Ultrasound Diathermy dan Exercise untuk Mengurangi Permasalahan Fisioterapi pada Pasien Carpal Tunnel Syndrome (CTS)
Physiotherapy Management of Patient With Carpal Tunnel Syndrome (CTS)
Abstract
Hilangnya keterampilan motorik dan sensasi merupakan masalah bagi pasien carpal tunnel syndrome (CTS). Kasus dalam penelitian ini melibatkan 3 orang wanita berusia di atas 40 tahun yang bekerja pada pekerjaan yang banyak melibatkan gerakan pergelangan tangan berulang-ulang. Kapasitas fungsional pasien menunjukkan bahwa pasien mampu melakukan pekerjaan rumah tangga namun masih diganggu oleh nyeri. Tes nyeri VAS menunjukkan nyeri saat berdiri diam, bergerak, atau menekan. Pengujian rentang gerak sendi (LGS) menunjukkan keterbatasan dalam fleksi-ekstensi pergelangan tangan. Pengujian sensorik dengan diskriminasi 2 poin memberikan hasil normal dan positif pada tes Pray, Tinnel dan Phalen. Diagnosa terapi fisik pada penelitian ini adalah adanya gangguan berupa nyeri dan keterbatasan gerak pada kasus 1 dan 2. Sedangkan pada kasus 3, permasalahan terapi fisik adalah nyeri dan keterbatasan gerak serta berkurangnya kekuatan otot genggaman. Dalam hal ini batasan fungsional adalah keterbatasan dalam melakukan tugas sehari-hari seperti bekerja, memasak, mengangkat 5 kg dan pekerjaan rumah tangga lainnya. Ketiga pasien tersebut tidak memiliki batasan dalam berpartisipasi karena walaupun pasien kesakitan, ia masih dapat berpartisipasi dalam aktivitas sehari-hari dan sosial. Masalah ini diatasi melalui intervensi USG diathermy (USD) yang bertujuan untuk mengurangi nyeri pergelangan tangan. terapi olahraga berupa mobilisasi saraf median dan perpindahan tendon, bertujuan untuk meningkatkan rentang gerak sendi dan mengurangi rasa kaku, serta latihan dengan bola untuk mengembalikan cengkeraman. Setelah 3 sesi pengobatan USD, mobilisasi selip saraf median dan tendon serta latihan bola pada pasien CTS dengan masalah nyeri, keterbatasan gerak dan penurunan kemampuan genggaman berhasil diintervensi, dengan hasil yang baik. Penilaian nyeri menggunakan VAS mengalami penurunan. LGS pada pergelangan tangan klien dan penilaian kapasitas fungsional PRWE secara bertahap membaik.
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