P-2-12-05
APPLYING CRITERIA OF DISABILITY IN INDONESIA
Angela B.M. Tulaar (University of Indonesia, Jakarta, Indonesia)
As a fairly young Medical Specialty whose training was only recognized in 1987, practicing Physical Medicine and Rehabilitation in Indonesia is faced with many challenges, being given less priority compared to other fields of health concern.
The WHO criteria for Impairment, Disability, and Handicap has been used in the 1995 National Hunsehold Health Survey of Indonesia. It yielded quite surprising numbers such as 22,6% for visual impairment, 25,3% for visceral impairment and 46% for sceletal impairment. For Disability it showed 21,3% on communication, 10,5% on self care, and 24% on locomotion.
Several functional measurement Indexs were modified for local application and compared with the standard ones they showed enough validity. Examples are the modified Barthel Index to measure the Activities of Daily Living of Stroke Patients compared to the Barthel Index resulting in an r of 0,9309 with p=0,001.
The RAP (Rehabilitation Activities Profile) was also modified and applied for Stroke patients, being more sensitive in the items for self care and mobility. (p<0,05)
P-2-13-01
Stiffness of the ankle joints in stroke patients with spasticity
Masaru-Seki, Yoshihisa-Masakado, Kazuto-Akaboshi, Hiroyuki-Toikawa, Akio-Kimura, Naoichi-Chino (keio University, Tokyo, Japan)
Purpose: In this study, we wanted to evaluate the non-reflex and reflex mediated stiffness of spastic and normal ankle joints.
Method: This study was performed on chronic hemiparetic stroke subjects, who were evaluated by the modified Ashworth clinical scale and healthy control. The non-reflex and reflex mediated stiffness toa 10ー stretch of the ankle extensors by the isokinetic maschine (KINCOM500H) were measured. Surface EMG recordings were also made from the triceps surae and tibialis anterior muscle.
Result and conclusion: We found that the non-reflex mediated stiffness of the spastic ankle joints was larger than the reflex mediated stiffness of the contralateral ankle joints and the stiffness of healthy control. A positive correlation was found for stroke subjects between the stiffness of stroke subjects and the modified Ashworth clinical scale.
