The Validity and Reliability of the MacNew Heart Disease Health Related Quality of Life Questionnaire: The Indonesian Version.

BACKGROUND: The MacNew heart disease health related quality of life tool is used widely in the cardiac populations to evaluate the impact of disease and intervention including rehabilitation. In addition to the English version, it is also available for several other languages except the Indonesian language. Therefore, the purpose of this study were 1) to translate the MacNew questionnaire from the English version to the Indonesian language and 2) to estimate the preliminary validity and reliability of the Indonesian MacNew for patients with coronary artery disease. METHODS: Forward and backward translation procedure was used to develop the Indonesian MacNew. The Indonesian MacNew was administered to 24 patients after one week of revascularization surgery. Reliability was assessed by internal consistency and test-retest reliability. To evaluate concurrent validity, the correlation of the compatible domain of the Indonesian MacNew and SF-36 was assessed. RESULTS: Internal consistency reliability of the Indonesian MacNew was confirmed with Cronbach's α of the global scale and all three subscales exceeding 0.95. Test- retest reliability was acceptable with intraclass correlation coefficient of 0.66 for the global score. Furthermore, an acceptable concurrent validity was established with statistically significant correlation between Indonesian MacNew and SF-36 (pearson correlation ranging from 0.47 to 0.71). CONCLUSION: The first results of the Indonesian MacNew indicate acceptable validity and reliability as a measurement tool to assess health related quality of life of Indonesian patients with coronary artery disease.

The Addition of Active Stretching to Balance Strategy Exercise is the Most Effective as a Home-Based Exercise Program in Improving the Balance of the Elderly.

Background: The decreased balance in the elderly increases the risk of falling. An effective type of exercise is needed to improve balance for the elderly. Aims: The purpose of this study was to determine the difference in the effectiveness of adding active stretching with dynamic stretching to balance strategy exercise as a home-based exercise program in improving the balance for the elderly. Participants and Methods: This research was a randomized control trial. The participants were 36 elderly selected based on the inclusion and exclusion criteria, divided into three groups. Group 1 was given dynamic stretching exercises to balance strategy exercises, Group 2 was assigned active stretching exercises to balance strategy exercise, and Group 3 was given balance strategy exercise only as a control group. Each group was given different exercises three times a week for 6 weeks. The balance ability of the elderly is measured using a Berg balance scale (BBS). Results: The mean difference scores of BBS before and after exercise with paired sample t-test increased in both groups with P < 0.05. It means that all groups had a significant impact, where the highest different score is in Group 2. The one-way ANOVA test showed a significant difference in the average posttest BBS value between the groups. Furthermore, the data were analyzed by the LSD post hoc test, where the results showed that all groups have significant differences against other groups (P < 0.05), with the best group being Group 2. Conclusion: According to the results, the addition of active stretching exercise to the balance strategy exercise as a home-based exercise program is the most effective in improving balance for the elderly.

Discitis Following Radiofrequency Nucleoplasty: A Case Report.

INTRODUCTION: Radiofrequency nucleoplasty is a minimally invasive procedure to treat chronic low back pain, especially mild degenerative disc diseases. Discitis after radiofrequency nucleoplasty is a rare case. CASE PRESENTATION: A 62-year-old male patient with a chief complaint of 10 years low back pain, gradually worsening for the last two years, a history of hypertension, chronic kidney disease, and routine dialysis twice a week, referred to the center. He underwent a lumbar medial branch block using radiofrequency and radiofrequency nucleoplasty procedure of lumbar 4-5 (L4-L5). Three weeks after the intervention, he could not move his legs, associated with urinary and fecal incontinence. MRI (magnetic resonance imaging) of the lumbar spine was performed, and the results indicated hyperintensity in L4-L5, suspicious of discitis. Laminectomy at L4 and L5 was performed. Eight months after surgery, the patient could feel and lift legs, and urinary and fecal incontinence was also controlled. CONCLUSIONS: Early diagnosis of discitis is critical and challenging. Delay in diagnosis may lead to treatment delay and the development of neurological deficits. Comprehensive treatment with bed rest, antimicrobial therapy, and sensible application of timely surgery are essentials to an optimal outcome.