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Efek Latihan dengan Teknik Close Kinetic Chain terhadap Peningkatan Lingkup Gerak Sendi Lutut dan Kemampuan Fungsional Lutut pada Pasien Pasca Rekonstruksi ACL (ACLR): A Case Report Handayani, Tri Mukti; Pristianto, Arif; Mardianto, Halim
Academic Physiotherapy Conference Proceeding 2024: Academic Physiotherapy Conference Proceeding
Publisher : Universitas Muhammadiyah Surakarta

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Introduction: ACL (Anterior Cruciate Ligament) is a ligament that helps stabilize the knee joint. This ligament is most frequently injured, usually occurring in football, basketball and other sports players. ACL injuries occur with high frequency in the United States, while in Indonesia, ACL injuries are the second most common case. ACL reconstruction (ACLR) is recommended and proven to be a very effective technique and usually provides satisfactory results. However, several complications will arise after undergoing ACLR in various ways, such as social status and function, functional ability, and the patient's quality of life, so a rehabilitation process is needed. Case Presentation: The article is a case report study with a teenage male patient in RSD K.R.M.T Wongsonegoro Semarang (brother D, 16 years old; height: 167 cm; weight: 50 kg; BMI: 17.9; occupation: student; hobby: football) post ACLR autograft hamstring 2 months ago on the left side of the knee. Patients entering the 2nd phase of rehabilitation are currently being given close kinetic chain exercises to increase the range of motion of the knee joint and the functional ability of the knee which will be evaluated using a goniometer and International Knee Documentation Committee (IKDC) evaluation form. Management and Outcome: Exercises using the Close kinetic chain technique can increase the range of motion of the knee joint and improve the functional ability of the patient's knee. Exercises are given after ACL reconstruction during phase 2 rehabilitation. Discussion: Training is carried out 3 times a week with training sessions lasting approximately 2 hours. The exercises given are static bike, squatting exercises, andclose kinetic chain exercise in the form of squats, lunges, single leg stance, and wall slides. Exercise can increase muscle strength, stability and muscle flexibility so that it can increase the range of motion of the joint in knee flexion movements and the functional ability of the knee. Conclusion: Special exercise programs provided by physiotherapy have an important role in the rehabilitation process. Static bike training, squat training, etcclose kinetic chain exercise in the form of squats, lunges, single leg stance, and wall slides are given to overcome condition problems after ACLR, especially in phase 2.

Penatalaksanaan Rehabilitasi Fisioterapi pada Kasus Pasca Rekonstruksi Anterior Cruciate Ligament Sinistra Fase 2: A Case Report Hardalena, Lidya; Wahyuni, W; Mardianto, Halim
Academic Physiotherapy Conference Proceeding 2024: Academic Physiotherapy Conference Proceeding
Publisher : Universitas Muhammadiyah Surakarta

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Pendahuluan: Aktivitas fisik yang berlebihan atau olahraga dapat menimbulkan resiko terkena cedera. Cedera olahraga biasa terjadi karena adanya cedera yang bersifat langsung maupun tidak langsung. Cedera Anterior Cruciate Ligament (ACL) adalah cedera lutut yang umum terjadi saat berolahraga. Cedera ini umumnya terjadi pada olahraga yang melibatkan gerakan zig-zag, perubahan arah gerakan, perubahan kecepatan yang mendadak seperti pada olahraga sepak bola, basket, bola voli, dan futsal. Komplikasi yang terjadi setelah rekonstruksi ACL adalah keterbatasan gerakan terutama gerakan fleksi knee yang dapat mengakibtakan kelemahan otot, kesulitan berjalan dan rasa nyeri pada lutut Presentasi Kasus: Jenis studi yang digunakan dalam penelitian yaitu metode penelitian case report di RSD KRMT Wongsonegoro pada pasien laki-laki berusia 21 tahun yang merupakan seorang mahasiswa yang telah melakukan operasi rekonstruksi ACL sinistra. Pasien menjalani fisioterapi dengan kondisi dapat berjalan tanpa alat bantu tetapi pasien masih mengeluhkan nyeri dan krepitasi saat berjalan pada lutut kiri. Metode dan Hasil: Rehabilitasi fisioterapi dilakukan di RSD KRMT Wongsonegoro Semarang selama 2 minggu dengan 4 kali pertemuan dan home program di rumah pada pasien pasca rekonstruksi ACL sinistra dan didaptkan hasil penurunan rasa nyeri, meningkatakan kekuatan otot, meningkatkan lingkup gerak sendi, meningkatkan keseimbangan dan mengembalikan kemampuan aktivitas fungsional sehari-hari. Diskusi: Rehabilitasi fisioterapi fase 2 pada pasien pasca rekonstruksi ACL sinistra pada latihan awal dapat dilakukan dengan jenis latihan menggunakan berat badan, latihan resistance, latihan keseimbangan dan latihan koordinasi. Latihan yang dilakukan selama terapi yaitu statis bycyle, squat, lunges, dan step up dapat mengurangi keterbatasan gerakan lutut dan meningkatkan kemampuan fungsional Kesimpulan: Rehabilitasi fisioterapi fase 2 pasca rekonstruksi ACL sinistra terbukti dapat menurunkan rasa nyeri, meningkatakan kekuatan otot, meningkatkan lingkup gerak sendi, meningkatkan keseimbangan dan mengembalikan kemampuan aktivitas fungsional sehari-hari.

Management Fisioterapi pasca Rekonstruksi Anterior Cruciate Ligament Dextra di RSD K.R.M.T Wongsonegoro Semarang: Studi Kasus Badzlina, Farah Afifah; Susilo, Taufik Eko; Mardianto, Halim
Academic Physiotherapy Conference Proceeding 2024: Academic Physiotherapy Conference Proceeding
Publisher : Universitas Muhammadiyah Surakarta

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Introduction: ACL injuries are common in sports like futsal and soccer, with 45% and 68% occurring due to non-contact injuries. Grade 2 and 3 injuries often result from tears. Post-reconstruction, physiotherapy is necessary to allow the patient to return to activities. There are five phases after ACL reconstruction. Case Presentation: A 20-year-old male patient was diagnosed with a total right ACL tear and experienced pain and limited range of motion. Therapy is conducted twice a week, with the patient entering phase 2. Physiotherapy interventions include strengthening exercises, squats, lunges, and one leg stance on various surfaces. Management and Outcome: Therapy is carried out 2 times every week and while the intervention is being given, the patient has started to enter phase 2. Physiotherapy interventions are given, such as Strengthening exercise, a combination of squats, lunges, and one leg stance on a mini mat, on a trampoline, and on a ballance ball reversed. Evaluations include muscle strength, joint range of motion, and functional ability using the Tegner Lysholm knee scoring scale. Discussion: Strengthening exercises are given before entering the next phase, and cryotherapy may aid tissue recovery. After four physiotherapy interventions, the patient experienced an increase in LGS, extra knee muscle strength, and functional ability. Conclusion: The post anterior cruciate ligament reconstruction phase 2 patients underwent four physiotherapy interventions, resulting in an increase in LGS, dextra knee muscle strength, and functional knee functional ability.

Manajemen Fisioterapi pada Post Rekonstruksi PCL Fase 1: Case Report Syafira, Khansa; Fatmarizka, Tiara; Mardianto, Halim
Academic Physiotherapy Conference Proceeding 2024: Academic Physiotherapy Conference Proceeding
Publisher : Universitas Muhammadiyah Surakarta

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Introduction: Football is a sport that is prone to injuries, one of which is a torn posterior cruciate ligament (PCL). The PCL is a ligament that acts as the main barrier to posterior translation of the knee. The treatment of PCL injuries is divided into 2, namely conservative (surgery) and non-conservative, depending on the severity. In conservative treatment, it is necessary to perform early mobilization after the injury to increase ROM and stability. Case Presentation: a 15-year-old patient post PCL reconstruction with complaints of, swelling in the left knee, limited Range Of Motion (ROM) and decreased of muscle strength came to RSUD KRMT Wongsonegoro Semarang to carry out rehabilitation. Management and Outcome: Rehabilitation had been done three times a week to facilitate the improvement of knee ROM and muscle strength and decreased the swelling. Rehabilitation consists of quadset, SLR, Side SLR, ankle pumping, wall slide, prone hang, and gait training. Discussion: Rehabilitation immediately following conservative treatment helps to improve muscle strength and ROM and reduce knee swelling. In addition, strengthening exercises on the quadriceps muscle will help reduce the risk of further knee injury, and controlled swelling will also speed the return of muscle function. Conclusion: The present case conclude that the physiotherapy rehabilitation program on post PCL reconstruction can have a good effect on improvement of knee ROM and muscle strength.

PHYSIOTHERAPY MANAGEMENT IN POST ACL RECONTUTION USING CLOSE KINETIC CHAIN EXERCISE IN PHASE III: A CASE REPORT Widodo, Faressa; Wijianto, W; Mardianto, Halim
Academic Physiotherapy Conference Proceeding 2021: Academic Physiotherapy Conference Proceeding
Publisher : Universitas Muhammadiyah Surakarta

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Introduction: One of the ligaments in the knee is the anterior cruciate ligament where the function of the ligament itself is joint stabilization. 60% sports injuries occur in the knee, one of which is specifically a tear in the anterior cruciate ligament (ACL) ligament with the largest incidence rate of 16% during sports activities then the role of physiotherapy using close chain kinetic is expected to overcome pain, increase range of motion, reduce muscle atrophy and increase muscle strength. Case Presentation: A 23-year-old man last year had an accident while playing soccer and the patient felt the instability of his right knee when he was running, then after an MRI was done at the hospital 6 months ago the patient had ruptured anterior cruciate ligament ligament (ACL) so 3 months ago it was done post anterior cruciate ligament (ACL) reconstruction measures. Management and Outcomes: Giving therapy Exercises such as close chain exercise are effective for reducing pain, increasing muscle strength around the knee joint, reducing atrophy in the muscles around the knee joint as measured by the medline. Discussion: After doing physiotherapy rehabilitation for 6 times therapy, the pain reduction from the first therapy was worth 3 then the last therapy was 2 measured by NRS (numeric rating scale), then the range of motion increased by 5o from before exercise measured with a goneometer, for anthropometry it increased by 0.5 cm to 2 cm and muscle strength was stable at 5. Conclusion: After 2 weeks of therapy for 6 x sessions with intervention of close chain kinetic exercise therapy, the results were decreased pain, increased range of motion, increased muscle strength, reduced repeated falls, and reduced atrophy in the muscles that work on the knee joint.

PHYSIOTHERAPY MANAGEMENT FOR POST RECONSTRUCTION POSTERIOR CRUCIATE LIGAMENT ACUTE PHASE: A CASE STUDY Monitari, Triska; Supriyadi, Arin; Mardianto, Halim
Academic Physiotherapy Conference Proceeding 2021: Academic Physiotherapy Conference Proceeding
Publisher : Universitas Muhammadiyah Surakarta

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Introduction: Rupture is a tear of tissue caused by trauma. Posterior Cruciate Ligament (PCL) ruptures can be caused by direct or indirect contact with the knee. A grade 3 PCL injury requires surgery. Rehabilitation in PCL injuries focuses on quadriceps muscle augmentation to counteract the force of the hamstrings muscles and the gravity that move the tibia towards the posterior. Case Presentation: A football athlete suffered a knee injury while playing football. From mri examination found the diagnosis of rupture PCL sinistra grade 3, then undergo reconstruction surgery PCL sinistra. The results of the examination there are several problems in patients, such as oedem, atrophy, spasm, pain (press &motion), and limited motion. Management and outcome:interventions given in the form of exercise therapy as much as 3 times. Pain measured by Numeric Rating Scale (NRS), oedem (metline), range of motion (gonio meter). Discussion: Based on the interventions provided found results that exercise has benefits in patients post acute phase PCL reconstruction that has the goal of maximum protection on grafting, maintaining patellar mobility, maintaining quadriceps muscle tone, maintaining full passive extensions, controlling pain and oedem, early mobilization in knee joints Conclusion:Intervention in the form of exercise therapy can relieve pain, reduce oedem and improve ROM in patients post acute phase PCL reconstruction.

PHYSIOTHERAPY MANAGEMENT POST RECONSTRUCTION ANTERIOR CRUCIATE LIGAMENT: A CASE STUDY Nurhidayah, Indah Suci; Rahayu, Umi Budi; Mardianto, Halim
Academic Physiotherapy Conference Proceeding 2021: Academic Physiotherapy Conference Proceeding
Publisher : Universitas Muhammadiyah Surakarta

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Introduction: Anterior Cruciate Ligament (ACL) is one of the ligaments present in the knee and serves as a stabilizer of the anterior translation of the femur bone. Non-contact injuries are most common in athletes, usually due to sudden shaft changes resulting in tibia translation of the femur. About 60% of sports injuries are most common in the lower limbs, as many as 16% of injuries are caused by torn ligaments from the knee. Post-reconstruction rehabilitation of ACL aims to prevent complications such as swelling, limited scope of joint motion, muscle weakness, decreased balance and restoration of knee functional abilities Case Presentation: A 23-year-old patient came to one of the hospitals in Semarang with a diagnosis of sinistra ACL rupture, underwent reconstruction 2 months ago. Currently the patient undergoes a phase 2 physiotherapy program because he still complains of mild pain, joint stiffness when waking up, limited joint movement. Management and Outcome: Therapy is carried out for 4 weeks, with an exercise program using static bicycle, lunges, single leg, squat, single leg with cone, side step with theraband. Some tests are performed such as pain measurement using NRS (Numeric Rating Scale), measurement of joint sphere of motion using goneometer, and atrophy measurement using meterline. Discussion: Exercises given in patients post ACL reconstruction aim to improve susceptible joint motion, stimulate blood circulation, maintain muscle elasticity and reduce pain. Significant loss of function as well as inhibition of nerves can lead to atrophy. It causes quadriceps to become weak. To train the strength of the hamstring muscles and quadriceps can use close kinetic chain exercises to produce co-contraction of the muscles around the joints. Conclusion: In this case, it shows that close kinetic chain exercises can increase the range of motion of the joints, reduce pain, and prevent atrophy.

Physiotherapy Rehabilitation Program in Phase-2 Anterior Cruciate Ligament Reconstruction Recovery: A Case Report Rizkya, Rinta; Widodo, Agus; Mardianto, Halim
Academic Physiotherapy Conference Proceeding 2023: Academic Physiotherapy Conference Proceeding
Publisher : Universitas Muhammadiyah Surakarta

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Background: Anterior cruciate ligament (ACL) injury is a common knee injury in both the general population and athletes. Structured and systematic and progressive rehabilitation is recommended in the post ACL reconstruction and conservative management, the goal of rehabilitation is to overcome neuromuscular related disorders, muscle strength deficits, joint scope of motion deficits, balance, knee stabilization, motor control and return to sports safely Objective: Physiotherapy rehabilitation program for phase 2 anterior cruciate ligament reconstruction recovery. Methods: The study used the Case Report method which was carried out at the K.R.M.T Wongsonegoro Semarang Hospital on a 25-year-old male patient diagnosed with postoperative ACL reconstruction dextra with complaints of pain in the left knee, swelling and limited knee bending. Results: Physiotherapy intervention in the form of Excercise is able to reduce pain, swelling, increase muscle strength and increase the scope of motion of the knee joint and improve functional activities. Conclusion: Based on research using this Case Report, it shows that the physiotherapy rehabilitation program on ACL reconstruction as a whole obtained the results of changes and improvements.

Management Fisioterapi Pada Kasus Post OP ACL Reconstruction Dextra Fase 3 di RSUD K.R.M.T Wongsonegoro Semarang Aristiawati, Bulan Febri Putri; Fatmarizka, Tiara; Mardianto, Halim
Jurnal Cakrawala Akademika Vol. 2 No. 1 (2025): Edisi Juni 2025
Publisher : PT. Pustaka Cendekia Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70182/jca.v2i1.576

Anterior Cruciate Ligament (ACL) merupakan bagian ligamen pada lutut yang mempunyai fungsi utama yaitu sebagai stabilisasi lutut dalam mencegah pergerakan tulang tibia bergeser ke depan dan mengontrol gerakan saat rotasi lutut. Tujuan: Untuk mengetahui efektivitas management fisioterapi pada kasus post op acl reconstruction dextra fase 3 di Rsud K.R.M.T Wongsonegoro Semarang. Metode: Kondisi awal pasien yaitu mengeluhkan nyeri pada area lutut kanan pada saat berjalan jauh maupun ketika melakukan kegiatan beribadah, lalu setelah diberikan penanganan fisioterapi berupa static cycle, running (treadmill), agility training (ledder drills & cone), agility training (hurdle), strength training dan (angkat beban, leg press, leg extension, leg curl) terjadi peningkatan yang signifikan selama sebulan 3x pertemuan dengan dosis 3 kali dalam seminggu setiap sesinya 10-15 menit. Hasil: evaluasi dilakukan dengan menggunakan Range Of Motion (ROM), Manual Muscle Testing dan Antropometri terjadi peningkatan yang signifikan. Kesimpulan: static cycle, running (treadmill), agility training (ledder drills & cone), agility training (hurdle), strength training dan (angkat beban, leg press, leg extension, leg curl) selama sebulan 3x pertemuan dengan dosis 3 kali dalam seminggu hasil perubahan yang cukup signifikan.

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