PROGRAM FISIOTERAPI PADA PASIEN DI ICU DENGAN KONDISI POST CRANIECTOMY ET CAUSA TRAUMATIC BRAIN INJURY: CASE STUDY
DOI:
https://doi.org/10.22219/physiohs.v6i2.28609Keywords:
Traumatic Brain Injury, Intensive Care Unit, Glasgow Coma Scale, Early Functional AbilitieAbstract
Traumatic Brain Injury (TBI) adalah cedera otak yang menyebabkan kerusakan langsung pada pembuluh darah, akson, neuron, dan glia sehingga dapat menimbulkan beberapa gejala tergantung pada tingkat keparahannya seperti pusing, merasa lelah, bahkan kehilangan kesadaran. Pasien TBI dengan tingkat keparahan sedang sampai berat sering kali memerlukan perawatan di Intensive Care Unit (ICU). Dalam hal ini, penanganan fisioterapi pada pasien TBI di ICU dapat berfokus pada masalah fungsionalnya yang terdiri dari pernapasan, batuk dan retensi sputum, tanda-tanda inflamasi, nyeri, spasme otot, kekuatan otot, penurunan sensori, serta penanganan ataupun pencegahan luka dekubitus dengan program fisioterapi yang didasarkan oleh protokol fisioterapi di ICU sehingga protokol-protokol tersebut perlu dilihat efektivitasnya terhadap penanganan kasus TBI di ICU. Tujuan penelitian ini adalah untuk menjelaskan seputar Program fisioterapi pada pasien di ICU dengan kondisi post craniectomy et causa TBI di RS Hermina Pasteur. Metode penelitian ini adalah metode kepustakaan dengan membaca buku, jurnal, dan juga literatur yang berkaitan dengan kasus yang diangkat serta melakukan observasi langsung pada pasien. Parameter yang digunakan meliputi Manual Muscle Testing (MMT), antropometri (lebar edema), kesimetrisan pengembangan dada, skor Glasgow Coma Scale (GCS), dan skor Early Funtional Abilities (EFA). Hasil yang didapatkan terjadi peningkatan kekuatan otot dengan nilai MMT 0/5 menjadi 1/5 setelah diberikan stimulasi sensori dan aktivasi otot-otot intrinsik. Lalu lebar edema menunjukkan nilai yang fluktuatif dengan pemberian hand dan ankle pumping karena dipengaruhi oleh kondisi pasien dan pemberian obat-obatan. Kemudian, terjadi peningkatan pengembangan dada lobus upper dextra dari asimetris menjadi simetris. Lalu terjadi peningkatan skor GCS dari skor GCS 4 menjadi 9. Kemudian, terjadi peningkatan skor EFA dari skor EFA 25 menjadi 33. Akan tetapi, terjadi penurunan skor GCS dan EFA dikarenakan kondisi pasien belum stabil dan absen pada hari sabtu dan minggu dalam pemberian intervensi fisioterapi yang karena liburnya poli fisioterapi.
Downloads
References
Alaparthi, G. K., Raigangar, V., Bairapareddy, K. C., Gatty, A., Mohammad, S., Alzarooni, A., Atef, M., Abdulrahman, R., Redha, S., Rashid, A., & Tamim, M. (2021). A National Survey in United Arab Emirates on Practice of Passive Range of Motion by Physiotherapists in Intensive Care Unit. PLoS ONE, 16(8 August), 1–13. https://doi.org/10.1371/journal.pone.0256453
Gefen, A., Ousey, K., & Lecompte, T. (2016). Effect of Positioning on Pressure Ulcer Development: An Experimental Study in Healthy Volunteers.
Gunjal, S. B., Shinde, N. K., Kazi, A. H., & Mahajan, A. A. (2015). Effectiveness of Deep Breathing versus Segmental Breathing Exercises on Chest Expansion in Pleural Effusion. International Journal of Health Sciences & Research (Www.Ijhsr.Org), 5(7), 234. www.ijhsr.org
Hankemeier, A., & Rollnik, J. D. (2015). The Early Functional Abilities (EFA) Scale to Assess Neurological and Neurosurgical Early Rehabilitation Patients. BMC Neurology, 15(1), 1–10. https://doi.org/10.1186/s12883-015-0469-z
Hussain, G., Wang, J., Rasul, A., Anwar, H., Imran, A., Qasim, M., Zafar, S., Kamran, S. K. S., Razzaq, A., Aziz, N., Ahmad, W., Shabbir, A., Iqbal, J., Baig, S. M., & Sun, T. (2019). Role of Cholesterol and Sphingolipids in Brain Development and Neurological Diseases. Lipids in Health and Disease, 18(1), 1–12. https://doi.org/10.1186/s12944-019-0965-z
John D. Corrigan, P. (2021). Treating Patients with Traumatic Brain Injury. Substance Abuse and Mental Health Services Administration, 52(5), 259–260. https://doi.org/10.1016/j.denabs.2007.06.004
K, S., S, K., & M, B. (n.d.). Comparative Evaluation of Nebulized Salbutamol and Ipratropium Bromide with Standard Treatment in Patients of Chronic Obstructive Pulmonary disease (COPD). 2015.
Leache, L., Aquerreta, I., Aldaz, A., Monedero, P., Idoate, A., & Ortega, A. (2020). Effectiveness of Adjunctive Nebulized Antibiotics in Critically Ill Patients with Respiratory Tract Infections. European Journal of Clinical Microbiology and Infectious Diseases, 39(2), 361–368. https://doi.org/10.1007/s10096-019-03733-6
Norton, L., Parslow, N., Johnston, D., Ho, C., Afalavi, A., Mark, M., O’sullivan-Drombolis, D., & Moffatt, S. (2021). Best Practice Reccomendations for the Prevention and Management of Pressure Ulcers. Wound Care Canada, C. https://www.woundscanada.ca/docman/public/health-care-professional/bpr-workshop/172-bpr-prevention-and-management-of-pressure-injuries-2/file
Prastika, P., Supono, S., & ... (2019). Ankle Pumpling Exercise and Leg Elevation in 30O Has the Same Level of Effectiveness To Reducing Foot Edema At Chronic Renal …. … Conference of Kerta …, 241–248. http://ejournal-kertacendekia.id/index.php/ICKCNA/article/view/109
Quatman-Yates, C. C., Hunter-Giordano, A., Shimamura, K. K., Landel, R., Alsalaheen, B. A., Hanke, T. A., & McCULLOCH, K. L. (2020). Physical Therapy Evaluation and Treatment After Concussion/Mild Traumatic Brain Injury. Journal of Orthopaedic and Sports Physical Therapy, 50(4), CPG1–CPG73. https://doi.org/10.2519/jospt.2020.0301
Raine, S., Meadows, L., & Lynch-Ellerington, M. (2009). Bobath Concept: Theory and Clinical Practice in Neurological Rehabilitation.
Rosyidi, R. M., Priyanto, B., Laraswati, N. K. P., Islam, A. A., Hatta, M., Bukhari, A., Kamil, M., & Wardhana, D. P. W. (2019). Characteristics and Clinical Outcome of Traumatic Brain Injury in Lombok, Indonesia. Interdisciplinary Neurosurgery: Advanced Techniques and Case Management, 18(February), 100470. https://doi.org/10.1016/j.inat.2019.04.015
Samosir, N. R., & Azizan, A. (2023). Effectiveness of Segmental Breathing and Expansion Thorax Exercise in Young to Middle-Aged Post-Covid Survivors. 5(1), 5–11.
Shumway-Cook, A., & Woollacott, M. (2012). Motor Control Translating Research into Clinical Practice Fourth Edition. http://www.lww.com.
Srivastava, A., Sharma, N., Kumar Srivastav, A., & Gehlot, A. (2021). Methods & Protocol Functional Rehabilitation in Intensive Care Units for Post Craniotomy Patients : Study Protocol. 11(3), 569–582.
Swaminathan, N., Praveen, R., & Surendran, P. J. (2019). The Role of Physiotherapy in Intensive Care Units: A Critical Review. Physiotherapy Quarterly, 27(4), 1–5. https://doi.org/10.5114/pq.2019.87739
Tobi, K. (2019). Management of Traumatic Brain Injury in the Intensive Care Unit: A Useful Mnemonic and A Review of the Literature. Neurologic Clinics, 26(2), 409–426. https://doi.org/10.1016/j.ncl.2008.02.001
W.Tsao, J. (Ed.). (2012). Traumatic Brain Injury : A Clinician’s Guide to Diagnosis, Management, and Rehabilitation.
X, L., J, L., & J, S. (2019). Effectiveness of Air-Cell-Based Position for Preventing Pressure Ulcers in High-Risk Populations: A Randomized Controlled Trial. International Journal Nurse Student.
Younes, S., Ahmed, N., Ahmed, I., & Hassan, E. (2022). Effect of Multimodality Chest Physiotherapy Interventions on Prevention of Ventilator Associated Pneumonia among Mechanically Ventilated Patients. Alexandria Scientific Nursing Journal, 24(1), 36–46. https://doi.org/10.21608/asalexu.2022.246005
Zhao, X., & Yu, X. (2019). Expert Consensus on Nebulization Therapy in Pre-hospital and In-Hospital Emergency Care. Annals of Translational Medicine, 7(18), 487–487. https://doi.org/10.21037/atm.2019.09.44
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Riza Pahlawi, Amelia Rizki Nurmartha
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
Authors who publish with Physiotherapy Health Science (PhysioHS) agree to the following terms:
- For all articles published in Physiotherapy Health Science (PhysioHS), copyright is retained by the authors. Authors give permission to the publisher to announce the work with conditions. When the manuscript is accepted for publication, the authors agree to automatic transfer of the publishing right to the publisher.
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution-ShareAlike 4.0 International License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
