VACS (VARIOUS ALERTNESS COGNITIVE STIMULATION) EFFEKTIF MENINGKATKAN LEVEL KOGNITIF PASIEN PASCA STROKE

Yuni Ardi Isma Safitri; Hendri Kurniawan

doi:10.61902/motorik.v16i2.290

Yuni Ardi Isma Safitri Klinik Mandiri Centre Stroke and Neurorehabilitation, Jakarta
Hendri Kurniawan

DOI: https://doi.org/10.61902/motorik.v16i2.290

Keywords: Stroke, Kognitif, Cognistat, VACS

Abstract

Stroke merupakan disfungsi otak disebabkan oleh gangguan suplai darah ke otak. Stroke menyebabkan gangguan motorik, sensorik dan termasuk kognitif. Rehabilitasi fungsional pasca stroke sangat dipengaruhi oleh kemampuan kognitif. Proses rehabilitasi kognitif pasca stroke umumnya berlangsung lama, berulang-ulang, dan membosankan. Various Alertness Cognitive Stimulation (VACS) merupakan suatu terobosan latihan kognitif berbasis komputer yang menggabungkan komponen – komponen kognitif dan motorik. Penelitian ini bertujuan untuk mengetahui efektifitas VACS terhadap level kognitif pasien pasca stroke yang menjalani program neurorehabilitasi.

Penelitian dilakukan dengan desain quasi experimental pre-tes post-test with control. Sampel penelitian diperoleh dengan purposive sampling. Instrument yang digunakan dalam penelitian ini adalah cognistat. Pengolahan data dilakukan dengan uji komparasi menggunakan softwere SPSS 24.

Hasil penelitian. Mayoritas sampel berjenis kelamin laki-laki (62,5%), rentang usia lansia-manula atau >46 tahun (87,5%), onset <24 bulan (47,5%), dengan sisi lesi sinistra (62.5%). Uji komparasi berpasangan pada kelompok perlakuan menunjukkan hasil perbedaan signifikan di semua komponen cognistat (orientation, attention, comprehention, repetition, naming, construction, memory, calculation, similiarities, dan judgment) dengan p-value < 0.05. Sedangkan pada kelompok kontrol diperoleh hasil signifikan pada 4 komponen (attention, comprehention, calculation dan similiarities).

Kesimpulan. VACS dalam neurorehabilitasi efektif untuk meningkatkan level kogitif pasien pasca stroke

References

Nan, W., Dias, A.P.B. & Rosa, A.C. (2019). Neurofeedback Training for Cognitive and Motor Function Rehabilitation in Chronic Stroke: Two Case Reports. Frontiers in Neurology. 10(800): 1-6. doi: 10.3389/fneur.2019.00800
[2]. Bustren, E.L., Sunnerhagen, K.S., & Alt Murphy, M. (2017). Movement kinematics of the ipsilesional upper extremity in persons with moderate or mild stroke. Neurorehabil Neural Repair. 31: 376-386.
[3]. Badan Penelitian dan Pengembangan Kesehatan. (2018). Riset Kesehatan Dasar (Riskesdas) Tahun 2018. Jakarta: Kementerian Kesehatan Republik Indonesia
[4]. Chen, C. (2015). Effec of visual training on cognitive fungtion in stroke patient. American Journal Occupational Therapy (AJOT). No. 4. Vol. 2. (pp. 329-333).
[5]. Malik & Maulina. (2015). Fungsi kognitif pasien stroke berdasarkan Mini Mental State Examination (MMSE) di rumah sakit umum cut meutia kabupaten aceh utara. Jurnal Kedokteran Universitas Syiah Kuala. (pp. 169-181).
[6]. Watters, O. & O’Connor, J. J. (2011). Review - A role for tumor necrosis factor-a in ischemia and ischemic preconditioning. Journal of Neuroinflammation. 8:87 http://www.jneuroinflammation.com/content/8/1/87
[7]. Sun, J., Tan, L., & Yu, J. (2014). Post-Stroke Cognitive Impairment: Epidemiology, Mechanisms And Management. National Center for Biotechnology Informationdiakses. Vol.2. No. 8.
[8]. Shumway-Cook, A., &Woollacott, M.H. 2007. Motor control: theory and practical applications. 3rd eds. Baltimore : Lippincott, Williams & Wilkins
[9]. Zakiyah & Mahtrami. (2015). Games berplatform Andreoid Untuk terapi pasca stroke. Seminar Nasional Informatika Medis. No. 6. Vol. 14.
[10]. Putri, M.N., Mutiawati, E., & Madani, W. (2017). Hubungan Derajad Stroke Terhadap Status Kognitif Pasien Stroke Iskemik di Poliklinik Saraf Rumah Sakit Umum Daerah Dr. Zainoel Abidin Banda Aceh. Jurnal Ilmiah Mahasiswa Medisa. (pp. 61-67).
[11]. Rokhayah, S., & Budi, M. H. (2016). Perbedaan stroke lesi hemisfer kiri dan stroke lesi hemisfer kanan terhadap terjadinya dimensia di RSUD Banyumas. Sainteks. (pp. 33-40). http://jurnal nasional.ump.ac.id/index.php/SAINTEKS/article/view/1502
[12]. Puspita, M & Putro, G. (2008). Hubungan Gaya Hidup terhadap Kejadian Stroke di Rumah Sakit Umum daerah Gambiran Kediri. Buletin Penelitian Sistem Kesehatan. No. 3. Vol. 11. (pp. 263-269).
[13]. Kristiyawati, S.P., Irawaty, D., & Hariyati, Rr.T.S. (2009). Faktor risiko yang berhubungan de-ngan kejadian stroke di RS Panti Wilasa Citarum Sema-rang. Jurnal Keperawatan dan Kebidanan (JIKK). No. 1. Vol. 1. (pp. 1-7). Semarang: STIKES Telogorejo.
[14]. Sofyan, A. M., Sihombing, I. Y., & Hamra, Y. (2013). Hubungan umur, kenis kelamin, dan hipertensi dengan kejadian stroke. Jurnal Ilmiah Fakultas Kedokteran Universitas Halu Oleo. (pp. 1-30). http://ojs.uho.ac.id/index.php/medula/article/viewFile/%20182/125
[15]. Ronchi, D. D., Palmer, K., Pioggiosi, P., Atti, A. R., Berardi, D., Ferrari, B., et al. (2007). The combined effect of age, education and stroke on dementia and cognitive impairment no dementia in the elderly. Dementia Abd Geriatic Cognitif Disorder. No. 24. Vol. 4. (pp. 266-273).
[16]. Lee, K., Kim, S., Kim, K., Kim, Y., & Chang, W., (2015). Six-month functional recovery os stroke patients: a multy time point study. International Journal of Rehabilitation Research. No. 2. Vol. 38.
[17]. Nair, R.D., Cogger, H., Wortington, E., & Lincoln, N.B. (2016). Cognitive rehabilitation for memory deficits after atroke. Cocrane. Issue. 9 Art. CD002293
[18]. Yeh, T., Wu, C., Hsieh, Y., Chang, K., Lee, L., Hung, J., … Liao, Y. (2017). Synergistic effects of aerobic exercise and cognitive training on cognition, physiological markers, daily function, and quality of life in stroke survivors with cognitive decline: study protocol for a randomized controlled trial. Trials, 18(1). doi:10.1186/s13063-017-2153-7
[19]. Liu, W., Wang, X., O’Connor, M., Wang, G., & Han, F. (2020). Brain-Derived Neurotrophic Factor and Its Potential Therapeutic Role in Stroke Comorbidities. Neural Plasticity, 1–13. doi:10.1155/2020/1969482
[20]. Marosi, K. & Mattson, M.P. (2013). BDNF mediates adaptive brain and body responses to energetic challenges. TEM. 919, 1-10. http://dx.doi.org/10.1016/j.tem.2013.10.006
[21]. Batool-Anwar, S., Kales, S.N., Patel, S.R., Varvarigou, V., De Young, P.N., & Malhotra, A. (2014). Obstructive sleep apnea and psychomotor vigilance task performance. Nat Sci Sleep. 6: 65–71. doi: 10.2147/NSS.S53721
[22]. Marie, C., Pedard, M., Quirie, A., Tessier, A., Garnier, P., Totoson, P., & Demougeot, C. (2018). Brain-derived neurotrophic factor secreted by the cerebral endothelium: A new actor of brain function? Journal of Cerebral Blood Flow & Metabolism. 38(6) 935–949. DOI: 10.1177/0271678X18766772
[23]. Kwakkel, G., Buma, F.E., & Selzer, M.E. (2014). Understanding the mechanisms underlying recovery after stroke. In: Selzer, M., Clarke, S., Cohen, L., Kwakkel, G., Miller, R. (Eds.), Textbook of Neural Repair and Rehabilitation. Cambridge University Press, Cambridge, 7–23
[24]. Van de Ven, R. M., Murre, J. M. J., Veltman, D. J., & Schmand, B. A. (2016). Computer-Based Cognitive Training for Executive Functions after Stroke: A Systematic Review. Frontiers in Human Neuroscience, 10. doi:10.3389/fnhum.2016.00150
[25]. Hill, N. T. M., Mowszowski, L., Naismith, S. L., Chadwick, V. L., Valenzuela, M., & Lampit, A. (2017). Computerized Cognitive Training in Older Adults With Mild Cognitive Impairment or Dementia: A Systematic Review and Meta-Analysis. American Journal of Psychiatry, 174(4), 329–340. doi:10.1176/appi.ajp.2016.1603036