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"Tujuan: Mengetahui manfaat pemberian mirror therapy dibandingkan sham therapy terhadap pemulihan fungsi tangan. Desain penelitian: Studi intervensi. Metode: Studi randomisasi tersamar tunggal pada pasien strok serangan pertama. Subjek dibagi menjadi 2, yaitu kelompok mirror dan sham, yang diberikan mirror therapy atau sham therapy sebagai tambahan terapi okupasi standar. Parameter Hasil: Fugl Meyer Assessment dan Functional Independence Measure (FIM). Hasil: Delapan belas pasien (rerata usia 53,9 tahun), dengan lama awitan kurang dari 6 bulan ikut serta dalam penelitian ini. Didapatkan peningkatan signifikan pada rerata skor Fugl Meyer pada kedua kelompok setelah 3 minggu dan 6 minggu perlakuan (p<0,001), sedangkan skor FIM meningkat hanya pada 3 minggu pertama. Peningkatan skor Fugl Meyer lebih tinggi pada kelompok mirror (rerata=20,5) dibanding kelompok sham (rerata 13,75), walaupun secara statistik tidak signifikan. Kesimpulan: Mirror therapy dapat meningkatkan pemulihan motorik pada pasien strok fase pemulihan. Dibutuhkan penelitian lebih lanjut dengan sampel lebih besar untuk mendapatkan hasil yang bermakna.

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Objective: To evaluate the effect of mirror therapy on motor recovery of stroke patients.

Study design: Intervention study.

Methods: A randomized, controlled, assessor blinded trial in outpatient with first stroke, that were divided into two groups: mirror and sham. They completed a protocol of six week mirror therapy or sham therapy for 30 minutes 3 times a week, in addition to standard occupational therapy program.

Outcome parameters: Fugl Meyer Assessment for upper extremity and Functional Independence Measure (FIM).

Results: Eighteen patients (mean age 53,9 yo), all within 6 months post stroke were enrolled. Fugl Meyer score increased in both group after three weeks and six weeks intervention (p<0,001), FIM score increased only in the first three weeks. The Fugl Meyer mean score improved more in the mirror group than in the sham group (by mean 20,5 vs. 13,75), but statistically not significant.

Conclusions: Mirror therapy could enhances hand motor recovery in subacute stroke patient. Due to limited sample, further study is needed."

"Tujuan: Menilai manfaat edukasi mengenai gangguan berkemih neurogenik pada pasien cedera medulla spinalis (CMS) di RSUP Fatmawati terhadap pengetahuan dan kemampuan mengatasi masalah.Metode: Desain studi eksperimental. Subyek 22 orang pasien paraplegi karena CMS dengan gangguan berkemih neurogenik yang dirawat pertama kali di RSUP Fatmawati. Subyek diberikan program edukasi yang terdiri dari 7 topik selama rentang 3 minggu. Dilakukan penilaian pengetahuan dan kemampuan masalah dengan menggunakan kuesioner pada awal penelitian, pasca pemberian edukasi, dan 3 bulan pasca edukasi. Selain itu dilakukan penilaian kepentingan topik edukasi menurut subyek dengan skala Likert.Hasil: 22 subyek menyelesaikan penilaian awal dan pasca edukasi, namun hanya 18 orang yang dapat dihubungi saat follow up 3 bulan. Terdapat peningkatan pengetahuan yang bermakna antara awal dan pasca edukasi (p=0,033), pasca edukasi dan follow up (p=0,047). Terdapat peningkatan yang bermakna pada kemampuan menyelesaikan masalah antara awal dan pasca edukasi (p=0,000), tidak terdapat perubahan bermakna antara pasca edukasi dan follow up (p=0,157). Seluruh topik edukasi yang diberikan dianggap penting oleh subyek.Kesimpulan: Terdapat peningkatan pengetahuan dan kemampuan menyelesaikan masalah setelah pemberian edukasi, dan terdapat retensi sampai dengan 3 bulan pasca edukasi. Pemberian program edukasi mengenai gangguan berkemih neurogenik pada pasien CMS penting untuk meningkatkan pengetahuan dan kemampuan menyelesaikan masalah, serta mencegah komplikasi urologis.

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Objective : To evaluate the effect of educational program in neurogenic bladder for spinal cord injury patient at Fatmawati General Hospital in improving knowledge and problem solving skill.

Methods : This is a experimental study. Twenty two paraplegic SCI patients with neurogenic bladder in Fatmawati hospital was included in this study. The subjects was given educational program which consist of 7 topics in 3 weeks period. Questionnaire for evaluating knowledge and problem solving skill was given at the beginning of the study, after completion of education program, and 3 months after education. A likert scale-based questionnaire also given at the end of education to assess patient?s perception of importance regarding the education topics.

Results : All subjects finished the initial and post education assessment, but only 18 subjects finished follow up evaluation. There was significant difference in knowledge between initial and post education assessment (p=0.033) and between post education and follow up (p=0.047). There was significant improvement in problem solving skill between initial and post education assessment (p=0.000) and no significant difference between post education and follow up (p=0.157). All topics given perceived as important by all the subjects.

Conclusion : There is a significant improvement in knowledge and problem solving skill after educational program, and there is retention up to 3 months after education. Educational program in neurogenic bladder for patients with SCI during hospital stay is important in improving patient?s knowledge and problem solving skill also for prevention of urological complication."

"ABSTRAK Latar belakang. International Classification of Functioning, Disability and Health ICF dipublikasi oleh World Health Organization untuk menstandardisasi deskripsi kesehatan dan disabilitas. Comprehensive core set ICF for spinal cord injury SCI in long-term context merupakan perangkat komprehensif yang mewakili sejumlah kategori terpilih dari seluruh klasifikasi dan dapat digunakan bersama dengan penentu kualifikasi ICF untuk mendeskripsikan fungsi dan disabilitas penderita setelah mengalami cedera medula spinalis CMS . Penggunaan penentu kualifikasi ICF menimbulkan pertanyaan perihal reliabilitas interrater.Tujuan. Menilai reliabilitas interrater comprehensive core set ICF for SCI in long-term context dalam praktik rehabilitasi.Metode. Uji reliabilitas merupakan studi observasional yang dilakukan secara potong lintang. Subjek adalah 30 penderita CMS dengan paraplegia kronik yang bertempat tinggal di Wisma Pondok Bambu dan Yayasan Wisma Cheshire. Rater penilai ialah 1 orang SpKFR serta 2 orang PPDS IKFR. Uji reliabilitas menilai 110 kategori ICF, terdiri dari 23 kategori dari komponen fungsi tubuh, 63 kategori dari komponen aktivitas dan partisipasi, serta 24 kategori dari komponen faktor lingkungan. Semua data berbasis ICF diperoleh dari pemeriksaan fisik dan wawancara subjek menggunakan comprehensive core set ICF for SCI in long-term context. Semua wawancara dilakukan secara individual oleh 1 orang PPDS IKFR yang sama, yang telah mengikuti pelatihan prinsip ICF. Pengumpulan data dilakukan dalam ruangan yang tenang dan berlangsung sekitar 2 jam. Reliabilitas dan properti setiap kategori dianalisis secara statistik menggunakan agreement dan weighted kappa. Agreement >60 dan weighted kappa >0,6 menunjukkan reliabilitas baik. Kualifikasi 8 yang berarti tidak spesifik dan 9 yang berarti tidak dapat diterapkan, dianggap missing data.Hasil. Median durasi wawancara berbasis comprehensive core set ICF for SCI in long-term context adalah 31,9 rentang 20,7-62,4 menit. Persentase agreement antar penilai bervariasi antara 0-100 . Weighted kappa bervariasi antara -0,064-1,000. Keseluruhan kategori, 20 kategori dari komponen fungsi tubuh, 59 kategori dari komponen aktivitas dan partisipasi, serta 14 kategori dari faktor lingkungan, memiliki agreement yang baik, yaitu 86,4 , 87,0 , 93,7 , serta 58,3 . Beberapa kategori ICF memiliki reliabilitas yang buruk dan tidak dapat dinilai.Simpulan. Seluruh komponen ICF menunjukkan reliabilitas interrater yang baik dan bervariasi antar kategori dan antar penilai. Penelitian ini menandakan reliabilitas interrater comprehensive core set ICF for SCI in long-term context dapat diterima. Disarankan untuk mengembangkan panduan penilaian yang lebih rinci dan sederhana untuk mengurangi perbedaan antar penilai. Penentu kualifikasi mungkin lebih mudah bila jumlah kualifikasi dikurangi, khususnya pada komponen faktor lingkungan.

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ABSTRACTBackground. The International Classification of Functioning, Disability and Health ICF was published by the World Health Organization to standardize descriptions of health and disability. The comprehensive core set ICF for spinal cord injury SCI in long term context is a comprehensive tool that represents a selection of categories from the whole classification and can be used along with the ICF qualifier scale to describe patients rsquo functioning and disability following SCI. The application of the ICF qualifier scale poses the question of interrater reliability.Objective. To study the interrater reliability of the comprehensive core set ICF for SCI in long term context in rehabilitation practice.Methods. A cross sectional reliability study was conducted. A consecutive sample of 30 SCI patients with chronic paraplegia from Wisma Pondok Bambu and Yayasan Wisma Cheshire participated. One physiatrist and two Physical Medicine and Rehabilitation PM R residents rated the subject rsquo s functioning in 110 ICF categories, consists of 23 categories of the component ldquo body functions rdquo , 63 categories of the component ldquo activity and participation rdquo , and 24 categories of the component ldquo environmental factors rdquo . All ICF data were collected via physical examination and patient interview using the comprehensive core set ICF for SCI in long term context. All interviews were performed independently by the same PM R resident, trained in principles of ICF. Data collection was carried out in quiet room and lasted approximately 2 hour. Reliability and the properties of each category were estimated using the observed agreement and weighted kappa statistic. An observed agreement 60 and weighted kappa 0.6 showed good reliability. The response options 8 lsquo not specified rsquo and 9 lsquo not applicable rsquo were considered missing data.Results. Median time for interviews with the comprehensive core set ICF for SCI in long term context was 31.9 range 20.7 62.4 minutes. The percentage of the observed agreement between the raters ranged from 0 to 100 . The weighted kappa ranged from 0.064 to 1.000. Overall categories, 20 categories of the component ldquo body functions rdquo , 59 categories of the component ldquo activity and participation rdquo , and 14 categories of the component ldquo environmental factors rdquo showed observed good agreement 86.4 , 87.0 , 93.7 , and 58.3 , respectively . Some categories in the ICF were rated as unreliable and immeasurable.Conclusion. The overall ICF components demonstrated good interrater reliability and varied considerably across categories and between raters. This study indicated that the interrater reliability of the comprehensive core set ICF for SCI in long term context was acceptable. It is recommended to establish detailed and simpler measuring guidelines to reduce the differences between raters. The metric of the qualifiers rsquo scale may be improved by reducing the number of qualifiers especially for ldquo environmental factors rdquo component."