the 4th day onset with NIHSS in the same day (p=0,005), besides between the history of stroke/TIA, aritmia and hypercholesterolemia with NIHSS.

CONCLUSION

Cerebral ischemic patients showed changes of serum, plasma and erythrocyte Mg levels which were influenced by other risk factors and there was significant relationship between plasma Mg and NIHSS score in the 4th day."

"Stroke merupakan kondisi emergency yang terjadi karena iskemi serebral, dengan penurunanaliran darah dan oksigen ke jaringan serebral yang dapat menyebabkan kerusakan otak yangpermanen bahkan sampai dengan kematian. Latar belakang dalam pengambilan kasusStroke dikarenakan terdapat 15 juta orang yang mengalami stroke setiap tahun danmerupakan penyebab kematian kedua diatas usia 60 tahun dan penyebab kematian kelimapada usia 15-59 tahun. Tujuan penelitian ini untuk mengetahui hubungan antara karakteristik,tingkat kecemasan dan ketergantungan dengan penerimaan diri pasien keterbatasan gerakakibat stroke. Hasil penelitian didapatkan terdapat hubungan karakteristik usia dan tingkatkecemasan dengan penerimaan diri pasien keterbatasan gerak akibat stroke. Hasil penelitian merekomendasikan Rumah Sakit umum sebagai pemberi layanan kesehatanyang berfokus pada pelayanan kesehatan fisik hendaknya juga meningkatkan layanankesehatan jiwa dalam memberika asuhan keperawatan yang komperhensif.

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Stroke is an emergency condition that occured as the cerebral ischemic, with decreased inblood flow and oxygen to the cerebral tissues that can caused permanent brain damaged andeven up to death, basic in decision Stroke cased because there are 15 million people whosuffered stroke each year and the second leading caused of death above the age of 60 yearsand the fifth leading caused of death at the age of 15 59 years.

The purpose of this study todetermine the relationship between the characteristics, the level of anxiety and selfacceptancedependence with reduced mobility as stroke patients.

The results showed there arerelation characteristics of the age and level of anxiety with self acceptance limitation ofmotion in stroke patient.

The results of the study recommended to general hospital as thehealth care provider that focuses on physical health services should be also improving mentalhealth services in providing a comprehensive nursing care. "

"[ABSTRAKLATAR BELAKANG. Kelemahan otot yang terjadi pada 75% - 80% pasien stroke menyebabkan terbatasnya aktivitas pasien stroke. Cara pengukuran kekuatan otot yang mudah digunakan di klinis adalah dengan hand-held dinamometer, sedangkan untuk mengukur kemampuan berjalan yang cukup efektif pada pasien stroke adalah uji jalan 2 menit. Telah banyak penelitian yang mendapatkan adanya hubungan antara kekuatan otot sisi paresis dengan kemampuan berjalan pada pasien stroke, namun belum ada yang menghubungkan antara kekuatan otot tersebut dengan uji jalan 2 menit. Tujuan penelitian ini untuk mengetahui korelasi antara kekuatan otot sisi paresis dengan kemampuan berjalan pada pasien stroke kronik yang diukur dngan uji jalan 2 menit dan mengetahui kelompok otot yang paling berpengaruh terhadap kemampuan berjalan tersebut.METODE. Pada 28 subyek penelitian yang memenuhi kriteria dan bersedia mengikuti penelitian dilakukan pengukuran kekuatan otot tungkai sisi paresis, yaitu otot ekstensor panggul, fleksor panggul, ekstensor lutut, fleksor lutut, dorsifleksor pergelangan kaki, plantarfleksor pergelangan kaki, dengan hand-held dinamometer, kemudian dilakukan uji jalan 2 menit. Data demografis dan klinis pasien dikumpulkan dan dicatat.HASIL. Diperoleh korelasi positif yang bermakna antara kekuatan otot tungkai sisi paresis yaitu otot ekstensor panggul, fleksor panggul, ekstensor lutut, fleksor lutut, dorsifleksor pergelangan kaki, dan plantarfleksor pergelangan kaki dengan jarak tempuh berjalan yang diuji dengan uji jalan 2 menit (r= 0,410 hingga r = 0,645) . Diperoleh korelasi positif yang bermakna antara kekuatan otot tungkai sisi paresis yaitu otot ekstensor panggul, fleksor panggul, ekstensor lutut, fleksor lutut, dorsifleksor pergelangan kaki, dan plantarfleksor pergelangan kaki dengan kecepatan berjalan yang diuji dengan uji jalan 2 menit (r= 0,409 hingga r = 0,641). Otot yang paling berpengaruh terhadap kemampuan berjalan pada pasien stroke kronik dengan nilai r tertinggi dan p terendah adalah otot plantarfleksor pergelangan kaki, diikuti dorsifleksor pergelangan kaki, fleksor panggul, fleksor lutut, ekstensor lutut, dan terakhir ekstensor panggul.KESIMPULAN. Terdapat korelasi positif antara kekuatan otot tungkai sisi paresis dengan kemampuan berjalan pada pasien stroke kronik, dengan otot yang paling berpengaruh terhadap kemampuan berjalan yaitu otot plantarfleksor pergelangan kaki.

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ABSTRACTBACKGROUND. Muscle weakness that occurs in 75% - 80% of stroke patients causing limited activity of stroke patients. The easy way to measure muscle strength in clinical is by using a hand-held dynamometer, whereas the effective way to measure the ability to walk in stroke patients is using a 2-minute walk test. Previous studies said that there was relationship between muscle strength in paretic side with walking ability in stroke patients, but there is still no study about correlation between the muscle strength with a 2 minute walk test. The purpose of this study to determine the correlation between muscle strength of the lower extremity of the paretic side with walking ability in patients with chronic stroke using 2 minutes walk test, and determine which muscle groups that has the best correlation with the ability of walking.METHOD. There were 28 subjects who were eligible and willing to participate in the research. They got measurements of lower extremity muscle strength of the paretic side (hip extensor muscles, hip flexors, knee extensors, knee flexors, ankle dorsiflexor, ankle plantarflexor) using hand-held dynamometer, then 2 minutes walk test. Patient demographic and clinical data were collected and recorded.THE RESULTS. There are significant positive correlation between the strength of the lower extremity muscles of the paretic side (hip extensor, hip flexors, knee extensors, knee flexors, ankle dorsiflexor, and ankle plantarflexor muscles) with the length of 2-minute walk test (r = 0.410 - r = 0.645). There are significant positive correlation between the strength of the lower extremity muscles of the paretic side (hip extensor, hip flexors, knee extensors, knee flexors, ankle dorsiflexor, and ankle plantarflexor muscles) with walking speed of the 2-minute walk test (r = 0.409 - r = 0,641). The muscles with the best correlation with the ability of walking in patients with chronic stroke are the muscles with the highest r and the lowest p, plantarflexor ankle muscles, followed by dorsiflexor ankle muscles, hip flexors muscles, knee flexors muscles, knee extensor muscles, and hip extensor muscles.CONCLUSION. There are positive correlation between the strength of the lower extremity muscles of the paretic side with walking ability in patients with chronic stroke, and the muscles with the best correlation with the ability of walking are plantarflexor ankle muscles. ;BACKGROUND. Muscle weakness that occurs in 75% - 80% of stroke patients causing limited activity of stroke patients. The easy way to measure muscle strength in clinical is by using a hand-held dynamometer, whereas the effective way to measure the ability to walk in stroke patients is using a 2-minute walk test. Previous studies said that there was relationship between muscle strength in paretic side with walking ability in stroke patients, but there is still no study about correlation between the muscle strength with a 2 minute walk test. The purpose of this study to determine the correlation between muscle strength of the lower extremity of the paretic side with walking ability in patients with chronic stroke using 2 minutes walk test, and determine which muscle groups that has the best correlation with the ability of walking.METHOD. There were 28 subjects who were eligible and willing to participate in the research. They got measurements of lower extremity muscle strength of the paretic side (hip extensor muscles, hip flexors, knee extensors, knee flexors, ankle dorsiflexor, ankle plantarflexor) using hand-held dynamometer, then 2 minutes walk test. Patient demographic and clinical data were collected and recorded.THE RESULTS. There are significant positive correlation between the strength of the lower extremity muscles of the paretic side (hip extensor, hip flexors, knee extensors, knee flexors, ankle dorsiflexor, and ankle plantarflexor muscles) with the length of 2-minute walk test (r = 0.410 - r = 0.645). There are significant positive correlation between the strength of the lower extremity muscles of the paretic side (hip extensor, hip flexors, knee extensors, knee flexors, ankle dorsiflexor, and ankle plantarflexor muscles) with walking speed of the 2-minute walk test (r = 0.409 - r = 0,641). The muscles with the best correlation with the ability of walking in patients with chronic stroke are the muscles with the highest r and the lowest p, plantarflexor ankle muscles, followed by dorsiflexor ankle muscles, hip flexors muscles, knee flexors muscles, knee extensor muscles, and hip extensor muscles.CONCLUSION. There are positive correlation between the strength of the lower extremity muscles of the paretic side with walking ability in patients with chronic stroke, and the muscles with the best correlation with the ability of walking are plantarflexor ankle muscles. , BACKGROUND. Muscle weakness that occurs in 75% - 80% of stroke patients causing limited activity of stroke patients. The easy way to measure muscle strength in clinical is by using a hand-held dynamometer, whereas the effective way to measure the ability to walk in stroke patients is using a 2-minute walk test. Previous studies said that there was relationship between muscle strength in paretic side with walking ability in stroke patients, but there is still no study about correlation between the muscle strength with a 2 minute walk test. The purpose of this study to determine the correlation between muscle strength of the lower extremity of the paretic side with walking ability in patients with chronic stroke using 2 minutes walk test, and determine which muscle groups that has the best correlation with the ability of walking.METHOD. There were 28 subjects who were eligible and willing to participate in the research. They got measurements of lower extremity muscle strength of the paretic side (hip extensor muscles, hip flexors, knee extensors, knee flexors, ankle dorsiflexor, ankle plantarflexor) using hand-held dynamometer, then 2 minutes walk test. Patient demographic and clinical data were collected and recorded.THE RESULTS. There are significant positive correlation between the strength of the lower extremity muscles of the paretic side (hip extensor, hip flexors, knee extensors, knee flexors, ankle dorsiflexor, and ankle plantarflexor muscles) with the length of 2-minute walk test (r = 0.410 - r = 0.645). There are significant positive correlation between the strength of the lower extremity muscles of the paretic side (hip extensor, hip flexors, knee extensors, knee flexors, ankle dorsiflexor, and ankle plantarflexor muscles) with walking speed of the 2-minute walk test (r = 0.409 - r = 0,641). The muscles with the best correlation with the ability of walking in patients with chronic stroke are the muscles with the highest r and the lowest p, plantarflexor ankle muscles, followed by dorsiflexor ankle muscles, hip flexors muscles, knee flexors muscles, knee extensor muscles, and hip extensor muscles.CONCLUSION. There are positive correlation between the strength of the lower extremity muscles of the paretic side with walking ability in patients with chronic stroke, and the muscles with the best correlation with the ability of walking are plantarflexor ankle muscles. ]"

"Ansietas merupakan masalah psikososial yang banyak terjadi pada klien stroke. Ansietas yang tidak ditangani dapat menjadi penyulit bagi klien untuk mengikuti program pengobatan secara efektif dan memperlambat proses pemulihan. Salah satu psikoterapi yang dapat diberikan untuk mengatasi ansietas adalah Acceptance and Commitment Therapy (ACT). Penelitian ini bertujuan untuk mengetahui pengaruh ACT terhadap ansietas klien stroke yang dirawat di Rumah Sakit Stroke Nasional (RSSN) Bukittinggi. Desain penelitian yang digunakan adalah quasi experimental pre-post test with control group. Sampel penelitian berjumlah 60 orang dengan teknik pengambilan sampel consecutive sampling.Hasil penelitian menunjukkan ada perbedaan yang signifikan skor rata-rata ansietas antara kelompok yang mendapatkan ACT (intervensi) dengan kelompok yang tidak mendapatkan ACT (kontrol) p value=0,002 (P<0,05). ACT direkomendasikan untuk diterapkan sebagai terapi keperawatan untuk mengatasi ansietas pada klien stroke yang dirawat di rumah sakit umum.

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Anxiety is a psychological problem that experienced by patients with stroke. Untreated anxiety can be a serious barrier for the patient to follow an effective treatment program and also slowing down the recovery process. One of psychotherapy that can be provided to treat anxiety is Acceptance and Commitment Therapy (ACT).

The purpose of this study was to determine the effect of ACT towards stroke patient's anxiety who are hospitalized at the National Stroke Hospital Bukittinggi. This study used a quasi-experimental prepost test with control group design. The research sample consisted of 60 people with consecutive sampling technique.

The results of the study revealed that the significant difference of anxiety scores between the groups who received ACT (intervention) with the group without receiving ACT (control), p value=0.002 (P <0.05). ACT was recommended to be applied as a nursing therapy to overcome anxiety to the patient who are hospitalized in the general hospital."