Latihan Isometrik adalah suatu latihan yang dilakukan dengan kontraksi otot secara Isometrik ( kontraksi Isometrik ). Kontraksi otot deibedakan menjadi 2, yaitu kontraksi isotonik (dimana terjadi perubahan panjang otot, tapi tidak pada tonus ototnya) dan kontraksi isometrik (terjadi perubahan tonus otot, tapi tidak terjadi perubahan panjang otot). Selengkapnya untuk memahami cara kerja otot dapat dibaca di "MEKANISME KERJA OTOT".
Latihan isometrik diantaranya bermanfaat untuk meningkatkan kekuatan otot (sejauh ini yang terbukti adalah meningkatkan kekuatan otot statis ) serta mengurangi nyeri. Latihan isometrik bahu tentu saja ditujukan untuk meningkatkan kekuatan otot-otot bahu dan mengurangi keluhan nyeri di daerah bahu (salah satunya frozen shoulder).
***
***
Berikut adalah "latihan isometrik bahu"
Silakan mendownload "latihan isometrik bahu" dengan me-klik link di atas. Secara garis besar, latihan isometrik bahu ini di lakukan dengan posisi berdiri Tidak ada peralatan khusus yang dibutuhkan, akan tetapi pada ilustrasi di atas memanfaatkan tembok dan sebuah bantal untuk melakukan latihan.
catatan Penting:
*anda dapat mencetak (print) petunjuk "latihan isometrik bahu"
*pada petunjuk tertulis "kanan / kiri", maksudnya adalah tangan / lengan yang perlu dilatih, yaitu sisi yang mengalami permasalahan.
download petunjuk "latihan isometrik bahu"
apabila kurang jelas, silakan berkomentar di bawah.
Showing posts with label modalitas. Show all posts
Showing posts with label modalitas. Show all posts
Sunday, January 31, 2010
Wednesday, January 27, 2010
Shoulder Pain and Disability Index (SPADI)
Shoulder Pain and Disability Index (SPADI) adalah suatu bentuk instrumen untuk mengukur / menilai dan mengevaluasi nyeri bahu dan disability yang menyertainya. Shoulder Pain and Disability Index (SPADI) terdiri dari 2 skala, skala nyeri ( pain scale ) dan skala disability ( disability scale ). Secara garis besar, SPADI berupa kuisioner dengan jawaban berupa angka yang mengintepretasikan keadaan yang paling sesuai dengan yang dialami oleh penderita nyeri bahu.
***
***
Agar lebih Jelas tentang SPADI silakan download: "Shoulder Pain and Disability Index" (SPADI)
***
***
Agar lebih Jelas tentang SPADI silakan download: "Shoulder Pain and Disability Index" (SPADI)
Tuesday, October 27, 2009
Ultrasound Therapy (Basic : 2)
Ultrasound Transmission through the Tissues
All materials (tissues) will present an impedance to the passage of sound waves. The specific impedance of a tissue will be determined by its density and elasticity. In order for the maximal transmission of energy from one medium to another, the impedance of the two media needs to be as similar as possible. Clearly in the case of US passing from the generator to the tissues and then through the different tissue types, this can not actually be achieved. The greater the difference in impedance at a boundary, the greater the reflection that will occur, and therefore, the smaller the amount of energy that will be transferred. Examples of impedance values can be found in the literature e.g. Robertson et al 2007,Ward 1986.
The difference in impedance is greatest for the steel/air interface which is the first one that the US has to overcome in order to reach the tissues. To minimise this difference, a suitable coupling medium has to be utilised. If even a small air gap exists between the transducer and the skin the proportion of US that will be reflected approaches 99.998% which means that there will be no effective transmission.
us reflect
The coupling media used in this context include water, various oils, creams and gels. Ideally, the coupling medium should be fluid so as to fill all available spaces, relatively viscous so that it stays in place, have an impedance appropriate to the media it connects, and should allow transmission of US with minimal absorption, attenuation or disturbance. For a good discussion regarding coupling media, see Casarotto et al 2004, Klucinec et al 2000, Williams 1987 and Docker et al 1982. At the present time the gel based media appear to be preferable to the oils and creams. Water is a good media and can be used as an alternative but clearly it fails to meet the above criteria in terms of its viscosity. There is no realistic (clinical) difference between the gels in common clinical use (Poltawski and Watson 2007). The addition of active agents (e.g. anti-inflammatory drugs) to the gel is widely practiced, but remains incompletely researched. We are currently evaluating this intervention further.
As a matter of (clinical) interest, the US treatment should be cleaned with an alcohol based swab (not just wiped with tissue) between treatments (Schabrun et al, 2006) to minimise the potential transmission of microbial agents between patients.
In addition to the reflection that occurs at a boundary due to differences in impedance, there will also be some refraction if the wave does not strike the boundary surface at 90°. Essentially, the direction of the US beam through the second medium will not be the same as its path through the original medium - its pathway is angled. The critical angle for US at the skin interface appears to be about 15°. If the treatment head is at an angle of 15° or more to the plane of the skin surface, the majority of the US beam will travel through the dermal tissues (i.e. parallel to the skin surface) rather than penetrate the tissues as would be expected.
Absorption and Attenuation :
The absorption of US energy follows an exponential pattern - i.e. more energy is absorbed in the superficial tissues than in the deep tissues. In order for energy to have an effect it must be absorbed, and at some point this must be considered in relation to the US dosages applied to achieve certain effects (ter Haar, 1999, Watson, 2008, Watson and Young, 2008).us exponential
Because the absorption (penetration) is exponential, there is (in theory) no point at which all the energy has been absorbed, but there is certainly a point at which the US energy levels are not sufficient to produce a therapeutic effect. As the US beam penetrates further into the tissues, a greater proportion of the energy will have been absorbed and therefore there is less energy available to achieve therapeutic effects. The half value depth is often quoted in relation to US and it represents the depth in the tissues at which half the surface energy is available. These will be different for each tissue and also for different US frequencies. The table below gives some indication of typical (or average) half value depths for therapeutic ultrasound. (after Hoogland 1995)
As it is difficult, if not impossible to know the thickness of each of these layers in an individual patient, average half value depths are employed for each frequency
3 MHz 2.0 cm
1 MHz 4.0 cm
These values (after Low & Reed) are not universally accepted (see Ward 1986) and some research (as yet unpublished) suggests that in the clinical environment, they may be significantly lower.
To achieve a particular US intensity at depth, account must be taken of the proportion of energy which has been absorbed by the tissues in the more superficial layers. The table gives an approximate reduction in energy levels with typical tissues at two commonly used frequencies, and more detailed information is found in the dose calculation material
As the penetration (or transmission) of US is not the same in each tissue type, it is clear that some tissues are capable of greater absorption of US than others. Generally, the tissues with the higher protein content will absorb US to a greater extent, thus tissues with high water content and low protein content absorb little of the US energy (e.g. blood and fat) whilst those with a lower water content and a higher protein content will absorb US far more efficiently. Tissues can be ranked according to their relative tissue absorption and this is critical in terms of clinical decision making (Watson, 2008).
Although cartilage and bone are at the upper end of this scale, the problems associated with wave reflection mean that the majority of US energy striking the surface of either of these tissues is likely to be reflected. The best absorbing tissues in terms of clinical practice are those with high collagen content – LIGAMENT, TENDON, FASCIA, JOINT CAPSULE, SCAR TISSUE (Watson 2000, 2008, Watson & Young, 2008, ter Haar 1999, Nussbaum 1998, Frizzel & Dunn 1982)
The application of therapeutic US to tissues with a low energy absorption capacity is less likely to be effective than the application of the energy into a more highly absorbing material. Recent evidence of the ineffectiveness of such an intervention can be found in Wilkin et al (2004) and Markert et al (2005) whilst application in tissue that is a better absorber will, as expected, result in a more effective intervention (e.g. Sparrow et al 2005, Leung et al 2004).
Pulsed Ultrasound
Most machines offer the facility for pulsed US output, and for many clinicians, this is a preferable mode of treatment. Until recently, the pulse duration (the time during which the machine is on) was almost exclusively 2ms (2 thousandths of a second) with a variable off period. Some machines now offer a variable on time though whether this is of clinical significance has yet to be determined. Typical pulse ratios are 1:1 and 1:4 though others are available (see dose calculations). In 1:1 mode, the machine offers an output for 2ms followed by 2ms rest. In 1:4 mode, the 2ms output is followed by an 8ms rest period. The adjacent diagram illustrates the effect of varying the pulse ratio.
The effects of pulsed US are well documented and this type of output is preferable especially in the treatment of the more acute lesions. Some machines offer pulse parameters that do not appear to be supported from the literature (e.g. 1:9; 1:20). Some manufacturers describe their pulsing in terms of a percentage rather than a ratio (1:1 = 50% 1:4 = 20% etc). The proportion of time that the machine is ON compared with OFF is a relevant factor in dosage calculations and further details are included in the dose calculation support material.
klik here to read more about Ultrasound:
source: http://www.electrotherapy.org/modalities/ultrasound%20basics.htm
All materials (tissues) will present an impedance to the passage of sound waves. The specific impedance of a tissue will be determined by its density and elasticity. In order for the maximal transmission of energy from one medium to another, the impedance of the two media needs to be as similar as possible. Clearly in the case of US passing from the generator to the tissues and then through the different tissue types, this can not actually be achieved. The greater the difference in impedance at a boundary, the greater the reflection that will occur, and therefore, the smaller the amount of energy that will be transferred. Examples of impedance values can be found in the literature e.g. Robertson et al 2007,Ward 1986.
The difference in impedance is greatest for the steel/air interface which is the first one that the US has to overcome in order to reach the tissues. To minimise this difference, a suitable coupling medium has to be utilised. If even a small air gap exists between the transducer and the skin the proportion of US that will be reflected approaches 99.998% which means that there will be no effective transmission.
us reflect
The coupling media used in this context include water, various oils, creams and gels. Ideally, the coupling medium should be fluid so as to fill all available spaces, relatively viscous so that it stays in place, have an impedance appropriate to the media it connects, and should allow transmission of US with minimal absorption, attenuation or disturbance. For a good discussion regarding coupling media, see Casarotto et al 2004, Klucinec et al 2000, Williams 1987 and Docker et al 1982. At the present time the gel based media appear to be preferable to the oils and creams. Water is a good media and can be used as an alternative but clearly it fails to meet the above criteria in terms of its viscosity. There is no realistic (clinical) difference between the gels in common clinical use (Poltawski and Watson 2007). The addition of active agents (e.g. anti-inflammatory drugs) to the gel is widely practiced, but remains incompletely researched. We are currently evaluating this intervention further.
As a matter of (clinical) interest, the US treatment should be cleaned with an alcohol based swab (not just wiped with tissue) between treatments (Schabrun et al, 2006) to minimise the potential transmission of microbial agents between patients.
In addition to the reflection that occurs at a boundary due to differences in impedance, there will also be some refraction if the wave does not strike the boundary surface at 90°. Essentially, the direction of the US beam through the second medium will not be the same as its path through the original medium - its pathway is angled. The critical angle for US at the skin interface appears to be about 15°. If the treatment head is at an angle of 15° or more to the plane of the skin surface, the majority of the US beam will travel through the dermal tissues (i.e. parallel to the skin surface) rather than penetrate the tissues as would be expected.
Absorption and Attenuation :
The absorption of US energy follows an exponential pattern - i.e. more energy is absorbed in the superficial tissues than in the deep tissues. In order for energy to have an effect it must be absorbed, and at some point this must be considered in relation to the US dosages applied to achieve certain effects (ter Haar, 1999, Watson, 2008, Watson and Young, 2008).us exponential
Because the absorption (penetration) is exponential, there is (in theory) no point at which all the energy has been absorbed, but there is certainly a point at which the US energy levels are not sufficient to produce a therapeutic effect. As the US beam penetrates further into the tissues, a greater proportion of the energy will have been absorbed and therefore there is less energy available to achieve therapeutic effects. The half value depth is often quoted in relation to US and it represents the depth in the tissues at which half the surface energy is available. These will be different for each tissue and also for different US frequencies. The table below gives some indication of typical (or average) half value depths for therapeutic ultrasound. (after Hoogland 1995)
As it is difficult, if not impossible to know the thickness of each of these layers in an individual patient, average half value depths are employed for each frequency
3 MHz 2.0 cm
1 MHz 4.0 cm
These values (after Low & Reed) are not universally accepted (see Ward 1986) and some research (as yet unpublished) suggests that in the clinical environment, they may be significantly lower.
To achieve a particular US intensity at depth, account must be taken of the proportion of energy which has been absorbed by the tissues in the more superficial layers. The table gives an approximate reduction in energy levels with typical tissues at two commonly used frequencies, and more detailed information is found in the dose calculation material
As the penetration (or transmission) of US is not the same in each tissue type, it is clear that some tissues are capable of greater absorption of US than others. Generally, the tissues with the higher protein content will absorb US to a greater extent, thus tissues with high water content and low protein content absorb little of the US energy (e.g. blood and fat) whilst those with a lower water content and a higher protein content will absorb US far more efficiently. Tissues can be ranked according to their relative tissue absorption and this is critical in terms of clinical decision making (Watson, 2008).
Although cartilage and bone are at the upper end of this scale, the problems associated with wave reflection mean that the majority of US energy striking the surface of either of these tissues is likely to be reflected. The best absorbing tissues in terms of clinical practice are those with high collagen content – LIGAMENT, TENDON, FASCIA, JOINT CAPSULE, SCAR TISSUE (Watson 2000, 2008, Watson & Young, 2008, ter Haar 1999, Nussbaum 1998, Frizzel & Dunn 1982)
The application of therapeutic US to tissues with a low energy absorption capacity is less likely to be effective than the application of the energy into a more highly absorbing material. Recent evidence of the ineffectiveness of such an intervention can be found in Wilkin et al (2004) and Markert et al (2005) whilst application in tissue that is a better absorber will, as expected, result in a more effective intervention (e.g. Sparrow et al 2005, Leung et al 2004).
Pulsed Ultrasound
Most machines offer the facility for pulsed US output, and for many clinicians, this is a preferable mode of treatment. Until recently, the pulse duration (the time during which the machine is on) was almost exclusively 2ms (2 thousandths of a second) with a variable off period. Some machines now offer a variable on time though whether this is of clinical significance has yet to be determined. Typical pulse ratios are 1:1 and 1:4 though others are available (see dose calculations). In 1:1 mode, the machine offers an output for 2ms followed by 2ms rest. In 1:4 mode, the 2ms output is followed by an 8ms rest period. The adjacent diagram illustrates the effect of varying the pulse ratio.
The effects of pulsed US are well documented and this type of output is preferable especially in the treatment of the more acute lesions. Some machines offer pulse parameters that do not appear to be supported from the literature (e.g. 1:9; 1:20). Some manufacturers describe their pulsing in terms of a percentage rather than a ratio (1:1 = 50% 1:4 = 20% etc). The proportion of time that the machine is ON compared with OFF is a relevant factor in dosage calculations and further details are included in the dose calculation support material.
klik here to read more about Ultrasound:
source: http://www.electrotherapy.org/modalities/ultrasound%20basics.htm
Saturday, August 29, 2009
Penanganan pada Kasus Fraktur Terbuka
PENANGANAN FRAKTUR TERBUKA
Fraktur adalah terputusnya kontinuitas struktur jaringan tulang atau tulang rawan yang umumnya disebabkan trauma, baik trauma langsung maupun tidak langsung. Akibat dari suatu trauma pada tulang dapat bervariasi tergantung pada jenis, kekuatan dan arahnya trauma ( Apley & Solomon, 1993; Rasjad, 1998; Armis, 2002).
Fraktur terbuka adalah fraktur yang terjadi hubungan dengan dunia luar atau rongga tubuh yang tidak steril, sehingga mudah terjadi kontaminasi bakteri dan dapat menyebabkan komplikasi infeksi.
Semua faktur terbuka harus dianggap terkontaminasi sehingga mempunyai potensi untuk terjadi infeksi. Penting untuk diketahui bahwa diagnosis, klasifikasi dan pengelolaannya dapat berbeda dari fraktur tertutup. Penanganan fraktur terbuka dapat mengikuti pengelolaan trauma lain jika merupakan suatu trauma multipel
Pada fraktur tulang dapat terjadi pergeseran fragmen-fragmen tulang. Pergeseran fragmen bisa diakibatkan adanya keparahan cedera yang terjadi, gaya berat maupun tarikan otot yang melekat padanya. Pergeseran fragmen fraktur akibat suatu trauma dapat berupa aposisi (pergeseran kesamping / sideways, tumpang tindih dan berhimpitan / overlapping, bertubrukan sehingga saling tancap/ impacted); angulasi (penyilangan antara kedua aksis fragmen fraktur); panjang / length (pemanjangan atau pemendekan akibat distraction atau overlapping antar fragmen fraktur) atau terjadi rotasi (pemuntiran fragmen fraktur terhadap sumbu panjang).
Hubungan garis fraktur dengan energi trauma
Garis Fraktur Mekanisme trauma Energi
Transversal, oblik, spiral, (sedikit bergeser / masih ada kontak) Angulasi / memutar Ringan
Butterfly, transversal (bergeser), sedikit kominutif Kombinasi Sedang
Segmental kominutif (sangat bergeser) Variasi Berat
Klasifikasi Fraktur Terbuka
Dikenal beberapa klasifikasi fraktur terbuka seperti menurut Byrd et al.(1981) yang menekankan pentingnya vaskularisasi tulang, kemudian menurut Oestern dan Tscherne (1984) yang menekankan pentingnya tingkat kerusakan jaringan lunak dan luas kontusio otot, serta menurut AO group oleh Muller et al. (1990) yang menekankan berat ringannya cedera kulit, cedera otot dan tendon serta cedera neurovaskuler. (cit. Court-Brown et al, 1996).
Klasifikasi fraktur terbuka paling sering digunakan menurut Gustillo dan Anderson (1976), yang menilai fraktur terbuka berdasarkan mekanisme cedera, derajat kerusakan jaringan lunak, konfigurasi fraktur dan derajat kontaminasi. Klasifikasi Gustillo ini membagi fraktur terbuka menjadi tipe I,II dan III
***
***
Klasifikasi Fraktur terbuka menurut Gustillo dan Anderson ( 1976 )
Tipe Batasan
I Luka bersih dengan panjang luka <> 1 cm tanpa kerusakan jaringan lunak yang berat
III Kerusakan jaringan lunak yang berat dan luas, fraktur segmental terbuka, trauma amputasi, luka tembak dengan kecepatan tinggi, fraktur terbuka di pertanian, fraktur yang perlu repair vaskuler dan fraktur yang lebih dari 8 jam setelah kejadian.
• Tipe I berupa luka kecil kurang dari 1 cm akibat tusukan fragmen fraktur dan bersih. Kerusakan jaringan lunak sedikit dan fraktur tidak kominutif. Biasanya luka tersebut akibat tusukan fragmen fraktur atau in–out.
• Tipe II terjadi jika luka lebih dari 1 cm tapi tidak banyak kerusakan jaringan lunak dan fraktur tidak kominutif.
• Pada tipe III dijumpai kerusakan hebat maupun kehilangan cukup luas pada kulit, jaringan lunak dan putus atau hancurnya struktur neurovaskuler dengan kontaminasi, juga termasuk fraktur segmental terbuka atau amputasi traumatik.
Klasifikasi ini juga termasuk trauma luka tembak dengan kecepatan tinggi atau high velocity, trauma didaerah pertanian, fraktur terbuka yang memerlukan repair vaskular, fraktur terbuka lebih 8 jam setelah kecelakaan
Kemudian Gustillo et al. (1984) membagi tipe III dari klasifikasi Gustillo dan Anderson (1976) menjadi tiga subtipe, yaitu tipe IIIA, IIIB dan IIIC (tabel 3).
IIIA terjadi apabila fragmen fraktur masih dibungkus oleh jaringan lunak, walaupun adanya kerusakan jaringan lunak yang luas dan berat.
IIIB fragmen fraktur tidak dibungkus oleh jaringan lunak sehingga tulang terlihat jelas atau bone expose, terdapat pelepasan periosteum, fraktur kominutif. Biasanya disertai kontaminasi masif dan merupakan trauma high energy tanpa memandang luas luka.
IIIC terdapat trauma pada arteri yang membutuhkan repair agar kehidupan bagian distal dapat dipertahankan tanpa memandang derajat kerusakan jaringan lunak.
Klasifikasi lanjut fraktur terbuka tipe III (Gustillo dan Anderson, 1976) oleh Gustillo, Mendoza dan Williams (1984):
Tipe Batasan
IIIA Periosteum masih membungkus fragmen fraktur dengan kerusakan jaringan lunak yang luas
IIIB Kehilangan jaringan lunak yang luas, kontaminasi berat, periosteal striping atau terjadi bone expose
IIIC Disertai kerusakan arteri yang memerlukan repair tanpa melihat tingkat kerusakan jaringan lunak.
Armis (2001) membuat klasifikasi fraktur terbuka dengan sistim skoring yang dinamakan Sistem Skoring Sardjito (SSS) yang dilakukan dengan memberikan skoring pada setiap variabel yang meliputi kerusakan kulit, kerusakan otot, kondisi tulang, kondisi neurovaskuler dan derajat kontaminasi kemudian skor dijumlahkan
Klasifikasi fraktur terbuka sesuai Sistem Skoring Sardjito (Khairuddin & Armis, 2002).
Batasan => skor
I. Skin Damage
A.Wound:
Ø < score ="15+1="16)">1cm tapi tak banyak kerusakan jaringan lunak dan fraktur tak kominutif.
Derajat III
Kerusakan hebat pada kulit, jaringan lunak dan struktur neurovascular dengan kontaminasi,
III A fragmen tulang masih dibungkus jaringan lunak,
III B fragmen tulang tak dibungkus jaringan lunak terdapat pelepasan lapisan periosteum, fraktur kominutif,
III C trauma pada arteri yang membutuhkan repair agar bagian distal dapat dipertahankan, terjadi kerusakan jaringan lunak hebat.
Trauma high-velosity termasuk klasifikasi IIIB atau IIIC walaupun lukanya kecil tapi terjadi kerusakan jaringan lunak dibawahnya sangat hebat. Insidensi infeksi derajat I 2% dan derajat II 10%.
sumber :
http://bedahugm.net/Bedah-Orthopedi/Fraktur-Terbuka/Komplikasi.html
Monday, May 11, 2009
Sinar Infra Merah (Infra red)
Sinar Infra Merah (Infra red)
Sinar infra merah juga dikenal dengan nama sinar infra red. Sinar infra merah ini sebenarnya merupakan suatu pancaran gelombang elektromagnetik dengan panjang gelombang 7.700 hingga 4.000.000 A.
Sinar infra merah ini secara alami dapat ditemukan atau berasal dari sinar matahari. Akan tetapi sinar ini juga dapat diperoleh / dibuat dengan berbagai cara, misalnya;
a. Bantalan listrik. Lampu non luminious infra red, lampu-lampu pijar akan mengeluarkan sinar infra merah gelombang panjang, pendek dan sinar visible
b. Carbon pendek akan mengeluarkan sinar infra merah yang disertai seinar visible dan ultra violet.
c. Air Hangat
Klasifikasi Sinar Infra merah:
• Panjang Gelombang
a. Gelombang panjang (non penetrating). Panjang gelombang di atas 12.000 A hingga 150.000 A. penetrasi hanya sampai ke lapisan superficial epidermis (sekitar 0,5 mm)
b. Gelombang pendek (penetrating). Panjang gelombang dari 7.700 A hingga 12.000 A. daya penetrasi hingga jaringan subkutan, karenanya dapat mempengaruhi pembuluh darah kapiler, pembuluh limfe, ujung-ujung saraf dan jaringan lain di bawah kulit.
• Tipe
a. tipe A : panjang gelombang 780-1500 mm, penetrasi dalam
b. tipe B : panjang gelombang 1500-3000 mm, penetrasi dangkal
c. tipe C : panjang gelombang 3000- sekitar 10.000 mm, penetrasi dangkal
Generator Sinar Infra merah:
Pada dasarnya generator infra merah dibedakan menjadi dua:
• non luminious. Generator jenis ini hanya menghasilkan / memancarkan sinar infra merah saja.
• Luminious. Generator ini tidak hanya memancarkan sinar infra merah saja tapi juga sinar visible dan ultra violet. Meskipun demikian, prosentase pancaran yang terbesar adalah sinar infra merah.
Efek fisiologis sinar infra merah
Apabila sinar infra merah diabsorbsi oleh kulit, maka akan terjadi peningkatan suhu secara local (di daerah yang mengabsorbsi sinar tersebut). Dengan peningkatan suhu / temperatur, maka akan timbul pengaruh berikutnya yaitu;
• Meningkatnya proses metabolise.
Proses metabolism yang terjadi pada lapisan superficial kulit akan meningkat sehinga suplay oksigen dan nutrisi ke jaringan akan meningkat. Demikian pula pada pengeluaran sisa-sisa metaboisme.
• Vasodilatasi pembuluh darah
Pembuluh darah kapiler akan segera melebar (dilatasi) setelah penyinaran infra merah, sehingga kulit tampak kemerahan tapi tidak merata . hal tersebut dinamakan eritema.
Eritema ini terjadi bila ada energi dengan temperatur tinggi (panas) yang diterima ujung saraf sensorik yang kemudian mempengaruhi mekanisme pengatur panas. Untuk itu, mekanisme vasomotor mengadakan reaksi pelebaran pembuluh darah sehingga panas dapat disebarkan merata ke seluruh jaringan melalui sirkulasi darah.
Dengan peningkatan sirkulasi darah maka suplay oksigen dan nutrisi ke jaringan akan meningkat, dengan demikiankadar sel darah putih dan anti body dalam jaringan akan meningkat. Hal itu menyebabkan pemeliharaan jaringan menjadi lebih baik dan perlawanan terhadap agen penyebab radang juga semakin baik.
• Pigmentasi
Penyinaran yang berulang-ulang akan menyebabkan pigmentasi pada jaringan yang bersangkutan. Pigmentasi yang terjadi biasanya mengelompok dan tidak merata karena adanya perusakan pada sebagian sel-sel darah merah ditempat tersebut.
• Pengaruh pada saraf sensorik
Pemanasan ringan berpengaruh sedative terhadap ujung saraf sensorik, sedang pemanasan berlebihan akan menimbulkan iritasi.
• Pengaruh pada jaringan otot
Selain kenaikan temperature yang akan membantu relaksasi otot juga akan meningkatkan kemampuan otot untuk berkontraksi.
Spasme menurun karena efek panasa yang meningkatkan metabolise termasuk pembuangan sisa metabolise penumpukan asam laktat yang menyebabkan terjadinya spasme)
• Destruksi jaringan
Kerusakan jaringan timbul karena penyinaran yang berlebihan dalam waktu lama sehingga menimbulkan panas yang berlebihan (tidak dapat ditoleransi tubuh).
• Peningkatan temperatur tubuh
Hal ini akan terjadi bila penyinaran dilakukan pada area tubuh secara luas dan dalam waktu yang lama. Hal tersebut akan berpengaruh juga pada penurunan tekanan darah sistemik.
• Mengaktifkan kelenjar keringat
Rangsangan panas yang dibawa ujung saraf sensorik akan mengaktifkan kerja kelenjar keringat pada daerah yang diberi penyinaran.
Efek teraputik sinar infra merah
• Mengurangi nyeri
Penyinaran infra merah merupakan salah satu cara efektif untuk mengurangi nyeri. Hal ini karena :
- Bila diberikan mild heating : pengurangan nyeri karena efek sedatif superfisial sensory nerve ending (ujung saraf sensorik superfisial)
- Bila diberi stronger heating : akan terjadi counter irritation yang pada akhirnya menurunkan nyeri.
- Karena nyeri timbul akibat akumulasi sisa metabolisme yang disebut substansi P maka dengan meningkatnya metabolism dan sirkulasi darah, substansi p tersebut akan dibuang.
• Relaksasi otot
Relaksasi otot akan mudah dicapai bila jaringan otot dalam keadaan hangat dan tidak merasa nyeri.
• Meningkatkan suplay darah
Peningkatan temperature akan diikuti oleh vasodilatasi yang akan menyebabkan peningkatan suplay darah ke area yang bersangkutan.
• Menghilangkan sisa-sisa metabolism
Penyinaran di daerah yang luas akan mengaktifkan glandula gudofera (kelenjar keringat) di seluruh tubuh, dengan demikian akan meningkatkan pembuangan sisa-sisa metabolism melalui keringat. Pengaruh ini sangat bermanfaat untuk kondisi arthritis.
Indikasi penyinaran Infra merah:
• kondisi peradangan setelah sub-akut : kontusio, muscle strain, muscle sprain, trauma sinovitis.
• Arthritis : rheumatoid arthritis, osteoarthritis, myalgia, lumbago, neuralgia, neuritis
• Gangguan sirkulasi darah : thrombo-angitis obliterans, tromboplebitis, reynold’s desease
• Penyakit kulit : folliculitis, furuncolosi, wound
• Persiapan exercise dan massage
Kontra Indikasi penyinaran Infra merah:
• Daerah dengan insufisiensi darah
• Gangguan sensibilitas kulit
• Ada kecenderungan terjadi perdarahan
• Luka bakar
• Electric shock
• Headache / pusing
• Pingsan tiba-tiba sewaktu penyinaran
• Menggigil
• Mata
Sumber : Hand Book Sumber Fisis Politeknik Kesehatan Surakarta Jurusan Fisioterapi dengan berbagai perubahan
Subscribe to:
Posts (Atom)