<![CDATA[Background: The aging process induces changes in the anatomical and physiology of multiple organs and body systems, resulting in gradual reduction in cardiovascular and pulmonary functional capacities. This decline subsequently impairs cardiorespiratory fitness, ultimately leading to complaints of fatigue, that can be assessed by a Fatigue Assessment Scale (FAS). Aerobic exercise, such as elderly exercise, enhances cardiorespiratory fitness by promoting increasing blood flow to muscles. Supplementing these activities with expiratory muscle strengthening exercises using a Positive Expiratory Pressure/PEP threshold device help to reinforce the expiratory muscles, which are commonly weakened with aging. Objective: To prove the effectiveness of adding expiratory muscle-strengthening exercises to elderly exercise the fatigue complaints of the pre-frail elderly. Methods: A randomized controlled trial was used for this research. There were 24 subjects who met the study criteria were randomly divided into an intervention group (n=12) who receive PEP 5 times per week + elderly exercise 3 times per week for 6 weeks, and a control group (n=12) who only had elderly exercise 3 times per week for 6 weeks. Fatigue complaints were measured before and after intervention using the FAS questionnaire. Results: There was an increase in FAS scores before and after treatment in both the intervention group (p<0.001) and the control group (p<0.001). Comparison between groups showed a significant FAS score difference in the intervention group (p=0.010). Conclusion: The addition of expiratory muscle strengthening exercises to elderly exercise for 6 weeks had a better improvement in fatigue complaints compared to only having elderly exercise.]]>
