TERAPI pd PASCA BEDAH ORTOPEDI

OEDEM
Prinsip: distop causanya & dibantu baliknya
(akut)
• Elastis bandage:
– Arah dr distal ke proksimal
– Lapis 1st penguluran minimal, lapis 2nd diulur 50% -
75% dr daya ulurnya
– 24 j/hr, kecuali saat medikasi ato pembersihan
• Elevasi:
– Tinggi skt 20 cm ( skt 30 derajat)
– Waktu, 2 jam elevasi, 1 jam rest
• Kompres dingin (handuk dicelup air es / ice
pack)
– Tugas: cari dosis + derajat dinginnya (+ evidence
basednya)
• Effleurage
– Proksimal oedem
– Dosis: 10 x/sesi, 3 sesi/terapi, rest antar sesi 1’.
• Isometrik
– Dosis: tahan 6”, rest 3 “, 10 x/sesi, 3 sesi/terapi ,
rest antar sesi 60”
• Aktif exc
– Dosis: 10 x/sesi, 3 sesi/terapi , rest antar sesi 60”
• Pasif exc
– Dosis: 10 x/sesi, 3 sesi/terapi , rest antar sesi 60”
 NYERI
Prinsip: stop causa & bloking nyerinya
• Same with swelling therapy (because swelling
is etiology of pain)
• pain blocking with TENS, IFT: dosage?
 DECREASE of ROM
Basic principle: stop etiology n increase ROM
• Same with pain management
• Special exercises:
– Hold relax (PNF) : select pattern of movement
– Hold relax modified: without pattern of
movement
• Dosage: 10 x/session, 3 session/therapy, rest 60”
- When? If pain is dominant
- Contract relax
• Dosage: 10 x/session, 3 session/therapy, rest 60”
- When? If pain is loss
 DECREASE of MUSCLE POWER
Basic principle: stop etiology & increase muscle
power
• Same with pain management
• Special Exercises:
– Strengthening exercises: look at Holten method
– Bicycling exc: look at Holten method
 FUNCTIONAL LIMITATION
• Functional exc:
– Lying to long sitting
– Long sitting to sitting on side bed (“ongkang2”)
• When the anesthesia is spinal block, lumbar flexion
past 24 hours of operation
– Standing with walker
– Walking NWB with walker  2 crutch ( point gait
or swing gait? )
– SLR exc. Prepare for partial weight bearing exc
• Partial weight bearing exercises:
– Start PWB with 10% of body weight, (used
bathroom scales for training)
– Increase 10% per week, but maximal loading is 60
% of body weight
• Full weight bearing exercises:
– When consolidation of fracture is complete