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"Rehabilitasi pasien penyakit paru obstruktif kronik (PPOK) yang stabil bertujuan untuk mengurangi sesak, meningkatkan toleransi latihan, dan meningkatkan status kesehatan. Pada dekade terakhir banyak dikembangkan teknik terapi mandiri salah satunya adalah menggunakan perangkat positive expiratory pressure (PEP). Penelitan ini bertujuan untuk menilai efektivitas latihan pernapasan menggunakan perangkat PEP pada volume ekspirasi paksa detik pertama (VEP1), kapasitas fungsional, dan kualitas hidup pada pasien PPOK. Desain penelitian yang digunakan yaitu studi intervensional prospektif yang membandingkan efek sebelum dan sesudah latihan pernapasan menggunakan PEP selama 8 minggu. Subjek yang menyelesaikan penelitian sebanyak 20 orang. Latihan pernapasan dilakukan dua kali sehari dengan durasi 15 menit pada masing-masing sesi latihan. Tekanan yang digunakan disesuaikan dengan kemampuan pasien yaitu inspirasi berbanding ekspirasi 1:3. Tekanan ditentukan sebelum memulai latihan dan dievaluasi setiap dua minggu. Hasil keluaran yang dinilai adalah nilai VEP1, kapasitas fungsional yang diukur dengan kecepatan berjalan dalam uji jalan 4 meter dan kualitas hidup yang diukur dengan kuesioner St. George s Respiratory Questionnaire (SGRQ). Nilai VEP1 sebelum intervensi adalah 1369,5±569,63 ml dan sesudah sebesar 1390±615,01 ml (p=0.585). Kecepatan berjalan sebelum intervensi 1,43±0.31 m/s dan sesudah 1,56±0,40 m/s (p=0.248). Skor kuesioner SGRQ domain gejala terdapat penurunan dari rerata 44,00±17,88% menjadi 25,31±14,06% (p=0.000), domain aktivitas dari rerata 54,22±28,18% menjadi 40,38±24,25% (p=0.006), domain dampak dari 32,83% (0,00-67,46) menjadi 16,32% (0,00-61,33) (p=0.002), dan skor total dari 39,46% (6,30-75,42) menjadi 25,96% (5,24-61,34) (p=0.001). Peningkatan kecepatan berjalan dan perbaikan skor SGRQ memenuhi nilai minimum clinically important difference (MCID). Latihan pernapasan menggunakan perangkat PEP selama 8 minggu dapat meningkatkan nilai VEP1, kapasitas fungsional dan kualitas hidup pasien PPOK.

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Rehabilitation of stable chronic obstructive pulmonary disease (COPD) aims to reduce dyspnoe, increase exercise tolerance, and improve health status. In the last decade, many independent therapy techniques have been developed, one of them is positive expiratory pressure (PEP). The aim of this study was to assess the effectiveness of breathing exercises using a PEP device on Forced Expiratory Volume in 1 second (FEV1), functional capacity, and quality of life in COPD patients. The study design was a prospective interventional studies that compared the effects before and after breathing exercises using PEP for 8 weeks. Twenty subjects completed the study. Breathing exercises were carried out twice a day, 15 minutes duration at each session. The pressure used is adjusted to the patient's ability, reaching inspiration to expiration ratio of 1:3. Pressure was determined before starting the exercise and evaluated every two weeks. The outcome were FEV1, functional capacity measured by walking speed in the 4 meter gait speed assesment and quality of life as measured by the St. George s Respiratory Questionnaire (SGRQ). FEV1 ​​before intervention were 1369,5±569,63 ml and after 1390±615,01 ml (p=0.585). Walking speed before intervention was 1,43±0,31 m/s and after 1,56±0,40 m/s (p=0,248). The symptom domain SGRQ questionnaire score has a decrease from 44,00±17,88% to 25,31±14,06% (p=0,000), the activity domain from 54,22±28,18% to 40,38±24,25% (p=0.006), the impact domain of 32,83% (0,00-67,46) to 16,32% (0,00-61,33) (p=0,002), and the total score of 39,46% (6,30-75,42) to 25,96% (5,24-61,34) (p=0.001). Increase in walking speed and SGRQ score exceed the minimum clinically important difference (MCID). Breathing exercises using a PEP device for 8 weeks can increase FEV1, functional capacity and quality of life of COPD patients."

"Tujuan: Penelitian ini bertujuan untuk menilai perbedaan latihan jentera dan sepeda statis terhadap perubahan kapasitas fungsional dan kualitas hidup pada penderita Penyakit Paru Obstruktif Kronik (PPOK) kondisi stabil.Metode: Metode penelitian eksperimental dengan jumlah sampel 44 orang, terdiri dari 22 orang dengan latihan sepeda statis dan 22 orang dengan latihan jentera yang datang ke poli Rehabilitasi Medik RS Persahabatan. Penilaian kapasitas fungsional menggunakan metode Uji Jalan 6 Menit (UJ6M) dilakukan minggu I, V dan IX. Penilaian kualitas hidup diukur menggunakan St. George’s Respiratory Questionnaire (SGRQ) dilakukan minggu I dan IX. Program latihan dilakukan selama 8 minggu.Hasil: Latihan jentera dan sepeda statis menghasilkan perbaikan signifikan baik dalam hal hasil uji jalan 6 menit dan SGRQ sejak minggu I sampai IX. Namun dalam perbandingan latihan yang memberikan hasil terbaik, jentera meningkatkan jarak tempuh jalan 6 menit lebih baik dibandingkan sepeda statis secara konsisten pada minggu I–V, V-IX dan I-IX (p <0,001). Untuk nilai SGRQ, hasil kedua latihan tidak berbeda signifikan.Kesimpulan: Kelompok latihan jentera memiliki peningkatan kapasitas fungsional yang lebih besar dan berbeda bermakna dibandingkan kelompok latihan sepeda statis pada subjek PPOK stabil. Kelompok latihan jentera memiliki peningkatan kualitas hidup yang tidak berbeda bermakna dibandingkan kelompok latihan sepeda statis pada subjek PPOK stabil.

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Objective: This study aimed to assess the differences between treadmill and ergocycle exercise on changes in functional capacity and quality of life in patients with stable Chronic Obstructive Pulmonary Disease (COPD).

Methods: This is an experimental research with a sample of 44 subjects, consisting of 22 subjects in the ergocycle exercise group and 22 subjects in the treadmill exercise group, at Persahabatan Hospital Medical Rehabilitation Clinic. Assessment of functional capacity using the 6 Minute Walking Test (6MWT) was performed on weeks I, V and IX. Assessment of quality of life was measured using the St. George's Respiratory Questionnaire (SGRQ) performed on the week I and IX. Training program was conducted for 8 weeks.

Results: Treadmill and ergocycle exercise produce significant improvement in both the 6MWT results and SGRQ since week I to IX. But in comparison, treadmill exercise improves 6MWT distance better than ergocycle consistently at week I-V, V-IX and I-IX (p <0.001). For the SGRQ score, both exercises did not differ significantly.

Conclusion: The treadmill exercise group had a larger and significantly different improvement in functional capacity than the ergocycle exercise group in stable COPD subjects. Treadmill exercise group improvements on quality of life was not significantly different than the ergocycle exercise group in stable COPD subjects."

"Tesis ini disusun untuk mengetahui data profile MEP dan APB serta efek latihan penguatan otot ekspirasi dengan perangkat PEP terhadap MEP dan APB pada lansia sedentary. Penelitian menggunakan desain uji acak terkontrol (randomized control trial) dengan latihan PLB sebagai kontrol. Subjek penelitian adalah lansia berusia lebih dari 60 hingga 75 tahun, sedentary, MocaINA ≥ 26, tidak merokok dalam 5 tahun terakhir, memiliki care giver, dapat berbahasa Indonesia, nilai spirometri normal atau abnormal, dapat memahami dan mempraktekkan dengan benar penggunaan alat PEP dan latihan PLB, bersedia mengisi log book dengan benar dan teratur dan bersedia mengikuti penelitian secara sukarela serta menandatangani lembar persetujuan. Semua subjek penelitian (n=72) yaitu 35 orang dari kelompok PEP dan 37 orang dari kelompok PLB dilakukan penilaian MEP dan APB pada awal minggu pertama serta penentuan intensitas latihan yaitu 50% 1 RM pada kelompok PEP. Latihan dilanjutkan sebagai home program selama 4 minggu dengan kelompok PEP melakukan kunjungan setiap minggu untuk menentukan intensitas latihan yaitu 50% dari 1 RM yang baru sedangkan kelompok latihan PLB melakukan kunjungan pada minggu ketiga untuk evaluasi. Selama penelitian terdapat 6 subjek penelitian yang drop out, 2 dari kelompok PEP dan 4 dari kelompok PLB. Pada awal minggu kelima dilakukan kembali penilaian MEP dan APB pada kedua kelompok didapatkan kenaikan MEP dan APB yang secara klinis dan statistik signifikan ( p < 0,001) dengan kenaikan yang lebih besar pada kelompok PEP dan secara statistik kenaikan pada kelompok PEP jika dibandingkan dengan kenaikan yang terjadi pada kelompok PLB adalah signifikan (p < 0,001). Kesimpulan penelitian ini adalah data profile MEP lansia sedentary adalah rata-rata 48,73 ± 19,14 cmH2O pada kelompok PEP dan 40,61 ± 14,49 cmH2O pada kelompok PLB sedangkan data profile APB pada kelompok PEP rata-rata 268,64 ± 97,28 l/m dan 274,15 ± 79,25 l/m pada kelompok PLB. Latihan pernafasan dengan menggunakan perangkat PEP dapat meningkatkan nilai MEP dan APB pada lansia sedentary dimana didapatkan nilai median Δ MEP adalah 23 (10 – 38) cmH2O dan nilai median Δ APB adalah 40 (15 – 135) l/m dan secara statistik bermakna dengan nilai p < 0,001.

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This Thesis was aimed to determine the profile data of MEP and PCF as well as the effect of expiratory muscle strength training with PEP to MEP and PCF in sedentary elderly. The design was randomized control trial with PLB exercise as control. The subjects were eldery, ages more than 60 to 75 years old who were sedentary with MocaINA ≥ 26, no active history of cigarette smoking in the last 5 years, had assistance of care giver, actively speaking in Bahasa Indonesia, had normal or abnormal spirometry value, understood and were able to practice PEP or PLB exercise correctly, filling out log book regularly and correctly and voluntarily willing to join the research and signed signed inform consent form. All subjects (n=72) consisted of 35 subjects in PEP group and 37 subjects in control group (assigned to do PLB exercise). In the beginning of the first week the subject’MEP and PCF values were obtained and the intensity of exercise using PEP was determined at 50% of 1 RM. Exercise was continued as a home program for 4 weeks with the PEP group asked to come weekly to cardiorespiratory outpatient clinic in rehabilitation department to determine a new exercise intensity of 50% of the new 1 RM. While subjects in the PLB group came to cardiorespiratory outpatient clinic at the beginning of the third week to be evaluated. During this research 6 subjects dropped out, 2 subjects from PEP group and 4 subjects from PLB group. At the beginning of fifth week, MEP and PCF values were reassessed and the result demonstrated an increase in both MEP and PCF values (clinically and statistically) in both groups with a greater increase in PEP group. The increase in MEP and PCF values in PEP group was significant in comparison to the PLB group (p < 0,001. The study concluded that average profile data of MEP in sedentary elderly were 48,73 ± 19,14 cmH2O in PEP group and 40,61 ± 14,49 cmH2O in PLB group whereas average profile data of PCF in sedentary elderly were 268,64 ± 97,28 l/m and 274,15 ± 79,25 l/m in PLB group. Expiratory muscle strength training with PEP could increase MEP and PCF values in sedentary elderly with median Δ MEP was 23 (10 – 38) cmH2O and median Δ PCF was 40 (15 – 135) l/m and the increase was statistically significant with p < 0,001."

"Volume Ekspirasi Paksa detik pertama VEP1 merupakan salah satu uji diagnostik fungsi paru. Faktor yang mempengaruhi nilai VEP1 diantaranya, yaitu tinggi badan, usia, jenis kelamin, dan ras. Tujuan: Penelitian ini menganalisis hubungan antara VEP1 dengan kadar lemak pada individu dewasa dengan Indeks Masssa Tubuh normal. Metode: Penelitian ini menggunakan studi cross-sectional pada 62 individu dewasa yang memenuhi kriteria penelitian. Kadar lemak diukur menggunakan timbangan seca, sedangkan VEP1 diukur dengan menggunakan spirometer. Data tersebut dianalisis menggunakan uji normalitas Kolmogorov-Smirnov dan uji korelasi Spearman. Hasil: Koefisien korelasi atau r terhadap kadar lemak dan VEP1 pada laki-laki didapatkan koefisien korelasi r sebesar -0,164 p>0,05. Koefisien korelasi terhadap kadar lemak dan VEP1 pada perempuan sebesar 0,10 p>0,05. Hasil pengolahan data menunjukkan tidak adanya korelasi bermakna antara kadar lemak dengan VEP1 pada individu dewasa dengan IMT normal baik pada laki-laki p=0,414 maupun pada perempuan p=0,566

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Forced Expiratory Volume in the first second FEV1 is one of diagnostic test for Pulmonary Function Test. Several factors that affect FEV1 are body height, age, gender, and ethnic.

Objective: This research is aimed to find relation between body fat percentage and FEV1.

Method A cross sectional study in 62 adults included into the criteria was conducted in this research. Body fat percentage was measured using seca weighing scales, while FEV1 was measured using spirometer. The data was analyzed with Kolmogorov Smirnov normality test and Person Correlation test.

Result: R value towards body fat percentage and FEV1 in males is about 0,164 p 0,05. R value towards body fat percentage and FEV1 in females is about 0,10 p 0,05. The result shows that there is no significant correlation between body fat percentage and FEV1 in males normal BMI adults p 0,414 and in females normal BMI adults p 0,566."

"Latar belakang: Teknisi pesawat terbang militer terpajan polutan dan zat solvent di tempat kerja dan asap rokok yang dapat mengakibatkan penurunan nilai volume ekspirasi paksa detik pertama (VEP1) yang dapat menurunkan kinerja teknisi pesawat. Tujuan penelitian adalah untuk membuktikan pengaruh antara polutan pekerjaan dan merokok terhadap nilai VEP1 pada teknisi pesawat terbang militer.Metode: Penelitian potong lintang ini dengan sampling purposif di antara teknisi pesawat terbang militer yang dilakukan 16-17 Mei 2013 di Skatek 021 Halim PK dan Lakespra Saryanto. Data diperoleh oleh peneliti dengan wawancara menggunakan kuesioner dan hasil pemeriksaan spirometri. Analisis data menggunakan regresi linear.Hasil: Subyek penelitian sebanyak 135 orang. Nilai VEP1 antara 57-122 dengan rerata 87.88 dan standar deviasi (SD) 12.61. Polutan pekerjaan dan lama merokok merupakan faktor risiko dominan terhadap nilai VEP1. Dengan kenaikan 1 skor polutan pekerjaan akan menurunkan nilai VEP1 sebesar 2.57 [koefisien regresi (r) = -2.57, P=0.000]. Selain itu dengan pertambahan 1 tahun lama merokok akan menurunkan nilai VEP1 sebesar 0.22 (r= -0.22, P=0.015).Kesimpulan: Polutan pekerjaan dan lama merokok menurunkan nilai VEP1 pada teknisi pesawat terbang militer.

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Background: Military aircraft technicians exposed to pollutants and solvent substances in the workplace and cigarette smoke can lead to impairment of forced expiratory volume in one second (FEV1) which can degrade the performance of aircraft technicians. The research objective is to prove the effect between pollutants and smoking on FEV1 among military aircraft technicians.

Method: This cross-sectional study with purposive sampling among military aircraft technician who performed 16 to 17 May 2013 in the 021 Skatek Halim PK and Lakespra Saryanto. Data obtained by the researchers with the interviews using a questionnaire and the results of spirometry. Analysis of the data using linear regression.

Result: Research subjects as much as 135 people. FEV1 value between 57-122 with a mean of 87.88 and standard deviation (SD) 12.61. Pollutants and smoking duration is the dominant risk factor for FEV1 value. With rising 1 scores pollutants will decrease the value of the work at 2.57 FEV1 [regression coefficient (r) = -2.57, P = 0.000]. In addition to the increase in 1 year smoking duration will decrease the value of FEV1 at 0.22 (r = -0.22, P = 0.015).

Conclusion: Pollutants and smoking duration lowers the value FEV1 on military aircraft technicians"

"Tuberkulosis paru dapat menyebabkan perubahan permeabilitas lapisan pleura akibat aktivitas inflamasi mycobacterium tuberculosis sehingga terjadinya akumulasi cairan di rongga pleura dan mengganggu pengembangan paruparu. Karakteristik efusi pleura ditemukan sebanyak 87% dari 119 kasus efusi pleura disebabkan oleh penyakit pada rongga toraks (lokal) seperti TB. Sesak napas manifestasi klinis paling umum namun sering melemahkan dan secara signifikan mengganggu kualitas hidup. Latihan napas dapat menjadi salah satu intervensi keperawatan mandiri untuk mengurangi sesak napas. Karya ilmiah akhir ners ini akan menganalisis asuhan keperawatan pasien Ny AA (46 tahun) dengan masalah keperawatan pola napas tidak efektif dengan intervensi latihan napas Bubble Positive Expiratory Pressure. Cara kerja Bubble Positive Expiratory Pressure membuat gelembung dalam air diharapkan membuat tekanan positif yang menahan saluran udara dan membantu lebih banyak udara masuk dan keluar dari paru-paru. Trend perubahan fungsi pernapasan setelah melakukan Bubble Positive Expiratory Pressure dapat terlihat dengan sesak napas dari skala 7/10 menjadi 4/10, frekuensi napas dari 24x/menit menjadi 20x/menit, adanya penggunaan otot bantu napas menjadi minimal, dan tipe pernapasan dari nasal kanul 5 liter/menit dengan Spo2 96% menjadi room air dengan Spo2 98%. Latihan napas Bubble Positive Expiratory Pressure dapat menjadi intervensi keperawatan mandiri yang dapat dilakukan pada pasien dengan masalah paru-paru.

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Pulmonary tuberculosis can cause changes in the permeability of the pleural layer due to the inflammatory activity of Mycobacterium tuberculosis, resulting in fluid accumulation in the pleural cavity and disrupting lung development. Characteristics of pleural effusion found as much as 87% of 119 cases of pleural effusion caused by diseases of the thoracic cavity (local) such as TB. Shortness of breath is the most common clinical manifestation but is often debilitating and significantly impairs quality of life. Breathing exercises can be one of the independent nursing interventions to reduce shortness of breath. This final scientific paper will analyze the nursing care of the patient Mrs. AA (46 years) with nursing problems with ineffective breathing patterns with Bubble Positive Expiratory Pressure breathing exercises. How Bubble Positive Expiratory Pressure works by creating bubbles in the water is expected to create positive pressure that holds the airways and helps more air in and out of the lungs. The trend of changes in respiratory function after doing Bubble Positive Expiratory Pressure can be seen with shortness of breath from a scale of 7/10 to 4/10, respiratory rate from 24x/minute to 20x/minute, minimal use of accessory muscles, and type of breathing from nasal cannul 5 liters/minute with oxygen saturation 96% to room air with oxygen saturation 98%. Bubble Positive Expiratory Pressure breathing exercises can be an independent nursing intervention that can be done in patients with lung problems."

"Keluhan sesak napas atau dispnea merupakan gejala umum yang selalu dikeluhkan oleh pasien PPOK. Pengelolaan dispnea pada penderita PPOK di tatanan layanan kesehatan, selain menggunakan terapi farmakologi juga dengan pemberian terapi non farmakologi. Terapi non farmakologi untuk penderita PPOK tersebut meliputi 3 aspek utama, yaitu olah napas/breathing, olah pikiran/thinking dan olah fungsional/functioning. Tatalaksana non farmakologi untuk kasus PPOK sebagian besar berfokus pada upaya kontrol pernapasan melalui teknik Pursed Lip Breathing. Namun belum banyak penelitian yang mengkaji pengaruh kontrol pikiran dalam mengatasi keluhan dispnea pasien PPOK. Penelitian ini menggabungkan antara kontrol pernapasan melalui latihan Pursed Lip Breathing (PLB) dan kontrol pikiran melalui latihan Progressive Muscle Relaxation (PMR). Penelitian ini merupakan penelitian quasy experiment dengan pendekatan pre-post test design pada 20 responden di setiap kelompok intervensi. Kelompok intervensi I diberi kombinasi latihan PLB dan PMR selama 10 menit, 2 kali sehari, selama 7 hari. Sedangkan kelompok intervensi II diberi kombinasi latihan PLB selama 10 menit, 2 kali sehari, selama 7 hari. Hasil penelitian menunjukkan adanya perbedaan yang bermakna pada derajat dispnea setelah pemberian kombinasi latihan PLB dan PMR (p = 0,000; α = 0,05). Dengan demikian, kombinasi latihan PLB dan PMR merupakan salah satu intervensi yang efektif untuk menurunkan derajat dispnea pada pasien PPOK. Rekomendasi pada penelitian ini adalah diperlukannya pengembangan program terapi komplementer di pendidikan dan pelayanan keperawatan untuk modifikasi standar asuhan keperawatan dengan memasukkan terapi komplementer kombinasi latihan PLB dan PMR dalam asuhan keperawatan pasien PPOK. 

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Shortness of breath or dyspnea are common symptoms that are always complained of by Chronic Obstructive Pulmonary Disease (COPD) patients. Management of dyspnea in patients with COPD are pharmacological therapy and non-pharmacological therapy. Non-pharmacological therapy for patients with COPD includes 3 main aspects, namely breathing, mind processing and functional functioning.

Non-pharmacological management for COPD cases focuses mostly on respiratory control efforts through the Pursed Lip Breathing technique. But not many studies have examined the effect of mind control in overcoming complaints of COPD dyspnea patients. This study combines breathing control through Pursed Lip Breathing (PLB) exercise and mind control through Progressive Muscle Relaxation (PMR) exercise.

This research is a quasy experiment with a pre-post test design approach to 20 respondents in each intervention group. The intervention group I was given a combination of PLB and PMR exercises for 10 minutes, 2 times a day, for 7 days. While the intervention group II was given a combination of PLB exercises for 10 minutes, 2 times a day, for 7 days.

The results showed a significant difference in the degree of dyspnea after PLB and PMR exercises (p = 0.000; α = 0.05). The combination of PLB and PMR exercises is an effective intervention to reduce the degree of dyspnea in COPD patients.

The recommendation in this study is the need to develop complementary therapy programs in education and nursing services for modification of nursing care standards by incorporating complementary therapy in combination with PLB and PMR exercises in the nursing care of COPD patients."

"ABSTRAKNama : Arie Jefry Ka rsquo;arayenoProgram Studi : Magister Ilmu Keperawatan Universitas IndonesiaJudul : Pengaruh Latihan Pernapasan Buteyko Terhadap Saturasi Oksigen Perifer Dan Arus Puncak Ekspirasi Pada Pasien Asma Asma sebagai penyakit jalan napas obstruktif dengan penyempitan jalan napas, cenderung diikuti dengan peningkatan laju pernapasan. Konsep dasar teori Buteyko adalah mengajarkan cara bernapas yang benar pada pasien asma. Tujuan penelitian ini yaitu mengidentifikasi pengaruh latihan pernafasan Buteyko terhadap nilai saturasi oksigen perifer dan arus puncak ekspirasi pada pasien asma. Desain penelitian yang digunakan adalah kuasi eksperimen, pretest dan posttest dengan kelompok kontrol. Responden penelitian berjumlah 24 orang, terdiri dari 12 orang yang melakukan latihan pernapasan Buteyko pada kelompok intervensi dan 12 orang pada kelompok kontrol. Hasil penelitian menunjukkan terdapat pengaruh yang bermakna terhadap arus puncak ekspirasi pada kelompok intervensi p value = 0.001 . Namun tidak terdapat pengaruh yang bermakna terhadap saturasi oksigen perifer p value = 0,082 . Hasil penelitian ini menunjukkan bahwa latihan pernapasan Buteyko dapat diberikan sebagai terapi pelengkap, bagian dari perawatan pada pasien asma. Kata kunci: arus puncak ekspirasi, asma, buteyko breathing exercise, saturasi oksigen perifer

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ABSTRACTName Arie Jefry Ka 39 arayenoStudy Program Master of Nursing Science, University of IndonesiaTitle Effect of Buteyko Breathing Exercises Against Peripheral Oxygen Saturation And Peak expiratory flow in patients with Asthma Asthma is a disease with obstructive airway constriction of the airway, tend to be followed by an increase in respiratory rate. The basic concept of the Buteyko theory is taught how to breathe correctly in asthma patients. The purpose of this study is to identify the Buteyko breathing exercises influence on the value of peripheral oxygen saturation and peak expiratory flow in patients with asthma. The research design is quasi experimental, pretest and posttest with control group. Respondents totaling 24 people, consisting of 12 people doing Buteyko breathing exercises in the intervention group and 12 in the control group. The results showed a significant effect on peak expiratory flow in the intervention group p value 0.001 . However, there is no significant effect on peripheral oxygen saturation p value 0.082 . The results of this study indicate that the Buteyko breathing exercises can be administered as complementary therapies, part of the treatment in patients with asthma.Keywords asthma, buteyko breathing exercise, peak expiratory flow, peripheral oxygen saturation"

"ABSTRAKLatar Belakang. Atelektasis merupakan komplikasi pernapasan perioperatif yang sering terjadi hingga 24 jam pascaoperatif, namun dapat bertahan hingga beberapa hari. Penggunaan PEEP dapat membuka alveolus yang kolaps pascaoperatif. Penelitian ini berusaha membandingkan efek PEEP 5 cmH20 dan 10 cmH2O terhadap distribusi ventilasi pada pasien pascaoperatif menggunakan EIT.Metoda. Uji klinis acak ini dilakukan di RS Cipto Mangunkusumo terhadap 35 pasien operasi kranioktomi dan laparotomi elektif (usia 18-60 tahun, durasi bedah > 3 jam, paru normal). Subjek dirandomisasi ke dalam 2 kelompok intervensi: ventilasi mekanik pascaoperatif PEEP 5 cmH20 (PEEP-5) dan PEEP 10 cmH2O (PEEP-10). Hipotesis penelitian adalah distribusi ventilasi PEEP-10 lebih baik dibandingkan PEEP-5. Parameter ∆TIV, ∆EELI (global dan regional) dan CR diambil dari monitor EIT PulmoVista 500®.Hasil. Nilai ∆TIV antara bagian paru anterior dan posterior berbeda bermakna secara statistik pada menit ke-20 (p=0,012), namun masih ada subjek kelompok PEEP-5 dengan distribusi ventilasi tidak homogen hingga 1 jam pengukuran. Nilai ∆EELI global dan regional dalam 1 jam secara statistik bermakna dengan nilai p<0,05. Nilai ∆CR (anterior dan posterior) bermakna secara statistik (p=0,000) dalam 1 jam. Tidak ditemukan perbedaan ratio PF, lama intubasi dan lama rawat di UPI. Tidak ditemukan komplikasi paru/ekstraparu lain dan mortalitas.Simpulan. Distribusi ventilasi berdasarkan gambaran EIT antara penggunaan PEEP 10 cmH2O dan PEEP 5 cmH2O tidak berbeda secara statistik dalam 1 jam penggunaan ventilasi mekanik pascaoperatif. Distribusi ventilasi hanya bermakna secara statistik pada menit ke-20. pernapasan perioperatif

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ABSTRACTBackground. Atelectasis is the most common perioperative respiratory complications up to 24 hours postoperatively, but can last up to several days. PEEP can open postoperative alveolar collapse. We determined to compare the effect of PEEP 5 cmH20 and 10 cmH2O on distribution of ventilation in patients postoperatively using EIT.Method. This randomized clinical trial conducted in Cipto Mangunkusumo Hospital to 35 patients underwent elective craniotomy and laparotomy (18-60 years of age, surgery> 3 hours, normal lung). Subjects were randomized into two intervention groups: postoperative mechanical ventilation PEEP 5 cmH20 (PEEP-5) and 10 cmH2O PEEP (PEEP-10). The hypothesis is distribution of ventilation PEEP-10 is better than PEEP-5. Parameter ΔTIV, ΔEELI (global and regional) and ΔCR were taken from a monitor EIT PulmoVista 500®.Results. ΔTIV values ​​between anterior and posterior parts of lung statistically significant difference in the 20th minute (p=0.012), but there is still a subject of the PEEP group-5 which has a non-homogeneous distribution of ventilation up to 1 hour of measurement. The value of ΔEELI (global and regional ) in 1 hour statistically significant with p <0.05. ΔCR value (anterior and posterior) was statistically significant (p = 0.000) in 1 hour. No differences found for PF ratio, length of intubation and duration of hospitalization in ICU. No pulmonary/extrapulmonaary complications and mortality were found.Conclusion. Distribution of ventilation based EIT imaging between the use of PEEP 10 cmH2O and PEEP 5 cmH2O do not differ statistically within 1st hour of the postoperative mechanical ventilation. Distribution of ventilation is statistically significant only in the 20th minute.;Background. Atelectasis is the most common perioperative respiratory complications up to 24 hours postoperatively, but can last up to several days. PEEP can open postoperative alveolar collapse. We determined to compare the effect of PEEP 5 cmH20 and 10 cmH2O on distribution of ventilation in patients postoperatively using EIT.Method. This randomized clinical trial conducted in Cipto Mangunkusumo Hospital to 35 patients underwent elective craniotomy and laparotomy (18-60 years of age, surgery> 3 hours, normal lung). Subjects were randomized into two intervention groups: postoperative mechanical ventilation PEEP 5 cmH20 (PEEP-5) and 10 cmH2O PEEP (PEEP-10). The hypothesis is distribution of ventilation PEEP-10 is better than PEEP-5. Parameter ΔTIV, ΔEELI (global and regional) and ΔCR were taken from a monitor EIT PulmoVista 500®.Results. ΔTIV values ​​between anterior and posterior parts of lung statistically significant difference in the 20th minute (p=0.012), but there is still a subject of the PEEP group-5 which has a non-homogeneous distribution of ventilation up to 1 hour of measurement. The value of ΔEELI (global and regional ) in 1 hour statistically significant with p <0.05. ΔCR value (anterior and posterior) was statistically significant (p = 0.000) in 1 hour. No differences found for PF ratio, length of intubation and duration of hospitalization in ICU. No pulmonary/extrapulmonaary complications and mortality were found.Conclusion. Distribution of ventilation based EIT imaging between the use of PEEP 10 cmH2O and PEEP 5 cmH2O do not differ statistically within 1st hour of the postoperative mechanical ventilation. Distribution of ventilation is statistically significant only in the 20th minute.;Background. Atelectasis is the most common perioperative respiratory complications up to 24 hours postoperatively, but can last up to several days. PEEP can open postoperative alveolar collapse. We determined to compare the effect of PEEP 5 cmH20 and 10 cmH2O on distribution of ventilation in patients postoperatively using EIT.Method. This randomized clinical trial conducted in Cipto Mangunkusumo Hospital to 35 patients underwent elective craniotomy and laparotomy (18-60 years of age, surgery> 3 hours, normal lung). Subjects were randomized into two intervention groups: postoperative mechanical ventilation PEEP 5 cmH20 (PEEP-5) and 10 cmH2O PEEP (PEEP-10). The hypothesis is distribution of ventilation PEEP-10 is better than PEEP-5. Parameter ΔTIV, ΔEELI (global and regional) and ΔCR were taken from a monitor EIT PulmoVista 500®.Results. ΔTIV values ​​between anterior and posterior parts of lung statistically significant difference in the 20th minute (p=0.012), but there is still a subject of the PEEP group-5 which has a non-homogeneous distribution of ventilation up to 1 hour of measurement. The value of ΔEELI (global and regional ) in 1 hour statistically significant with p <0.05. ΔCR value (anterior and posterior) was statistically significant (p = 0.000) in 1 hour. No differences found for PF ratio, length of intubation and duration of hospitalization in ICU. No pulmonary/extrapulmonaary complications and mortality were found.Conclusion. Distribution of ventilation based EIT imaging between the use of PEEP 10 cmH2O and PEEP 5 cmH2O do not differ statistically within 1st hour of the postoperative mechanical ventilation. Distribution of ventilation is statistically significant only in the 20th minute."

"Latar Belakang: Perubahan sistemik pada PPOK menyebabkan terjadinya disfungsi otot yang berhubungan dengan penurunan fungsi keseimbangan. Gangguan keseimbangan menimbulkan konsekuensi terhadap kejadian jatuh. Penambahan latihan keseimbangan pada PPOK dapat meningkatkan fungsi keseimbangan, namun belum menjadi standar tatalaksana pada program rehabilitasi PPOK. Latihan ketahanan dengan menggunakan jentera dan sepeda statis menunjukkan adanya peningkatan nilai uji fungsi keseimbangan pasien PPOK, namun belum ada penelitian yang membandingkan antara kedua latihan tersebut dalam meningkatkan fungsi keseimbangan pasien PPOK. Tujuan: Menilai efek latihan jentera dan latihan sepeda statis selama delapan minggu terhadap perbaikan fungsi keseimbangan pasien PPOK.Metode. Uji klinis teracak terhadap pasien PPOK stabil grup A,B,C dan D pada usia 55-80 tahun. Subjek dibagi dalam dua kelompok, yaitu kelompok jentera dan kelompok sepeda statis. Kedua kelompok mendapat program rehabilitasi paru selama delapan minggu. Dilakukan evaluasi fungsi keseimbangan dengan menggunakan Berg Balance Scale BBS pada awal penelitian, 4 dan 8 minggu setelah mulai penelitian. Hasil: Terdapat 16 subjek PPOK yang menyelesaikan penelitian. Didapatkan peningkatan yang signifikan secara statistik pada nilai BBS baik pada latihan jentera maupun pada latihan sepeda statis setelah delapan minggu latihan dengan nilai akhir BBS 51,88 dan 50,25 secara berurutan. Tidak didapatkan perbedaan yang bermakna secara statistik antara selisih peningkatan nilai BBS latihan jentera dan latihan sepeda statis dengan nilai tengah 3,00 dan 3,50 secara berurutan. Kesimpulan: Nilai BBS menunjukkan perbaikan bermakna secara statistik baik pada latihan jentera maupun sepeda statis. Tidak terdapat perbedaan efek yang bermakna secara statistik antara latihan pada kedua kelompok tersebut.

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Background: Systemic changes in COPD result in muscle dysfunction that associated with decreased balance function. Impaired balance has consequences for falling events. The addition of balance exercises to COPD can improve balance function, but it has not yet become the standard treatment for COPD rehabilitation programs. Endurance exercises using treadmill and static cycle show an increase in balance function test of COPD patients, but no studies have compared the two exercises in order to improve the balance function of COPD patients.

Aim: To assess the effects of treadmill and static cycle exercise for eight weeks on improving balance function of COPD patients. Method. Randomized Clinical trials of stable COPD patients on A, B, C and D group at age 55 80 years. Subjects were divided into two groups, treadmill and static cycle group. Both groups received pulmonary rehabilitation program for eight weeks. Evaluation of balance function using Berg Balance Scale BBS at the beginning of the study, 4 and 8 weeks after the study.

Results: There were 16 subjects of COPD who completed the study. There was a statistically significant increase in the value of BBS in both treadmill and static cycle group after eight weeks of exercise with a final BBS score of 51.88 and 50.25 respectively. There was no statistically significant difference between the improvement value of BBS in treadmill and static cycle exercise with median values of 3.00 and 3.50 respectively.

Conclusion: The BBS score showed statistically significant improvements in treadmill and static cycles exercise. There was no statistically significant different effect of exercises in both groups. "