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"Latar Belakang : lnstabilitas postural I jatuh adalah ketidakmampuan untuk mempertahankan pusat kekuatan anti gravitasi pada dasar penyanggah tubuh (misalnya, kaki saat berdiri), atau memberi respon secara cepat pada setiap perpindahan posisi atan keadaan staffs. Prevalensi instabilitas postural di AS 30% dari penduduk usia lebih 60 tahun pernah jatuh, di RSCM tahun 2003 sebesar 23,3%. Faktor risiko yang melatar belakangi terjadinya jatuh adalah faktor ekstrinsik an faktor intrinsik. Faktor intrinsik terbagi dua sistemik (pneumonia, hipatensi ortostatik, hiponatremi, gagal jantung, infeksi saluran kemih) dan lokal (OA servikal, OA gem, Benign paroxiysmalpositional vertigo (BPPV), gangguan penglihatan, gangguan pendengaran, kelemahan otot tungkai bawah). Jatuh memiliki penyulit yang cukup serius, mulai dari cedera ringan sampai fraktur femur. Dengan mengetahui faktor risiko jatuh sedini mungkin, maka kita dapat mencegah terjadinya jatuh dan penyulitnya.Tujuan : mengetahui sebaran faktor intrinsik lokal serta hubungannya dengan instabilitas postural I jatuh.Metodologi : Studi potong lintang dengan basal-sampel 97 orang usia Lanjut yang memenuhi kriteria inklusi. Waktu : Januari-Juni 2005 di Divisi Geriatri RSCM. Tingkat instabilitas diukur dengan posturografri.Hasil : Dari penelitian ini didapat hasil prevalensi instabilitas postural sebesar 64.9%. Prevalensi perempuan 52,3% dan laki-laki 47,7%. Menurut kelompok umur prevalensi tertinggi pada umur > 80 taken sebesar 75,0%. Pada analisa bivariat osteoariritis servikal merupakan faktor intrinsik lokal yang mempunyai hubungan bermakna terhadap kejadian instabilitas postural dengan OR 3,28 (1K 95% 1,25-8,63) p= 0,02 dan pada analisa multivariat dengan inetode backward regresi logistitik didapatkan nilai OR 3,22 (1K 95% 1,18-89,74) p = 0,02. Gangguan pendengaran merupalcan faktor intrinsik lokal yang mernpunyai hubungan bermalma terhadap instabilitas postural pada analisa bivariat dengan nilai OR : 3,95 (1,29-12,11) p= 0,02 dan pads analisa multivariat dengan ailai OR 3,22 (1,18-89,74) pr= 0,02. Osteoartritis genii, BPPV, gangguan penglffiatan dan kelemaban otot tungkai bawah hell m dapat dibuktilcan mempunyai hubungan bermakna dengan instabilitas postural pada penelitian ini.Simpulan : Prevalensi instabilitas postural pada penelitian ini sebesar 64,9%. Ganggaan pendengaran dan OA servikal menrpakan faktor instrinsik lokal yang mempunyai hubungan yang bermakna terhadap instabilitas postural. OA genii, BPPV, gangguan penglihatan dan kelemahan otot tungkai bawah belum dapat dibuktikan mempunyai hubungan bermakna dengan instabilitas postural pada penelitian ini.

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Backgrounds : Instability/falls is inability to maintain central anti gravity strength of supporting structures of the body (e.g. feet while standing) or to give adequate response to positional changes or static condition Prevalence of postural instability in US reached > 30% in population aged > 60 years old A Study conducted in RSCM by Handayani (2003) found the prevalence as high as 23.3%. -Risk factors that responsible for falls are intrinsic and extrinsic factors. Intrinsic factors consist of systemic (pneumonia, orthostatic hypotension, hyponatresmia, heart failure, urinary tract infection) and local factors (cervical OA, knee OA, BPPV, visual impairment, hearing impairment, lower lambs weakness). Falls may have mild complication like mild trauma to serious complications such as femoral fracture. By identifying risk factors of instability/falls earlier, we may prevent falls and its complications.

Objective = to determine intrinsic local factors and its relationship with instability/falls.

Methods : Cross sectional study on 97 elderly patients who fullfled inclusion criteria was conducted in RSCM from January to June 2005 in outpatient clinic, Geriatric Division FKUI 1 RSCM.

Results : From this study we found the prevalence of instability was 64.9%. The prevalence in female (52.3%) was higher than male (47.7%) patience According to age group, the highest prevalence was found in age group of > 80 years (75%). After bivariat analysis, we found cervical OA was intrinsic local factor which bad significant relation with incidence of postural instability with OR 3.28 (CI 95% 1.25-8.63); Bivariat and multivariate analysis of logistic regression using backward method we found OR 3.22 (Cl 95% 1.18-89.74); p= 0.02. Hearing impairment was local intrinsic factor that had significant relation with postural instability after bivariat analysis with OR 3.95 (Cl 95% 1.29-12_ l 1); p= 0.02 and multivariate analysis with OR. 3.22 (Cl 95% 1.18$9.74); p= 0.02. BPPV, knee OA, visual impairment and lower limb weakness had not been proven yet to have significant relation with postural instability in this study.

Conclusion : Prevalence of instability in thus study is 64.9%. Hearing impairment and cervical OA were intrinsic local factors that showed statistically significant relation with postural instability. Knee OA, BPPV, visual impairment, and lower limb weakness had not been proven to have significant relation with instability in this study."

"Tesis desain ini mengajukan pendekatan desain berbasis portability dan untuk pengguna yang movement-challenged. Untuk mempelajari bagaimana fenomena shrinking space berdasarkan portability dan extensibility terjadi, dilakukan observasi mikro dari video yang menunjukkan manuver sehari-hari dari pengguna kursi roda. Gerakan kemudian di trace untuk memperlihatkan interaksi antara pengguna dan elemen spasial sekitar seperti pintu, tiang, furniture, dan lainnya. Peran yang ditemukan adalah elemen spasial sebagai elemen yang mendukung tubuh, seperti support gerakan horizontal dan vertikal, support kekuatan tubuh, dan memperlancar flow manuver. Sebagai elemen elemen spasial yang berbasis extensibility, muncul gagasan desain compact sebagai basis pendekatan perancangan arsitektur untuk pengguna yang movement-challenged untuk merespon fenomena shrinking space.

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This design thesis proposes a design approach based onportability and extensibility for movement-challenged users. To explore how the shrinking space phenomena transpire due to lack of portability and extensibility, a micro observation of movement and interaction of the body with spatial elements based on video and direct experience is done. Movement is then traced to highlight interactions between the body and spatial elements. Spatial elements is found to have roles as extensibility tool or body support, such as horizontal and vertical movement support, body strength support, maneuvering support, etc. Thus, spatial element being an element of extensibility, suggest the notion of compact space as a design proposition for movement-challenged user and to respond to the shrinking space phenomena."

"Il volume intende illustrare come in questo panorama complesso si inseriscano anche gli aspetti legati al movimento e all’azione. Considerando alcune delle più diffuse patologie neurologiche che comportano disturbi e alterazioni del movimento, si analizzano gli aspetti riabilitativi del canale motorio, essenziali per la cura, la prevenzione e la partecipazione di ciascuno di noi a tutti gli aspetti della vita quotidiana, secondo il concetto di salute definito dall’OMS."

"Hyperkinetic movement disorders is a state-of-the-art resource devoted to disorders characterized by excessive movement. Organized according to specific disorders or syndromes, each chapter is written by a group of internationally recognized experts. Chapters have been organized by the individual authors to best highlight the salient features of the disorders. Each chapter features a video accompaniment that provides highly instructive examples of each disorder, offering clinicians an important video-based tool to aid in making correct diagnoses. The video is on an accompanying DVD and can also be found at www.springerimages.com/Suchowersky. Without a visual evaluation of the phenomenology, diagnosis of the hyperkinetic disorder is fraught with error. Hyperkinetic movement disorders is a unique and essential new text written for neurologists, psychiatrists, neurosurgeons, internists, residents and all others interested in movement disorders. An invaluable resource, it will lead to a better understanding and recognition of the hyperkinetic movement disorders, and that, in turn, will lead to better care for patients."

"Contents: The adaptive system : plasticity and recovery -- Training motor control, increasing strength and fitness, and promoting skill -- Acquisition -- Measurement -- Standing up and sitting down -- Walking -- Reaching and manipulation -- Balance -- Upper motor neuron lesions -- Cerebellar ataxia / written with Phu Hoang -- Somatosensory and perceptual-cognitive impairments -- Stroke / written with Julie Bernhardt -- Traumatic brain injury / written with Anne Moseley and Leanne Hassett -- Parkinson?s disease / written with Colleen Canning -- Multiple sclerosis / written with Phu Hoang."