ABSTRAK
Tujuan : Penelitian ini bertujuan untuk mengkaji tendon and nerve glidingexercise (TNGE) yang dikombinasikan dengan penggunaan bidai pergelanganmetacarpophalangeal (MCP) netral dalam penatalaksaan konservatif padapenderita Sindrom terowongan karpal (STK).Metode : Disain penelitian ini dilakukan secara consecutive sampling pada 33orang dengan 42 tangan yang telah didiagnosa dengan sindrom terowongan karpalderajat I sampai dengan IV yang ditentukan dengan pemeriksaan EMG ( kriteriaBland ). Total subjek penelitian yang menyelesaikan penelitian sebanyak 20 orangdengan 29 tangan. seluruh subjek mendapat latihan TNGE yang dikombinasikandengan penggunaan bidai MCP netral. TNGE bertujuan untuk melatih tendon dansaraf, dimana pada latihan tendon terdapat lima gerakan dan pada latihan sarafterdapat 6 gerakan, masing – masing gerakan dilakukan secara berurutan.Penelitian berlangsung selama enam minggu dimana setiap minggu dilakukanpenilaian subjektif dan pada akhir minggu keenam ditambahkan penilaian objektifdengan EMG. Seluruh rangkaian gerakan pada masing – masing tujuan latihandiulang setiap sepuluh kali. Latihan dilakukan tiga kali sehari dan setiap gerakanditahan selama 5 detik. Keluhan pasien dinilai dengan penilaian Subjektif denganFunctional Status Scale (FSS) dan Symptom Severity Scale (SSS) dan penilaianObjektif dengan pemeriksaan EMG menilai KHS sensorik, Distal latensi motorikdan sensorik.Hasil : 29 tangan dianalisa dalam penelitian ini. Penilaian subjektif FSS dan SSSmembandingkan antara minggu pertama dengan minggu selanjutnya. FSS1 16,14± 4,61 FSS2 13,0 (9 – 18), p < 0,001, SSS1 26,0 (17 – 48) SSS2 23,14 ± 6,26,p < 0, 004, FSS1 16,14 ± 4,61 FSS3 12 ± 3,14, p < 0, 001, SSS1 26,0 (17 – 48)SSS3 19,0 (13 – 33), p < 0, 001, FSS1 16,14 ± 4,61 FSS4 10,0 (8 – 17), p < 0, 001,SSS1 26,0 (17 – 48) SSS4 17,0 (13 – 31), p < 0, 001, FSS1 16,14 ± 4,61 FSS510,0 (7 – 16), p < 0,001, SSS1 26,0 (17 – 48) SSS5 15,0 (11 – 26), p < 0, 001,FSS1 16,14 ± 4,61 FSS6 9,0 (7 – 16), p < 0,001, SSS1 26,0 (17 – 48) SSS6 14,0(11 – 26). p < 0,001. Hasil penilaian objektif KHS sensori pre – post intervensi50,0 (26,4 – 67,9) - 50,0(25,6 – 67,50), p = 0,717, Distal latensi motorik pre –post intervensi 4,8 ± 1,16 - 4,8 ± 1,16, p = 1,000, Distal latensi sensorik pre – postintervensi 2,8 (1,7-4,7) - 2,8 (2-5), p = 0,457.
ABSTRACT
Purpose : This research is aimed to assess the tendon and nerve gliding exercise(TNGE) which is combined with the use of wrist splints neutralmetacarpophalangeal (MCP) in the conservative procedures for patients withCarpal Tunnel Syndrome (CTS).Methods : This research was designed and conducted using consecutive samplingon 33 people in which 42 hands have been diagnosed with 1st to 4th degree CarpalTunnel Syndromes, determined using EMG scan (Bland criteria). The number ofresearch subjects totals up to 20 people and 29 number of hands. All of thesubjects received a TNGE exercise combined with the use of neutral MCP wristsplint. The TNGE exercise is done to train the tendon and the nerves, where in thetendon exercise there are five movements and in the nerves exercise there are 6movements, each movement being done consecutively.The entire set of movementin each exercise was repeated ten times. The exercise is done three times a dayand each movement is held steady in position for five seconds. The patient’scomplain was assessed by the Subjective Assessment using Functional StatusScale (FSS) and Symptom Severity Scale (SSS) and the Objective Assessmentusing EMG scan to evaluate the NCV sensory, distal motor latency and distalsensory latency levels.Results : 29 hands were analyzed in this research. The FSS dan SSS subjectiveassessment compared between the first week and the following weeks. FSS1 16,14± 4,61 FSS2 13,0 (9 – 18), p < 0,001, SSS1 26,0 (17 – 4 ) SSS2 23,14 ± 6,26,p < 0, 004, FSS1 16,14 ± 4,61 FSS3 12 ± 3,14, p < 0, 001, SSS1 26,0 (17 – 48)SSS3 19,0 (13 – 33 ), p < 0, 001, FSS1 16,14 ± 4,61 FSS4 10,0 (8 – 17), p < 0, 001,SSS1 26,0 (17 – 48) SSS4 17,0 (13 – 3 ), p < 0, 001, FSS1 16,14 ± 4,61 FSS5 10,0(7 – 16), p < 0,001, SSS1 26,0 (17 – 48) SSS5 15,0 (11 – 26), p < 0, 001, FSS116,14 ± 4,61 FSS6 9,0 (7 – 16), p < 0,001, SSS1 26,0 (17 – 48) SSS6 14,0(11 – 26), p < 0, 001. The NCV sensory pre – post intervention objectiveassessment reveals: 50,0 (26,4 – 67,9) - 50,0(25,6 – 67,50), p = 0,717, Distalmotor latency pre – post intervention at 4,8 ± 1,16 - 4,8 ± 1,16, p = 1,000, Distalsensory latency pre – post intervention at 2,8 (1,7-4,7) - 2,8 (2-5), p = 0,457. |
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