TERAPI LATIHAN ASSISTED ACTIVE MOVEMENT DALAM

MENINGKATKAN LINGKUP GERAK SENDI ELBOW PADA

KONDISI POST OPERASI ORIF FRAKTUR 1/3 DISTAL HUMERI

KARYA TULIS ILMIAH AKHIR

FENDY WIDIATMOKO

1210702028

UNIVERSITAS PEMBANGUNAN NASIONAL “VETERAN’’ JAKARTA

FAKULTAS ILMU-ILMU KESEHATAN

PROGRAM STUDI FISIOTERAPI

2015

TERAPI LATIHAN ASSISTED ACTIVE MOVEMENT DALAM

MENINGKATKAN LINGKUP GERAK SENDI ELBOW PADA

KONDISI POST OPERASI ORIF FRAKTUR 1/3 DISTAL HUMERI

KARYA TULIS ILMIAH AKHIR

Diajukan Sebagai Salah Satu Syarat Untuk Memperoleh Gelar

Diploma III Fisioterapi

FENDY WIDIATMOKO

1210702028

UNIVERSITAS PEMBANGUNAN NASIONAL “VETERAN’’ JAKARTA

FAKULTAS ILMU-ILMU KESEHATAN

PROGRAM STUDI FISIOTERAPI

2015

v

TERAPI LATIHAN ASSISTED ACTIVE MOVEMENT DALAM

MENINGKATKAN LINGKUP GERAK SENDI ELBOW PADA

KONDISI POST OPERASI ORIF FRAKTUR 1/3 DISTAL

HUMERI

Fendy Widiatmoko

Abstrak

Fraktur 1/3 distal humeri adalah rusaknya kontinuitas tulang humerus pada 1/3

distal yang disebabkan oleh trauma secara langsung maupun tidak langsung.

Tulang mengalami fraktur biasanya diikuti kerusakan jaringan disekitarnya seperti

ligamen, otot, tendon, pembuluh darah dan persyarafan. Salah satu upaya

pengembalian bentuk tulang yang mengalami fraktur dengan tindakan operasi.

Pada kasus ini ditemukan keterbatasan lingkup gerak sendi, dan penurunan

kemampuan fungsional. Untuk penanganan yang efektif dan efisien, maka

dilakukan metode pemeriksaan yaitu pemeriksaan nyeri dengan Simple Diskritif

Visual Analogue Scale (VAS), pemeriksaan lingkup gerak sendi dengan

goneometer. Untuk membantu mengatasi masalah-masalah tersebut, salah satu

modalitas fisioterapi yang dapat digunakan adalah terapi latihan assisted active

movement.Tujuan umum dari karya tulis ilmiah akhir ini ialah sendi elbow pada

post operasi ORIF fraktur 1/3 distal humeri setelah diberikan terapi latihan

assisted active movement, sedangkan tujuan khusus dari karya tulis ilmiah akhir

ini ialah untuk mengetahui manfaat dari terapi latihan active assisted pada kasus

fraktur elbow 1/3 distal. Metode yang dilakukan dalam oenulisan karya tulis

ilmiah akhir ini ialah metode dengan cara pengumpulan data. Setelah dilakukan

sebanyak 6 kali, didapatkan hasil berupa peningkatan lingkup gerak sendi dan

nyeri berkurang. Dari hasil yang diperoleh, maka dapat disimpulkan bahwa

dengan penggunaan modalitas fisioterapi berupa terapi latihan yaitu Assisted

active movement dapat membantu menggurangi permasalahan yang timbul akibat

post operasi ORIF fraktur 1/3 distal humeri dengan pemasangan plate and screw.

Kata kunci : fraktur 1/3 distal humeri, VAS, LGS, Terapi Latihan

vi

EXERCISE THERAPY JOINT MOTION TO INCREASE THE

SCOPE ELBOW ON CONDITION OPERATION POST

FRACTURE 1/3 DISTAL HUMERAL ORIF

Fendy Widiatmoko

Abstract

Fraktur 1/3 humeri distal is destroying of humerus bone kontinuitas at 1 / 3 distal

which because of trauma directly and also indirectly. Natural bone of fraktur

isusually followed by damage of network about him like ligament, muscle,

tendon, venous and nerve. One of the effort return of natural bone form fraktur

with operation action. At this case found by limitation of scope move joint, and

degradation of functional ability. For efficient and effective handling, hence

conducted by inspection method that is inspection of pain in bone with Visual

Analogue Scale ( VAS), Range Of Motion (ROM) move joint with goneometer.

To assist to to overcome the problems, one of the physiotherapy modalitas able to

be used by practice therapy of assisted public movement. The goal for active of

masterpiece write this final erudite is joint of elbow at post operate for ORIF

fraktur 1 / 3 humeri distal after given by practice therapy of assisted movement

active, while special target of masterpiece write this final erudite is to know

benefit of practice therapy of active assisted at case of fraktur elbow 1 / 3 distal.

Method performed within masterpiece oenulisan write this final erudite is method

by data collecting. After conducted counted 6 times, got result of in the form of

make-up of scope move pain in bone and joint decrease. From result of which

obtained, hence can be concluded that with usage of physiotherapy modalitas in

the form of practice therapy that is Assisted movement active can assist increase

problems of arising out effect of post operate for ORIF fraktur 1 / 3 humeri distal

with installation of screw and plate.

Keywords: 1/3 distal humeral fracture, VAS, ROM, Therapeutic Exercises

viii

DAFTAR ISI

HALAMAN JUDUL ........................................................................................ i

LEMBAR ORSINALITAS .............................................................................. ii

LEMBAR PUBLIKASI .................................................................................. iii

PENGESAHAN .............................................................................................. iv

ABSTRAK ...................................................................................................... v

ABSTRACT ..................................................................................................... vi

KATA PENGANTAR ..................................................................................... vii

DAFTAR ISI .................................................................................................... viii

DAFTAR TABEL ........................................................................................... x

DAFTAR GAMBAR ....................................................................................... xi

DAFTAR LAMPIRAN ................................................................................... xii

BAB I PENDAHULUAN ............................................................................... 1

I.1 Latar Belakang ........................................................................................ 2

I.2 Identifikasi Masalah ................................................................................. 4

I.3 Rumusan Masalah ..................................................................................... 4

I.4 Tujuan Penulisan ....................................................................................... 5

BAB II TINJAUAN PUSTAKA ...................................................................... 6

II.1 Fraktur 1/3 Distal Humerus ..................................................................... 6

II.2 Problematik Fisioterapi ........................................................................... 17

II.3 Diagnosa Fisioterapi ................................................................................ 18

II.4 Metode Intervensi Fisioterapi .................................................................. 18

II.5 Edukasi dan Home progam ..................................................................... 19

BAB III METODOLOGI PENGAMBILAN DATA DAN INTERVENSI .... 20

III.1 Rencana Intervensi Fisioterapi ............................................................... 20

III.2 Waktu dan Tempat Pengambilan Data .................................................. 25

III.3 Kriteria Kasus Terpilih ........................................................................... 25

III.4 Definisi Operasional ............................................................................... 25

III.5 Cara Pengumpulan Data dan Analisa Data ........................................... 26

III.6 Intervensi Fisioterapi ............................................................................. 26

III.7 Rencana Edukasi .................................................................................. 27

III.8 Rencana Evaluasi ................................................................................... 27

III.9 Deskripsi Data dan Analisa Data ........................................................... 27

BAB IV PELAKSANAAN STUDI KASUS .................................................. 28

IV.1 Identitas .................................................................................................... 28

IV.2 Assesment ............................................................................................... 28

IV.3 Daftar Masalah Fisioterapi Dan Diagnosa Fisioterapi ............................ 30

IV.4 Perencanaan Fisioterapi .......................................................................... 30

IV.5 Intervensi Fisioterapi .............................................................................. 30

IV.6 Home Program ........................................................................................ 31

IV.7 Evaluasi .................................................................................................... 31

IV.8 Deskripsi Data dan Analisa Data ............................................................ 33

ix

BAB V PEMBAHASAN ................................................................................ 35

BAB VI PENUTUP ......................................................................................... 37

VI.1 Kesimpulan ........................................................................................... 37

DAFTAR PUSTAKA ...................................................................................... 39

DAFTAR RIWAYAT HIDUP

LAMPIRAN

x

DAFTAR TABEL

Tabel 1 Variabel Dependent ............................................................................ 26

Tabel 2 Evaluasi Lingkup Gerak Sendi .......................................................... 32 Tabel 3 Evaluasi Nyeri ................................................................................... 32

Tabel 4 Evaluasi kekuatan otot ...................................................................... 33

xi

DAFTAR GAMBAR

Gambar 1 Tipe Fraktur ................................................................................... 7

Gambar 2 Sendi Siku ..................................................................................... 12

Gambar 3 Fraktur humerus 1/3 distal .............................................................. 29

Gambar 4 Fraktur humerus 1/3 distal Setelah Operasi ORIF ......................... 29

Gambar 5 Perubahan Lingkup Gerak Sendi .................................................... 33

Gambar 6 Perubahan Nyeri ............................................................................ 34

Gambar 7 Perubahan Kekuatan Otot .............................................................. 34

xii

DAFTAR LAMPIRAN

Lampiran 1 Persetujuan Pasien

Lampiran 2 Laporan Studi Kasus

Lampiran 3 Surat Permohonan Ijin Pengambilan Pasien

Lampiran 4 Surat Persetujuan Pengambilan Data