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"ABSTRAKThe physiotherapy statistics from the Saraburi Hospital in Thailand show that patients with chronic lower back pain from muscle tearing have a higher tendency toward chronic pain, requiring continuous treatment. Most physiotherapists use radial shockwave therapy (RSWT) or radial pulse therapy to treat patients with chronic muscle tears. The aim of this study was to determine the immediate efficacy of RSWT on patients with lower back pain caused by chronic muscle strain. The purpose of this work is to assess the effectiveness of RSWT in the treatment of chronic back muscle pain. The type of this research is quasi-experimental research study. The location is this study is Physical Therapy Clinic at the Saraburi Hospital in Thailand. The study participants had pain intensities of greater than 5 out of 10. The experimental group (30 patients) received RSWT to the lower back for 10-15 minutes once a week for 6 weeks. The control group (30 patients) received ultrasound (US) treatments to the lower back using the semi-static technique with gel, but without turning the machine on, for 15 minutes once a week for 6 weeks. Both groups were taught to avoid bending and carrying heavy loads, as well as the correct way to lift heavy objects. None of the patients received medications, injections, massages, or acupuncture. The pain levels in both groups at work and at rest were measured using a visual analog scale. The treatment results were evaluated and compared at the 1st, 4th, and 6th treatments. The patient satisfaction was assessed at the 6 treatments as follows: 1 = most, 2 = high, 3 = moderate, 4 = low, and 5 = minimum. The effects on daily life and career performance were measured before the study and at the end as follows: 1 = most, 2 = high, 3 = moderate, 4 = low, 5 = minimum, and 6 = no effect. A statistical analysis was performed on the demographic data as well as on the pain level comparisons. The results of the RSWT and US treatments were measured while the patients were resting and working at 1, 4, and 6 months. Twelve and 18 of the patients were cured, respectively. In the US groups, 6 patients were statistically significantly better at the , , and treatments (but no cures). The post-treatment satisfaction was not significantly different between the RSWT and US groups. Consequently, the use of RSWT to treat chronic muscle strain can reduce pain immediately, and it can cure pain completely in some cases. Therefore, it should be used to treat more patients with chronic muscle strain. It should also be considered for use in chronic pain cases in which the patient does not respond to other conservative treatments."

"Fisioterapi dada pada anak dengan masalah bersihan jalan napas tidak efektif merupakan tindakan mandiri perawat yang menjadi kontroversi akhir dekade ini. Tujuan penelitian: Mengidentifikasi dampak fisioterapi dada terhadap status pernapasan (SpO2, WCSSS, HR) pada anak usia kurang dari dua tahun dengan ISPA di RSGS. Metode: Descriptive correlational dengan pre test dan post test tanpa kelompok kontrol. Hasil: Setela intervensi fisioterapi dada terdapat perbedaan yang signifikan pada status pernapasan sebelum dan sesudah fisioterapi dada yang dilihat dari penurunan rata-rata skor keparahan klinis (WCSSS) dari 2,96 menjadi 2,07, kenaikan rata-rata saturasi oksigen perifer (SpO2) dari 95% menjadi 97% dan penurunan Heart rate dari 149x/menit menjadi 130x/menit pada infant dan 118x/menit menjadi 97x/menit pada toddler (p value <0,05). Saran: perlunya penelitian dengan kelompok kontrol dan jumlah sampel yang banyak untuk mengetahui besarnya pengaruh inhalasi terhadap fisioterapi dada.

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CPT for children with ineffective airway clearance as one of nursing intervention is in controversial in last decades.

The aims are to obtain the impact of CPT on under-two-year children respiratory status (SpO2, WCSSS, HR) in Gatot Subroto hospital.

Method: descriptive correlation without controlled group with pre-test dan post-test.

Results: After CPT intervention there is a significant different between child’s respiratory status before and after CPT’s intervention showed by WCSSS declined from 2,96 to 2,07, SpO2 increased from 95% to 97% and heart rate declined from 149 x/min to 130x/min for infant and from 118x/min to 97x/min for toddler (P value < 0,05).

Recommendation: deep analysis using large sample and control group are required to measure the impact of inhalation therapy to CPT."

"Community-Acquired Pneumonia CAP adalah penyakit sistem pernapasan yang menyerang jaringan parenkim paru. Penyakit ini banyak mengancam individu dewasa dengan penurunan sistem imun. Penderita CAP mengalami peningkatan setiap tahunnya akibat peningkatan polusi udara yang berada di wilayah perkotaan, terutama pada kawasan industri. Penderita CAP akan mengalami peningkatan produksi sputum yang berujung pada kesulitan dalam mengeluarkan sputum. Pasien dengan CAP sering mengalami penurunan refleks batuk yang membuat sputum terakumulasi di jalan napas sehingga menyebabkan peningkatan usaha untuk bernapas. Fisioterapi dada merupakan salah satu teknik pembersihan jalan napas pada pasien dengan penurunan refleks batuk. Karya Ilmiah Akhir Ners ini bertujuan untuk menganalisis intervensi fisioterapi dada untuk mengurangi gejala serta mencegah perburukan pada pasien dengan CAP. Metodologi yang digunakan adalah metode studi kasus dan analisa penelitian yang telah ada. Hasil analisa yang didapatkan menunjukkan fisioterapi dada dapat menurunkan usaha napas pasien, pengurangan episode demam, perubahan karakteristik sputum, serta penuruan persentase mortalitas melalui skoring CURB-65.

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Community Acquired Pneumonia CAP is a respiratory disease that attacks the pulmonary parenchymal tissue. This disease threatens many adults with decreased immune system. CAP sufferers are increasing every year due to increasing air pollution in urban areas, especially in industrial areas. CAP sufferers will experience an increase in sputum production that leads to difficulties in removing sputum. Patients with CAP often have decreased cough reflexes that make sputum accumulate in the airway causing increased effort to breathe. Chest physiotherapy is one of the airway cleansing techniques in patients with decreased cough reflexes.

This Final Scientific Work of Ners aims to analyze the interventions of chest physiotherapy to reduce symptoms and prevent worsening of patients with CAP. The methodology used is the case study method and the existing research analysis. The results obtained showed chest physiotherapy can decrease the patient 39 s breathing effort, reduction of febrile episodes, changes in sputum characteristics, as well as the percentage of mortality by scoring CURB 65."

"Penyakit Covid-19 merupakan penyakit yang menyebabkan masalah pernapasan. Covid-19 memiliki beberapa gejala yang biasanya muncul setelah periode inkubasi. Beberapa gejala umum dari Covid-19 yaitu demam, batuk dan kelelahan, gejala lain seperti produksi sputum, sakit kepala, diare, dispnea, dan lymphopenia juga dapat terjadi. Beberapa pasien yang mengalami batuk dengan produksi sputum memiliki keterbatasan untuk mempertahankan kebersihan jalan napas secara mandiri karena sputum yang terlalu kental dan ketidakmampuan untuk batuk secara efektif. Ketidakmampuan untuk mengeluarkan sputum dapat menyebabkan penumpukan sputum di jalan napas yang menyebabkan obstruksi sehingga ventilasi berkurang. Salah satu peran perawat di IGD adalah melakukan stabilisasi pasien dari sisi Airway, Breathing, Circulation, Disability, Exposure (ABCDE). Pada pasien dengan retensi sputum dapat mengalami penyumbatan jalan napas. Salah satu intervensi keperawatan yang umum untuk pasien dengan retensi sputum yaitu kolaborasi pemberian mukolitik dan prosedur suction. Namun prosedur suction ini dapat menimbulkan nyeri dan risiko cedera jalan napas jika sputum terlalu kental, sehingga perlu dipertimbangkan antara manfaat dan efek sampingnya. Intervensi non invasive lain yang dapat dilakukan untuk mengeluarkan dahak adalah fisioterapi dada dan batuk efektif. Pada studi kasus ini mempresentasikan kasus seorang perempuan (45 tahun) dengan demam 4 hari sebelum masuk rumah sakit, lemas, sesak, pusing, mual, anosmia dan tidak bisa tidur, batuk produktif namun kesulitan mengeluarkan sputum, terkonfirmasi positif Covid-19 melalui swab antigen dan PCR. Saat berada di IGD pasien mendapatkan terapi oksigenasi nasal kanul, medikasi dan fisioterapi dada. Setelah dilakukan dua kali fisioterapi dada, pasien dapat mengeluarkan dahak dan saturasi meningkat. Studi kasus ini menunjukkan seberapa kegunaan fisioterapi dada dan batuk efektif sebagai salah satu intervensi untuk membantu mengatasi diagnosa ketidakefektifan bersihan jalan napas pada pasien Covid-19.

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Covid-19 is a disease that causes respiratory problems. Covid-19 has several symptoms that usually appear after the incubation period. Some of the common symptoms of Covid-19 are fever, cough, fatigue, other symptoms such as sputum production, headache, diarrhea, dyspnea, and lymphopenia can also occur. Some patients who have a cough with sputum production have limited ability to maintain a clean airway independently because of excessively thick sputum and an inability to cough effectively. The inability to excrete sputum can lead to a buildup of sputum in the airways which obstructs so that ventilation is reduced. One of the nurse's roles in the ER is to stabilize the patient from the Airway, Breathing, Circulation, Disability, Exposure (ABCDE) side. Patients with sputum retention may experience airway obstruction. One of the common nursing interventions for patients with sputum retention is the collaboration of mucolytic administration and suction procedures. However, this suction procedure can cause pain and the risk of airway injury if the sputum is too thick, so it is necessary to consider the benefits and side effects. Another non-invasive intervention that can be done to remove sputum is chest physiotherapy and effective coughing. In this case study, we present the case of a woman (45 years old) with fever 4 days before hospital admission, weakness, shortness of breath, dizziness, nausea, anosmia and unable to sleep, productive cough but difficulty expel sputum, confirmed positive for Covid-19. While in the ED the patient received nasal cannula oxygenation therapy, medication, and chest physiotherapy. After two chest physiotherapy, the patient was able to expel sputum and increased saturation. This case study shows how effective chest and cough physiotherapy is as an intervention to help overcome the diagnosis of ineffective airway clearance in Covid-19 patients."