Peran Latihan Terapeutik Pada Pasien Wanita 23 Tahun Dengan Lupus Eritematosus Sistemik (LES)
DOI:
https://doi.org/10.36408/mhjcm.v8i2.608Keywords:
LES, arthritis, latihan aerobik, latihan LGSAbstract
Lupus eritematosus sistemik (LES) merupakan penyakit autoimun yang heterogen yang melibatkan banyak organ dengan gambaran klinis yang beragam. Penyakit ini ditandai oleh produksi antibodi terhadap komponen-komponen inti dan umumnya terjadi pada wanita (rasio 9:1), setelah masa pubertas (pada usia 20-30 tahun) serta dipengaruhi oleh faktor genetika.
Pada LES didapatkan keterlibatan kulit dan mukosa, sendi, darah, jantung, paru, ginjal, susunan saraf pusat (SSP) dan sistem imun. Dilaporkan bahwa pada 1000 pasien LES di Eropa yang diikuti selama 10 tahun, manifestasi klinis terbanyak berturut-turut adalah arthritis sebesar 48,1%, ruam malar 31,1%, nefropati 27,9%, fotosensitivitas 22,9%, keterlibatan neurologik 19,4% dan demam 16,6%. Kami melaporkan pasien LES wanita usia 23 tahun dengan arthritis yang mengakibatkan limitasi lingkup gerak sendi (LGS) bahu dan jari tangan sehingga kesulitan dalam melakukan aktivitas sehari-hari (AKS) menggunakan tangan antara lain menggenggam dan memakai pakaian dalam, gangguan pola jalan akibat kekakuan lutut kiri. serta keterbatasan ambulasi (jarak tempuh) akibat nyeri sendi ekstremitas bawah. Pasien diberikan program latihan aerobik dan LGS ekstremitas bawah menggunakan static ergocycle, latihan LGS ekstremitas atas dengan Mechanical Therapy Unit (MTU) serta latihan motorik halus dan latihan AKS. Setelah satu bulan, pasien mengalami perbaikan dalam menggenggam dan memakai pakaian dalam serta dapat berjalan dalam jarak sekitar 100m tetapi pasien masih berjalan jinjit pada kaki kiri akibat kekakuan lutut dan pergelangan kaki kiri.
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References
2. Balsamo S, Neto L. Fatigue in systemic lupus erythematosus: An association with reduced physical fitness. Autoimmunity Reviews 2011; 10: 514–18.
3. Perandini L, Pinto A, Roschel H, Benatti F, Lima F, Bonfá E, et al. Exercise as a therapeutic tool to counteract inflammation and clinical symptoms in autoimmune rheumatic diseases. Autoimmunity Reviews 2012; 12 : 218–24.
4. Wallace D. Principles of Therapy, Local Measures, and NSAIDs. In: Wallace D, Bevra H, editors. Dubois’ lupus erythematosus. 7th ed. New York: Lippincott Williams and Wilkins; 2007: 1133-34.
5. L.A. Perandini, Pinto A, Roschel H, Bennati F, Lima F, Bonfa E, et al. Exercise as a therapeutic tool to counteract inflammation and clinical symptoms in autoimmune rheumatic diseases. Autoimmunity Reviews 2012; 12 : 218–24.
6. Robb-Nicholson LC, Daltroy L, Eaton H, Gall V,Wright E, Hartley LH, et al. Effects of aerobic conditioning in lupus fatigue: a pilot study. Br J Rheumatol 1989;28(6):500–5.
7. Goldman R, Schilling EM, Dunlop D, Langman C, Greenland P, Thomas RJ,et al. A pilot study on the effects of exercise in patients with systemic lupus erythematosus. Arthritis Care Res 2000;13(5):262–9.
8. Tench CM, McCarthy J, McCurdie I, White PD, D'Cruz DP. Fatigue in systemic lupus erythematosus: a randomized controlled trial of exercise. Rheumatology (Oxford) 2003;42(9):1050–4.
9. Clarke-Jenssen AC, Fredriksen PM, Lilleby V, Mengshoel AM. Effects of supervised aerobic exercise in patients with systemic lupus erythematosus: a pilot study. Arthritis Rheum 2005;53(2) : 308–12.
10. Carvalho MR, Sato EI, Tebexreni AS, Heidecher RT, Schenkman S, Neto TL. Effects of supervised cardiovascular training program on exercise tolerance, aerobic capacity, and quality of life in patients with systemic lupus erythematosus. Arthritis Rheum 2005;53(6) : 838–44.
11. Yuen HK, Holthaus K, Kamen DL, Sword DO, Breland HL. Using wii fit to reduce fatigue among african american women with systemic lupus erythematosus: a pilot study. Lupus 2011;20(12):1293–9
12. Miossi R, Benatti FB, de Sá Pinto AL, Lima FR, Borba EF, Lprado DM, et al. Exercise training counterbalances chronotropic incompetence and delayed heart rate recovery in systemic lupus erythematosus: a randomized trial. Arthritis Care Research 2012; 64(8): 1159-66.
13. Pedersen BK, Febbraio MA. Muscle as an endocrine organ: focus on musclederived interleukin-6. Physiol Rev 2008;88(4):1379–406.
14. Dale M. Exercise and Lupus: Effects and Guidelines. Saddleback Memorial Medical Center; 2000.
15. Bogdanovic G, Stojanovich L, Djokovic A, Stanisavljevic N. Physical activity program is helpful for improving quality of life in patients with systemic lupus erythematosus. Tohoku J. Exp. Med 2015; 237: 193-99.
16. Sharif K, Watad A, Bragazzi N, Lichtbroun M, Amital H, Shoenfeld Y. Physical activity and autoimmune diseases: get moving and manage the disease. Autoimmunity Reviews 2018; 17: 53–72.
17. Marivone A, Mônica C, Lílian T, Wander O, Marcos M, Ilma A. Evaluation of respiratory impairment in patients with systemic lupus erythematosus with the six-minute walk test. Rev Bras Reumatol 2014; 54 (3) : 192 – 99.
18. Goodman C, Helgeson K. Exercise prescription for medical conditions. Philadelphia: F.A. Davis Company. 2011: 106-7.
19. Ministry of Health, Social Services and Equality. Clinical Practice Guidelines on Systemic Lupus Erythematosus. 2015 : 32.
20. Zittermann A, Sabatschus O, Jantzen S, Platen P, Danz A, Stehle P. Evidence for an acute rise of intestinal calcium absopsion in response to aerobic exercise. Eur J Nutr 2002: 189-96.
21. Prentice WE. Therapeutic modalities in rehabilitation. 3rd ed. New York : Mc Graw-Hill; 2005: 259-393.
22. Watchie J. Cardiovascular and pulmonary physical therapy?: a clinical manual. 2nd ed. Missouri: Saunders; 2010.
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