Supporting Examination

•Laboratory
February 22nd, 2016

PT 10,4 detik WBC 7,7 103/mm3

APTT 25,4 detik RBC 3,68 106/mm3
Glukosa GDS 99 mg/dl HB 12,3 g/dl
Ureum 38 mg/dl HCT 37,7%
Kreatinin 1,13 mg/dl PLT 216 103/mm3
SGOT 24 U/L
SGPT 15 U/L
Natrium 144 mmol/l
Kalium 4,1 mmol/l
Klorida 112 mmol/l
Kolesterol Total 153 mg/dl
Kolesterol HDL 41 mg/dl
Kolesterol LDL 102 mg/dl
Trigliserida 111 mg/dl
 Radiology CT-Scan

• Radiology CT-Scan
Impression :
Infark Cerebri Dextra
Hipodens Lesion in
Capsula Interna Dextra
 Diagnosis

• Medical : Hemiparese sinistra et cause Non-Haemorrhage Stroke

• Surgery : -
Diagnosis Fungsional
1. Impairment
Non-Haemorrhage Stroke
Left Hemiparesis on Extremities
Transfer Impairment
Coordination Impairment
Muscle Spaticity on Left Extremities
Hypertension
2. Disability
Balance Disturbance
Transfer Disturbance
Self Hygine disorder
Activity Daily Life Dependent
3. Handicap
Cannot Work as a Farmer
 Problem List

• Medical : Non-Haemorrhage Stroke + Hemiparese sinistra + Hypertension

• Surgical : -
Rehabilitation Medicine :
R1 (Mobilization) : -
R2 (ADL) : Activity Daily Life Dependent
R3 (Communication) : -
R4 (Psyhological) : He worried about his condition
R5 (Social Economy) : Supported by family
R6 (Vocational) : Cannot work as Farmer
R7 (Others) :
Left side Muscle Weakness
Left side Sensory disorder
Transfer Impairment
Coordination Impairment
Muscle Spaticity on Left Extremities
 Treatment Goals

• Short Term
1.Improve muscle strength of the right
extremities
2. Improve balance
3. Preserve coordination
4. Sharpening Proprioceptive sensoric
• Long Term
1. Prevent for the 2nd stroke attack
2. Back to work
3. Improve quality of life
 Planning

• Medical
• PDx: Cerebral CT-Scan
• PTx :
IVFD RL 20 tpm
Citicoline 500 mg/ 12 jam/IV
Ranitidine 50 mg/ 12 jam/IV
Sohobion 1 amp/ 24 jam/IM
Aspilet 80 mg/ 24 jam/oral
• PMx : Sign and Symptoms
• PEx : Education about the disease, control risk factors
and regularly control to neurology department
 Planning (Cont)
• Rehabilitation Medicine
R1 (Mobilization) : -
R2 (ADL) :
PDx :-
PTx : Activity Daily Life Exercise
PMx :-
Pex :-
R3 (Communication) : -
R4 (Psyhological) : He worried about his condition
PDx :-
PTx : Give explanation about the disease and treatment goals
PMx : Psychological condition
PEx : Give motivation to the patient and support for his family
R5 (Social Economy) : Supported by family
R6 (Vocational) : Cannot work as Farmer
PDx :-
PTx :-
PMx : Vital sign, muscle strength, neurological status
PEx : Need family support, suggest him to back to work if his
condition is improved
 Planning (Cont)
• R7 (Others) :
Left Side Muscle Weakness
Left Side Sensory disorder
Transfer Impairment
Coordination Impairment
Muscle Spaticity on Left Extremities
PDx : MMT on Extremities
PTx : 1. Breathing exercise active with deep breathing
Therapeutic Exercise
1. Active range of motion exercise of upper and lower extremities
2. Strenght Exercise, especially for Gatrocnemius Muscle
3. Electrical Stimulation on Tibialis anterior and Gastrocnemius sinistra
4. Gradual Transfer Exercise (Mobilization From Sitting To Standing)
5. Coordination Exercise for left extremities
6. Standy Balance Exercise
7. Sensory reeducation on left side of body
PMx : Clinical sign and symptom, Vital Sign, musculoskeletal and neurological condition
PEx :
1. Explanation about the benefit, purpose of the exercise and planning program
2. Suggest the patient and support family to do exercise regularly
3. Active range of motion exercise of upper and lower extremities,
4. Healthy lifestyle and dietary