Exercise As Medicine For MSK
Exercise As Medicine For MSK
Exercise As Medicine For MSK
MUSCULOSKELETAL DISORDERS
ARI SUDARSONO
PHYSIOTHERAPIST & LECTURER
Gangguan MSK yang sering
terjadi:
Nyeri pinggang
Sakit kepala
Nyeri dan kaku leher
Nyeri dan kaku bahu ec. Frozen Shoulder
Nyeri dan gangguan fungsi lutut ec. OA lutut
Gangguan postur (Skoliosis, flat foot, dll)
Apa yang dapat Fisioterapis lakukan?
Massage…?
Mobilisasi dan Manipulasi sendi….?
Setrum..?? Ultrasound/ Uleg2..??
Dry Needling…?
EXERCISE
Sejarah Fisioterapi
460 B.C H ippocra tes
1813
Per Henrik Ling is the “Father of Swedish Gymnastics” who founded
the Royal Central Institute of Gymnastic (RCIG) which helps in
manipulation and exercise for those who are ill.
1894
4 nurses in Great Britain formed the Chartered Society of
Physiotherapy
1913
The School of Physiotherapy of the University of
Otago, New Zealand.
1914
The formation of Reed College, Portland, Oregon which graduates
“reconstruction aides” that plays a major role during the World War I.
.
1916
The polio epidemic became widespread in the United States
and the urge to muscle testing and muscle re-education to
function grew dramatically
1917
The United States entered World War I. The army
started to recognize the urge to recruit “reconstruction aide” to
rehabilitate the injured soldiers.
1921
The first physical therapy journnal was published in United States in “
The PT review”
Mary McMillan organized the American Women’s Physical
Therapeutic Association ( now called American Physical Therapy
Association (APTA) )
1924
Georgia Warm Springs Foundation promoted the field by suggesting to use
physical therapy as a treatment for polio.
1946
Congress adopted the Hill Burton Act to build hospital across the country to
increase the public’s access to health care facilities.
Early 1950
In England,Neurophysiologist (Herman Kabat) developed
neurological exercise (Proprioceptive Facilitation)
1960
Physiotherapist practices in the neuromuscular area expanded
significantly with the development of techniques for adults who
experienced stroke, cerebral palsy, and disorder of the central nervous system.
Physical therapists provide services that develop,
maintain and restore people’s maximum movement and
functional ability.
They can help people at any stage of life, when
movement and function are threatened by ageing, injury,
diseases, disorders, conditions or environmental factors.
Physical therapists help people maximise their quality of
life, looking at physical, psychological, emotional and
social wellbeing.
Dilihat dari sejarahnya
Dilihat dari dasar
ilmunya
Dilihat dari manfaatnya Fisioterapi adalah tindakan untuk
mengoptimalkan & memperbaiki
fungsi GERAK (movement)
dengan dasar ilmu gerak
(neurofisiologi, kinesiologi, dsb)
Fisioterapis adalah
Movement Expert
TL pada MSK?
Untuk meningkatkan fungsi otot (kekuatan, ketahanan
fleksibiltas)
Untuk menambah ROM
Untuk mengurangi nyeri, akibat patologi pada
Otot
Tendon
Sendi (Kapsul-Ligamen)
Pengaruh Untuk Kebugaran tubuh (ketahanan, imunitas)
Meningkatkan kekuatan otot
3 plane strength exercise
Overload principle
SAID principle
Reversibility principle
FITT Principle
Latihan penguatan fungsional 3 bidang
gerak
Latihan penguatan yang efektif menggabungkan gerakan
pada 3 (semua) bidang gerak: Sagittal, Coronal /frontal
dan Transverse. Jadi gerakannya “spiral and diagonal”
Semua gerakan fungsional pada manusia selalu terjadi
lebih dari 1 bidang gerak maka latihan penguatan 3
bidang gerak ini akan lebih cocok digunakan untuk
pengembalian ke arah fungsional
Contoh latihan : Menendang bola (fleksi-abduksi-ext.rot
hip), menyisir rambut (fleksi-abduksi-ext.rot bahu & fleksi-
supinasi siku), dll
Basic Training Principles
Overload Principle
Physical conditioning is improved
when the body is placed under
greater than normal workload until it
adapts to a new level.
Manipulate aspects of frequency,
intensity, time and type of activity
gradually until the body adapts to a
new load.
SAID (Specific Adaptation to Imposed Demands)
A conditioning programme’s effects are specific to the type of
stress applied.
As the body is placed under stress of varying intensities and
durations, it attempts to overcome the stress by adapting
specifically to the imposed demands.
For example, muscles around a joint can be developed and
conditioned to provide optimal stabilisation of the joint.
Likewise, when a muscle primarily produces motion of a joint,
proper conditioning can prevent the muscle from undergoing an
unwanted movement. The demands of a specific athletic event
must be a progressive stress applied in that athlete’s training.
Basic Training Principles
Adaptation Principle
Body adapts and responds over
time to exercise and the demands
placed on the body.
Can be acute/short term or
chronic/long term.
Demands must be placed on the
body on a regular and repeated
basis for chronic adaptations to
occur.
Basic Training Principles
Specificity Principle
SAID – Specific, Adaptation,
Imposed, Demands
The type and degree of adaptation
to the body depends on the type and
amount of exercises performed.
High reps builds endurance.
Heavy weight builds size and
strength.
Specificity applies to a
specific group of muscles.
Basic Training Principles
Reversibility Principle