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"TUJUAN: Tujuan penelitian ini adalah mengetahui korelasi antara pola jalan dengan pemulihan motorik berdasarkan stadium Brunnstrom pada penderita pasca strokeMETODE: Subjek penelitian adalah penderita stroke fase subakut dan fase kronis ( onset > 2 minggu) yang non hemiparesis, hemiparesis kanan dan hemiparesis kiri. Dilakukan pemeriksaan fisik dan penilaian pemulihan motorik berdasarkan stadium Brunnstrom. Diberikan penjelasan mengenai prosedur pelaksanaan penelitian. Subjek berjalan pada lintasan sepanjang 10 meter sehingga didapatkan kecepatan berjalannya. Selanjutnya subjek berjalan pada alat gait analyser selama 2 menit, dengan memasukkan kecepatan tiap subjek di alat gait analyser. Didapatkan nilai step length sisi sehat, step length sisi sakit, stride length dan cadence tiap-tiap subjek.HASIL: Terdapat 30 subjek dalam penelitian ini. Rerata nilai step length sisi sehat 29,69 + 12,65 cm, step length sisi sakit 32,36 + 10,75 cm, stride length 61,85 + 16,89 cm, cadence 71 + 21,66 langkah/menit. Frekuensi subjek dengan pemulihan motorik Brunnstrom 2 terdapat 2 orang (6,7%), Brunnstrom 3 terdapat 6 orang (20%), Brunnstrom 4 terdapat 5 orang (16,7%) pada Brunnstrom 5 terdapat 8 orang( 26,7%) dan Brunnstrom 6 terdapat 9 orang (30%).SIMPULAN: Terdapat korelasi lemah sampai sedang antara step length sisi sehat, step length sisi sakit, stride length, cadence dengan pemulihan motorik berdasarkan stadium Brunnstrom.

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OBJECTIVE: The purpose of this research is to find out correlation between gait pattern with motor recovery based on Brunnstrom stages for stroke patient.METHODS: The subject of these research are stroke patient in subacute and chronic phase ( onset > 2 weeks) non hemipharetic, right and left hemipharetic. Physical examination and scoring motor recovery based on Brunnstron stage. The patient were given the explanation of the procedure for the research. The subject walks on 10 metres track to get walking speed. Next, subject walks on the gait analyzer for 2 minutes, with walking speed installed to gait analyzer. The outcome measurements consist of step length on unaffected and affected side, stride length and cadence for every subjects.RESULTS: There are 30 subject in this research. Average step length score on unaffected 29,69 + 12,65 cm, step length on affected side 32,36 + 10,75 cm, stride length 61,85 + 16,89 cm, cadence 71 + 21,66 step/minutes. Frequent subject with motor recovery Brunnstrom 2 are 2 subjects ( 6,7%), Brunnstrom 3 are 6 subjects (20%), Brunnstrom 4 are 5 subjects ( 16,7 %), Brunnstrom 5 are 8 subject (26,7%) and Brunnstrom 6 are 9 subject (30%).CONCLUSIONS: There is a mild until moderate correlation between step length on unaffected and affected, stride length, cadence and motor recovery based on Brunnstrom stages."

"ABSTRAKPENDAHULUAN: Teknik motor imagery diketahui berpengaruh terhadap fungsi motorik anggota gerak atas pasien stroke iskemik kronik. Meskipun demikian, belum diketahui pengaruh teknik motor imagery terhadap neuroplastisitas secara molekular pada pasien stroke iskemik kronik. Penelitian ini bertujuan mengetahui pengaruh teknik motor imagery terhadap fungsi anggota gerak atas dan neuroplastisitas pasien stroke iskemik kronik.METODE: Kami melaporkan 3 kasus stroke iskemik kronik. Kasus pertama wanita usia 40 tahun dengan stroke pertama awitan 5 tahun dan komorbid systemic lupus erythematosus (SLE). Kasus kedua wanita usia 53 tahun dengan stroke pertama awitan 3 tahun, komorbid hipertensi dan diabetes mellitus tipe 2. Kasus ketiga pria usia 51 tahun dengan stroke berulang ketiga awitan 1 tahun, komorbid hipertensi dan hiperlipidemia. Kami melakukan intervensi teknik motor imagery 1 sesi per minggu selama 12 minggu, dengan durasi 20 menit per sesi, menggunakan panduan elektroensefalografi (EEG) elektroda tunggal portabel. Luaran fungsional dinilai dengan Chedoke Arm and Hand Activity Inventory-13 (CAHAI-13) sebelum dan sesudah intervensi. Parameter neuroplastisitas diukur dari kadar Brain Derived Neurotrophic Factor (BDNF) serum yang dinilai pada pra-intervensi, minggu ke-6, dan pasca-intervensi minggu ke-12HASIL: Pemulihan fungsi anggota gerak atas yang bermakna secara klinis didapatkan pada kasus kedua dengan peningkatan skor CAHAI-13 sebesar 21 poin disertai peningkatan kadar BDNF serum pada minggu ke-6 yang relatif menetap pada pengukuran minggu ke-12. Pada kasus ketiga didapatkan peningkatan skor CAHAI-13 yang tidak bermakna secara klinis, sementara pada kasus pertama tidak didapatkan perubahan. Kadar BDNF pada kasus pertama dan ketiga memiliki kecenderungan yang sama, yaitu meningkat pada minggu ke-6, dan turun kembali pada minggu ke-12 dengan kadar yang masih lebih tinggi dibandingkan kadar pra-intervensi.KESIMPULAN: Teknik motor imagery 1 sesi per minggu selama 12 minggu, durasi 20 menit per sesi, terbukti berpengaruh terhadap neuroplastisitas pasien stroke iskemik kronik, dan terhadap pemulihan motorik anggota gerak atas pasien stroke iskemik kronik serangan pertama awitan 3 tahun.

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ABSTRACTINTRODUCTION: Motor imagery is known to affect motor function of upper limbs in chronic ischemic stroke patients. However, the effect of motor imagery on molecular neuroplasticity in chronic ischemic stroke patients is not yet established. This study aims to determine the efect of motor imagery on upper limb function and neuroplasticity of chronic ischemic stroke patients.METHODS: We reported 3 cases of chronic ischemic stroke. The first case was a 40-year-old woman with stroke onset 5 years and comorbid systemic lupus erythematosus (SLE). The second case was a 53-year-old woman with a first strokte of 3 years onset, comorbid hypertension and diabetes mellitus type 2. The third case was a 51-year-old with third recurrent stroke of 1 year onset, comorbid hypertension and hyperlipidemia. We performed motor imagery 1 session per week for 12 weeks, with a duration of 20 minutes per session, using single electrode portable electroencephalograph (EEG) guidance. Functional outcomes were assessed using the Chedoke Arm and Hand Activity Inventory-13 (CAHAI-13) before and after intervention. Neuroplasticity parameters were measured from serum Brain Derived Neurotrophic Factor (BDNF) levels which were assessed at pre-intervention, week 6, and week 12 post-intervention.RESULTS: Clinically significant recovery of upper limb function was found in the second case with an increase in the CAHAI-13 score of 21 points, accompanied by an increase in serum BDNF levels at week 6 which was relatively stable at week 12. In the third case, there was an increase in the CAHAI-13 score which was not clinically significant, while in the first case there was no change. Serum BDNF levels in the first and third cases had the same tendency, which increased at week 6 and decreased at week 12, with the levels still higher than pre-intervention levels.CONCLUSION: Motor imagery 1 session per week for 12 weeks, with the duration of 20 minutes per session, has been shown to have an effect on neuroplasticity of chronic ischemic stroke patients, and on motor recovery of limbs in patient with first chronic ischemic stroke of 3 years onset."

"Menurut World Health Organization (WHO) ada sekitar 46,6 juta penderita stroke yang mengalami disabilitas. Selama ini dalam menentukan program rehabilitasi medik yang tepat dengan memperhatikan dominansi tangan pasien pasca stroke masih belum dilakukan, sehingga penentuan dominansi tangan ini penting untuk dilakukan. Berbagai studi meneliti mengenai hubungan lateralisasi otak dan dominansi tangan namun masih jarang yang meneliti hubungan sisi hemiparesis pada pasien stroke dengan dominansi tangan dan menghubungkannya dengan pemulihan fungsi anggota gerak atas. Penelitian ini bertujuan untuk menjawab pertanyaan tersebut dengan mengetahui variasi perubahan dominansi tangan pasca stroke yang diukur dengan Edinburgh Handedness Inventory - Short Form (EHI-SF) dan fungsi anggota gerak atas pasca stroke yang diukur dengan Fugl-Meyer Upper Extremity (FMA-UE) dan Chedoke Arm and Hand Activity Inventory (CAHAI). Penelitian observasional prospektif dengan desain cross sectional ini dilakukan di Poli Rehabilitasi Medik Neuromuskular RSCM pada bulan September 2021 sampai Oktober 2022. Populasi subjek adalah pasien stroke iskemik fase subakut dan kronik dengan hemiparesis yang memenuhi kriteria penerimaan dan penolakan. Dominansi tangan ditentukan dengan EHI-SF, sedangkan fungsi anggota gerak pasca stroke diukur dengan FMA-UE dan CAHAI. Penelitian ini melibatkan 62 orang subjek yang terbagi menjadi dua kelompok, yaitu kelompok dominan ipsilateral (n=27) dan dominan kontralateral (n=35). Didapatkan hubungan bermakna antara sisi hemiparesis dengan dominansi tangan (p < 0,001). Selain itu, didapatkan hubungan bermakna antara pemulihan fungsi anggota gerak dengan dominansi tangan pasca stroke. Tidak didapatkan hubungan yang bermakna antara pemulihan fungsi anggota gerak dengan sisi hemiparesis. Kesimpulan penelitian ini adalah dominansi tangan berhubungan dengan sisi hemiparesis dan pemulihan fungsi anggota gerak, dan pemulihan fungsi anggota gerak tidak berhubungan dengan sisi hemiparesis.

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According to the World Health Organization (WHO) there are around 46.6 million stroke sufferers who experience disability. So far, determining the right medical rehabilitation program based on hand dominance in post-stroke patients has not been carried out. Various studies have examined the relationship between brain lateralization and hand dominance, but the relationship between the side of hemiparesis in stroke patients with hand dominance and their correlation with the recovery of upper limb function has not been established. This study aims to answer this question by knowing the variations in post-stroke hand dominance as measured by the Edinburgh Handedness Inventory - Short Form (EHI-SF) and post-stroke upper limb function as measured by Fugl-Meyer Upper Extremity (FMA-UE) and Chedoke Arm and Hand Activity Inventory (CAHAI). This prospective observational study with cross-sectional design was conducted at the Neuromuscular Medical Rehabilitation Polyclinic, Cipto Mangunkusumo Hospital from September 2021 to October 2022. The study population was subacute and chronic ischemic stroke patients with hemiparesis who met the inclusion and exclusion criteria. Hand dominance was determined by EHI-SF, while post-stroke limb function was measured by FMA-UE and CAHAI. This study involved 62 subjects who were divided into two groups, namely the dominant ipsilateral group (n=27) and the dominant contralateral group (n=35). A significant relationship was found between the side of the hemiparesis and hand dominance (p <0.001). In addition, a significant relationship was found between the recovery of limb function and hand dominance after stroke. No significant relationship was found between the recovery of limb function and the side of the hemiparesis. The conclusion of this study is hand dominance is associated with the side of the hemiparesis and recovery of limb function, and recovery of limb function is not associated to the side of hemiparesis.

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"Afasia motorik merupakan salah satu gangguan komunikasi yang terjadi akibat stroke dan dapat menyebabkan gangguan terhadap kepercayaan diri seseorang yaitu harga diri dan efikasi diri yang mana kedua hal ini merupakan bagian terpenting dari masing-masing individu dalam mencapai status sosialnya dalam berkomunikasi. Teknik restrukturisasi kognitif digunakan untuk efikasi diri dan harga diri dengan memiliki asumsi bahwa dasar restrukturisasi kognitif yaitu respon-respon perilaku. Penelitian ini bertujuan untuk melihat pengaruh terapi restrukturisasi kognitif terhadap harga diri dan efikasi diri pasien stroke dengan afasia motorik. Metode penelitian ini menggunakan quasi experimental design dengan pendekatan desain pretest posttest nonequivalent control grup, dimana desain ini melibatkan dua kelompok yang akan diobservasi sebelum dan sesudah intervensi. Hasil penelitian menunjukkan adanya pengaruh yang signifikan pada harga diri setelah diberikan intervensi restrukturisasi kognitif dengan (pvalue= 0,001; α<0,05), dan pengaruh yang signifikan pada tingkat efikasi diri setelah diberikan intervensi dengan (pvalue= 0,001; α<0,05). Hasil penelitian ini merekomendasikan restruktuisasi kognitif menjadi salah satu intervensi dalam pemberian asuha keperawatan secara holistik mencakup biologis, psikologis, sosiologis dan spiritual kepada pasien pasca stroke dengan afasia motorik unutk dapat menaikkan harga diri dan efikasi pada pasien untuk membantu mengolah perasaan dan keyakinan psikologis pasien pasca stroke dalam menjalani proses rehabilitasinya

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Motor aphasia is one of the communication disorders that occurs due to stroke and can cause interference with one's self-confidence, namely self-esteem and self-efficacy, both of which are the most important parts of each individual in achieving their social status in communicating. Cognitive restructuring technique is used for self-efficacy and self-esteem with the assumption that the basis of cognitive restructuring is behavioral responses. This study aims to examine the effect of cognitive restructuring therapy on self-esteem and self-efficacy of stroke patients with motor aphasia. This research method uses a quasi-experimental design with a non-equivalent control group pretest posttest design approach, where this design involves two groups to be observed before and after the intervention. The results showed that there was a significant effect on self-esteem after being given a cognitive restructuring intervention with (p-value = 0.001; <0.05), and a significant effect on the level of self-efficacy after being given an intervention with (p-value = 0.001; <0.05). ). The results of this study recommend cognitive restructuring to be one of the interventions in providing holistic nursing care including biological, psychological, sociological and spiritual to post-stroke patients with motor aphasia to increase self-esteem and efficacy in patients to help process the psychological feelings and beliefs of post-stroke patients. in the process of rehabilitation"

"[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. ]"

"Latar Belakang: Stroke iskemik merupakan penyebab kematian terbanyak kedua dan penyebab utama disabilitas di seluruh dunia. Beberapa faktor risiko yang sudah diketahui diantaranya pola hidup, penyakit komorbid, usia, jenis kelamin, dan ras. Namun, kadar serum vitamin D yang kurang ternyata juga dikaitkan dengan penyakit neurodegeneratif, serta luaran klinis yang lebih buruk. Penelitian ini dilakukan untuk mengetahui korelasi kadar serum vitamin D dengan derajat keparahan pada stroke iskemik yang dinilai berdasarkan NIHSS. Pada penelitian ini juga akan menilai asupan vitamin D serta pajanan sinar matahari.Metode: Penelitian ini merupakan studi potong lintang pada pasien stroke iskemik di RSUPN dr. Cipto Mangunkusumo dan RS Universitas Indonesia. Karakteristik subjek penelitian berupa usia, jenis kelamin, faktor risiko, penyakit komorbid dengan komplikasi, asupan protein, asupan lemak, asupan vitamin D, pajanan sinar matahari, kadar serum vitamin D, serta derajat keparahan. Dilakukan analisis korelasi kadar serum vitamin D dengan derajat keparahan berdasarkan NIHSS.Hasil: Terdapat 59 subjek dengan diagnosis stroke iskemik dengan rerata usia 63 tahun dan mayoritas laki-laki (62,7%). Faktor risiko terbanyak adalah hipertensi (83,1%), berat badan lebih dan obesitas (64,4%), merokok (57,6%), dan diabetes melitus (42,4%). Penyakit komorbid dengan komplikasi tersering yang ditemukan adalah gangguan jantung (35,6%). Sebanyak 79,7% subjek penelitian memiliki asupan protein yang kurang, sedangkan asupan lemak seluruhnya tergolong cukup. Sebagian besar (52,5%) subjek penelitian memiliki status asupan vitamin D kurang, 5 orang mengonsumsi suplementasi vitamin D secara rutin, derajat pajanan sinar matahari rendah (89,8%). Sebanyak 59,3% memiliki status kadar serum vitamin D defisiensi dengan derajat keparahan terbanyak adalah skor NIHSS 5-15 (76,3%). Terdapat korelasi antara asupan vitamin D dengan derajat keparahan stroke iskemik (r -0,307, p 0,018).Kesimpulan: Kadar serum vitamin D memiliki korelasi dengan derajat keparahan stroke iskemik (r -0,469, p <0,001). Kadar serum vitamin D yang kurang berbanding terbalik dengan skor NIHSS yang didapatkan pada penderita stroke iskemik onset akut.

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Background: Ischemic stroke is the second leading cause of death and the leading cause of disability worldwide. Some of the known risk factors include lifestyle, comorbid diseases, age, gender, and race. However, deficient serum vitamin D levels are also associated with neurodegenerative diseases, as well as worse clinical outcomes. This study was conducted to determine the correlation of serum vitamin D levels with severity in ischemic stroke as assessed by the NIHSS. This study will also assess vitamin D intake and sunlight exposure.

Methods: This study is a cross-sectional study on ischemic stroke patients at RSUPN dr. Cipto Mangunkusumo and University of Indonesia Hospital. Characteristics of the study subjects included age, gender, risk factors, comorbid diseases with complications, protein intake, fat intake, vitamin D intake, sun exposure, serum vitamin D levels, and severity. Correlation analysis of serum vitamin D levels with severity based on NIHSS was conducted.

Results: There were 59 subjects with a diagnosis of ischemic stroke with an average age of 63 years and the majority were male (62.7%). The most common risk factors were hypertension (83.1%), overweight and obesity (64.4%), smoking (57.6%), and diabetes mellitus (42.4%). Comorbid disease with the most common complication found were cardiac disorders (35.6%). A total of 79.7% of the study subjects had insufficient protein intake, while the fat intake was entirely considered adequate. Most (52.5%) of the study subjects had deficient vitamin D intake status, 5 people took vitamin D supplementation regularly, the degree of sun exposure was low (89.8%). A total of 59.3% had vitamin D deficiency serum level status with the most severity being NIHSS score 5-15 (76.3%). There was a correlation between vitamin D intake and ischemic stroke severity (r -0,307, p 0,018).

Conclusion: Serum vitamin D levels have a correlation with ischemic stroke severity (r -0,469, p <0,001). Insufficient serum vitamin D levels are inversely proportional to the NIHSS score obtained in patients with acute onset ischemic stroke."

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Pendahuluan: Stroke merupakan kondisi yang dapat menyebabkan penurunan kemampuan motorik dan mempengaruhi kemampuan untuk dapat beraktivitas. Menurut Riskesdas 2018, sekitar 13,9% penderita stroke di Indonesia mengalami stroke berat dan hanya 36,3% penderita stroke yang dapat hidup sendiri. Hal ini menjadikan stroke sebagai kondisi penyebab disabilitas terbesar di Indonesia. Oleh sebab itu, penelitian ini bertujuan untuk melihat apakah terdapat perubahan dominansi tangan sepanjang proses pemulihan pasien setelah serangan stroke. Informasi ini akan sangat bermanfaat untuk menentukan apakah rehabilitasi akan difokuskan pada tangan dominan yang paresis atau lebih baik mengubah tangan dominan. Metode: Penelitian ini merupakan penelitian pendahulan deskriptif retrospektif dengan tujuan melihat karakteristik pasien stroke beserta proses pemulihannya dan perubahan dominansi tangan sepanjang proses pemulihannya. Penelitian akan menggunakan sampel pasien stroke hemiparesis yang merupakan data sekunder dari rekam medis. Hasil dan Pembahasan: Hasil penelitian menunjukan rata-rata usia pasien penderita stroke adalah 57,91 tahun dengan sebagian besar berada pada fase Brunnstrom Recovery Stages (BRS) 6. Terdapat perubahan frekuensi dominansi tangan kanan (n=10) dan campuran (n=1) sebelum stroke menjadi dominansi tangan kanan (n=7) dan campuran (n=4) setelah stroke dengan skor Edinburgh Handedness Inventory (EHI) sebelum stroke 88,82 menjadi 59,27 setelah stroke. Kesimpulan: Terdapat perubahan dominansi tangan pada pasien yang mengalami stroke pada sisi dominan.

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Introduction: Stroke is a condition where there is a decrease in motor capabilities and has an impact on daily activities. According to Riskesdas 2018, around 13,9% stroke patient in Indonesia have severe disabilities and only 36,3% stroke survivor could live independently. This is why stroke has become the condition which cause the greatest disabilities in Indonesia. In light of these considerations, this research aims to see the effect of stroke on hand dominance and its recovery stages. By knowing the hand dominance in relation to the recovery stages, a proper and suitable rehabilitation program would be given. Method: This research is a pilot study with descriptive-retrospective design which aim to see the characteristic of stroke patients with its recovery stages. The research will use hemiparetic stroke patient data from secondary data on the medical record. Result and Dicussion: : The result of this research showed an average age of stroke patient is 57,91 years with most of them at Brunnstrom Recover Stages 6. There were also changes in the frequency of right hand dominance (n=10) and mixed hand dominance (n=1) before stroke to right hand dominance (n=7) and mixed hand dominance (n=4) after stroke with Edinburgh Handedness Inventory average score was 88,82 before stroke to 57,91 after stroke Conclusion: There is a difference of hand dominance in patient with stroke on the dominance side.

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"Latar Belakang. Perbaikan fungsi berjalan adalah target fungsional yang paling relevan pasca-stroke. Oleh karena itu diperlukan alat ukur yang dapat menilai kemampuan fungsional pasca-stroke yang aman dan tidak menimbulkan kelelahan. Tujuan dari penelitian ini untuk menilai korelasi antara Fatigue Severity Scale dan Skala Borg dengan uji jalan 2 menit pada penderita stroke.Metode. Studi potong lintang pada 35 subjek stroke subakut dan kronik di RSUPN Cipto Mangunkusumo. Dilakukan uji korelasi Pearson antara Fatigue Severity Scale dan Skala Borg dengan hasil pengukuran uji jalan 2 menit.Hasil. Pada pasien stroke terdapat korelasi sedang yang signifikan pada Skala Borg kaki lelah ge;3 dengan uji jalan 2 menit baik pada jarak tempuh r=-0,505, p=0,046 maupun kecepatan r=-0,498, p=0,050 namun tidak terdapat korelasi antara FSS dengan hasil pengukuran uji jalan 2 menit. Tidak terdapat korelasi antara Skala Borg usaha dan sesak dengan jarak tempuh uji jalan 2 menit.Kesimpulan. Terdapat korelasi sedang yang bermakna secara statistik antara Skala Borg kaki lelah dengan hasil pengukuran uji jalan 2 menit.Tidak terdapat korelasi antara FSS dengan uji jalan 2 menit.

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Background. Improvement of walking function is the most relevant functional target post stroke Therefore we need a measuring tool that can assess the functional ability of post stroke that is safe and does not cause fatigue. Aim of this study to assess the correlation between Fatigue Severity Scale and Borg Scale with 2 minute walking test in stroke patient.Method. Cross sectional study on 35 subacute and chronic stroke subjects at RSUPN Cipto Mangunkusumo. A Pearson correlation test was conducted between FSS and Borg Scale with 2 minute walking test.Result. In stroke patients there was a significant moderate correlation between Borg Scale leg fatigue ge 3 with 2 minute walking test on distance r 0,505, p 0.046 and walking speed r 0,498, p 0,050 but there was no correlation between FSS and 2 minute walking test. There was no correlation between the Borg Scale dypsnea and leg fatigue with 2 minute walking test.Conclusion. There was a statistically significant correlation between Borg Scale leg fatigue with 2 minute walking test. There was no correlation between FSS with 2 minute walking test."

"Vitamin D memiliki efek mempertahankan fungsi endovaskular dan mengatur aktivitas inflamasi dalam dinding pembuluh darah. Lemak viseral, disebutkan sebagai prediktor risiko yang baik untuk penyakit vaskular karena berperan aktif secara metabolik serta bersifat meningkatkan pengeluaran sitokin proinflamasi Kedua hal ini berpengaruh dalam peningkatan risiko kejadian stroke akut. Sampai saat ini penelitian yang membahas korelasi antara kedua faktor tersebut masih inkosisten. Studi potong lintang dilakukan pada subyek berusia >18 tahun dengan stroke akut yang menjalani perawatan di RSUPN Dr. Cipto Mangunkusumo dan RS Universitas Indonesia. Pengukuran kadar lemak viseral menggunakan bioelectrical impedance analysis bedridden multifrekuensi. Penilaian kadar serum vitamin D (25 (OH)D) menggunakan metode chemiluminescent immunoassay. Terdapat total 73 subyek penelitian, sebanyak 55 subyek (75,3%) dengan insufisiensi dan 15 subyek (20,5%) mengalami defisiensi vitamin D, dengan nilai rerata di 17,08±7,85 ng/mL. Sejumlah 78,1% subyek memiliki kadar lemak viseral yang tinggi. Terdapat korelasi negatif (r= -0,271) yang signifikan (p <0,021) antara kadar lemak viseral dan kadar vitamin D serum pada stroke akut. Dilakukan analisis multivariat lanjutan, didapatkan kadar lemak viseral dan jenis pakaian (pakaian tertutup) menjadi faktor paling signifikan dalam menilai kadar vitamin D serum.Terdapat korelasi yang signifikan antara kadar lemak viseral dengan kadar vitamin D 25 (OH) pada pasien stroke akut.

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Vitamin D has effects in maintaining endovascular function and regulating inflammatory activity in the vascular wall. Visceral fat is said to be a good risk predictor for vascular disease because it plays a metabolically active role and increases the release of pro-inflammatory cytokines, both of which are influential in increasing the risk of acute stroke events. Studies that discuss the correlation between these two factors are still inconsistent.  A cross-sectional study was conducted on subjects aged >18 years with acute stroke who underwent treatment at Dr. Cipto Mangunkusumo Hospital and University of Indonesia Hospital. Measurement of visceral fat levels using bioelectrical impedance analysis bedridden multifrequency. Assessment of serum vitamin D (25(OH)D) levels using chemiluminescent immunoassay method.  In a total of 73 subjects, 55 (75.3%) subjects had vitamin D insufficiency and 15 (20,5%) subject had deficiency, with mean values at 17.08±7.85 ng/mL. A total of 78.1% of subjects had high visceral fat levels. There was a significant (p<0.021) negative correlation (r= -0.271) between visceral fat and serum vitamin D levels in acute stroke. In a further multivariate analysis, visceral fat content and type of clothing (concealing clothing) was found to be the most significant factor in assessing serum vitamin D levels. There is a significant correlation between visceral fat levels and 25 (OH) vitamin D levels in acute stroke patients."

"Stroke iskemik merupakan penyebab utama disabilitas jangka panjang dengan beban ekonomi serta angka kematian yang tinggi di Indonesia. Malnutrisi pada pasien stroke iskemik berhubungan dengan masa rawat inap lebih lama, luaran fungsional lebih buruk, dan mortalitas yang lebih tinggi. Malnutrisi ditandai oleh adanya penurunan massa otot yang dapat dinilai dengan pemeriksaan indeks massa bebas lemak (fat free mass index, FFMI) menggunakan bioelectrical impedance analysis (BIA). Inflamasi sebagai salah satu penyebab malnutrisi pada pasien stroke iskemik dapat ditandai oleh peningkatan rasio neutrofil terhadap limfosit (neutrophil-to-lymphocyte ratio, NLR). Penelitian ini merupakan studi potong lintang untuk melihat korelasi antara FFMI dan NLR pada 47 subjek dengan stroke iskemik akut berusia >18 tahun hingga 65 tahun yang dirawat di RSUPN Dr. Cipto Mangunkusumo (RSCM) dan RS Universitas Indonesia (RSUI) selama bulan November–Desember 2023. Hasil penelitian menunjukkan rerata usia subjek adalah 57±7,1 tahun dan sebagian besar subjek adalah laki-laki (61,7%). Hipertensi merupakan faktor risiko tertinggi yang ditemukan pada subjek penelitian (83%). Sebagian besar subjek memiliki status gizi berat badan normal (31,9%) dan obesitas (31,9%), sedangkan subjek dengan malnutrisi sebesar 8,5%. Rerata nilai FFMI pada subjek penelitian adalah 18±2,2 kg/m² dan diperoleh 12,8% subjek dengan kategori FFMI rendah. Rerata nilai NLR adalah 3,7±1,3 dan diperoleh 36,2% subjek dengan kategori NLR tinggi. Nilai FFMI dan NLR pada subjek penelitian memiliki korelasi negatif signifikan dengan nilai korelasi r=-0,38, p<0,01.

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Ischemic stroke is a leading cause of long-term disability with a high economic burden and mortality rate in Indonesia. Malnutrition in ischemic stroke patients is associated with longer hospitalization, worse functional outcomes, and higher mortality. Malnutrition is characterized by a decrease in muscle mass that can be assessed by examining the fat free mass index (FFMI) using bioelectrical impedance analysis (BIA). Inflammation as one of the causes of malnutrition in ischemic stroke patients can be characterized by an increase in the neutrophil-to-lymphocyte ratio (NLR). This study is a cross-sectional study to see the correlation between FFMI and NLR in 47 subjects with acute ischemic stroke aged >18 years to 65 years who were admitted to Dr. Cipto Mangunkusumo Hospital (RSCM) and University of Indonesia Hospital (RSUI) during November-December 2023. The results showed that the mean age of the subjects was 57±7.1 years and most of the subjects were male (61.7%). Hypertension was the highest risk factor found in the study subjects (83%). Most subjects had a nutritional status of normal weight (31.9%) and obesity (31.9%), while subjects with malnutrition amounted to 8.5%. The mean FFMI value in the study subjects was 18±2.2 kg/m2 and 12.8% of subjects with low FFMI category were obtained. The mean value of NLR was 3.7 ± 1.3 and 36.2% of subjects with high NLR category were obtained. The FFMI and NLR values in the study subjects had a significant negative correlation with a correlation value of r = 0.38, p <0.01."