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Introduction: Alteration of foot posture may influence the knee loading, particularly in medial compartment. The purpose of this study was to find the relation of foot postures with clinical finding in medial knee osteoarthritis (KOA).Methods: Subjects with medial KOA who met inclusion criteria were recruited consecutively, in Nursing home on August to October 2018. The foot posture has determined by Foot Posture Index (FPI). The severity of KOA has measured by Kelgreen-Lawrence (KL) grading system, and pain level using numeric rating score (NRS).Results: There were 37 subjects consisted of male and female with normal foot subsequently 17(8.5%) and 3(15%), male and female with abnormal food subsequently 3(15%) and 1(16%). There were 12 (32.43%) of pronated foot, 5 (13.51%) of supinated foot, and 20 (54.06%) of normal foot subjects. The subjects with abnormal foot posture have severe medial KOA (p<0.001), while the pain sensation similar between groups (p=0.321, p=0.688).Conclusion: There was a correlation between foot posture and the severity of medial KOA.Keywords: Foot posture, Knee osteoarthritis, Foot posture index, Numeric rating score

Background: Low-Level Laser Therapy (LLLT) is a physical modality used in a rehabilitation support service. Patients with lower third molar impacted experience decline in QOL due to inflamatory response,such as bleeding, swelling, stiffness and pain. This leads to disability in daily activities, such as eating and drinking during several days post removal.Methods: It is a randomized controlled trial (RCT) and single blind study. A total of 21 subjects in LLLT and 21 subjects in control groups with the age range of 18-30 years. Subjects in the study group were given a totaldose of 54 J, energy density 18J/cm2 on day 0, 3 and 7 post lower third molar impacted surgery. Both groups were assessed for QOL values using the Short Form 36 (SF-36) before and after therapy.Result: Decrease in Pain (VAS) and Trismus on the third and seventh day post operatively were statistically significant (p <0.05) between the two groups. QOL improvement on the SF-36 domains of Role Physically(RP), Bodily Pain (BP), General Health (GH) was statistically significant (p <0.05) in both groups. Moreover, QOL improvement in Physical Components (PCS) was also significant between the two groups.Conclusion: LLLT could reduce postoperative pain of lower third molar impacted patients from day 0 to 3 and completely painless on the seventh day postoperatively. LLLT therapy eliminated Trismus on the third dayafter the surgey. Increase QOL in patients with lower third molar impacted removal after LLLT was evident in the physical component. The positive changes in pain and trismus reduction, also QOL improvement postLLLT can restore patients’ activities of daily living as usual in a short period of time.Keywords : Low Level Laser Therapy (LLLT), Pain, Trismus, Quality of Life, Rehabilitation, Lower Third Molar Removal.

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Background: Diabetic foot ulcer is a problem in patients with diabetes mellitus (DM). One adjuvant therapy that can enhance wound healing is Low-Level Laser Therapy (LLLT), but there is no established guideline regarding the dosage. In Indonesia, there has been no study comparing the energy density of LLLT on diabetic ulcer healingMethods: This is an experimental study on 28 subjects with a randomized diabetic foot ulcer. Group A received standard treatment of ulcer and LLLT 5J/cm2. Group B received standard treatment of ulcer and LLLT 10J/cm2.Results: The difference in wound size between group A and group B were 4.15 mm2 and 7.5 mm2 (p=0.178). The healing rate of group A and group B were 4.15 (-10-34.5) mm2/4 weeks and 7.5 (-2.8-34) mm2/4weeks (p=0.168). Conclusions: There was no statistically significant difference between the group receiving LLLT 5J/cm2 or 10 J/cm2 in diabetic foot ulcer healing.

BackgroundPain from knee and hip osteoarthritis (OA) can have a significant impact on the physical function and quality of life of affected individuals worldwide. The objective of this study was to evaluate the effect of extracorporeal shockwave therapy (ESWT) on pain, flexibility, function, and medial collateral ligament (MCL) thickness in knee osteoarthritis (KOA). MethodsA study of quasi experimental design was performed involving 15 subjects aged 50 – 70 years with Kellgren-Lawrence grade 2-3 KOA. All subjects were evaluated regarding baseline -pain using visual analogue scale (VAS), range of motion (ROM), functional outcome using Western Ontario and McMaster Universities Arthritis Index (WOMAC), and MCL size. Extracorporeal shock wave therapy was given 3 times, at baseline, and 4 and 8 weeks after intervention. All subjects were given 4000 shocks at intensities of 1.5 – 4 Bar (raised gradually) per session. The shocks were given in the supine position, knee flexed 90o, without topical anesthetic. Statistical analyses were conducted using a dependent t-test. ResultsAfter 8 weeks of intervention, ESWT significantly improved pain score (p<0.01), WOMAC (p<0.01) and MCL thickness (p<0.01) in patients with OA of the knee. However, there was no significant difference in knee ROM, both for degree of flexion and extension (p>0.05). ConclusionThe use of ESWT for treatment of knee OA had a beneficial effect on pain relief, function outcome and MCL thickness. However, there remains a lack of clarity regarding the frequency and dosage levels of ESWT required to achieve maximum improvement.

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