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Abstract

Amputation is the removal of a member of the body which involves cutting a part or all of the limb. Problems arising from amputation include surgical wound pain, decreased joint motion, decreased muscle strength, and decreased functional ability. The purpose of this study was to determine physiotherapy interventions in cases of sinistra transtibial amputation due to chronic limb ischemia. This research is a case study conducted at the Gatot Subroto Army Hospital in February-March 2018. Data obtained from interviews, observation, assessment, and management of Physiotherapy. In this case study the limitations of the problem to be discussed are pain, stiffness, spasm, limited scope of joint motion and decreased muscle strength. The modalities that will be applied are Trans Electrical Nerve Stimulation (TENS) and exercise therapy in the form of active motion exercises, stretching, strengthening, and core stability exercises. The results of this case study show that the TENS modality can reduce silent pain, tenderness and motion pain in amputees. Active motion exercises, stretching, strengthening, and core stability exercises can reduce stiffness, spasm, and increase the scope of joint motion and increase muscle strength so as to be able to prepare patients to walk using aids.

Bahasa Abstract

Amputasi merupakan pengangkatan anggota tubuh yang melibatkan pemotongan sebagian atau seluruh anggota badan. Masalah yang muncul akibat amputasi di antaranya nyeri luka operasi, penurunan lingkup gerak sendi, penurunan kekuatan otot, dan penurunan kemampuan fungsional. Tujuan penelitian ini yaitu untuk mengetahui intervensi fisioterapi pada kasus post amputasi transtibial sinistra akibat chronic limb ischemia. Penelitian ini merupakan studi kasus yang dilakukan di RSPAD Gatot Subroto pada bulan Februari-Maret tahun 2018. Data diperoleh dari wawancara, pengamatan, pengkajian, dan penatalaksanaan fisioterapi. Dalam studi kasus ini batasan permasalahan yang akan dibahas yaitu nyeri, kekakuan, spasme, keterbatasan lingkup gerak sendi dan penurunan kekuatan otot. Modalitas yang akan diterapkan yaitu Trans Electrical Nerve Stimulation (TENS) dan terapi latihan berupa latihan gerak aktif, peregangan, penguatan, dan latihan core stability. Hasil studi kasus ini menunjukkan modalitas TENS mampu menurunkan nyeri diam, nyeri tekan dan nyeri gerak pada penderita amputasi. Latihan gerak aktif, peregangan, penguatan, dan latihan core stability mampu mengurangi kekakuan, spasme, dan meningkatkan lingkup gerak sendi serta meningkatkan kekuatan otot sehingga mampu mempersiapkan pasien untuk berjalan dengan menggunakan alat bantu.

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