Medical Rehabilitation Clinic Research Articles

The Prevalence and Characteristics Of Instability Using TUG And FRT in Elderly at RSUD Dr. Soetomo, Surabaya Period October 2023 – April 2024

Instability is one of the geriatric syndromes that can cause falls in the elderly. Instability in the elderly is something to be aware of because it can cause injuries that result in decreased activity, decreased quality of life, and even death. This study aimed to describe the prevalence and characteristics of the elderly with instability in the Medical Rehabilitation Clinic at Dr. Soetomo General Hospital in the period October 2023 - April 2024. This was a cross-sectional descriptives study with total of 33 patients were given instruments such as Functional Reach Test for static instability, Timed Up and Go Test for dynamic instability, and interviews to examine variables of age, gender, and nutritional status. The result of this study showed 60.6% patients experienced static instability and 57.9% patients experienced dynamic instability. Both instabilities were mostly found in young elderly age, female gender, and normal nutritional status. This study found that more than 50% patients experienced static and dynamic instability with a higher prevalence of static instability.

Machine Learning Model for Predicting Walking Ability in Lower Limb Amputees.

Background/Objectives: The number of individuals with lower limb loss (LLL) is rising. Therefore, identifying the walking potential in individuals with LLL and prescribing adequate prosthetic systems are crucial. Various factors can influence participants' walking ability, to different extents. The aim of the present study was to apply machine learning methods to develop a predictive mode. This model can assist rehabilitation and limb loss care teams in making informed decisions regarding prosthesis prescription and predicting walking ability in individuals with LLL. Methods: The present study was designed as a prospective cross-sectional study encompassing 104 consecutively recruited participants with LLL (average age 62.1 ± 10.9 years, 80 (76.9%) men) at the Medical Rehabilitation Clinic. Demographic, physical, psychological, and social status data of patients were collected at the beginning of the rehabilitation program. At the end of the treatment, K-level estimation of functional ability, a Timed Up and Go Test (TUG), and a Two-Minute Walking Test (TMWT) were performed. Support vector machines (SVM) were used to develop the prediction model. Results: Three decision trees were created, one for each output, as follows: K-level, TUG, and TMWT. For all three outputs, there were eight significant predictors (balance, body mass index, age, Beck depression inventory, amputation level, muscle strength of the residual extremity hip extensors, intact extremity (IE) plantar flexors, and IE hip extensors). For the K-level, the ninth predictor was The Multidimensional Scale of Perceived Social Support (MSPSS). Conclusions: Using the SVM model, we can predict the K-level, TUG, and TMWT with high accuracy. These clinical assessments could be incorporated into routine clinical practice to guide clinicians and inform patients of their potential level of ambulation.

Chronic pain after traumatic brain injury: a collaborative care approach.

Chronic pain is common after traumatic brain injury (TBI), frequently limits daily activities, and is associated with negative outcomes such as decreased community participation. Despite the negative impact of chronic pain, few people with TBI receive effective treatment. This paper describes a collaborative care (CC) intervention, TBI Care, adapted specifically to treat chronic pain in people living with TBI, emphasizing expert clinician input, cognitive behavioral therapy (CBT) techniques, and other non-pharmacological approaches for decreasing pain interference. 79 participants engaged in the CC intervention from two academic medical rehabilitation clinics with weekly assessments of pain intensity, interference, and medication use. Participant feedback on the intervention was gathered by interview with the care manager (CM) at the last treatment session and/or booster session. Provider feedback was gathered by a confidential survey post intervention. Ninety percent of participants received at least 11 of the target 12 sessions with a care manager (CM), the majority occurring over the phone. Participants endorsed an average of 7 pain locations. All participants received pain education, skills in self-monitoring, goal setting/behavioral activation and relaxation training. Pain interference scores (impact on activity and enjoyment), tracked weekly by the CM, significantly decreased across sessions. 89% of participants received recommendations for CBT skills, 65% received referrals for additional treatments targeting pain interference, and 43% received care coordination. 75% of participants reported 6 or more medications/supplements at both the first and last session, with changes recommended primarily for headache treatment. Feedback from participants and providers was positive. TBI Care, a novel patient-centered CC approach, was flexibly delivered, tailored to the needs of those living with TBI and chronic pain, with a high level of participant engagement, and satisfaction among participants and providers. This approach, prioritizing pain self-management strategies and other non-pharmacological approaches, along with optimizing pharmacological treatment, led to significant reductions in self-reported pain interference and intensity during the intervention. Using a CC model in TBI is feasible and successfully improved access to evidence-based treatments for chronic pain as well as outcomes for pain interference and intensity. ClinicalTrials.gov, identifier NCT03523923.

EFFECT OF ULTRASOUND THERAPY AND MUSCLE ENERGY TECHNIQUE ON CHANGING THE ROM IN THE CASE GENU OSTEOARTHRITIS AT IMMANUEL HOSPITAL BANDUNG

Osteoarthritis is a chronic condition that develops slowly, characterized by weakening and wear of the cartilage itself and the formation of new bone on the joint surfaces. In cases of knee osteoarthritis, the clinical diagnosis is generally made in individuals aged 45 years and over or in older people who experience pain in the knee area related to activity and stiffness in the knee joint. The aim of this study was to evaluate the impact of providing Ultrasound Therapy and Muscle Energy Technique on changes in Range of Motion (ROM) in cases of Osteoarthritis Genu at the medical rehabilitation clinic at Immanuel Hospital Bandung.This research uses a quasi-experimental design with the design used is One-Group Pretest-Posttest. This study used 20 Osteorthritis Genu patients, using the Shapiro Wilk Test normality test method and using Paired Sample T-test analysis. Based on the research results, it can be concluded: 1. The average ROM value before being given Ultrasound Therapy and Muscle Energy Technique was 120, with a minimum value of 110 and a maximum value of 128 and a standard deviation value of 4.42. 2. The average ROM value after being given Ultrasound Therapy and Muscle Energy Technique was 123.05, with a minimum value of 113 and a maximum value of 132 and a standard deviation value of 4.39. 3. There is an effect of giving Ultrasound Therapy and Muscle Energy Technique on changes in ROM values, it can be shown that the significance value of the Paired sample t-test is 0.000.

The Impact of Complex Rehabilitation Treatment on Sarcopenia-Pathology with an Endocrine Morphological Substrate and Musculoskeletal Implications.

The pathogenesis of sarcopenia is multifactorial, including changes in the endocrine system. Easy-to-perform screening tests can guide the diagnosis of sarcopenia and the rehabilitation therapeutic conduct, which can act on many physiopathological links. This study was conducted over a period of 5 months, from April to August 2022, and included 84 patients hospitalized for a period of 10 days in the Balneal and Rehabilitation Sanatorium Techirghiol for complex physiotherapy, which included balneotherapy. In dynamics, both at admission and discharge, specific screening tests for sarcopenia (SARC-F questionnaire, grip strength, testing muscle strength at the level of the quadriceps, sit-to-stand tests (the time required for five consecutive rises and the number of rises performed in 30 s)) and the Visual Analogue Scale (VAS) for pain were performed. The study was conducted according to the norms of deontology and medical ethics. Results: A significant proportion of patients had a positive result in at least one of the tests for the screening of sarcopenia syndrome. The most eloquent results were obtained from the statistical analysis of the following parameters evaluated at admission: the SARC-F questionnaire and the sit-to-stand test-the number of rises in 30 s. In terms of dynamics, after performing the complex rehabilitation treatment, the patients recorded improvements in the established screening tests and improvements in pain symptoms evaluated with the help of the VAS. Conclusions: Sarcopenia, a pathology developed with aging, is frequently encountered among adults. In the future, it is important to perform screening for sarcopenia in both endocrinology and medical rehabilitation clinics. Good management of sarcopenia can influence therapeutic conduct and can prevent complications, improving the functional capacity and the quality of life of the patients.

Development of Diathermy with Mc. Kenzi Exercise Therapy for Cases of Low Beck Pain (LBP) at RSI Nashrul Ummah Lamongan

Back pain caused by musculoskeletal disorders can usually be exacerbated by activity, this is different from pain in other conditions. Elderly patients may experience back pain caused by vertebral fractures due to osteoporosis, spinal stenosis, spinal osteoarthritis, among other conditions (Smeltzer, 2011). The results of interviews and observations are then discussed in a discussion to determine the factors causing the problem with a fishbone diagram. Discussions for determining the priority of problem solving are carried out using USG analysis (urgency, seriousness, growth). The USG method (urgency, seriousness, growth) is one of the methods to determine the priority of problems and their solutions (Wardani & Minarno, 2021). The next discussion is to determine a strategy for solving problems using a SWOT (strength, weakness, opportunity, threats) analysis. The results of the fishbone analysis on human factors include the limitations of human resources (HR) making the handling of diathermy development with Mc. Kenzi exercise therapy exercise at RSI NU Lamongan is disturbed and the limited land for the medical rehabilitation and physiotherapy clinic of RSI NU Lamongan makes there is no gymnasium in the physiotherapy poly.

Rehabilitation of Post-COVID-19 Musculoskeletal Sequelae in Geriatric Patients: A Case Series Study.

The musculoskeletal system is affected in over 40% of patients with Coronavirus disease 2019 (COVID-19). There is an increased need for post-acute rehabilitation after COVID-19, especially in elderly people with underlying health problems. The aim of this study was to evaluate the benefits of an early and goal-orientated rehabilitation program using combined approaches, robotic medical devices together with other rehabilitation techniques and therapies, in elderly people after acute COVID-19. Ninety-one patients (62.64 ± 14.21 years) previously diagnosed with severe SARS-CoV-2 infection were admitted to the Medical Rehabilitation Clinical Hospital Baile Felix, Romania, for medical rehabilitation, but only six patients (85.33 ± 3.07 years) met the inclusion criteria and participated in the study. The rehabilitation treatment was complex, performed over 4 weeks, and included combined approaches: exercise therapy, robotic gait training, occupational therapy, and massages. Activity and participation evaluation were performed using the Barthel Index and Functional Independence Measure for activities of daily living (ADLs). Assessments were performed at admission and discharge from the rehabilitation clinic. Lokomat patients' reports revealed that the patients had improved motor control (with one exception). The measurement of functional ability revealed an improvement in most cases. This study presents some of the first data on outcomes of COVID-19 patients' musculoskeletal rehabilitation in our country. Early complex medical rehabilitation improved functional independence and autonomy in ADLs in very old patients, post-COVID-19.

Correlation Between Physical Activity, Body Composition, And Micronutrition Intake In Patients Of Knee Osteoarthritis At The Medical Rehabilitation Clinic, Fatmawati Hospital Jakarta In 2021

Background : Osteoarthritis (OA) is a degenerative joint disease associated with joint cartilage damage that usually occurs in the aging process. This study is to analyze the correlation between physical activity, body composition, and the micronutrients intake such as vitamin C, D, E, and Calsium the patients with knee OA at the Medical Rehabilitation Clinic (MRC) at Fatmawati Hospital, Jakarta in 2021.Methods: This is a cross sectional quantitative research. The samples were 45 patients who have been diagnosed with knee osteoarthritis in outpatient medical rehabilitation clinic at Fatmawati General Hospital Jakarta who met the inclusion criteria.Results : the results of statistical tests showed that there was a significant difference in the average percentage of body fat with the gradation of OA patients, p value = 0.004. However, there was no significant difference between the average physical activity score, and intake of macronutrients (energy, protein, fat and carbohydrates), BCAAs (arginine and histidine), and intake of micronutrients (vitamin C, vitamin D, vitamin D, vitamin E and Calcium)Conclusion: Percent body fat is the variable with the highest correlation among other factors.

Correlation of Knee Osteoarthritis Patients' Characteristics and the Results of 30-Second Sit-to-Stand Test with Quality of Life

Pain, joint stiffness, and difficulty performing activities like rising from sitting to standing are signs and symptoms of knee osteoarthritis (OA). These conditions are risk factors for limited mobility and lower quality of life. Knee OA is closely associated with age, women, obesity, and other characteristics. The study's objectives were to determine the correlation of knee OA patients' characteristics with functional mobility using the 30-second sit-to-stand test (30STS) and the correlation of functional mobility with quality of life using the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) Index. The research method was descriptive-analytic cross-sectional using medical records of 73 knee OA patients at the Medical Rehabilitation Clinic at Soreang Hospital, Muhammadiyah Hospital, Al Islam Hospital, Al-Ihsan Regional General Hospital West Java Province, Bandung, from March until August 2021. Patients' characteristics such as age (p=0.02), onset (p=0.01), OA grade (p=0,03), and knee deformity (p=0.04 ) have a negative correlation with functional mobility based on 30STS as well as functional mobility had a negative correlation with various aspects of quality of life, such as pain (p=0.03), stiffness (p=0.02), and functional limitation (p=0.00) subscales based on WOMAC index. Age, the onset of disease, OA grade, and knee deformity significantly correlate to functional immobility. Based on the WOMAC index, functional immobility correlates with the patient's quality of life.

Correlation and comparison of quadriceps endurance and knee joint position sense in individuals with and without unilateral knee osteoarthritis

BackgroundKnee osteoarthritis (KOA) is a painful degenerative joint disease that may limit activities of daily living. This study aimed to determine the relationship between quadriceps endurance and knee joint position sense (JPS) in KOA individuals and compare the quadriceps endurance and knee JPS with and without KOA.MethodsThis comparative cross-sectional study was conducted in medical rehabilitation clinics, King Khalid University, Saudi Arabia. This study recruited 50 individuals diagnosed with unilateral KOA (mean age = 67.10 ± 4.36 years) and 50 asymptomatic individuals (mean age = 66.50 ± 3.63 years). Quadriceps isometric endurance capacity (sec) was measured using a fatigue resistance test, and knee JPS (degrees) were assessed using a digital inclinometer and evaluated in sitting and standing positions.ResultsQuadriceps isometric endurance showed a significant moderate negative correlation with knee JPS in 20° of flexion (r = -0.48, p < 0.001); 40° of flexion: r = -0.62, p < 0.001; 60° of flexion: r = -0.58, p < 0.001) in sitting and 20° of flexion (r = -0.25, p = 0.084) in standing position in KOA individuals. When compared to the asymptomatic, the quadriceps endurance was lower (p < 0.001), and knee joint position errors were larger (p < 0.001) in KOA individuals.ConclusionResults of this study showed that quadriceps endurance capacity is negatively associated with knee JPS. KOA individuals demonstrated lower quadriceps endurance and larger JPS compared to asymptomatic.

Characteristics of The Patients with Low Back Pain in The Medical Rehabilitation Clinic, dr. Ramelan Naval Hospital Surabaya

Background : The total number of visit of patients with low back pain in the Medical Rehabilitation Subdepartment of Dr. Ramelan Naval Hospital Surabaya from January to November 2018 is approximately 38.7% of all visits. Low back pain is defined as pain between the edge of the ribs and the gluteus fold which can be.Material and Methods : This was a cross sectional study, based on the analysis of the medical records from the LBP patients in July to September 2018, in the Dr. Ramelan Hospital RSAL Medical Rehabilitation Clinic. The inclusion criteria of LBP is: patient with main symptom of pain or other unpleasant feelings in the lower spine and surrounding areas, between the edge of the ribs and the gluteus fold. Results : There were 151 data analyzed from July to September 2018, patients with pain complaints were (86.84%). The data obtained showed majority of patients was 51-60 years old. Most of the patients were women.Conclusion : Most of the patients diagnosed with Low Back Pain (LBP) at the Medical Rehabilitation Clinic of RSAL Dr. Ramelan Surabaya, was 51-60 years old, women were the majority, 80%s had complain of pain and there were any of comorbidities.

Correlation Between Joint Position Sense, Threshold To Detection of Passive Motion of The Knee Joint And Walking Speed of Post-Stroke Patient

Background: Sensori motor dysfunction such as muscle weakness, impaired sensation, changes in muscle tone, reduced movement control are common in stroke patients. Locomotion function requires continuous afferent sensory input. Impairment of sensory function can hinder the ability to recruit muscles during walking. Patients generally walk slowly, cadence, step and stride length are shorter and the double phase of support increases. Goal: Analyzing the correlation between the propioceptive function of the knee joint and walking speed in post-stroke patients, who are treated at the Outpatient Medical Rehabilitation Clinic of RSU Dr.Soetomo Surabaya. Methode: An observational analytic cross sectional study, nine subjects measured walking speed (10MWT), joint position sense (JPS) and threshold to detetction of passive motion (TTDPM) of the knee joint, in the period March - November 2020.. Results: There is a moderate correlation between 10MWT and JPS 150 on the non-paretic side (r 0.676; p=0.045) and JPS 300 on the paretic side (r 0.668; p=0.049). And there is a strong correlation between 10MWT and JPS 600 on the paretic side (r 0.824; p=0.006). However, there is no significant correlation between 10MWT and TTDPM. Conclusion: There is correlation between the propioceptive function of the knee joint and the walking speed of post-stroke patients. The smaller the percentage of joint position error, the stronger the correlation with walking speed.

Effects of Elastic Taping Application Added on Conventional Rehabilitation Therapy to Improve Shoulder Pain and Upper Extremity Motor Function on Subacute Phase Stroke Patients with Shoulder Subluxation

ABSTRACTIntroduction: To determine the effect of adding elastic taping to conventional rehabilitation therapy on the improvement of shoulder pain and motor function of the upper limbs in patients with subacute strokewith shoulder subluxation.Methods: Research subjects who met the inclusion criteria were recruited from medical rehabilitation clinic in RSUD Dr, Soetomo. The total research subjects were 20 people (10 in treatment group and 10 incontrol group). The parameters were Visual Analoque Scale (VAS) for assessing shoulder pain and Fugl Meyer Assessment (FMA) for assessing motor function in the upper limbs.Results: There were significant differences before and after therapy for 3 weeks for VAS (p value = 0.00) in the treatment and control groups, there were significant differences in FMA in the treatment group (p value = 0.04), there were no significant difference in FMA in the control group (p value = 0.06). There was no significant difference in changes of VAS (p value = 0.23) and FMA (p value = 0.32) between the treatment and control groups before and after therapy for 3 weeks.Conclusion: The treatment group and the control group gave the same results on improvement of shoulder pain and motor function of the upper limbs before and after therapy for 3 weeks. There was an improvement in motor function of the upper limbs in the treatment group and there was no improvement in motor function of the upper limbs in the control group befor e and after therapy for 3 weeks.Keywords: conventional rehabilitation therapy, elastic taping, Fugl Meyer Assessment (FMA), Glenohumeral subluxation (GHS), Hemiplegic shoulder pain (HSP), Visual Analoque Scale (VAS).

Kejadian Pasien drop out dari Rencana Pelayanan Rehabilitasi Medik Rumkital di RSAL Dr. Ramelan

&lt;div class="WordSection1"&gt;&lt;p&gt;&lt;strong&gt;Background &lt;/strong&gt;: The high number of patient visits to medical rehabilitation clinic, from January to June 2018 is 13.772 patients, the number of patients from July to December 2018 is 11.142 patients, and the number of patients from januari to july 2019 is 13.781 patients.Therefore it is important to know the continuity of service, as planned by medical rehabilitation specialist.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methode &lt;/strong&gt;: Descriptive research with population was obtained in medical record for duration 1 December 2019 to 29 February 2020 in the medical rehabilitation clinic of Dr Ramelan Surabaya&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Result&lt;/strong&gt; : Patient visits that dropped out in 3 months were 795 patients (less than 10 visit in 3 months ). Patient visits that did not drop out in 3 months were 194 patients more than or equal to 10 visits in 3 months&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion &lt;/strong&gt;: The incidence of patient drop out for planned rehabilitation services is 80,3842%. So the incidence of patient drop-out for planned rehabilitation services is not meeting the standards.&lt;/p&gt;&lt;p&gt; &lt;/p&gt;&lt;p&gt;&lt;strong&gt;Key words &lt;/strong&gt;: Drop Out, Patient Visit, medical rehabilitation clinic&lt;/p&gt;&lt;/div&gt;

Benefits of robotic devices in medical rehabilitation of a case with neurofibromatosis type1

The term neurofibromatosis (NF) describes a group of genetic disorders that primarily affect the cell growth of neural tissues. Three clinically and genetically distinct forms of neurofibromatosis have been described: neurofibromatosis type 1 (NF1), neurofibromatosis type 2 (NF2) and schwannomatosis. The inheritance pattern is autosomal dominant for all three types. We present the case of a 57 years old man, admitted to the Medical Rehabilitation Clinical Hospital Baile Felix, Romania, who was diagnosed with spastic tetraparesis, neurofibromatosis type 1, chronic viral hepatitis B and D, hypercholesterolemia, sarcopenia and osteoporosis. The objectives of the rehabilitation treatment were combating pain; preventing and correcting vicious postures at rest and during activity; maintaining or increasing joint mobility; increasing the mobility of the cervical and lumbar spine; decreasing spasticity; increasing strength of paralyzed muscles; improving motor control of paralyzed limbs; transfers re-education, gait re-education; improving breathing; improving ADLs; maintaining autonomy; gaining daily independence; prevention of recurrent complications and increasing the quality of life. The rehabilitation treatment was complex, performed over a period of 2 weeks and included various physiotherapy approaches, hydrokinetotherapy, massage, occupational therapy, robotic devices and virtual reality. It improved the patient's functional independence and quality of life. Innovations in information technology will refine and increase the efficiency, expertise and competence of medical rehabilitation, in order to ensure comfort for the patient and an appropriate and safe therapeutic approach. Keywords: neurofibromatosis, robotic devices, medical rehabilitation,

Long-term outcomes of survivors of mechanical ventilation in intensive care unit (ICU) and their views on ICU rehabilitation clinics

To describe the long-term outcomes of intensive care unit (ICU) survivors of mechanical ventilation, and investigate the views of survivors on ICU rehabilitation clinics. A single-center cross-sectional descriptive study was designed. ICU survivors of mechanical ventilation admitted to the First Affiliated Hospital of Guangzhou Medical University from January to December 2016 were enrolled. Data were collected from August 2017 to March 2018. The general information questionnaire, Medical Outcomes Study 36-Item Short Form Health Survey (SF-36) and ICU rehabilitation clinics questionnaire were used to evaluate ICU survivors social-demographic factors, social and economic outcomes, clinical data, quality of life and the views on ICU rehabilitation clinics. A total of 248 ICU survivors of mechanical ventilation were included in the study, 130 (52.4%) of them were followed up successfully. The mean time from ICU discharge to follow-up day was (19.64±3.20) months. The average age of the survivors was (60.09±15.42) years old, and 55.4% of them were over 60 years old. Among 130 ICU survivors, severe pneumonia was the dominant ICU admission diagnosis (23.1%), followed by surgical operations (cardiac surgery 16.9%, other surgical operations 20.8%), lung transplantation (13.1%), and acute exacerbation of chronic obstructive pulmonary disease (AECOPD, 12.3%), etc. The first APACHE II score after ICU admission was 16.88±7.37, the mechanical ventilation time was (12.52±12.34) days, and the length of ICU stay was (16.71±15.11) days. In terms of social and economic outcomes, the proportion of having full-time or part-time jobs decreased from 32.3% (42/130) before ICU admission to 25.4% (33/130) by the date of follow-up, while the unemployed rate increased from 6.9% (9/130) to 18.5% (24/130). Only 45.1% (23/51) of the ICU survivors returned to the post before ICU admission. 36.2% (47/130) of the ICU survivors reported that they needed care from others, and 86.9% (113/130) reported that their treatment experiences in ICU had an impact on their lives. In terms of quality of life, physiological function dimension, which was 34.62±33.15, scored the lowest and suffered the most. The physical pain dimension and mental health dimension suffered the least, and the scores were 90.19±16.98 and 75.28±15.15, respectively. Furthermore, physical component summary (PCS) score was 61.12±17.09, and mental component summary (MCS) score was 65.97±21.85. In terms of the views of ICU rehabilitation clinics, 68.5% (89/130) of the subjects believed that the establishment of ICU rehabilitation clinics was very helpful or helpful. The long-term outcomes of ICU survivors of mechanical ventilation are not optimistic. Their quality of life is lower than that of general people. It is necessary to set up ICU rehabilitation clinics.

Association between Fear of Falling, Balance and Functional Mobility in the Elderly

Background: Falling is the main problem that causes fear of falling in the elderly. Impaired balance is an important factor that causes falling. Falls Efficacy Scale-International (FES-I) is a tool to measure fear of falling, while balance condition can be measured using Biodex Balance System-SD (BBS-SD). Moreover, Timed up and Go Test (TUG) is a tool to measure functional mobility. The research aimed to determine correlation between fear of falling, balance and functional mobility in the elderly. Methods: The research was conducted in 39 elderly subjects at Outpatient Medical Rehabilitation Clinic of Dr. Soetomo General Hospital, Surabaya, Indonesia, who were measured using FES-I, BBS-SD and TUG. Results: The FES-I and BBS-SD probability values showed no correlation between fear of falling and balance, with p=0.064 (p&gt;0.05). Moreover, the FES-I and TUG probability values also showed no correlation between fear of falling and functional mobility, with p=0.251 (p&gt;0.05). Conclusion: There was no correlation between fear of falling, balance and functional mobility in the elderly at Outpatient Medical Rehabilitation Clinic of Dr. Seotomo General Hospital, Surabaya, Indonesia.

HUBUNGAN DUKUNGAN SOSIAL DENGAN DEPRESI PADA PASIEN PASCA STROKE (Studi Analitik Observasional di Rumah Sakit Islam Sultan Agung Semarang)

Stroke is one of diseases which can be the number one cause of disability in the worldx and cause of death number two in the world. The incidence of stroke increases with increasing age. The purpose of this study was to determine the relationship of social support with depression in stroke patients. This type of research uses analytic observation with cross sectional design. The sample used was non-hemorrhagic post-stroke patients and post-stroke hemorrhagic outpatients in the medical rehabilitation clinic of Sultan Agung Islamic Hospital Semarang by taking into account the inclusion and exclusion criteria. Data collection by visiting the patient's house and conducting interviews using social support questionnaires and BDI. Data analysis using Pearson test. The results obtained were 84 non-hemorrhagic stroke patients and 30 hemorrhagic stroke patients. Most age is experienced at the age of 61-70 years as much as 45.2% in non-hemorrhagic strokes and 43% in hemorrhagic strokes. The most sex is female 53.6% in non-hemorrhagic stroke and 60% in men in hemorrhagic stroke. In non-hemorrhagic stroke patients, it was found that 92.9% received high social support while in hemorrhagic stroke patients, high social support was 73,3%. The degree of depression obtained a minimum of 85.7% depression according to the BDI scale for non-hemorrhagic stroke patients and the severe BDI scale of 43.3% for hemorrhagic stroke patients. There was no significant relationship between social support and the degree of depression in non-hemorrhagic stroke patients hemorrhagic stroke patient The conclusion was not found a meaningful relationship between social support and depression level in non-hemorrhagic and hemorrhagic post-stroke patients

KLINIK UTAMA REHABILITASI MEDIK DI BANJARMASIN

Along with the development of medical science and society needs Kementerian Kesehatan (Kemenkes) released a program in 2017, called JKN or Jaminan Kesehatan Nasional about improvement and build of quality of health infrastructure. Based on that program Kementrian Kesehatan expects the distribution of health facilities in each region. In Banjarmasin, rehabilitative health facilities is still not enough qualitatively and quantitatively, one of the rehabilitation health facilities is a medical rehabilitation facility. Medical rehabilitation’s patients in Banjarmasin hospitals always increase, so that hospital services become less than optimal, therefore additional outpatient services are needed through the clinic In reality amount of medical rehabilitation clinics are still not spread in Banjarmasin and the quality of clinics in Banjarmasin has not fulfilled the requirements of the physical environment where the physical environment is the biggest factor that affects the healing process. The healing environment approach is used as a method and concept of problem-solving. The method used is to determine and analyze the facts from the medical rehabilitation service, then applying the healing environment aspect to space, both internal and external space. The healing environment aspect consists of nature, senses, and psychology.

KLINIK UTAMA REHABILITASI MEDIK DI BANJARMASIN

Along with the development of medical science and society needs Kementerian Kesehatan (Kemenkes) released a program in 2017, called JKN or Jaminan Kesehatan Nasional about improvement and build of quality of health infrastructure. Based on that program Kementrian Kesehatan expects the distribution of health facilities in each region. In Banjarmasin, rehabilitative health facilities is still not enough qualitatively and quantitatively, one of the rehabilitation health facilities is a medical rehabilitation facility. Medical rehabilitation’s patients in Banjarmasin hospitals always increase, so that hospital services become less than optimal, therefore additional outpatient services are needed through the clinic In reality amount of medical rehabilitation clinics are still not spread in Banjarmasin and the quality of clinics in Banjarmasin has not fulfilled the requirements of the physical environment where the physical environment is the biggest factor that affects the healing process. The healing environment approach is used as a method and concept of problem-solving. The method used is to determine and analyze the facts from the medical rehabilitation service, then applying the healing environment aspect to space, both internal and external space. The healing environment aspect consists of nature, senses, and psychology.