HUBUNGAN ANTARA TIME WINDOW DAN JUMLAH SESI TERAPI OKSIGEN HIPERBARIK DENGAN DERAJAT KEKUATAN MOTORIK PASIEN PASCASTROKE ISKEMIK DI RS AL DR. MINTOHARDJO

Muhammad Rafli Pratama; Pritha Maya Savitri; Yuni Setyaningsih; Riezky Valentina Astari

doi:10.30598/molmed.2025.v18.i1.38

Muhammad Rafli Pratama Program Studi Kedokteran Program Sarjana, FK Universitas Pembangunan Nasional Veteran Jakarta
Pritha Maya Savitri Dep. Kesehatan Matra dan Manajemen Bencana, FK Universitas Pembangunan Nasional Veteran Jakarta
Yuni Setyaningsih Dep. Parasitologi, FK Universitas Pembangunan Nasional Veteran Jakarta
Riezky Valentina Astari Dep. Neurologi, FK Universitas Pembangunan Nasional Veteran Jakarta

DOI: https://doi.org/10.30598/molmed.2025.v18.i1.38

Keywords: Jumlah sesi, Pasca stroke iskemik, Terapi oksigen hiperbarik, Time window

Abstract

Stroke adalah gangguan neurologis yang diakibatkan karena kekurangan suplai darah ke bagian-bagian otak. Stroke iskemik terjadi sekitar 62,4% dari semua jenis stroke. Saat ini, Terapi Oksigen Hiperbarik (TOHB), yaitu pasien bernapas dengan 100% oksigen bersamaan dengan peningkatan tekanan atmosfer, dapat menjadi pilihan terapi dan bisa dilakukan setelah onset stroke iskemik untuk mendapatkan efek penyembuhan, salah satunya perbaikan motorik pasien stroke. Hasil yang dicapai bergantung pada periode dari onset terjadinya stroke hingga dilakukan tata laksana (time window) dan jumlah sesi terapi. Tujuan penelitian untuk mengetahui hubungan antara time window dan jumlah sesi terapi oksigen hiperbarik dengan derajat kekuatan motorik pasien pascastroke iskemik di Rumah Sakit Angkatan Laut Dr. Mintohardjo. Desain yang digunakan adalah potong lintang dengan metode total sampling. Terdapat 30 sampel yang dipilih berdasarkan kriteria inklusi. Sampel dianalisis dengan uji fisher exact. Hasil analisis bivariat menunjukkan p=0,011 untuk hubungan antara jumlah sesi terapi TOHB dengan derajat kekuatan motorik (RR=2,100; 95% Cl: 1,341 – 3,289) dan p=0,140 untuk hubungan antara time window TOHB dengan derajat kekuatan motorik. Kesimpulan yang diajukan yaitu jumlah sesi TOHB memengaruhi secara signifikan terhadap perubahan derajat kekuatan motorik dan meskipun pasien melakukan TOHB dalam rentang waktu tertentu setelah onset terjadinya stroke, tidak berpengaruh secara signifikan terhadap perubahan derajat kekuatan motorik. Disarankan untuk penelitian selanjutnya agar memperbanyak jumlah sampel dan mempertimbangkan faktor lain yang dapat memengaruhi hasil terapi.

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References

Salaudeen MA, Bello N, Danraka RN, Ammani ML. Understanding the Pathophysiology of Ischemic Stroke: The Basis of Current Therapies and Opportunity for New Ones. Vol. 14, Biomolecules. Multidisciplinary Digital Publishing Institute (MDPI); 2024.

Hadanny A, Rittblat M, Bitterman M, May-Raz I, Suzin G, Boussi-Gross R, et al. Hyperbaric oxygen therapy improves neurocognitive functions of post-stroke patients - a retrospective analysis. Restor Neurol Neurosci [Internet]. 2020;38(1):93–107. Available from: https://europepmc.org/articles/pmc7081098?pdf=render

Feigin VL, Stark BA, Johnson CO, Roth GA, Bisignano C, Abady GG, et al. Global, regional, and national burden of stroke and its risk factors, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Neurol [Internet]. 2021 Oct;20(10):795–820. Available from: https://linkinghub.elsevier.com/retrieve/pii/S1474442221002520

Kementerian Kesehatan RI. Laporan Nasional Riskesdas 2018. Jakarta; 2019.

Chen F, Qi Z, Luo Y, Hinchliffe T, Ding G, Xia Y, et al. Non-pharmaceutical therapies for stroke: mechanisms and clinical implications. Prog Neurobiol [Internet]. 2014;115:246–69. Available from: https://europepmc.org/articles/pmc3969942?pdf=render

Ding Z, Tong WC, Lu XX, Peng HP. Hyperbaric Oxygen Therapy in Acute Ischemic Stroke: A Review. Interv Neurol [Internet]. 2014;2(4):201–11. Available from: https://karger.com/INE/article/doi/10.1159/000362677

Ostrowski R, Stepien K, Pucko E, Matyja E. Hyperbaric oxygen modalities are differentially effective in distinct brain ischemia models. Med Gas Res [Internet]. 2016;6(1):39. Available from: https://journals.lww.com/10.4103/2045-9912.179344

Satyarthee GD. Hyperbaric oxygen therapy in ischemic stroke management: Standardized consensus-based therapeutic protocol. Vol. 67, Neurology India. Wolters Kluwer Medknow Publications; 2019. p. 653–4.

Yang H, Huang X, Yang C, Zhu S, Chen X, Zhang M, et al. Time Window for Acute Stroke Management: A Cross-Sectional Study Among Community Healthcare Practitioners in Primary Care. Int J Gen Med [Internet]. 2022;Volume 15:4483–93. Available from: https://www.dovepress.com/time-window-for-acute-stroke-management-a-cross-sectional-study-among--peer-reviewed-fulltext-article-IJGM

Hafez N, Hamdy M, Yassin O, Eltobgy K, Gaber M. Hyperbaric oxygen therapy in chronic ischemic cerebral stroke. J Neurol Sci [Internet]. 2015;357:e380–1. Available from: https://linkinghub.elsevier.com/retrieve/pii/S0022510X15018511

Rosario ER, Kaplan SE, Khonsari S, Vazquez G, Solanki N, Lane M, et al. The Effect of Hyperbaric Oxygen Therapy on Functional Impairments Caused by Ischemic Stroke. Neurol Res Int [Internet]. 2018;2018:1–12. Available from: https://www.hindawi.com/journals/nri/2018/3172679/

Kusuma ND, Ardhi MS, Widodo W, Setyowatie S. Profile Patients based on Risk Factors for Ischemic Stroke in the Neurology Inpatient Ward of Dr. Soetomo General Academic Hospital Surabaya during the Period of January to June 2022. AKSONA [Internet]. 2024;4(2):65–73. Available from: https://e-journal.unair.ac.id/aksona/article/view/52354

Pramanasari I. Ischemic Stroke Risk Factor Profile at Prof. Dr. W. Z. Johannes Hospital, Kupang, East Nusa Tenggara. AKSONA [Internet]. 2024;4(1):1–8. Available from: https://e-journal.unair.ac.id/aksona/article/view/45403

Boehme AK, Esenwa C, Elkind MS V. Stroke Risk Factors, Genetics, and Prevention. Circ Res [Internet]. 2017;120(3):472–95. Available from: https://www.ahajournals.org/doi/pdf/10.1161/CIRCRESAHA.116.308398

Rahayu TG. Analisis Faktor Risiko Terjadinya Stroke Serta Tipe Stroke. Faletehan Health Journal [Internet]. 2023;10(01):48–53. Available from: https://journal.lppm-stikesfa.ac.id/index.php/FHJ/article/view/410

Rizki Ramadhani A, Saiful Ardhi M, Prajitno S. PROFILE OF CHARACTERISTIC, RISK FACTOR, AND STROKE SEVERITY ON INFARCTION STROKE PATIENTS. MNJ (Malang Neurology Journal) [Internet]. 2022;8(2):109–12. Available from: https://mnj.ub.ac.id/index.php/mnj/article/view/591

Chen R, Ovbiagele B, Feng W. Diabetes and Stroke: Epidemiology, Pathophysiology, Pharmaceuticals and Outcomes. Am J Med Sci [Internet]. 2016;351(4):380–6. Available from: https://europepmc.org/articles/pmc5298897?pdf=render

Liska GM, Lippert T, Russo E, Nieves N, Borlongan C V. A Dual Role for Hyperbaric Oxygen in Stroke Neuroprotection: Preconditioning of the Brain and Stem Cells. Cond Med. 2018;1(4):151–66.

Zhai W wei, Sun L, Yu Z quan, Chen G. Hyperbaric oxygen therapy in experimental and clinical stroke. Med Gas Res [Internet]. 2016;6(2):111. Available from: https://journals.lww.com/10.4103/2045-9912.184721

Cozene B, Sadanandan N, Gonzales-Portillo B, Saft M, Cho J, Park YJ, et al. An Extra Breath of Fresh Air: Hyperbaric Oxygenation as a Stroke Therapeutic. Biomolecules [Internet]. 2020;10(9):1279. Available from: https://www.mdpi.com/2218-273X/10/9/1279/pdf?version=1599215731

Nguyen NB, Nguyen Thi HH, Thi H Le, Nguyen ST, Nguyen T Van. Results of acute cerebral infarction treatment with hyperbaric oxygen therapy, 2020-2022. Int Marit Health [Internet]. 2023;74(4):265–71. Available from: http://www.ncbi.nlm.nih.gov/pubmed/38111247

Schmutz J, Engelter S, Peters N, Schmucki P, Gelsomino M. Hyperbaric Oxygen in Post-Stroke Patients: A Feasibility Study. Clinical and Translational Neuroscience [Internet]. 2023;7(4):41. Available from: https://www.mdpi.com/2514-183X/7/4/41

Schiavo S, Richardson D, Santa Mina D, Buryk-Iggers S, Uehling J, Carroll J, et al. Hyperbaric Oxygen and Focused Rehabilitation Program: A Feasibility Study in Improving Upper Limb Motor Function After Stroke. Applied Physiology, Nutrition, and Metabolism. 2020;45.

Hu Q, Liang X, Chen D, Chen Y, Doycheva D, Tang J, et al. Delayed hyperbaric oxygen therapy promotes neurogenesis through reactive oxygen species/hypoxia-inducible factor-1α/β-catenin pathway in middle cerebral artery occlusion rats. Stroke [Internet]. 2014;45(6):1807–14. Available from: https://www.ahajournals.org/doi/pdf/10.1161/STROKEAHA.114.005116.