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Multidisciplinary Approach in Indonesia
from 29th International Conference on Spina Bifida and Hydrocephalus 'Diverse Needs, Same Rights'
by The International Federation for Spina Bifida and Hydrocephalus
Physical Medicine and Rehabilitation Management in Spina Bifida and Hydrocephalus: a Multidisciplinary Approach in Indonesia
Luh Karunia Wahyuni, Rizky Kusuma Wardhani, Budiati Laksmitasari. Physical Medicine and Rehabilitation Department, Faculty of Medicine, Universitas Indonesia, Ciptomangunkusumo Hospital, Indonesia
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Background: Indonesia does not yet have a database specifically for the prevalence of neural tube defects (NTDs). However, the Ministry of Health in Indonesia has carried out surveillance on congenital abnormalities and reported that NTDs including Spina Bifida are 22% of the 15 most common congenital disorders. Spina Bifida can cause various functional problems that can hinder children's activities and participation.
Methods: Physical medicine and rehabilitation (PMR), also known as physiatry or rehabilitation medicine, aims to enhance and restore functional ability and quality of life to those with physical impairments or disabilities, including children with Spina Bifida. Indonesian Health Insurance policy is that all disabled patients must be managed by a PMR specialist. As the biggest national referral hospital, Ciptomangunkusumo Hospital provided PMR services for children with Spina Bifida in a medical rehabilitation team consisting of PMR doctor, physiotherapist, occupational therapist, speech therapist, orthotist prosthetist, psychologist, rehabilitation nurse, and social worker.
Results: PMR services include comprehensive functional assessment, in-depth functional assessments (such as assessment of cognitive, gait, urination, defecation, and activity of daily living). Treatments that can be given include ADL training, gait training, modalities, orthosis, assistive devices, and psychosocial management. PMR specialists work multidisciplinary with other specialists such as pediatricians, urologists, neurosurgeons, and orthopedics. The application of the multidisciplinary approach that has been carried out include a collaborative patient management, case discussion, comprehensive guidelines, and joint webinar.
Conclusion: In the future, it is recommended that Indonesia has the database on Spina Bifida, better collaborative activities, and better quality of PMR services.
