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"Latar belakang. Pada anak Palsi Serebral terdapat hubungan antara motorik kasar (berdasarkan GMFCS) dan kemampuan manual (berdasarkan MACS) dengan kemampuan kognitif (berdasarkan tes IQ).Tujuan. Mengetahui hubungan antara skala GMFCS dan skala MACS dengan fungsi kognitif pada pasien Palsi Serebral (PS). Metode penelitian. Penelitian dilakukan tanggal 17 Februari sampai 17 Mei 2018 pada pasien Palsi Serebral usai 5-18 tahun yang berobat di Poliklinik Neurologi Anak / Poliklinik Rehabilitasi Medik RSCM / YPAC Jakarta yang memenuhi kriteria penelitian. Hasil penelitian. Pasien PS yang ikut serta dalam penelitian ini sejumlah 69 subyek, dengan karakteristik usia 4-6 tahun (26%), 6-12 tahun (57%), 12-18 tahun (17%) ; anak laki-laki (56,6%), perempuan (43.4%). Didapatkan tipe PS diplegi (68,1%), PS hemiplegi (2,9%), PS kuadriplegi (29%), dengan sebaran skala GMFCS I (14,5%), II (13%), III (27,5%), IV (17%), V (20,4%). Sebaran skala MACS: I (42%), II (13%), III (5,8%), IV (13%), V (26,2%). Sementara sebaran hasil tes IQ dengan skala WISC: 91-110 (3%), 80-90 (1%), 66-79 (4%), 52-65 (17%), 36-51 (25%), 20-35 (25%), <19 (25%). Simpulan. Pada pasien PS, makin buruk kemampuan motorik kasar (GMFCS) maka makin buruk pula kemampuan manual (MACS) dan makin rendah pula IQ nya. Makin buruk kemampuan manual (MACS) makin rendah pula IQ nya. Tipe PS kuadriplegi memiliki nilai IQ yang paling rendah dibandingkan tipe PS diplegi/hemiplegi.

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Objective.To determine the relationship between GMFCS and MACS with cognitive function in children with Cerebral Palsy. The study was conducted from February 17 to May 17, 2018. Children with Cerebral Palsy,  5-18 years old, were treated  at Pediatric Neurology Cipto Mangunkusumo Hospital/Medical Rehabilitation Cipto Mangunkusumo Hospital / YPAC Jakarta as outpatient, who met the research criteria.

Results. Children with Cerebral Palsy who participated in this study were 69 subjects, with characteristics of 4-6 years (26%), 6-12 years (57%), 12-18 years (17%); boys (56.6%), girls (43.4%). Cerebral Palsy type was obtained: diplegia (68.1%), hemiplegia (2.9%), quadriplegia (29%). Distribution scale of GMFCS: I  (14.5%), II (13%), III (27.5 %), IV (17%), V (20.4%). Distribution scale of MACS: I (42%), II (13%), III (5.8%), IV (13%), V (26.2%), while the distribution scale of IQ test with the WISC method: 91-110 (3%), 80-90 (1%), 66-79 (4%), 52-65 (17%), 36-51 (25%), 20 -35 (25%), <19 (25%).

Conclusions. Children with Cerebral Palsy, the worse gross motor function (GMFCS) then the worse manual ability (MACS) and the worse cognitive function (IQ). The worse manual ability (MACS) the lower the IQ. Quadriplegia type of Cerebral Palsy has the lowest IQ score compared to diplegia/ hemiplegia type of Cerebral Palsy."

"Latar Belakang : Fungsi motorik kasar pada seorang anak berkaitan erat dengan kemampuan untuk menggunakan tangannya. Pada anak dengan Palsi Serebral, Gross Motor Function Classification System (GMFCS) dan Manual Ability Classification System (MACS) merupakan sistem klasifikasi yang digunakan untuk menentukan tingkat fungsi motorik kasar dan tingkat kemampuan manual, sehingga perlu diketahui apakah kedua sistem klasifikasi ini juga saling berhubungan dalam menggambarkan kemampuan fungsional pada anak dengan Palsi Serebral. Penilaian tingkat GMFCS dan MACS dapat melengkapi gambaran tentang keterbatasan aktifitas dan restriksi partisipasi anak dengan Palsi Serebral menurut International Classification of Functioning, Disability and Health (ICF). Tujuan : Penelitian ini bertujuan untuk mengetahui hubungan antara GMFCS dan MACS pada anak dengan Palsi Serebral. Metode: Penelitian ini merupakan studi potong lintang analitik yang melibatkan 14 orang anak (8 orang laki-laki dan 6 orang perempuan) dengan rerata usia 6,21 tahun. Seluruh subjek merupakan Palsi Serebral tipe spastik dan 7 orang diantaranya adalah spastik kuadriplegik. Tingkat kemampuan motorik kasar diklasifikasikan berdasarkan GMFCS dan tingkat kemampuan manual berdasarkan MACS. Hubungan antara GMFCS dan MACS ditentukan dengan uji korelasi non parametrik Spearman's. Hasil: Didapatkan 57,1% anak mempunyai GMFCS tingkat V dan 35,7% dengan MACS tingkat V. Satu orang subjek dengan Palsi Serebral spastik hemiplegik berada pada GMFCS tingkat V dan MACS tingkat IV dan 1 orang subjek dengan Palsi Serebral spastik triplegik mempunyai GMFCS dan MACS tingkat IV. Lima orang subjek dengan Palsi Serebral spastik diplegik mempunyai tingkat GMFCS yang bervariasi dari tingkat I hingga tingkat V dan 60% mempunyai MACS tingkat II. Pada Palsi Serebral spastik kuadriplegik, 85,7% subjek mempunyai GMFCS tingkat V dan 71,4% dengan MACS tingkat V. Kesimpulan: GMFCS dan MACS saling berhubungan dalam menggambarkan tingkat fungsi motorik kasar dan tingkat kemampuan manual pada seluruh jenis Palsi Serebral.

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Background : Gross motor function correlates strongly with the children's ability to use their hands. The Gross Motor Function Classification System (GMFCS) and the Manual Ability Classification System (MACS) was designed to determine the level of gross motor function and manual ability, and we need to know the relationship between these classifications to describe the functional ability for the children with Cerebral Palsy. GMFCS and MACS will give the complete description about the activity limitation and participation restriction in children with Cerebral Palsy, according to the International Classification of Functioning, Disability and Health (ICF).

The aim : To investigate the relationship among the GMFCS and MACS in children with Cerebral Palsy.

Methods: This is was the analytic cross sectional study which involving 14 children with the average age 6,21 years old (8 males and 6 females). All of the children was diagnosed as spastic Cerebral Palsy with 1 hemiplegic, 5 diplegic, 1 triplegic and 7 quadriplegic. The children were classified by researcher according to the GMFCS for their motor function and according to the MACS for the functioning of their hands when handling objects in daily activities. The relationship among the GMFCS and MACS was analyzed with the Spearman correlation test.

Results: From all of the children, 57,1% was the children with GMFCS level V and 35,7% with MACS level V. One subject with spastic hemiplegic was the child with level V in GMFCS and level IV in MACS and 1 subject with spastic triplegic have the GMFCS and MACS level IV. Five subjects with spastic diplegic were have varying distribution in all of GMFCS levels and 60% from all of spastic diplegic children have the MACS level II. In spastic quadriplegic, 85,7% were the subjects with level V in GMFCS and 71,4% with level V in MACS.

Conclusion: The GMFCS and MACS correlate each other for describing the level of gross motor function and manual ability in all of the types of Cerebral Palsy. "

"Palsi serebral adalah penyebab utama disabilitas fisik di negara berkembang. Penderita palsi serebral dengan ketidakmampuan ambulasi berpeluang mengalami kontraktur sendi dan kelainan postur, yang dapat memburuk. Kelainan postur yang dapat terjadi adalah skoliosis, pelvic obliquity dan subluksasi/dislokasi panggul dengan problem sekunder nyeri, hilangnya kemampuan mandiri, duduk, berdiri, berjalan, ulkus dekubitus, masalah dalam kebersihan perineal, kardiovaskular dan respirasi. Sehingga perlu dilakukan deteksi sejak dini kelainan postur terutama kejadian subluksasi/dislokasi panggul. Metode : Desain penelitian ini adalah studi potong lintang dengan tujuan melihat apakah terdapat hubungan antara derajat spastisitas otot aduktor panggul, level Gross Motor Function Classification System (GMFCS) dan nilai Migration Percentage (MP) untuk mendeteksi dislokasi panggul pada anak palsi serebral yang datang ke poli rawat jalan divisi pediatri Departemen Rehabilitasi Medik RSUPN Cipto Mangunkusumo. Spastisitas otot aduktor panggul dinilai menggunakan Modified Tardieu Scale (MTS) komponen R2, R1 dan R2-R1, level GMFCS dinilai dengan menggunakan panduan GMFCS dan nilai MP didapat dari pengukuran foto panggul AP oleh dokter spesialis Radiologi. Hasil : Dari 30 responden penelitian, 3 tungkai dieksklusi sehingga analisis spastisitas aduktor panggul dan MP dilakukan pada total 57 tungkai. Penelitian ini menunjukkan tidak ada korelasi antara derajat spastisitas otot aduktor panggul dengan nilai MP dalam mendeteksi dislokasi panggul (antara variabel R2 dan MP dengan nilai r = -0,060; p = 0,658. Antara variabel R1 dan MP dengan nilai r = - 0,136; p = 0,314) dan tidak ada perbedaan bermakna level GMFCS dengan nilai MP dalam mendeteksi dislokasi panggul (p = 0,831). Kesimpulan : Pada penelitian ini tidak didapatkan adanya korelasi antara derajat spastisitas otot aduktor panggul dengan nilai Migration Percentage dan tidak didapatkan adanya perbedaan bermakna level Gross Motor Function Classification System dengan nilai Migration Percentage dalam mendeteksi dislokasi panggul.

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Cerebral palsy was the most common cause of physical disability in the developing country. A non-ambulant child with cerebral palsy was vulnerable to the development of joint contractures and postural deformity, which are often progressive. Postural deformities that can arise were scoliosis, pelvic obliquity and hip subluxation/dislocation with the secondary problems were pain, loss of ability to be independence, sitting, standing, walking, pressure ulcers, perineal hygiene and cardiorespiration. It was necessary to make early detection for postural deformities particularly hip subluxation/dislocation.

Methods : This was a cross sectional study. The aim of this study to see there are any associations among the degree of hip adductor spasticity, the level of Gross Motor Function Classification System (GMFCS) and the Migration Percentage (MP) to detect the occurrence of hip dislocation in children with cerebral palsy who came to outpatient polyclinic pediatric division of Physical and Rehabilitation Departmen, RSUPN Cipto Mangunkusumo. The hip adductor spasticity was measured with Modified Tardieu Scale (MTS) R2, R1 dan R2-R1 component, The level of GMFCS was measured with GMFCS protocol and the MP has done by Radiolog on plain foto of pelvic AP.

Results : From the 30 respondens, 3 legs were exclude, therefor just 57 legs were analized for hip adductor spasticity and MP. This study shows that there was no correlation between degree of hip adductor spasticity and MP (between variable R2 and MP with score r = -0,060; p = 0,658. Between variable R1 and MP with score r = -0,136; p = 0,314), there was no significant difference between level of GMFCS and MP (p = 0,831).

Conclusion : This study shows that there is no correlation between degree of hip adductor spasticity and MP, there is no significant difference between level of GMFCS and MP to detect the occurance of hip dislocation in children with cerebral palsy."

"Latar belakang. Cerebral palsy CP adalah penyakit neurologi yang menyebabkan disabilitas jangka panjang. GMFCS adalah pengklasifikasian CP yang sering digunakan klinisi untuk melihat keparahan dan perkembangan penyakit CP. Terdapat beberapa faktor yang mungkin dapat memengaruhi perubahan motorik kasar pasien CP seperti usia, jenis kelamin, usia gestasi, tipe CP berdasar topografi, riwayat asfiksia, gambaran radiologi, ukuran lingkar kepala, adanya gangguan penglihatan, gangguan pendengaran, epilepsi dan lama mederita CP. Tujuan. Mengetahui karakteristik klinis pasien CP, perubahan motorik kasar berdasar GMFCS serta faktor-faktor yang mempengaruhinya.Metode penelitian. Penelitian berupa cross-sectional untuk melihat perubahan motorik kasar berdasarkan GMFCS dan faktor yang memengaruhinya. Analisis yang dipakai untuk mengetahui hubungan adalah uji MacNemar dan kai kuadrat. Hasil penelitian. Kejadian CP lebih banyak pada anak laki-laki 61 , lahir matur 75 , tipe tetraplegi 66 , radiologi abnormal 83,3 , lingkar kepala abnormal 83 dan adanya epilepsi 61. Didapatkan perbaikan bermakna antara GMFCS saat awal diagnosis dibandingkan GMFCS saat ini p

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Background. Cerebral palsy CP is a neurological disease that causes long-term disability. GMFCS is a CP classifier that clinicians often use to see the severity and progression of CP. There are several factors that may affect the gross motor changes in CP such as age, sex, gestational age, CP type based on topography, asphyxia history, radiological features, head circumference, visual impairment, hearing loss, epilepsy and duration of CP.

Objectives. The research aims to find the clinical characteristics of CP, gross motor changes based on GMFCS and the factors that influence it.Method. The study was cross sectional to see gross motor changes based on GMFCS and the factors that influenced it. The analysis used to determine the relationship is MacNemar and kai square test.

Results. The case of CP was greater in male 61, mature birth 75, tetraplegi type 66, abnormal radiology 83,3 , abnormal head circumference 83 and epilepsy 61 . There were significant improvements between GMFCS at the start of the diagnosis versus current GMFCS p "

"ABSTRAK Penanganan palsi serebral(PS) yang baik membutuhkanperan serta aktif pelaku rawat . Sehingga diperlukan alat ukur penilaian fungsimotorik kasar yang singkat dan dapat dimengerti .Tujuan penelitian ini adalahmenguji kesahihan dan keandalan FRQ-GMFCS versi Bahasa Indonesia .agardapat dipergunakan para klinisi dan pelaku rawat anak dengan PS. METODE.Desain penelitian dengan metode potong lintang pada 53 subjek,berusia 2-18 tahun.yang dikelompokan sesuai dengan pembagian usia pada FQGMFCS. Pengolahan data dilakukan dengan analisa univariat dan nilai CohenKappa . HASIL: Hasil uji kesahihan dan keandalan FRQ-GMFCS versi Indonesiamendapat hasil yang secara statistik bermakna. KESIMPULAN: FRQ-GMFCS versi Bahasa Indonesia terbukti memilikikesahihan dan keandalan yang baik serta cukup spesifik untuk digunakan klinisidan pelaku rawat anak dengan PS.ABSTRACT A good handling of cerebral palsy requires the activeparticipation of caregivers. So, we need an understandable short questionaire of gross motor function assessment.The aim of this study was to determine thevalidity and reliability of Indonesian version of FRQ-GMFCS so it can be usedfor clinicians and caregivers of children with cerebral palsy(CP). METODE:We conducteds a cross-sectional study in 53 caregivers of childrenwith CP, aged 2-18 yeras old and was grouped according to the age distribution ofthe FRQ-GMFCS. Data processing was performed with univariate analysis andCohen Kappa value. RESULTS: The validity and reliability of Indonesian version of FRQ-GMFCSstatistically are significant. CONCLUSION: Indonesian version of FRQ-GMFCS shown to have goodvalidity and reliability as well as the specific enough to be used clinicians andcaregivers of children with CP. ;BACKGROUND: A good handling of cerebral palsy requires the activeparticipation of caregivers. So, we need an understandable short questionaire of gross motor function assessment.The aim of this study was to determine thevalidity and reliability of Indonesian version of FRQ-GMFCS so it can be usedfor clinicians and caregivers of children with cerebral palsy(CP). METODE:We conducteds a cross-sectional study in 53 caregivers of childrenwith CP, aged 2-18 yeras old and was grouped according to the age distribution ofthe FRQ-GMFCS. Data processing was performed with univariate analysis andCohen Kappa value. RESULTS: The validity and reliability of Indonesian version of FRQ-GMFCSstatistically are significant. CONCLUSION: Indonesian version of FRQ-GMFCS shown to have goodvalidity and reliability as well as the specific enough to be used clinicians andcaregivers of children with CP. "

"Indonesia telah melakukan program keluarga berencana untuk meningkatkan kualitas keluarga. Penelitian terdahulu menunjukkan bahwa jumlah anak dalam suatu rumah tangga memiliki peran yang signifikan dalam kemampuan kognitif dan perkembangan dini anak. Penelitian ini berfokus pada dampak jumlah anak dalam rumah tangga terhadap skor kognitif anak-anak usia 7-14 tahun. Penelitian ini menggunakan analisis kuantitatif yang mengacu pada data IFLS 5 yang dilakukan pada tahun 2014 dan menggunakan metode regresi OLS dan regresi multilevel untuk mengolah data. Hasil penelitian ini menunjukkan adanya hubungan negatif dan signifikan antara jumlah anak dalam rumah tangga dengan hasil skor tes kognitif. Jumlah anak yang lebih banyak dalam suatu rumah tangga membuat skor tes kognitif lebih rendah (β = -0.191, p-value 0.000, 95% CI -0.248 -0.133). Penelitian ini juga menemukan bahwa rumah tangga memiliki peran yang sangat penting dalam menentukan kemampuan kognitif seorang anak. Oleh karena itu, mengembangkan program yang dapat mempromosikan kesadaran akan pentingnya pengendalian jumlah anak sangatlah penting untuk meningkatkan kualitas anak.

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Indonesia has implemented family planning program to rise family quality. Previous studies found that number of children in a household plays a significant role in the cognitive function and early development process of children. This study focused on impact of number of children in a household and the cognitive score of the children aged 7-14. This study used quantitative analysis of the IFLS wave 5 that was conducted in 2014 and applied OLS regression and multilevel regression method to process the data. This study found that there is a negative and statistically significant relationship between number of children present in a household and their cognitive test score results. More children in a household have a relationship with lower cognitive test score (β = -0.191, p value 0.000, 95% CI -0.248 -0.133). This study also found that a household plays a crucial role in building the cognitive ability. Fostering a program to promote the importance of controlling number of children on quality of the children is crucial."

"Latar Belakang: Bunuh diri merupakan perilaku disengaja untuk mengakhiri hidup, dengan satu kasus terlaksana setiap 20 percobaan. Sebanyak 90%-nya memiliki gangguan psikiatri, salah satunya skizofrenia. Tingkat bunuh diri pada orang dengan skizofrenia (ODS) dilaporkan 4–13%. Faktor risiko bunuh diri melibatkan distres subjektif, gangguan kognitif, dan distorsi sosial, yang dipengaruhi oleh masalah struktur dan fungsi otak. Gangguan kognitif pada ODS, seperti memori kerja dan pengambilan keputusan, berpotensi meningkatkan risiko bunuh diri. Penelitian ini bermaksud mencari hubungan fungsi kognitif, pengambilan keputusan, faktor obat, serta faktor yang memengaruhi lainnya dengan gagasan bunuh diri pada ODS yang belum banyak diteliti. Metode: Desain penelitian ini adalah kasus kontrol dalam rentang waktu Oktober 2023 hingga April 2024. Sampel penelitian adalah orang dengan diagnosis skizofrenia atau skizoafektif dalam fase remisi yang ada di Poliklinik Jiwa dan bangsal rawat inap RSUPN Cipto Mangunkusumo, kantor pusat Komunitas Peduli Skizofrenia Indonesia (KPSI), dan bangsal rawat inap RSJ dr. H. Marzoeki Mahdi Bogor. Besar sampel dari penelitian ini ada 49 dengan gagasan bunuh diri dan 49 tanpa gagasan bunuh diri. Penilaian kemampuan pengambilan keputusan menggunakan instrumen IOWA Gambling Task (IGT). Instrumen yang digunakan untuk menilai kecepatan pemrosesan, memori kerja, dan fungsi eksekutif adalah symbol coding, digit sequencing task, dan Tower of London. Perceived stress scale (PSS) digunakan untuk menilai distres subjektif. Data lain dinilai dengan kuesioner demografik. Analisis bivariat dan multivariat dengan regresi logistik digunakan untuk menilai faktor risiko dari gagasan bunuh diri pada ODS. Hasil: Dari 98 subjek, didapatkan adanya hubungan antara umur dengan gagasan bunuh diri pada ODS (p=0,008). Didapatkan ada hubungan antara jenis kelamin dengan gagasan bunuh diri (p=0,008; OR=3,24; IK95% 1,42 – 7,41). Didapatkan ada hubungan antara memori kerja dengan gagasan bunuh diri (p=<0,001). Hasil fungsi eksekutif A dan B ditemukan berhubungan dengan gagasan bunuh diri (p=0,028 dan p=0,047). Didapatkan ada hubungan antara distres subjektif dengan gagasan bunuh diri (p=<0,001). Pada analisis multivariat dengan regresi logistik, didapatkan ada hubungan yang bermakna antara umur (B=-1,44; p=0,020; aOR=0,24; IK95%=0,07 – 0,80), status pernikahan (B=-1,37; p=0,03; aOR=0,26; IK95%=0,07 – 0,90), memori kerja (B=2,33; p=0,043; aOR=10,23; IK95%=1,07 – 97,61), dan distres subjektif (B=2,41; p=<0,001; aOR=11,17; IK95%=3,46 – 36,06) dengan gagasan bunuh diri. Simpulan: Terdapat hubungan antara umur, status pernikahan, memori kerja, dan distres subjektif terhadap gagasan bunuh diri pada ODS. Dengan mengetahui faktor risiko ini, intervensi dengan faktor terkait dapat dilakukan.

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Background: Suicide is a deliberate act to end one’s life, with one completed case occurring for every 20 attempts. Approximately 90% of suicide survivors have psychiatric disorders, one of them is schizophrenia. Suicide rates among people with schizophrenia (PwS) are reported to range from 4% to 13%. Suicide risk factors include subjective distress, cognitive impairments, and social distortions, influenced by structural and functional brain issues. Cognitive impairments in PwS, such as working memory and decision-making, may increase suicide risk. This study aims to examine the relationship between cognitive function, decision-making, medications, and other influencing factors on suicidal ideation in PwS, which has not been widely studied.

Methods: This case-control study was conducted from October 2023 to April 2024. The sample consisted of individuals diagnosed with schizophrenia or schizoaffective disorder in remission condition, recruited from the Psychiatry Outpatient Clinic and inpatient wards of RSUPN Cipto Mangunkusumo, the central office of the Indonesian Schizophrenia Care Community (KPSI), and the inpatient wards of RSJ Dr. H. Marzoeki Mahdi Bogor. The sample included 49 individuals with suicidal ideation and 49 without. Decision-making ability was assessed using the Iowa Gambling Task (IGT). Cognitive functions such as processing speed, working memory, and executive function were evaluated using Symbol Coding, Digit Sequencing Task, and Tower of London tests, respectively. Subjective distress was measured using the Perceived Stress Scale (PSS). Additional data were collected using demographic questionnaires. Bivariate and multivariate analyses using logistic regression were performed to assess the risk factors for suicidal ideation in PwS.

Results: Among 98 subjects, age was significantly associated with suicidal ideation in PwS (p=0.008). Gender was also associated (p=0.008; OR=3.24; 95% CI=1.42–7.41). Working memory showed a significant relationship with suicidal ideation (p<0.001). Executive function tasks A and B were associated with suicidal ideation (p=0.028 and p=0.047, respectively). Subjective distress was significantly linked to suicidal ideation (p<0.001). Multivariate logistic regression analysis revealed significant associations between age (B=-1.44; p=0.020; aOR=0.24; 95% CI=0.07–0.80), marital status (B=-1.37; p=0.03; aOR=0.26; 95% CI=0.07–0.90), working memory (B=2.33; p=0.043; aOR=10.23; 95% CI=1.07–97.61), and subjective distress (B=2.41; p<0.001; aOR=11.17; 95% CI=3.46–36.06) with suicidal ideation.

Conclusion: Age, marital status, working memory, and subjective distress are associated with suicidal ideation in PwS. Understanding these risk factors may facilitate targeted interventions to mitigate suicide risk."

"Tesis ini disusun untuk menilai pengaruh latihan Functional Chewing terhadap fungsi mengunyah pasien anak palsi serebral dengan disfagia fase orofaringeal menggunakan metode penelitian evidence-based case report (EBCR). Pencarian literatur dilakukan pada Cochrane, Pubmed, Science direct, Oxford Academic dan Sage Journals sesuai dengan pertanyaan klinis. Penelitian ini menggunakan meta-analisis pada kedua jurnal yang didapat untuk menilai kualitasnya berdasarkan validitas, kepentingan dan aplikabilitasnya. Dari hasil meta-analisis didapatkan bahwa subjek penelitian adalah disfagia orofaringeal pada anak palsi serebral dengan GMFCS level V dan indikator kemampuan mengunyah Karaduman Chewing Performance Scale (KCPS) 4 yang mendapatkan latihan Functional Chewing memiliki kemampuan mengunyah yang lebih baik dibandingkan yang mendapatkan latihan oromotor tradisional. Kesimpulan penelitian ini adalah latihan Functional Chewing dapat meningkatkan kemampuan mengunyah pada pasien anak palsi serebral dengan disfagia fase orofaringeal.

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This thesis was designed to assess the effect of Functional Chewing exercise on the chewing function of children with cerebral palsy with oropharyngeal dysphagia using an evidence-based case report (EBCR) research method. A literature search was performed on Cochrane, Pubmed, Science direct, Oxford Academic and Sage Journals according to clinical questions. This study uses a meta-analysis of the two journals obtained to assess their quality based on their validity, importance and applicability. From the results of the meta-analysis, it was found that the research subject was oropharyngeal dysphagia in children with cerebral palsy with GMFCS level V and the Karaduman Chewing Performance Scale (KCPS) 4 chewing ability indicator who received Functional Chewing exercise had better chewing ability than those who received traditional oromotor exercise. The conclusion of this study is that Functional Chewing exercises can improve chewing ability in children with cerebral palsy with oropharyngeal dysphagia."

"ABSTRAKTujuan. 1. mengetahui hubungan antara FA yang lebar dengan perkembangan motorikkasar dan bahasa pada anak usia 6-24 bulan, 2. mengetahui hubungan antara fontanelanterior yang lebar dengan perkembangan otak yang abnormal dari pemeriksaan USG kepala,3. mengetahui faktor-faktor risiko yang berperan dalam perkembangan motorik kasar danbahasa pada anak dengan FA lebar.Metode. Desain penelitian adalah kasus kontrol untuk menilai perkembangan motorikkasar dan bahasa menggunakan pemeriksaan Denver II dan perkembangan otak dinilaidengan pemeriksaan USG kepala, pada anak usia 6-24 bulan dengan ukuran FA lebar (≥ 1 SD)sesuai kelompok usia. Kelompok kasus jika perkembangan motorik kasar dan bahasanyaterlambat sedangkan kelompok kontrol jika perkembangan motorik kasar dan bahasanyanormal yang dipasangkan sesuai kelompok usianya, yang berobat ke RSUPN dr. CiptoMangunkusumo antara bulan Desember 2017 sampai dengan Mei 2018. Faktor-faktor risikodianalisis secara bivariat dan multivariat.Hasil penelitian. Dari 127 anak dengan FA lebar, 9 anak dieksklusi, sehingga ada 118 anaksebagai subyek penelitian. Pada kelompok kasus maupun kontrol ada 59 subyek, terdiri dari18 anak (usia 6-<9 bulan), 16 anak (usia 9-<12 bulan), 17 anak (usia 12-<18 bulan) dan 8anak (usia 18-<24 bulan). Pada kelompok anak dengan FA lebar (>2SD) lebih banyakditemukan pada kelompok kasus, sebaliknya pada anak dengan FA ≥1 SD ≤ 2SD lebihbanyak ditemukan pada kelompok kontrol. Pada analisis bivariat didapatkan faktorrisiko yang bermakna adalah status gizi kurang, kelahiran prematur, LK abnormal danhasil USG kepala abnormal. Pada analisis multivariat didapatkan anak dengan FA lebarberhubungan bermakna dengan riwayat kelahiran prematur (OR 7,5; IK 95% 1,585-35,913)dan abnormalitas USG kepala (OR 29; IK 95% 3,82-225,37).Simpulan. Anak dengan FA lebar >2 SD lebih banyak ditemukan perkembangan motorikkasar dan bahasa yang terlambat, dan berhubungan bermakna dengan kelahiran prematurdan abnormalitas USG kepala.

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ABSTRACTBackground. Abnormalities in head circumference (HC) and anterior fontanel (AF) size in children may reveal clues to assessment of intrauterine brain growth disorders. Brain growth disorders may lead to clinical manifestations of impaired growth and development of children. Objectives. (1) to determine the relationship between large AF with gross motor and language developmental in children aged 6-24 months, (2) to determine the relationship between large AF with abnormalities of brain growth by cerebral ultrasound, (3) to find the association of risk factors of gross motor and language developmental in children with large AF. Methodes. A case control study was to assess gross motor and language development by using Denver II and brain growth by cerebral ultrasound in children aged 6-24 months with large AF (≥ 1 SD) visiting dr. Cipto Mangunkusumo National General Hospital between December 2017 and May 2018. Case group consisted of gross motor and language developmental delay, control group consisted of similar children but who were normal of gross motor and language development. Both groups were matched according to gender and aged. Bivariate and multivariate analysis were done to identify significant risk factors. Results. Out of 127 large AF children, 9 child who meet exclusion criteria, subject in the study was 118 children. Case groups and control groups were 59 subject; 18 subject (6-<9 months), 16 subject (9-<12 months), 17 subject (12-<18 months) and 8 subject (18-<24 months). Most children of AF >2 SD with gross motor and language development delay were compared to children of AF ≥1 SD- ≤2 SD with normal of gross motor and language development. Bivariate analysis showed that significantly of risk factors were under nutrition, premature, abnormality HC and abnormality cerebral ultrasound. Multivariate analysis showed that significantly prematurity (OR 7,5; IK 95% 1,585-35,913) and abnormality cerebral ultrasound (OR 29; IK 95% 3,82-225,37) in children of large AF with gross motor and language development delay. Conclussions. The most of children of large AF (> 2 SD) were gross motor and language development delay, and significantly with prematurity and abnormality cerebral ultrasound."

"[ABSTRAK Latar Belakang Masalah saluran napas yaitu pneumonia aspirasi merupakan masalah utama berkaitan dengan kualitas hidup morbiditas dan mortalitas pada anak palsi serebral PS Faktor yang berperan terhadap timbulnya pneumonia aspirasi antara lain adalah kelemahan otot napas gangguan koordinasi menelan refluks gastro esofagus status gizi dan imunitas yang kurang baik Namun hingga kini belum ada data seberapa besar insidens pneumonia aspirasi pada anak dengan PS di Indonesia dan faktor risiko yang berhubungan Tujuan Mengetahui insidens pneumonia aspirasi pada anak dengan PS dan hubungan faktor risiko dengan kejadian pneumonia aspirasi Metode Penelitian ini adalah studi kohort prospektif untuk menilai insidens pneumonia aspirasi dan studi potong lintang untuk menilai faktor risiko pneumonia aspirasi Penelitian ini dilakukan di Ruang Rawat Inap dan Klinik Neurologi Departemen Ilmu Kesehatan Anak Rumah Sakit Cipto Mangukusumo Waktu rekrutmen penelitian 1 Maret 31 Maret 2015 Waktu pengamatan tanggal 1 April 30 September 2015 Terhadap subyek dilakukan anamnesis termasuk penilaian faktor risiko dengan Dysphagia Disorder Survey pemeriksaan fisis dan R ntgen toraks sebagai data awal selanjutnya subyek diamati selama 6 bulan untuk mengevaluasi adanya pneumonia aspirasi Hubungan bivariat antara kejadian aspirasi dan faktor risiko dilakukan dengan uji Fisher dan Mann Whitney sedangkan analisis multivariat dilakukan dengan regresi logistik Hasil Total subjek penelitian adalah 40 anak dengan PS Dua subjek mengalami drop out karena meninggal dunia dan dua subjek loss to follow up sehingga terdapat 36 pasien yang berhasil diamati hingga enam bulan Sebanyak 8 dari 36 22 2 pasien pada penelitian ini mengalami kejadian aspirasi baik silent aspiration 5 5 maupun pneumonia aspirasi secara klinis 19 4 Derajat beratnya PS berhubungan dengan pneumonia dan silent aspiration p 0 040 sedangkan pneumonia dan silent aspiration tidak berhubungan dengan gangguan koordinasi menelan p 0 2 dan status gizi p 0 107 Simpulan Insidens pneumonia aspirasi pada anak PS adalah 22 2 dengan derajat beratnya PS sebagai faktor risiko terjadinya PS ABSTRACT Background Respiratory problems such as aspiration pneumonia are major morbidities and mortalities in children with cerebral palsy and play major role in the quality of life of these children Several risk factors may contribute to these problems including respiratory muscle weakness dysphagia gastro esophageal reflux disease nutrition and immune problem Nevertheless there are still no data on the incidence and risk factors of aspiration pneumonia in children with cerebral palsy in Indonesia Aim To determine the incidence and risk factors of aspiration pneumonia in children with cerebral palsy Method Incidence of pneumonia was studied prospectively and the prevalence of the risk factors was studied as cross sectional Subjects were recruited from March 1st ndash 31st 2015 through Neurology Clinic and Pediatric Ward Cipto Mangukusumo Hospital At baseline we evaluate history physical examination risk factors using Dysphagia Disorder Survey and chest X ray to evaluate the incidence of silent aspiration Subjects were followed up for six months to determine the incidence of aspiration pneumonia Analysis of the risk factors contributing to aspiration pneumonia were tested using Fisher rsquo s exact test and Mann Whitney Multivariate analysis was tested using logistic regression Result A total of 40 children with cerebral palsy were recruited Two subjects died during follow up and two subjects were loss to follow up giving a total of 36 subjects who completed the study Eight out of 36 subjects 22 2 had one or more episodes of aspiration consisting of silent aspiration 5 5 and clinically diagnosed aspiration pneumonia 19 4 Gross motor function was statistically signifant as risk factor of aspiration pneumonia p 0 040 while dysphagia p 0 2 and nutritional status p 0 107 were not associated with pneumonia and silent aspiration Conclusion Incidence of aspiration pneumonia and silent aspiration in children with cerebral palsy is 22 2 with gross motor function as a risk factor ;Background Respiratory problems such as aspiration pneumonia are major morbidities and mortalities in children with cerebral palsy and play major role in the quality of life of these children Several risk factors may contribute to these problems including respiratory muscle weakness dysphagia gastro esophageal reflux disease nutrition and immune problem Nevertheless there are still no data on the incidence and risk factors of aspiration pneumonia in children with cerebral palsy in Indonesia Aim To determine the incidence and risk factors of aspiration pneumonia in children with cerebral palsy Method Incidence of pneumonia was studied prospectively and the prevalence of the risk factors was studied as cross sectional Subjects were recruited from March 1st ndash 31st 2015 through Neurology Clinic and Pediatric Ward Cipto Mangukusumo Hospital At baseline we evaluate history physical examination risk factors using Dysphagia Disorder Survey and chest X ray to evaluate the incidence of silent aspiration Subjects were followed up for six months to determine the incidence of aspiration pneumonia Analysis of the risk factors contributing to aspiration pneumonia were tested using Fisher rsquo s exact test and Mann Whitney Multivariate analysis was tested using logistic regression Result A total of 40 children with cerebral palsy were recruited Two subjects died during follow up and two subjects were loss to follow up giving a total of 36 subjects who completed the study Eight out of 36 subjects 22 2 had one or more episodes of aspiration consisting of silent aspiration 5 5 and clinically diagnosed aspiration pneumonia 19 4 Gross motor function was statistically signifant as risk factor of aspiration pneumonia p 0 040 while dysphagia p 0 2 and nutritional status p 0 107 were not associated with pneumonia and silent aspiration Conclusion Incidence of aspiration pneumonia and silent aspiration in children with cerebral palsy is 22 2 with gross motor function as a risk factor ;Background Respiratory problems such as aspiration pneumonia are major morbidities and mortalities in children with cerebral palsy and play major role in the quality of life of these children Several risk factors may contribute to these problems including respiratory muscle weakness dysphagia gastro esophageal reflux disease nutrition and immune problem Nevertheless there are still no data on the incidence and risk factors of aspiration pneumonia in children with cerebral palsy in Indonesia Aim To determine the incidence and risk factors of aspiration pneumonia in children with cerebral palsy Method Incidence of pneumonia was studied prospectively and the prevalence of the risk factors was studied as cross sectional Subjects were recruited from March 1st ndash 31st 2015 through Neurology Clinic and Pediatric Ward Cipto Mangukusumo Hospital At baseline we evaluate history physical examination risk factors using Dysphagia Disorder Survey and chest X ray to evaluate the incidence of silent aspiration Subjects were followed up for six months to determine the incidence of aspiration pneumonia Analysis of the risk factors contributing to aspiration pneumonia were tested using Fisher rsquo s exact test and Mann Whitney Multivariate analysis was tested using logistic regression Result A total of 40 children with cerebral palsy were recruited Two subjects died during follow up and two subjects were loss to follow up giving a total of 36 subjects who completed the study Eight out of 36 subjects 22 2 had one or more episodes of aspiration consisting of silent aspiration 5 5 and clinically diagnosed aspiration pneumonia 19 4 Gross motor function was statistically signifant as risk factor of aspiration pneumonia p 0 040 while dysphagia p 0 2 and nutritional status p 0 107 were not associated with pneumonia and silent aspiration Conclusion Incidence of aspiration pneumonia and silent aspiration in children with cerebral palsy is 22 2 with gross motor function as a risk factor , Background Respiratory problems such as aspiration pneumonia are major morbidities and mortalities in children with cerebral palsy and play major role in the quality of life of these children Several risk factors may contribute to these problems including respiratory muscle weakness dysphagia gastro esophageal reflux disease nutrition and immune problem Nevertheless there are still no data on the incidence and risk factors of aspiration pneumonia in children with cerebral palsy in Indonesia Aim To determine the incidence and risk factors of aspiration pneumonia in children with cerebral palsy Method Incidence of pneumonia was studied prospectively and the prevalence of the risk factors was studied as cross sectional Subjects were recruited from March 1st ndash 31st 2015 through Neurology Clinic and Pediatric Ward Cipto Mangukusumo Hospital At baseline we evaluate history physical examination risk factors using Dysphagia Disorder Survey and chest X ray to evaluate the incidence of silent aspiration Subjects were followed up for six months to determine the incidence of aspiration pneumonia Analysis of the risk factors contributing to aspiration pneumonia were tested using Fisher rsquo s exact test and Mann Whitney Multivariate analysis was tested using logistic regression Result A total of 40 children with cerebral palsy were recruited Two subjects died during follow up and two subjects were loss to follow up giving a total of 36 subjects who completed the study Eight out of 36 subjects 22 2 had one or more episodes of aspiration consisting of silent aspiration 5 5 and clinically diagnosed aspiration pneumonia 19 4 Gross motor function was statistically signifant as risk factor of aspiration pneumonia p 0 040 while dysphagia p 0 2 and nutritional status p 0 107 were not associated with pneumonia and silent aspiration Conclusion Incidence of aspiration pneumonia and silent aspiration in children with cerebral palsy is 22 2 with gross motor function as a risk factor ]"