REHABILITASI

Ialah semua tindakan yang ditujukan untuk mengurangi dampak disabilitas/handicap,

agar memungkinkan penyandang cacat berintegrasi dengan masyarakat.
1. Rehabilitasi Medik: suatu proses pelayanan kesehatan yang bertujuan untuk
mengembangkan kemampuan fungsional dan psikis individu dan kalau perlu mekanisme
kompensasimya agar individu dapat berdikari
2. Rehabilitasi Sosial: bertujuan agar penyandang cacat dapat berintegrasi kembali ke dalam
masyarakat dengan membantunya menyesuaikan diri pada keluarga, masyarakat dan
pekerjaannya dan juga dengan mengurangi beban sosial yang dapat menghambat proses
rehabilitasinya.
3. Rehabilitasi Kekaryaan (vocational): bimbingan kekaryaan, latihan kerja dan penempatan
selektif yang didesain untuk penyandang cacat.
Pelaksana program Rehabilitasi Medik:
1. Dokter
2. Fisioterapis
3. Terapi okupasi (fungsi motorik halus: mengancingkan baju, memakai alat makan,
menulis, dll)
4. Ortotis prostetis
5. Pekerja sosial medik
6. Psikolog
7. Ahli bina bicara
8. Perawat rehabilitasi

FISIOTERAPI
menghilangkan sakit dan nyeri, penguatan otot, modalitas fisik, mencapai gerak sendi normal,
dll.
(I)
TERAPI PANAS
1. Terapi panas superficial
- Hanya mencapai kutis atau jaringan subkutis
- Hot pack, infra red (mengurangi nyeri, relaksasi spasme otot superficial), kompres air
hangat, paraffin bath.
2. Terapi panas dalam
a. Diatermi gelombang mikro (MWD)
b. Diatermi gelombang pendek (SWD)
c. Diatermi gelombang suara ultra (USD)
(II)

TERAPI DINGIN

(III)

TRAKSI

Sulcus sign positive subluksasi bahu: pergeseran sendi bahu sebagian (belum
dislokasi)
(IV)

MASASE

(V)

EXERCISE TERAPI passive vs active

a. Latihan mobilitas sendi (Range of Motion ROM exercise)
b. Latihan penguatan (strengthening exercise )
c. Latihan daya tahan (endurance exercise)
d. Latihan koordinasi
e. Latihan dengan tujuan khusus

(VI)

STIMULASI LISTRIK

(VII) HYDROTERAPI

GANGGUAN BICARA
A) Afasia: gangguan berbahasa yang terjadi karena lesi di bagian hemisfer kiri (Wernickes
dan Brocas area). Kesulitan untuk mengerti atau memproduksi bahasa (kesulitan
berkomunikasi).
B) Disartria: gangguan artikulasi (masih dapat berkomunikasi secara lancar).
p.s motoric aphasia vs dysarthria: In Motoric aphasia the person may still be understood, but
sentences will not be grammatical. In very severe forms of Expressive Aphasia, a person may
only speak using single word utterances. Expressive aphasia differs from dysarthria, which is
typified by a patient's inability to properly move the muscles of the tongue and mouth to produce
speech.
Kelainan artikulasi: distortion, substitution, omission, dan addition

ORTOTIK PROSTETIK
a) Prostetik: bidang medik teknik yang mengukur, membuat serta mengepas alat2 pengganti
anggota tubuh yang hilang karena penyakit atau kecelakaan.
b) Ortotik: bidang medik teknik yang mengukur, membuat serta mengepas alat2 penguat
anggota tubuh yang mengalami kelayuan atau kelemahan.

UMN vs LMN
All the neurons contributing to the pyramidal and extrapyramidal systems should be
called upper motor neurons (UMN). The anterior horn cells and the related neurons in the

motor nuclei of some cranial nerves are called lower motor neurons (LMN). Axons of these
cells give rise to the peripheral motor nerves. These are lowest in position in the motor system
and recieve all the inputs from higher centers like medulla, pons, mid-brain and cerebral cortex
and transmit the same to the target organs. All impulses for motor activity are to be funelled into
them and these are also called final common pathway.

Signs of Upper Motor Neuron Lesions (UMNL)

1. Paralysis or weakness of movements of the affected side but gross movements may be
produced. No muscle atrophy is seen initially but later on some disuse atrophy may occur.
2. Babinski sign is present: The great toe becomes dorsiflexed and the other toes fan outward in
response to sensory stimulation along the lateral aspect of the sole of the foot. The normal
response is plantar flexion of all the toes.
3. Loss of performance of fine-skilled voluntary movements especially at the distal end of the
limbs.
4. Superficial abdominal reflexes and cremasteric reflex are absent.
5. Spasticity or hypertonicity of the muscles.
6. Clasp-knife reaction: initial higher resistance to movement is followed by a lesser resistance
7. Exaggerated deep tendon reflexes and clonus may be present.

Signs of Lower Motor Neuron Lesions (LMNL)

1. Flaccid paralysis of muscles supplied.
2. Atrophy of muscles supplied.
3. Loss of reflexes of muscles supplied.
4. Muscles fasciculation (contraction of a group of fibers) due to irritation of the motor neurons
seen with naked eye.
5. Muscle fibrillation (contraction of individual fibers) detected only by EMG
6. Muscle contracture (shortening of paralyzed muscles)
7. Presence of muscle wasting
8. Reaction of degeneration: When the LMN is cut, a muscle will no longer respond to
interrupted electrical stimulation 7 days after nerve section, although it will still respond to direct
current. After 10 days, response to direct current also ceases.

Mnemonic for Medical Students

Mnemonic for basis of difference: STORM Baby. Also remember: In a Lower motor neuron
lesion everything lowers.
Basis of Difference (STORM
Baby)
S = Strength
T = Tone
O = Others

UMNL

LMNL

Lowers
Increases (spastic)
Superficial reflexes
absentClonus

Lowers
Decreases (flaccid)
FasciculationsFibrillations
Reaction of degeneration

R = Reflexes = DTR or Deep

tendon reflexes
M = Muscle Mass
Baby = Babinski Sign

Increased

Decreased

Slight loss only

Positive (toe up)

Decreases / Atrophy
Negative (toe down)