Latihan Otot Dasar Panggul

8/16/2019 Latihan Otot Dasar Panggul

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REHABILITASI MEDIK UTK

GANGGUAN MIKSI LANSIA

dr. NURUL ULYANI, SpKFR(kuliah geriatri FK UNIZAR)


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GANGGUAN MIKSI LANSIA


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Anat!i tt da"ar panggul

!. le#atr ani

o Mrpkn $tt pen%angga

uta!a rgan& pel#i" 'rdiri dari tt

pu***%geu",

pure*tali",

ili***%geu",

***%geu".


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company name

!. ul*a#ern"u"

o Lapi"an pel#i* /lr %g paling di"tal, er/0

"ek"ual, tidak !en%kng rgan pel#i"


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Neuranat!i kandung ke!ih

kandung ke!ih 4 3ar di"ekitarn%a pd -anita


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company name

Iner#a"i peri/er Kandung Ke!ih


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company name

Iner#a"i peri/er KK..

1. A//erent" /r! detru"r "tret*h re*eptr","phin*ter,perineu!, genitalia

&. 6//erent"

a. 2ara"%!patheti* S& 8 S7

Re*eptr" 9hlinergi* 8 !u"*arini* ( at d% / the ladder )

. S%!patheti* '11 8 L&Re*eptr" Alpha adrenergi* ( at "phin*ter)

:etha adrenergi* ( at d% / theladder


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RECEPTORS INSIDE

THE BLADDER :

Cholinergic-

muscarinic

Betha - arenergic

Al!ha - arenergic


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INERVASI SENTRAL KK :

Lp 1 (nuklei *rtikpntin!e"en"e/alik) A"al Lu" /rntali"Si/at inhii"i thd Sa*ral Mi*turitin 9enter(SM9)2engi"ian KK

Kalau ru"ak ( Strke, 2arkin"n ) hipere/lek"ia

detru"r, tanpa di"inergia "pingter Inkntinen"ia Urin Lp & (Nuklei 2ntin!e"en"e/alik"akral) ;

2ntine Mi*turitin 9enter ( 2M9 )Fung"ikrdina"i detru"r dengan "pingter

Kalau ru"ak dia-ah 2M9 dan diata" SM9 ( S9I ) hipere/lek"ia detru"r < =etru"r Spingter =i"inergia (=S=) KK tn!ik IU


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INERVASI SENTRAL KK…..

Lp ( Nuklei 2el#i*2udendal) ; SM9+

Sa*ral Mi*turitin 9enter

Fung"i 1. Mengintegra"ikan "ti!uli dari Lp 1

&. Meneru"kan 2ara"i!pati" S& S7 Sa*ral

Mi*turitin Re/le0Kalau ru"ak KK Are/lek"ik + Atnia Reten"i Urin

IU #er/l-

Lp 7 ( Krtek" !tri" N. 2udendu"Spingter ek"terna


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company name

Iner#a"i

"entral KK


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company name

Fi"ilgi pr"e" !ik"i

'erdiri dari & /a"e

/illing ("trage) pha"e (pengi"ian KK) tekanan intra #e"ika !eningkat perlahan

"ti!ula"i re"eptr "i!pati" (eta adrenergi*)di d% KK relak"a"i detru"r, dan"ti!ula"i al/a adrenergi* di a"i"#e"ika4uretra kntrak"i inhii"i "i"te!

para"i!pati" (!angha!at kntrak"iladder+#e"ika)


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company name

Fi"ilgi pr"e" !ik"i..

#iding + e!pt%ing pha"e (peng"ngan

KK)

KK penuh ingin !ik"ipenurunan

akti#ita" tt "pin*ther 4 penurunan

tekanan di uretra !enghilangn%a re/lek

inhii"i dr "pin*ther !e*hani"! ke SM9

kntrak"i tt detru"r


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company name

2eruahan /i"ilgi pr"e" !ik"i

pada lan"ia


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company name


pada lan"ia.....


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company name


pada lan"ia.....


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=IAGN$SIS


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company name

Kla"i/ika"i /ung"inal inkntinen"ia urin

Type offail!e

Bla""e! fac#o! $#le# fac#o!

Failuret "tre

>ipera*ti#it%=e*re"ed

*!plian*e

=ener#ated pel#i* /lr :ladder ne*k de"*ent

Intrin"i* ladder ne*k"pin*ther /ailure

Failure

t e!pt%

Are/le0i*

>%p*ntra*tilit%

=etru"r "pin*ther

di""inerg%Nn rela0ing #luntar%"pin*ther Me*hani*al

"tru*tin(!i" :2>)


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company name

=IAGN$SIS ..

26M6RIKSAAN FISIK

2e!erik"aan u!u!

2e!erik"aan neurlgi"( kn"entra"ipada rt S& S7)

2e!erik"aan ad!en, genitalia, #agina


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company name

M%t! Sakral &7

2le#i* /lr !u"*le, e0terna

urethral4 anal "pin*ther, hip

e0ten"r, lateral rtatr Ankle plantar /lek"r,

lu!ri*al, inter""ei


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company name

2e!erik"aan genitalia

In"pek"i

Lihat #ul#a+#agina

tanda& irita"i, pel#i*

rgan prlap"


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company name

2!0 tt da"ar panggul dgn 1

3ari


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company name

2!0 tt da"ar panggul dgn &

3ari


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company name

Ring / *ntinen*e


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company name

=era3at kekuatan

tt da"ar

panggul


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company name

26M6RIKSAAN 26NUN?ANG

La. Urdina!ik. radilgi"


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company name

26NA'ALAKSANAAN

R6'6NSI URIN

KA'6'6RISASI

Ind-elling+kntin%u

:erkala (*lean inter!itten *ath)

Supra puik


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26NA'ALAKSANAAN...

INK$N'IN6NSIA URIN

'erapi perilaku

Latihan tt da"ar panggul

Far!akterapi

$pera"i+:edah


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company name

'6RA2I 26RILAKU

'IM6= @$I=ING + MIKSI '6R?A=AL

nr!al !ik"i B50+&7 3a!

pa"ien di!inta !ik"i "e"uai 3ad-al

"ulit pd p0 dg gangguan kgni"i

:LA==6R =IARY !en*atat intake *airan(3eni",3u!lah), -aktu dan #lu!e !ik"i

ALA' 26NAM2UNG C ppk, knd!kateter, kateter !enetap


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company name

Me!uat Dladder diar%E


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company name

LA'I>AN $'$' =ASAR

2ANGGUL


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company name

2rin"ip u!u! latihan

$#erlad "trength 4 enduran*e tt i"a!eningkat apal tt eker3a leih kera" drpdean %g ia"a

"trengthening high re"i"tan*el- repetitin, 7

"et, 51& repeti"i enduran*e l- re"i"tan*ehigh repetitin, "hrtre"t,!i" 7 detik.

Spe*i/i*it% tt %g dilatih kuat

Maintenan*e Re#er"iilit%


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Latihan tt da"ar panggul

2"i"i eraring+duduk+erdiri

Latihan na/a" in"pira"i dada

!enge!ang, tt perut relak", ek"pira"i

dada ke!pi", tt perut kntrak"i

Ken*angkan tt da"ar panggul ("eperti

"aat !enahan :AK, "aat ek"pira"i)

Latih kntrak"i pan3ang (1 detik) dankntrak"i pendek& dan *epat


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company name Kuliah $A: dr :a%u SpKFRK


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company nameKuliah $A: dr :a%u SpKFRK


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company name

Kuliah $A: dr :a%u SpKFRK


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9nth latihan tt da"ar panggul

(Kegel" e0er*i"e)

Ini#ially 'ighten the pel#i* /lr !u"*le" /r *unt / "i0 and rela0 /r"i0 "e*nd". 6a*h *ntra*tin *%*le "huld la"t 1& "e*nd" r H*ntra*tin" a !inute. Repeat &H ti!e". = thi" ti!e" ea*h da% ttalH *ntra*tin".

%ee& ' 'ighten the pel#i* /lr !u"*le" /r B "e*nd" e#er% 1&"e*nd" (H per !inute) /r 1 !inute", H *ntra*tin". = thi" ti!e"ea*h da% ttal 1H *ntra*tin".%ee& ( 'ighten the pel#i* /lr !u"*le" /r B "e*nd" e#er% 1&"e*nd" (H per !inute) /r 1H !inute", H *ntra*tin". = thi" ti!e"ea*h da% ttal &&H *ntra*tin".%ee&) *+'* 'ighten the pel#i* /lr !u"*le" /r B "e*nd" e#er% 1&"e*nd" (H per !inute) /r & !inute", 1 *ntra*tin". = thi" ti!e"ea*h da% ttal 1 *ntra*tin".Af#e! '* mon#,) 9ntinue !aintainen*e at 1 !inute" three ti!e" ada% r 1H !inute" t-i*e a da%, ttal / 1H *ntra*tin" a da%.


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6le*trtherap%+ "ti!ula"i li"trik

i" the appli*atin / ele*tri*al *urrent tpr#ke ner#e a*ti#it% and t "ti!ulate

/un*tin in di//erent rgan "%"te!".

'he ai! / ele*tri*al "ti!ulatin -ithin thepel#i* /lr regin i" t indu*e "keletal

!u"*le training, re!del "!th !u"*le

and r *nne*ti#e ti""ue" and t !dulateladder, -el, r "e0ual d%"/0


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Documents

Latihan Otot Dasar Panggul