Background: Patients with end-stage renal disease (ESRD) have a high baseline level of systemic inflammation. Serum C-Reactive Protein is an inflammatory marker that is widely used because it is more affordable and available in most hospitals in developing countries. Patients with ESRD tend to be less involved in physical activity when compared to sedentary patients in the same age group. The effect of intradialytic aerobic exercise on CRP levels has been widely studied, but the result studies about intradialytic aerobic exercise on CRP are still controversial.Objectives: To evaluate the effect of a 12-week intradialytic aerobic exercise program on serum CRP levels in ESRD at
Introduction: Most lower extremity amputations are currently caused by vascular disorders. Diabetes contributes to twothirds of all lower extremity amputations, while 6-10% of amputations are due to traumatic injury, and the remainder is due to a tumor. The role of physical medicine and rehabilitation experts is very important in providing an overview of the functional level based on the level of amputation. Case: 66 years old, female, referred from Orthopedic department with diagnosing right below-knee amputation 1 year ago, to be made a prosthesis. She underwent amputation because has an ulcer on the back of her foot that worsens and is always wet. She has diabetes mellitus type 2, diabetic nephropathy, hypertension, and peripheral artery disease that altered her condition. She already could do most of the daily activities and walk independently using a walker in a couple of months after surgery. From the physical examination, we found postural low back pain, limitation of right hip joint range of motion, peripheral polyneuropathy, decreased cardiorespiratory endurance, and less confident MFES that indicate fear of fall in geriatric. A complete geriatric assessment was done. Following the rehabilitation program for 6 months, the patient felt a more fit, full right hip range of motion was obtained. She walked more easily with her prosthesis and experienced improvements in physical function parameters Conclusion: The prosthesis was needed to decrease energy consumption during ambulation. Recommended amputation rehabilitation involves interaction between the health care team and the patient to achieve rehabilitation goals.
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