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"[ABSTRAKPada fraktur pelvis tidak stabil yang disertai dengan fraktur vertikal sakrum (AO Tipe C1.3) terdapat instabilitas terhadap gaya shearing aksial yang besar. Fiksasi pada fraktur tersebut harus memberikan kekuatan biomekanik yang baik dan minimal invasif. Penempatan sekrup iliosakral (SIS) di S1-S3 secara divergen dapat meningkatkan kekuatan biomekanik terutama kekakuan translasi. Tujuan penelitian ini adalah mengevaluasi kekuatan biomekanik SIS S1-S3 dan sekrup pubis (PS) dibandingkan konfigurasi fiksasi lain untuk memberikan solusi konfigurasi fiksasi baru pada fraktur pelvis AO Tipe C1.3.Simulasi fraktur pelvis dibuat dengan fraktur ramus pubis superior, inferior, dan fraktur vertikal sakrum ipsilateral (AO tipe C1.3) pada tulang sintetik Synbone®. Enam kombinasi fikasi yaitu Tension Band Plate (TBP)+PS, TBP+plat symphysis (SP), SIS S1-S2+PS, SIS S1-S2+SP, SIS S1-S3+PS, SIS S1-S3+SP diuji dengan diberikan beban aksial menggunakan mesin kompresi Tensilon® sampai titik kegagalan fiksasi sebesar ≥2 mm atau ≥20, kemudian dievaluasi kekakuan translasi, kekakuan rotasi, dan titik kegagalan fiksasi. Analisis statistik dilakukan dengan uji ANOVA dilanjutkan dengan uji post-hoc BonferroniDari hasil uji biomekanik didapatkan kelompok fiksasi SIS S1-S3+PS memiliki kekakuan translasi, kekakuan rotasi, dan titik kegagalan fiksasi tertinggi (830,36 N/mm, 599,68 N/°, dan 1522,20 N) terhadap beban aksial.Fiksasi SIS di S1-S3 dan sekrup pubis merupakan fiksasi terbaik untuk fraktur pelvis tidak stabil dengan fraktur vertikal sakrum karena mempunyai properti biomekanik yang baik dan secara klinis fiksasi ini memberikan keuntungan prosedur yang minimal invasif dan pasien dapat mobilisasi segera sehingga mengurangi komplikasi postoperatif.

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ABSTRACTIn unstable pelvic fracture with vertical sacral fracture (AO Type C1.3), there are tremendous instability towards axial shearing load. Ideally, the fixation should provide good biomechanical properties and minimal invasive. Divergent Iliosacral screw (ISS) placement on S1-S3 could enhance biomechanical strength. The purpose of this research was to evaluate the biomechanical properties of ISS S1-S3 and pubic screw (PS) compared to other configuration to provide solution for new configuration of fixation in AO Type C1.3 pelvic fracture.A simulation of pelvic fracture was created on superior and inferior pubic rami, and ipsilateral vertical sacral fracture (AO Type C1.3) on a synthetic bone (Synbone®). Six fixation combination including tension band plate (TBP)+PS, TBP+symphyseal plate (SP), ISS S1-S2+PS, ISS S1-S2+SP, ISS S1-S3+PS, ISS S1-S3+SP were tested using compression machine Tensilon® until failure point defined by ≥2 mm or ≥20 displacement was met. Translational stiffness, rotational stiffness and load to failure were evaluated. Statistical analysis was performed with ANOVA test followed by Bonferroni post hoc-test.From biomechanical test, fixation using ISS S1-S3+PS had the highest translational stiffness, rotational stiffness, and load to failure (830,36 N/mm, 599,68 N/°, and 1522,20 N respectively) toward axial load.Fixation by ISS S1-S3+PS was the best configuration in unstable pelvic fracture with vertical sacral fracture due to its good biomechanical strength, minimal invasiveness which renders early immobilization for patients hence decreasing postoperative complications., In unstable pelvic fracture with vertical sacral fracture (AO Type C1.3), there are tremendous instability towards axial shearing load. Ideally, the fixation should provide good biomechanical properties and minimal invasive. Divergent Iliosacral screw (ISS) placement on S1-S3 could enhance biomechanical strength. The purpose of this research was to evaluate the biomechanical properties of ISS S1-S3 and pubic screw (PS) compared to other configuration to provide solution for new configuration of fixation in AO Type C1.3 pelvic fracture.A simulation of pelvic fracture was created on superior and inferior pubic rami, and ipsilateral vertical sacral fracture (AO Type C1.3) on a synthetic bone (Synbone®). Six fixation combination including tension band plate (TBP)+PS, TBP+symphyseal plate (SP), ISS S1-S2+PS, ISS S1-S2+SP, ISS S1-S3+PS, ISS S1-S3+SP were tested using compression machine Tensilon® until failure point defined by ≥2 mm or ≥20 displacement was met. Translational stiffness, rotational stiffness and load to failure were evaluated. Statistical analysis was performed with ANOVA test followed by Bonferroni post hoc-test.From biomechanical test, fixation using ISS S1-S3+PS had the highest translational stiffness, rotational stiffness, and load to failure (830,36 N/mm, 599,68 N/°, and 1522,20 N respectively) toward axial load.Fixation by ISS S1-S3+PS was the best configuration in unstable pelvic fracture with vertical sacral fracture due to its good biomechanical strength, minimal invasiveness which renders early immobilization for patients hence decreasing postoperative complications.]"

"Permasalahan. Penelitian tentang efek sepatu hak tinggi masih menuai kontroversi akibat beberapa faktor, salah satunya adalah dalam mempengaruhi kurvatura vertebrae lumbales, sehingga belum diketahui secara pasti mekanisme perubahan kurvatura lordosis vertebrae lumbales.Tujuan. Mengetahui efek sepatu hak tinggi dalam mengubah parameter lumbosakropelvis, serta diketahuinya korelasi antar parameter lumbosakropelvis pada saat berdiri statis menggunakan sepatu hak tinggi.Metode. Penelitian ini melibatkan total 35 peserta wanita. Setiap peserta diwawancara, dipisahkan menjadi kelompok tidak terbiasa menggunakan sepatu hak tinggi Grup NHT dan kelompok terbiasa menggunakan sepatu hak tinggi Grup HT ; dilakukan penandatanganan formulir informed consent dan pemeriksaan fisik, kemudian dilakukan pemeriksaan radiografi konvensional pada segmen lumbal dan pelvis pada kondisi tanpa alas kaki dan dengan menggunakan sepatu hak tinggi.Hasil. Grup NHT menunjukan berkurangnya lordosis lumbal, berkurangnya sacral slope dan retroversi pelvis yang signifikan, namun pelvic incidence relatif tidak berubah. Grup HT menunjukan bertambahnya lordosis lumbal dan pelvic incidence yang signifikan, namun sacral slope dan pelvic tilt relatif tidak berubah. Pada grup NHT ditemukan korelasi antara sacral slope dan pelvic incidence, namun grup HT ditemukan korelasi antar parameter lumbosakropelvis, kecuali antara lordosis lumbal dengan pelvic incidence.Kesimpulan. Sepatu hak tinggi memberikan efek yang berbeda pada parameter lumbosakropelvis dan menghilangkan sebagian korelasinya.

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Problem. The research about shoes effects still give controversy results because of several factors, including the effect that influence the vertebrae lumbales curvature, so it hasn rsquo t known for certain about mechanisms that change the vertebrae lumbales lordosis curvature.

Purpose. To find out high heeled shoes effects that can change lumbosacroplevic parameter and also to discover the correlation between lumbosacroplevic parameter.

Method. This research involves a total of 35 women. Each subject must pass an interview session, separated into non high heeled user NHT grup and high heeled user HT grup with informed written consent and physical examination, then performed a conventional radiography examination on lumbal and pelvis while standing barefoot and wearing high heels shoes.

Result. NHT group shows a reducing lumbal lordosis, reducing sacral slope and pelvis retroversion significantly, but pelvic incidence angle insignificantly didn rsquo t chance. HT group shows an increasing lumbal lordosis and pelvic incindence significantly, but sacral and pelvic tilt insignificantly didn rsquo t chance. NHT group shows a correlation between sacral slope and pelvic incidence, but HT gorup has a correlation among the lumbosacropelvic parameters, except between lordosis lumbal and pelvic incidence.

Conclusion. High heels shoes have a diverse effect to change lumbosacropelvic parameters dan dismiss its correlation partially."

"Dalam kehidupan sehari-hari banyak hal yang mengharuskan orang untuk melakukan aktivitas lain sambil berjalan. Tujuan dari penelitian ini adalah untuk menganalisa perubahan kinesia dan biomekanika subjek dengan Parkinsonisme saat melakukan aktivitas lain selama berjalan / tugas ganda. Penelitian ini merupakan penelitian analitik observasional dengan desain potong lintang. Subjek dikelompokkan menjadi dua kelompok yang berbeda. Kelompok pertama terdiri dari 14 subjek dengan Parkinsonisme, dan kelompok kedua terdiri dari 14 subjek sehat dengan rentang usia yang sama (kontrol). Keadaan pola berjalan diukur dalam dua kondisi yang berbeda: (1) berjalan tanpa aktivitas lain (tugas tunggal) dan (2) berjalan sambil menjawab pertanyaan dari telepon (tugas ganda). Durasi satu siklus berjalan, panjang satu siklus berjalan, kecepatan berjalan, sudut ankle, dan episode freezing of gait dianalisa dengan Kinovea. Hasil penelitian menunjukkan bahwa tidak ada perbedaan yang signifikan antara subyek kontrol untuk semua variabel pola berjalan. Namun, ada perbedaan yang signifikan dalam semua variabel pola berjalan saat tugas ganda (P <0, 05) pada subjek dengan Parkinsonisme bila dibandingkan saat tugas tunggal. Temuan penelitian ini menunjukkan bahwa subjek dengan Parkinsonisme mengalami kesulitan melakukan aktivitas lain sambil berjalan / tugas ganda dan menyarankan terapi fungsional untuk peningkatan kualitas hidup.

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Many daily activities require people to complete another task while walking. The purpose of this study was to analyze the change of kinesia and biomechanics of the subjects with Parkinsonism when perform another tasks during walking / dual tasking.This research is an observational analytic research with cross sectional design. Subjects were classified into two different groups. The first group consisted of 14 subjects with Parkinsonism, and the second group consisted 14 age-matched healthy subjects (control). Gait performance was measured under two different conditions: (1) preferred walking (single task) and (2) walking while answering questions from telephone (dual task). Gait cycle time, gait cycle length, gait velocity, angkle joint angle, and freezing of gait episode were examined with Kinovea. Our results showed that there were no significant differences between control subjects for all gait variables. However, there were significant differences in all dual-task-related gait variables (P < 0, 05) in Parkinsonism subjects compared with single task. The findings of this study suggest that subjects with Parkinsonism have difficulty performing another task while walking / dual tasking and recommend for planning physiotherapy to improve the quality of life of the Parkinsonism.

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