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  • CME 238-Sindrom Nyeri Myofascial

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    CME 238-Sindrom Nyeri Myofascial

    Diunggah oleh

    Pika Lubis
    SIndrom Nyeri Myofascial

    Hak Cipta:

    © All Rights Reserved
    Unduh sebagai PDF, TXT atau baca online dari Scribd
    Tandai sebagai konten tidak pantas
    dari 4

    CONTINUING MEDICAL EDUCATION

    Akreditasi PB IDI–2 SKP

    Sindrom Nyeri Myofascial


    Andika Surya Atmadja
    Dokter Umum di Wilayah Pulomas, Jakarta Timur, Indonesia

    ABSTRAK
    4JOESPNOZFSJmyofascialBEBMBITFCVBILPOEJTJOZFSJCBJLBLVUNBVQVOLSPOJLEBSJPUPUBUBVQVOfasciaZBOHBLBONFNQFOHBSVIJTFOTPSJL 
    NPUPSJL BUBVQVOPUPOPNOZFSJmyofascialCJTBCFSTJGBUBLUJGBUBVMBUFOMyofascial trigger points BEBMBITVBUVUJUJLUFNQBUIJQFSJSJUBCFMCFSMPLBTJ
    EJTUSVLUVSPUPUBUBVfasciaZBOHNFOFHBOH KJLBEJUFLBOEBQBUNFOZFCBCLBOOZFSJMPLBMBUBVNFOKBMBS1SFWBMFOTJOZBTBNBBOUBSBMBLJMBLJEBO
    QFSFNQVBO UFSVUBNBQBEBVTJBUBIVO1FOZFCBCVNVNOZFSJmyofascial EBQBUCFSBTBMEBSJUSBVNBMBOHTVOHBUBVQVOUJEBLMBOHTVOH 
    LPOEJTJ QBUPMPHJT UVMBOH CFMBLBOH  QBQBSBO UFSIBEBQ UFHBOHBO ZBOH CFSVMBOH EBO LVNVMBUJG  BUBV QPTJTJQPTUVS UVCVI ZBOH UJEBL TFTVBJ
    ,SJUFSJBEJBHOPTJTTJOESPNOZFSJmyofascial ZBOHQBMJOHTFSJOHEJHVOBLBOBEBMBILSJUFSJB4JNPOT et al  
    5FSBQJGBSNBLPMPHJBEBMBI0"*/4 
    QFMFNBTPUPU BOUJEFQSFTBO EBOPCBUBOFTUFTJ5FSBQJOPOGBSNBLPMPHJEBQBUEJCFEBLBONFOKBEJJOWBTJGEBOOPOJOWBTJG

    Kata Kunci:%JBHOPTJT myofascial OZFSJ UFSBQJ trigger point

    ABSTRACT
    .ZPGBTDJBMQBJOTZOESPNFJTBOBDVUFPSDISPOJDQBJOGSPNNVTDMFPSGBTDJBUIBUXJMMBMUFSFETFOTPSZ NPUPSJD PSBVUPOPNJDTZTUFNNZPGBTDJBM
    QBJODBOCFFJUIFSBDUJWFPSMBUFOU.ZPGBTDJBMUSJHHFSQPJOUJTBIZQFSJSSJUBCMFTQPUMPDBUFEJOTUSFUDINVTDMFPSGBTDJB DBVTJOHMPDBMPSSFGFSSFE
    QBJOJGQBMQBUFE&RVBMQSFWBMFODFCFUXFFONFOBOEXPNFO FTQFDJBMMZBUUIFBHFPGZFBST5IFDPNNPODBVTFTPGNZPGBTDJBMQBJOBSF
    EJSFDUPSJOEJSFDUUSBVNB QBUIPMPHJDTQJOFDPOEJUJPO DPOUJOVPVTBOEDVNNVMBUJWFTUSFUDIFYQPTVSF PSJOBQQSPQSJBUFQPTUVSFQPTJUJPO5IF
    NPTUDPNNPOEJBHOPTUJDDSJUFSJBBSF4JNPOT et al DSJUFSJB 
    5IFDPNNPOQIBSNBDPMPHJDBMUSFBUNFOUTBSF/4"*%T NVTDMFSFMBYBOU BOUJ
    EFQSFTTBOU BOEBOFTUIFUJDBHFOU/POQIBSNBDPMPHJDBMUSFBUNFOUDBOCFJOWBTJWFPSOPOJOWBTJWFAndika Surya Atmadja. Myofascial Pain
    Syndrome.

    Keywords:%JBHOPTUJD NZPGBTDJBM QBJO UIFSBQZ USJHHFSQPJOU

    PENDAHULUAN BUBVfasciaZBOHNFOFHBOH KJLBEJUFLBOEBQBU UFSCFOUVLEJendplate PUPUZBOHNFOZFCBCLBO


    4JOESPN OZFSJ myofascial BEBMBI TFCVBI NFOZFCBCLBO OZFSJ MPLBM BUBV NFOKBMBS QFSVCBIBOEBOBCOPSNBMJUBTBLUJWJUBTendplate
    LPOEJTJ OZFSJ PUPU BUBVQVO fascia  BLVU .5S1T TFSJOH EJUFNVLBO EJ TFLJUBS EBFSBI EJneuromuscular junction*SJUBTJLPOUJOVQBEB
    NBVQVO LSPOJL  NFOZBOHLVU GVOHTJ MFIFSEBOQVOHHVOH endplate BLBO NFOZFCBCLBO QFOHFMVBSBO
    TFOTPSJL  NPUPSJL  BUBVQVO PUPOPN  ZBOH BTFUJMLPMJO CFSMFCJIBO  TFIJOHHB EBQBU
    CFSIVCVOHBO EFOHBO myofascial trigger NFOZFCBCLBO LFUFHBOHBO EBO LPOUSBLTJ
    /ZFSJ myofascial NBTJI TFSJOH UJEBL
    points .5S1T
     (FKBMB NPUPSJL EBQBU CFSVQB TFSBUPUPUZBOHUFSMPLBMJTBTJ1FOZFCBCVNVN
    UFSEJBHOPTJT  QBEBIBM NFSVQBLBO QFOZFCBC
    EJTGVOHTJNPUPSJLBUBVLFMFNBIBOPUPUBLJCBU OZFSJ myofascial EBQBU USBVNB MBOHTVOH
    VUBNB EJTBCJMJUBT LFSKB EBO QFOZFCBC LFEVB
    JOIJCJTJ NPUPSJL  UFSCBUBTOZB HFSBLBO EBO BUBVQVO UJEBL MBOHTVOH  LPOEJTJ QBUPMPHJT
    UFSCBOZBL EJTBCJMJUBT EJ "4 "EB QFOEBQBU
    LFLBLVBO PUPU (FKBMB TFOTPSJL EBQBU CFSVQB UVMBOHCFMBLBOH QBQBSBOUFSIBEBQUFHBOHBO
    CBIXB JTUJMBI TJOESPN QBEB OZFSJ myofascial
    OZFSJ UFLBO  OZFSJ BMJI  IJQFSBMHFTJB  BUBVQVO ZBOH CFSVMBOH EBO LVNVMBUJG  BUBV QPTJTJ
    UJEBL UFQBU LBSFOB TFCFUVMOZB NFSVQBLBO
    BMPEJOJB (FKBMB PUPOPN EBQBU TFQFSUJ QPTUVSUVCVIZBOHUJEBLTFTVBJ
    TVBUVQFOZBLJU
    CFSLFSJOHBU  BLUJWJUBT QJMPNPUPS  QFSVCBIBO
    TVIV LVMJU  MBLSJNBTJ  EBO TBMJWBTJ "LUJWJUBT 4JOESPN OZFSJ myofascial TFSJOH UFSKBEJ EBO
    ETIOLOGI DAN EPIDEMIOLOGI
    TJTUFN TBSBG TJNQBUJT BLBO NFOJOHLBULBO TFUJBQ NBOVTJB NVOHLJO QFSOBI NFNJMJLJ
    BLUJWJUBT NPUPSJL EBO NFOZFCBCLBO OZFSJ &UJPMPHJQFNCFOUVLBOtrigger point QBEBPUPU
    trigger point TFMBNB IJEVQOZB 1SFWBMFOTJOZB
    Myofascial trigger points BEBMBI TVBUV UJUJL EBO NFLBOJTNF UFSKBEJOZB HFKBMB TPNBUJL
    TBNB BOUBSB MBLJMBLJ EBO QFSFNQVBO 
    UFNQBUIJQFSJSJUBCFMCFSMPLBTJEJTUSVLUVSPUPU NBTJI CFMVN EJQBIBNJ Trigger point EJEVHB
    UFSVUBNBQBEBVTJBBOUBSBUBIVO

    Alamat Korespondensi email: f_andika_surya@yahoo.com

    CDK-238/ vol.43 no.3, th. 2016 176


    CONTINUING MEDICAL EDUCATION

    /ZFSJ myofascial EBQBU CFSTJGBU MPLBM BUBV Tabel. ,SJUFSJBEJBHOPTJTTJOESPNOZFSJmyofascial


    SFHJPOBM TFQFSUJQBEBMFIFS CBIV QVOHHVOH
    BUBT EBO CBXBI  CJBTBOZB VOJMBUFSBM BUBV No Kriteria mayor Kriteria minor
    MFCJI CFSBU EJ TBMBI TBUV TJTJ /ZFSJ PUPU
     /ZFSJTQPOUBOZBOH 5FSKBEJOZBOZFSJ
    EBQBU NFOFUBQ EFOHBO WBSJBTJ EBSJ SJOHBO UFSMPLBMJTBTJ TQPOUBOEBO
    IJOHHB TBOHBU CFSBU CJBTBOZB UJEBL IJMBOH QFSVCBIBOTFOTBTJ
    EFOHBO TFOEJSJOZB $JSJ LIBT OZFSJ JOJ BEBMBI EFOHBONFOFLBO
    trigger point
    UFSEBQBUOZBtrigger point.
     /ZFSJTQPOUBOBUBV "EBOZBSFTQPOT
    QFSVCBIBOTFOTBTJQBEB LFEVUMPLBMQBEB
    Myofascial Trigger Points TVBUVBSFBOZFSJBMJI TFSBUPUPUEFOHBO
    NFNQBMQBTJUBKBN
    Trigger point CFSVLVSBOLFDJM HVNQBMBOLFSBT  BUBVEFOHBOJOTFSTJ
    NVOHLJOEBQBUUFSMJIBUBUBVUFSBTBEJCBXBI KBSVNLFtrigger
    point
    LVMJUMyofascial trigger points EBQBUUFSKBEJEJ
    PUPUPUPU CFSCBHBJ BOHHPUB UVCVI TFCBHBJ  5FSBCBBEBOZB /ZFSJCFSLVSBOH
    SFTQPOT EBSJ DFEFSB BUBV LFMFCJIBO CFCBO HVNQBMBOBUBVCFOKPMBO EFOHBOQFSFHBOHBO
    QBEBPUPUZBOHOZFSJ PUPUBUBVJOKFLTJ
    PUPU5FSEBQBUIJQPUFTJTCBIXBTFSBUPUPUZBOH trigger point
    DFEFSB BLBO NFNFOEFL TFIJOHHB UFSKBEJ
    QFOJOHLBUBO UFHBOHBO
     BLJCBU QFOHFMVBSBO  /ZFSJUFLBOMPLBMQBEB
    Gambar. Trigger point QBEBTJOESPNOZFSJ
    UJUJLUFSUFOUVTFQBOKBOH
    CFSMFCJIBOJPOLBMTJVNEBSJTFSBUZBOHSVTBL  myofascial 
    CFOKPMBOBUBVHVNQBMBO
    BUBV TFCBHBJ SFTQPOT UFSIBEBQ BTFUJMLPMJO
    EBMBN KVNMBI CFTBS EBSJ motor end plate  "EBOZBQFOVSVOBO
    SVBOHHFSBLQBEB
    /ZFSJUFLBOMPLBMBUBVNFOKBMBSUFSKBEJLBSFOB TBSBG QVTBU EBO QFSJGFS /ZFSJ EBQBU TFCBHBJ CFSCBHBJEFSBKBU
    OPTJTFQUPSPUPUUFSTUJNVMBTJBLJCBULVSBOHOZB BLJCBU TFLVOEFS LFSVTBLBO KBSJOHBO ZBOH
    PLTJHFO EBO QFOJOHLBUBO NFEJBUPS JOnBNBTJ BLBO NFOVSVOLBO Q) TFSUB NFOHFMVBSLBO
    EJUFNQBUDFEFSB  #FMVN BEB QFNFSJLTBBO MBCPSBUPSJVN VOUVL
    IJTUBNJO EBO CSBEJLJOJO MPLBM 3FTQPOT
    NFOFHBLLBO TJOESPN OZFSJ myofascial.
    TFSBCVU $ BLBO EJUJOHLBULBO EJ QFSJGFS PMFI
    %JBHOPTJT NBTJI EJCVBU CFSEBTBSLBO IBTJM
    Myofascial trigger points EBQBU BLUJG BUBV TFSPUPOJO  QSPTUBHMBOEJO  thromboxane, EBO
    UFNVBOLMJOJT1FNFSJLTBBOQFOVOKBOHIBOZB
    MBUFO Myofascial trigger points BLUJG BLBO MFVLPUSJFOF BLJCBU IJQPLTJB EBO USBVNB
    EBQBU NFOEFUFLTJ QFSVCBIBO ZBOH UFSKBEJ 
    NFOJNCVMLBOSBTBOZFSJ TFIJOHHBNFODFHBI KBSJOHBO 4VCTUBOTJ 1 KVHB EJLFMVBSLBO EJ
    TFQFSUJFMFLUSPNJPHSBmEBQBUNFOHJEFOUJmLBTJ
    QFNBOKBOHBO PUPU NBLTJNBM  NFMFNBIOZB QFSJGFSEBONFOJOHLBULBOWBTPEJMBUBTJQFSJGFS
    PUPU ZBOH NFNJMJLJ trigger point BLUJG BLBO
    PUPU  NFNFEJBTJ SFTQPOT LFEVUBO MPLBM CJMB EBOTFOTJUJTBTJTFSBCVU$4FSBCVU$LFNVEJBO
    MFCJIDFQBUNFOHBMBNJLFMFMBIBO ultrasound
    EJTUJNVMBTJ  EBO NFOZFCBCLBO OZFSJ BMJI EJ BLBO NFOZBNQBJLBO JNQVMT NFOVKV LPSOV
    EBQBU NFNQFSMJIBULBO SFTQPOT LFEVU MPLBM
    BSFB OZFSJ ZBOH CFSTBOHLVUBO .5S1T MBUFO EPSTBMJT NFEVMMB TQJOBMJT ,POEJTJ TFQFSUJ
    ZBOHUFSDFUVTCJMBEJQBMQBTJ
    CJBTBOZB UJEBL CFSHFKBMB  UJEBL NFOJNCVMLBO JOJ EJTFCVU TFOTJUJTBTJ QFSJGFS 4FEBOHLBO
    OZFSJ QBEB BLUJWJUBT TFIBSJIBSJ  UFUBQJ OZFSJ TFOTJUJTBTJTFOUSBMCFSBSUJQFOJOHLBUBOSFTQPOT
    OFVSPO OPTJTFQUJG QBEB TJTUFN TBSBG QVTBU TATALAKSANA FARMAKOLOGI
    BQBCJMB EJCFSJ TUJNVMBTJ FLTUFSOBM  TFQFSUJ
    EJQBMQBTJ  EBO EBQBU UFSBLUJWBTJ KJLB PUPU #BJL TFOTJUJTBTJ TFOUSBM NBVQVO QFSJGFS EBQBU 5FSBQJ EBQBU CFSVQB UFSBQJ GBSNBLPMPHJ
    UFHBOH  MFMBI  BUBV DFEFSB #FCFSBQB TUVEJ UFSKBEJQBEBOZFSJLSPOJL(FKBMBZBOHQFSTJTUFO EBO JOUFSWFOTJ OPOGBSNBLPMPHJ 5FSBQJ
    NFOVOKVLLBO CBIXB  JOEJWJEV EBQBU NFSVQBLBO IBTJM TFOTJUJTBTJ QFSJGFS TJNQUPNBUJT NFMJQVUJ BOUJJOnBNBTJ  BOBHFUJL 
    BTJNQUPNBUJL NFNQVOZBJ latent trigger UFSIBEBQ OPTJTFQUPS EBO KVHB TFOTJUJTBTJ EBOOBSLPUJL0CBUBOUJJOnBNBTJOPOTUFSPJE
    points   TFOUSBMVOUVLNPEVMBTJEBONPEJmLBTJ5BOEB 0"*/4
     QBMJOH TFSJOH EJHVOBLBO LBSFOB
    TFOTJUJTBTJ TFOUSBM EBO QFSJGFS BEBMBI BMPEJOJB FGFLOZB TFCBHBJ BOBMHFUJL EBO BOUJJOnBNBTJ
    EBOIJQFSBMHFTJB .FTLJQVODBSBLFSKB0"*/4QBEBTJOESPNOZFSJ
    1BTJFO EFOHBO .5S1T EBQBU NFNJMJLJ HFKBMB
    myofascial NBTJI CFMVN EJLFUBIVJ  OBNVO
    PUPOPN TFQFSUJ CFSLFSJOHBU  BLUJWJUBT
    Diagnosis Sindrom Nyeri Myofascial TVEBI UFSCVLUJ CBJL VOUVL NFOBOHBOJ OZFSJ
    QJMPNPUPS  QFSVCBIBO QBEB TVIV LVMJU 
    NVTLVMPTLFMFUBM EBOTJOESPNOZFSJmyofascial
    MBLSJNBTJ  EBO TBMJWBTJ "LUJWJUBT TJTUFN TBSBG ,SJUFSJB EJBHOPTJT TJOESPN OZFSJ myofascial
    TFSJOH UVNQBOH UJOEJI EFOHBO OZFSJ
    TJNQBUJTBLBONFOJOHLBULBOBLUJWJUBTNPUPSJL NBTJICFSCFEBCFEBLBSFOBNBTJILVSBOHOZB
    NVTLVMPTLFMFUBM 4FCVBI 3$5 Randomized
    EBONFOZFCBCLBOOZFSJ LSJUFSJB EJBHOPTJT CFSCBTJT TUVEJ NVMUJTFOUFS
    Control Trial
     NFOVOKVLLBO CBIXB diclofenac
    JOUFSOBTJPOBMBUBVQFSUFNVBOLPOTFOTVTQBSB
    patch NFNQVOZBJ FGFL TJHOJmLBO QBEB
    BIMJ ,SJUFSJB ZBOH QBMJOH TFSJOH EJHVOBLBO
    Nyeri pada Sindrom Nyeri Myofascial TJOESPN OZFSJ myofascial EJ NVTLVMVT
    BEBMBI LSJUFSJB NFOVSVU 4JNPOT  et al  
    
    /ZFSJ NFSVQBLBO QSPTFT NVMUJEJNFOTJ USBQF[JVT 0QJPJE CJBTBOZB UJEBL EJHVOBLBO
    ,SJUFSJB EJBHOPTJT TJOESPN OZFSJ myofascial
    NFMJQVUJ LPNQPOFO TFOTPSJL EBO QFSTFQTJ  #FCFSBQB TUVEJ NFOVOKVLLBO QFNCFSJBO
    CFSVQB MJNB LSJUFSJB NBZPS EBO TFUJEBLOZB
    ZBOHNFOHBLUJWBTJCFCFSBQBBSFBQBEBTJTUFN PQJPJEMFNBIDVLVQFGFLUJG OBNVOTFCBHJBO
    TBUVEBSJUJHBLSJUFSJBNJOPS
    CFTBS TUVEJ UJEBL NFOEVLVOH QFOHHVOBBO

    CDK-238/ vol.43 no.3, th. 2016 177


    CONTINUING MEDICAL EDUCATION

    PQJPJEVOUVLUBUBMBLTBOBOZFSJQBEBTJOESPN EBQBU UFSMJIBU TFUFMBI UFSBQJ Dry needling Terapi Manual


    OZFSJmyofascial LBSFOBQFOHHVOBBOPQJPJE EBQBU NFOHBLTFT TUSVLUVS PUPU EBMBN ZBOH 5FSBQJ NBOVBM TBBU JOJ NVMBJ EJQFSIJUVOHLBO
    QBEB OZFSJ BLVU EBQBU counter productive UJEBL QFSOBI UFSDBQBJ UBOQB KBSVN  TFIJOHHB TFCBHBJ UFSBQJ ZBOH QBMJOH FGFLUJG VOUVL
    UFSIBEBQQSPTFTQFOZFNCVIBO EBQBU NFMFQBTLBO SFTUSJLTJ myofascial Dry NFOHJOBLUJWBTJ .5S1T 5FSBQJ JOJ UFSNBTVL
    needling QBEB.5S1TCFSCFEBEBSJBLVQVOUVS deep pressure massage, stretch therapy with
    XBMBVQVO BMBU ZBOH EJQBLBJ TBNB +BSVN spray, EBOsuperficial heat./BNVO CFMVNBEB
    #FCFSBQB TUVEJ 3$5  MBQPSBO LBTVT   EBO
    IBSVT EJNBTVLLBO EBO EJLFMVBSLBO EBSJ BSBI TUVEJ ZBOH EBQBU NFNCVLUJLBO LFFGFLUJGBO
    TUVEJ PCTFSWBTJPOBM  NFOVOKVLLBO CBIXB
    CFSCFEB TFDBSB DFQBU VOUVL NFOHFOBJ UJUJL KBOHLBQBOKBOHOZB
    lidocainepatchEBQBUNFOJOHLBULBOBNCBOH
    TFOTJUJGQBEBSFHJP.5S1#FCFSBQBTUVEJUFMBI
    OZFSJ TFDBSB TJHOJmLBO  TFIJOHHB EBQBU
    NFNQFMBKBSJ NFLBOJTNF ZBOH NVOHLJO
    NFOJOHLBULBO BLUJWJUBT TFIBSJIBSJ -JEPLBJO Ultrasound NFSVQBLBO UFLOJL ZBOH
    UFSKBEJ"EBZBOHNFOZFCVULBOCBIXBUFSKBEJ
    UPQJLBMKVHBEBQBUEJHVOBLBO NFOHVCBIFOFSHJMJTUSJLNFOKBEJHFMPNCBOH
    QFMFQBTBO PQJBU FOEPHFO QBEB TJTUFN TBSBG
    QVTBU BEBKVHBTUVEJZBOHNFOHBUBLBOCBIXB TVBSB EFOHBO UVKVBO NFOHIBTJMLBO FOFSHJ
    Tizanidine CFLFSKB TFCBHBJ BMGB  BHPOJT  SFTFQUPS PQJBU QFSJGFS MPLBM MFCJI UFSBLUJWBTJ QBOBTQBEBPUPUTranscutaneous electric nerve
    TFIJOHHB EBQBU NFOVSVOLBO TQBTUJTJUBT EJCBOEJOHLBOSFTFQUPSTJTUFNJL*OIJCJTJOZFSJ stimulation 5&/4
     KVHB EBQBU NFOHVSBOHJ
    PUPU QBEB TJOESPN OZFSJ myofascial EBQBU NFMBMVJKBMVSEFTFOEFOTFSPUPOJOFSHJLTFUFMBI OZFSJ  OBNVO CFMVN BEB CVLUJ ZBOH
    NFOVSVOLBO JOUFOTJUBT OZFSJ EBO EJTBCJMJUBT UFSBQJKBSVNKVHBNFNVOHLJOLBO.FOHJOHBU NFOEVLVOHLFVOHHVMBO5&/4EJCBOEJOHLBO
    #FCFSBQB TUVEJ NFOZBSBOLBO QFOHHVOBBO QFOVSVOBO OZFSJ ZBOH DFQBU TFUFMBI UFSBQJ JOKFLTJ trigger points BUBV NFEJLBTJ
    tizanidine TFCBHBJUFSBQJMJOJQFSUBNB KBSVN FGFLBOBMHFTJLJOJMFCJINFOHBSBIQBEB GBSNBLPMPHJ  TFIJOHHB CBSV EJHVOBLBO
    KBMBOOZB TFSBCVU TBSBG EJCBOEJOHLBO EFOHBO TFCBHBJ UFSBQJ BEKVWBO Electrical twitch
    SFBLTJLJNJBZBOHCFSKBMBOMBNB obtaining intramuscular stimulation &5*0.4
    
    #FO[PEJB[FQJO CFLFSKB NFOHIBNCBU
    NFSVQBLBONFUPEFNFOHHVOBLBOBSVTMJTUSJL
    QFOHFMVBSBOTFSPUPOJOQSFTJOBQTEBOFLTJUBTJ
    NFMBMVJ KBSVN FMFLUSPNJPHSBm NPOPQPMBS
    ("#"1BEBTFCVBIVKJDPCBLMJOJT LMPOB[FQBN Injeksi Trigger Points VOUVL NFODBQBJ deep motor endplates. 4UVEJ
    UFSCVLUJNFNQVOZBJFGFLBOUJOPTJTFQUJGVOUVL *OKFLTJ .5S1T IBNQJS TBNB EFOHBO dry $IV et al NFOVOKVLLBOQFSCBJLBOTJHOJmLBO
    TJOESPNOZFSJmyofascial needling  OBNVO QBEB UFLOJL JOJ EJMBLVLBO UFSIBEBQOZFSJEBOSVBOHHFSBL TFSUBTFEJLJU
    JOKFLTJ PCBU BOFTUFTJ BUBV TUFSPJE #FCFSBQB FGFL TBNQJOH 4UJNVMBTJ NBHOFUJL BEBMBI
    TATALAKSANA NON-FARMAKOTERAPI TUVEJ NFOZFCVULBO CBIXB JOKFLTJ trigger UFLOJL CBSV VOUVL NFOHBUBTJ OZFSJ QBEB
    5BUBMBLTBOB OPOGBSNBLPUFSBQJ EBQBU JOWBTJG points EFOHBO PCBU BOFTUFTJ UJEBL MFCJI CBJL TJOESPNB OZFSJ myofascial 4UVEJ TUJNVMBTJ
    BUBV OPOJOWBTJG .FUPEF OPOJOWBTJG EBQBU EBSJQBEB dry needling. *OKFLTJ TUFSPJE QBEB NBHOFUJL JOJ NBTJI UFSCBUBT  TFIJOHHB
    CFSVQBmTJPUFSBQJ TFQFSUJQFSFHBOHBO UFSBQJ .5S1TKVHBNBTJILPOUSPWFSTJBMLBSFOBIBOZB NFLBOJTNFUFSBQFVUJLOZBNBTJICFMVNKFMBT
    MBTFS ultrasound EBOtranscutaneous electrical TFEJLJUCVLUJZBOHNFOEVLVOHBEBOZBQSPTFT
    nerve stimulation 5&/4
     JOnBNBTJ QBEB QBUPmTJPMPHJ TJOESPN OZFSJ
    SIMPULAN
    myofascial
    4JOESPN OZFSJ myofascial BEBMBI TFCVBI
    Dry Needling LPOEJTJ OZFSJ CBJL BLVU NBVQVO LSPOJL EBSJ
    Botulinum Toxin PUPU BUBVQVO fascia NFOZBOHLVU GVOHTJ
    *OKFLTJ QBEB .5S1T FGFLUJG EBO TVEBI TFSJOH
    EJMBLVLBO *OKFLTJ JOJ EBQBU CFSVQB dry Clostridium botulinum NFOHIBTJMLBO UVKVI TFOTPSJL  NPUPSJL  BUBVQVO PUPOPN ZBOH
    needling, BOFTUFTJLFSKBDFQBUBUBVQVOMBNCBU  OFVSPUPLTJO OFVSPUPLTJO "(
     $BSB LFSKB CFSIVCVOHBO EFOHBO myofascial trigger
    BUBV TUFSPJE Trigger point dry needling BUBV UPLTJO JOJ BEBMBI NFOHIBMBOHJ FLTPTJUPTJT points .5S1T
    Myofascial trigger points BEBMBI
    EJLFOBM KVHB TFCBHBJ TUJNVMBTJ JOUSBNVTLVMFS WFTJLFM QSFTJOBQT UFSIBEBQ BTFUJMLPMJO EJ TVBUV UJUJLUFNQBU IJQFSJSJUBCFM CFSMPLBTJ EJ
    NFSVQBLBO UFLOJL NFOHHVOBLBO KBSVN endplate. #PUVMJOVN " EBO # TVEBI UFSTFEJB TUSVLUVS PUPU BUBV fascia ZBOH NFOFHBOH 
    CFSmMBNFOIBMVTQBEBUJUJLUJUJLUFSUFOUVQBEB TFCBHBJ BHFO UFSBQFVUJL CJPMPHJ EBO TFSJOH ZBOH KJLB EJUFLBO EBQBU NFOZFCBCLBO OZFSJ
    PUPUTLFMFUBMZBOHIJQFSJSJUBCFM .5S1T
    UBOQB EJHVOBLBO VOUVL UFSBQJ IJQFSBLUJWJUBT PUPU MPLBMBUBVNFOKBMBS
    PCBU Dry needling EBIVMV NFSVQBLBO TBMBI Botulinum toxin UJQF " #P/5"
     NFSVQBLBO
    TBUV ZBOH UFSDFQBU EBO QBMJOH FGFLUJG VOUVL OFVSPUPLTJO ZBOH NFODFHBI UFSKBEJOZB
    &UJPMPHJQFNCFOUVLBOtrigger point QBEBPUPU
    NFOHVSBOHJ OZFSJ 5FLOJL dry needling TVEBI LPOUSBLTJPUPUTFSUBNFNQVOZBJFGFLBOBMHFUJL
    EBO NFLBOJTNF UFSKBEJOZB HFKBMB TPNBUJL
    EJLFNCBOHLBO EFOHBO CFSCBHBJ WBSJBTJ EFOHBO NFOVSVOLBO QSPEVLTJ TVCTUBOTJ 1
    NBTJI CFMVN EJQBIBNJ 1FOZFCBC VNVN
    5VKVBOJOTFSTJKBSVNCFSmMBNFOIBMVTBEBMBI EBO HMVUBNBU *OKFLTJ #P/5" NFOVOKVLLBO
    OZFSJ myofascial EBQBU CFSBTBM EBSJ USBVNB
    VOUVLNFOHIBTJMLBOSFTQPOTLFEVU LPOUSBLTJ IBTJMTJHOJmLBOEBMBNNFOVSVOLBOJOUFOTJUBT
    MBOHTVOH BUBVQVO UJEBL MBOHTVOH  LPOEJTJ
    TJOHLBU
    QBEBPUPUZBOHUFSJOTFSTJ  OZFSJ EBO EVSBTJOZB OBNVO CBSV TFUFMBI
    QBUPMPHJTUVMBOHCFMBLBOH QBQBSBOUFSIBEBQ
    FNQBUNJOHHV*OKFLTJ#P/5"CBJLEJCFSJLBO
    UFHBOHBO ZBOH CFSVMBOH EBO LVNVMBUJG 
    KJLBOZFSJNFOFUBQEFOHBOUFSBQJLPOTFSWBUJG
    *OTFSTJKBSVNLF.5S1TBLBONFNQSPEVLTJSBTB BUBV QPTJTJQPTUVS UVCVI ZBOH UJEBL TFTVBJ
    &GFLTBNQJOHOZBBEBMBILFMFNBIBOPUPUEBO
    UJEBLOZBNBOTJOHLBU OBNVOEBQBUCFSUBIBO 1SFWBMFOTJOZB TBNB BOUBSB MBLJMBLJ EBO
    QBSBMJTJTZBOHIBNQJSTFMBMVCFSTJGBUMPLBMEBO
    TFMBNB  KBN 1FSCBJLBO SFOUBOH HFSBL  QFSFNQVBO UFSVUBNBQBEBVTJBUBIVO
    SFWFSTJCFM
    CFSLVSBOHOZBOZFSJEBOQFSCBJLBONPCJMJTBTJ Myofascial trigger points EBQBUEJLMBTJmLBTJLBO

    178 CDK-238/ vol.43 no.3, th. 2016


    CONTINUING MEDICAL EDUCATION

    NFOKBEJ BLUJG EBO MBUFO ,SJUFSJB EJBHOPTJT NBZPS EBO TFUJEBLOZB TBUV EBSJ UJHB LSJUFSJB JOWBTJGEBOOPOJOWBTJG
    ZBOH QBMJOH TFSJOH EJHVOBLBO BEBMBI LSJUFSJB NJOPS5FSBQJ TJOESPN OZFSJ myofascial EBQBU
    4JNPOT  et al  
     CFSVQB MJNB LSJUFSJB GBSNBLPMPHJ EBO OPOGBSNBLPMPHJ  ZBOH

    DAFTAR PUSTAKA
     (FSCFS/- 4JLEBS4 )BNNPOE+ 4IBI+"CSJFGPWFSWJFXBOEVQEBUFPGNZPGBTDJBMQBJOTZEOSPNFBOENZPGBTDJBMUSJHHFSQPJOUT+4QJOBM3FT'PVOEBUJPO
     4UFQJFO+5SJHHFSQPJOUESZOFFEMJOH+4QJOBM3FT'PVOEBUJPO
     "NJSEFIJ." "OTBSJ// /BHIEJ4 0MZBFJ( /PVSCBLITI.35IFOFVSPQIZTJPMPHJDBMFõFDUTPGESZOFFEMJOHJOQBUJFOUTXJUIVQQFSUSBQF[JVTNZPGBTDJBMUSJHHFSQPJOUT4UVEZQSPUPDPM
    PGBDPOUSPMMFEDMJOJDBMUSJBM#.+0QFOF
     5PVHI&" 8IJUF"3 $VNNJOHT5. 3JDIBSET4) $BNQCFMM+-"DVQVODUVSFBOEESZOFFEMJOHJOUIFNBOBHFNFOUPGNZPGBTDJBMUSJHHFSQPJOUQBJO"TZTUFNBUJDSFWJFXBOENFUBBOBMZTJT
    PGSBOEPNJTFEDPOUSPMMFEUSJBM&VS+1BJO
     -VP++ %VO/+$ISPOJDQBJO.ZPGBTDJBMQBJOBOEmCSPNZBMHJB*OUFSOBU+1IZTJDBM.FE3FIBCJMJUBUJPO
     %FTBJ.+ 4BJOJ7 4BJOJ4.ZPGBTDJBMQBJOTZOESPNF"USFBUNFOUSFWJFX1BJO5IFS
     #SPO$ (BTU" %PNNFSIPMU+ 4UFHFOHB# 8FOTJOH. 0PTUFOEPSQ3"#5SFBUNFOUPGNZPGBTDJBMUSJHHFSQPJOUTJOQBUJFOUTXJUIDISPOJDTIPVMEFSQBJO"SBOEPNJ[FEDPOUSPMMFEUSJBM
    #.$.FEJDJOF
     (JBNCFSBSEJOP." "õBJUBUJ( 'BCSJ[JP" $POTUBOUJOJ3.ZPGBTDJBMQBJOTZOESPNFTBOEUIFJSFWBMVBUJPO#FTU1SBDUJDFBOE3FT$MJO3IFVNBUPM
     )TJFI-' )POH$; $IFSO4) $IFO$$&öDBDZBOETJEFFõFDUTPGEJDMPGFOBDQBUDIJOUSFBUNFOUPGQBUJFOUTXJUINZPGBTDJBMQBJOTZOESPNFPGUIFVQQFSUSBQF[JVT+1BJOBOE4ZNQUPN
    .BOBHFNFOU 
    
     'MFDLFOTUFJO+ ;BQT% 3VHFS-%JTDSFQBODZCFUXFFOQSFWBMFODFBOEQFSDFJWFEFõFDUJWFOFTTPGUSFBUNFOUNFUIPETJONZPGBTDJBMQBJOTZOESPNF3FTVMUTDSPTTTFDUJPOBM OBUJPOXJEF
    TVSWFZ#.$.VTDVMPTLFMFUBM%JTPSEFS
     "öBUJ( 'BCSJ[JP" 4BWJOJ" -FS[B3 5BGVSJ& $POTUBOUJOJ3 FUBM"SBOEPNJ[FEDPOUSPMMFETUVEZDPNQBSJOHBMJEPDBJOFQBUDI BQMBDFCPQBUDI BOEBOFTUIFUJDJOKFDUJPOGPSUSFBUNFOUPG
    USJHHFSQPJOUTJOQBUJFOUTXJUINZPGBTDJBMQBJOTZOESPNF&WBMVBUJPOPGQBJOBOETPNBUJDQBJOUISFTIPMET$MJO5IFSBQFVUJDT
     %BMQJB[" %PEET5.ZPGBTDJBMQBJOSFTQPOTFUPUPQJDBMMJEPDBJOFQBUDIUIFSBQZ$BTFSFQPSU+1BJO1BMMJBUJWF$BSF1IBSNBDPUIFS
     %BMQJB[" -PSEPO4 -JQNBO"5PQJDBMMJEPDBJOFQBUDIUIFSBQZGPSNZPGBTDJBMQBJO+1BJO1BMMJBUJWF$BSF1IBSNBDPUIFS
     $IPV-8 )TJFI:- ,VBO54 )POH$;/FFEMJOHUIFSBQZGPSNZPGBTDJBMQBJO3FDPNNFOEFEUFDIOJRVFXJUINVMUJQMFSBQJEOFFEMFJOTFSUJPO#JP.FEJDJOF 
    
     $MJNFOU+. ,VBO54 'FOPMMPTB1 3PTBSJP'.#PUVMJOVNUPYJOGPSUIFUSFBUNFOUPGNZPGBTDJBMQBJOTZOESPNFJOWPMWJOHUIFOFDLBOECBDL"SFWJFXGSPNDMJOJDBMQFSTQFDUJWF&WJEFODF
    #BTFE$PNQMFNFOUBSZBOE"MUFSOBUJWF.FEJDJOF
     $IV+ 4DIXBSU[*&UJPNTUXJUDISFMJFGNFUIPEJODISPOJDSFGSBDUPSZNZPGBTDJBMQBJO&MFDUSPNZPHS$MJO/FVSPQIZTJPM

    CDK-238/ vol.43 no.3, th. 2016 179

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