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All Journal Sains Olahraga : Jurnal Ilmiah Ilmu Keolahragaan Narra J The Journal of Society Medicine (JSOCMED)
Pandia, Pandiaman
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Physics Public Health

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PENINGKATAN AMBILAN OKSIGEN MAKSIMAL (VO2 MAKS) DAN FAT FREE MASS (FFM) PADA PASIEN PENYAKIT PARU OBSTRUKSI KRONIS STABIL YANG MELAKUKAN OLAHRAGA Tarigan, Amira Permatasari; Miranda, Melly; Pandia, Pandiaman; Zulkarnain, Zulkarnain; Maryaningsih, Maryaningsih; Vera, Yeni; Zaluchu, Fotarisman
Sains Olahraga : Jurnal Ilmiah Ilmu Keolahragaan Vol 7, No 2: Oktober 2023
Publisher : Universitas Negeri Medan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24114/so.v7i2.49725

Abstract

Pasien PPOK yang mengalami atrofi dan disfungsi otot akan mengurangi pengambilan oksigen maksimal (VO2 maks) dalam jaringan. Berat badan dan penipisan massa bebas lemak (fat free mass) adalah masalah umum pada pasien PPOK dan terkait dengan kelemahan otot dan intoleransi latihan, kedua hal ini akan menyebabkan penurunan aktivitas dan kualitas hidup. Olahraga (latihan fisik) pada pasien PPOK memberikan efek yang baik terhadap toleransi latihan dan kualitas hidup. Tujuan dari penelitian ini adalah untuk menilai peran olahraga terhadap VO2 maks dan fat free mass pada pasien PPOK. Desain penelitian ini adalah eksperimental, dilakukan pada 20 pasien PPOK. Pasien melakukan latihan tubuh bagian atas dan bawah dengan latihan otot pernapasan dan sepeda statis, dua kali seminggu selama 4 minggu, mulai dari 5-20 menit/sesi. Pengukuran VO2 maks dihitung sebelum dan sesudah intervensi menggunakan Nury’s Formula® yang dirancang khusus untuk orang Indonesia (r = 0,68; p < 0,005), dengan mengkonversi jarak berjalan 6 menit. Fat free mass diukur dengan BIA (Bio Impendances analysis) pre dan pasca intervensi dan indeks massa bebas lemak dihitung sebagai FFM kg/m2. Analisis statistik dilakukan oleh T Test. Terdapat peningkatan VO2 maks diperoleh dengan tes berjalan 6 menit, dari rerata 9.24 menjadi 9.44 tetapi tidak signifikan secara statistik (p = 0,066). Pada FFM ada peningkatan tetapi tidak signifikan secara statistik pada indeks massa bebas lemak dari rerata 18.37 menjadi 18.44 (p < 0,689) setelah intervensi. Kejadian eksaserbasi tidak ditemukan ketika intervensi dilakukan. Latihan tubuh dapat meningkatkan VO2 maks dan fat free mass tetapi tidak signifikan secara statistik.Kata Kunci: Latihan tubuh, Formula Nury®, PPOK, VO2 maks, FFM
Functional capacity and quality of life improvement in stable chronic obstructive pulmonary disease (COPD) patients following physical exercise and chicken egg white supplementation Sihombing, Benny; Tarigan, Amira P.; Pandia, Pandiaman; Zaluchu, Fotarisman; Sinaga, Bintang YM.; Monica, Nanda S.; Rhinsilva, Ella; Zulkarnain, Zulkarnain
Narra J Vol. 3 No. 3 (2023): December 2023
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v3i3.404

Abstract

The pillars of comprehensive pulmonary rehabilitation program for chronic obstructive pulmonary disease (COPD) patients include physical exercise and good nutrition. The aim of this study was to evaluate the efficacy of pulmonary rehabilitation, which included physical exercise and chicken egg white supplementation, on the quality of life (QoL) and functional capacity among patients with stable COPD. The COPD patients were enrolled prospectively in this quasi-experimental study and completed a 12-week smartphone-guided home-based physical exercise program that comprised strength and resistance training three times per week for 30 minutes each session. Participants were divided into two groups: the control group who underwent physical exercise only, and the intervention group who had physical exercise and chicken egg white supplementation as a protein source. Patient characteristics including sex, age, nutritional status, comorbidities, smoking status, and obstruction severity, were evaluated. The COPD assessment test (CAT) score and six-minute walk test (6MWT) were used as the parameters to evaluate QoL and functional capacity, respectively. Of the total 50 patients included in the study, 12 were excluded due to follow-up and adherence problems. Our data indicated there were significant CAT score reduction and 6MWT improvement in both control and intervention groups after 12 weeks compared to baseline data. However, reduction of mean CAT score was higher in intervention compared to control group (-13.47±6.49 vs -5.42±5.07, p<0.001). In addition, the improvement of 6MWT was also higher in intervention group compared to control group (145.47±69.2 vs 32.42±17.3 meters, p<0.001). In conclusion, chicken egg white supplement to male patients with stable COPD who exercise with resistance and strength training could improve the QoL and functional capacity.
Effectiveness of smartphone application in increasing knowledge on COPD and its non-pharmacological management in COPD patients Adida, Fiony; Pandia, Pandiaman; Pradana, Andika; Tarigan, Amira P.; Ashar, Taufik; Dangana, Amos; Listyoko, Aditya S.
Narra J Vol. 3 No. 3 (2023): December 2023
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v3i3.412

Abstract

Chronic obstructive pulmonary disease (COPD) is among top ten of the world's causes of death. The development of the “Paru Sehat” smartphone application is a positive initiative and might have the potential to improve the disease management of COPD, improve patient’s quality of life, and reduce complications associated with COPD. However, its effectiveness in improving the knowledge of the COPD patients is unknown. The aim of this study was to determine the effectiveness of “Paru Sehat” in increasing knowledge on COPD and its non-pharmacological management in COPD patients. A quasi-experimental study with a one-group pretest-posttest was conducted among stable COPD patients at Prof. Chairuddin Panusunan Lubis Hospital, Medan, Indonesia. Bristol COPD knowledge questionnaire (BCKQ) was used to assess the knowledge scores of the patients before and after exposure to the “Paru Sehat” twice a week for four weeks. A dependent Student t-test was used to compare the knowledge scores between pre- and post-intervention for both knowledge domains (i.e., knowledge on the disease and non-pharmacological management). Student t-test or one-way ANOVA were used to determine the association between patients’ characteristics and the knowledge scores within pre- and post-treatment. Our data indicated a significant improvement of the knowledge scores on disease between pre- and post-treatment (15.92±3.79 vs 19.56±3.68, p<0.001). The knowledge score on non-pharmacological management also increased significantly post-treatment (7.52±2.02) compared to pre-treatment (10.08±2.379), p<0.001. In addition, this study found that educational attainment was associated with the scores of both knowledge domains of which individuals with senior high school or higher education level had significantly improvement of knowledge scores. This study highlights that although “Paru Sehat” application could improve the knowledge on COPD and its non-pharmacological management, its effects are less effective among individuals with low educational attainment.
Effectiveness of upper arm and breathing exercises to improve inflammatory markers in severe COVID-19 patients Tarigan, Amira P.; Firdaus, Ruby; Pandia, Pandiaman; Pradana, Andika; Abdullah, Muntasir; Sinaga, Sudirman P.; Wijanarko, Wahyu; Triwahyudi, Bibit; Vera, Yeni; Maryaningsih, Maryaningsih; Eyanoer, Putri C.; Listyoko, Aditya S.
Narra J Vol. 4 No. 1 (2024): April 2024
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v4i1.417

Abstract

Studies have suggested associations between inflammatory markers with the severity of coronavirus disease 2019 (COVID-19). Therefore, exercises that could reduce the level of inflammatory markers might be beneficial. The aim of this study was to determine the effect of upper arms and breathing exercises on inflammatory markers such as ferritin, lactate dehydrogenase (LDH), and C-reactive protein (CRP) in severe COVID-19 patients. A quasi-experimental with pre-test and post-test control group design was conducted among severe COVID-19 aged 18–70 years old, with or without comorbidities. Baseline data of inflammatory markers (ferritin, LDH, and CRP) were measured before the exercises and repeated post-exercise. The upper arm and breathing exercises were performed for ten days, twice a day (morning and evening) for ten minutes. A paired Student t-test was used to assess the changes in the inflammatory markers’ levels. Our data indicated that levels of ferritin and CRP were not significantly different between pre- and post-exercise. However, the level of LDH decreased significantly from 481.35 U/L to 331.80 U/L (p=0.001). This study highlights that pulmonary rehabilitation exercises might be beneficial to enhance the recovery process in severe COVID-19 patients.
Comparison of exhaled carbon monoxide levels and its association with nicotine dependence between electronic and tobacco cigarettes: A cross-sectional study among teenage smokers Raffael, Frans; Pandia, Pandiaman; Tarigan, Amira P.; Mutiara, Erna; Osakue, Osareniro E.
Narra J Vol. 3 No. 3 (2023): December 2023
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v3i3.418

Abstract

Carbon monoxide (CO), resulting from incomplete combustion such as tobacco smoking, serves as an indicator of nicotine addiction. The aim of this study was to compare the levels of exhaled CO levels between electronic cigarette (e-cigarette) and tobacco smokers and to determine the association between nicotine dependence and exhaled CO levels in e-cigarette and tobacco smokers. A cross-sectional study was conducted using purposive sampling on active smokers, with 70 smokers in each group. The nicotine dependence was measured using the Penn State Nicotine Dependence Index (PSNDI) questionnaire for the e-cigarette group and the Fagerstrom questionnaire for the tobacco smoking group. The CO level was measured using the smokerlyzer piCO. To compare the mean exhaled CO levels between e-cigarettes and tobacco smoker groups, the Mann-Whitney test was used. The Mann-Whitney test and Kruskal-Wallis test were used to assess the associations between nicotine dependence and mean exhaled CO levels in the e-cigarette smoker group and in the tobacco smoker group, respectively. The majority of e-cigarette smokers were 17 years old (65.7%) and male (75.7%). Among tobacco smokers, the majority were also 17 years old (44.3%), and mostly male (91.4%). The mean exhaled CO levels in the tobacco smoker group were significantly higher than the e-cigarette smoker group, 6.86 ppm vs 1.61 ppm with p<0.001. There was a significant association between nicotine dependence and exhaled CO levels among tobacco smokers (p<0.001). Nicotine dependence was not associated with exhaled CO levels among e-cigarette smokers. This study highlights that the smokerlyzer piCO devise could be used to screen nicotine addiction in tobacco smokers.
Effectiveness of adequate chicken egg white consumption on dyspnea degree and exacerbation incidence in stable COPD patients practicing strength and endurance exercises Monica, Nanda S.; Tarigan, Amira P.; Pradana, Andika; Mutiara, Erna; Pandia, Pandiaman; Sinaga, Bintang YM.; Sihombing, Benny; Rhinsilva, Ella; Zulkarnain, Zulkarnain; Listyoko, Aditya S.
Narra J Vol. 3 No. 3 (2023): December 2023
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v3i3.420

Abstract

Lack of physical exercise and inadequate nutritional intake in chronic obstructive pulmonary disease (COPD) patients could lead to low muscle mass and function, which causes reduced respiratory function, increased incidence of exacerbations, exercise intolerance, increased visits to health facilities, and low health status. Therefore, physical exercise and good nutritional intake are the main foundations of a comprehensive pulmonary rehabilitation program for COPD patients. The aim of the study was to determine the effect of chicken egg white supplementation on dyspnea degree and the incidence of exacerbations in stable COPD patients who perform physical exercise independently at home. A quasi-experimental study was conducted in 38 stable COPD patients based on the Global Initiative for Chronic Lung Disease (GOLD) 2021 classification criteria. The patients were divided into two groups: the control group who did smartphone application-assisted physical exercises and the intervention group who did the same physical exercises plus chicken egg white supplementation for 12 weeks. Performed physical exercises included both strength and endurance training. The degree of dyspnea was assessed with modified Medical Research Council (mMRC) dyspnea scale and the incidence of exacerbations was assessed by direct interviews at the beginning and at the end of the intervention. A Fisher’s exact test was used to assess the association between the intervention with dyspnea degree and exacerbation incidence. In the intervention group, chicken egg white supplementation for 12 weeks lowered the dyspnea degree by 3.16 times than the control (relative risk 3.16 with p=0.001). Furthermore, the incidence of exacerbations was also reduced by 1.8 times compared to the control group (relative risk 1.8, p=0.001). This study highlights a significant improvement in dyspnea degree and exacerbation incidence in COPD patients with the combination of protein supplementation and physical exercise. Therefore, adding chicken egg white intake could be beneficial for stable COPD patients practicing physical exercises.
Factors associated with small airway obstruction in COVID-19 survivors: A cross-sectional study among health-care providers Aritonang, Minarni ES.; Pandia, Pandiaman; Pradana, Andika; Ashar, Taufik
Narra J Vol. 3 No. 3 (2023): December 2023
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v3i3.437

Abstract

Coronavirus disease 2019 (COVID-19) has been identified for more than two years, yet studies assessing post-infection lung function are limited. Reports on lung function in COVID-19 patients indicate that patients have restrictive defects and small airway dysfunction that can persist and are not necessarily related to the severity of the disease. The aim of this study was to assess the incidence of small airway obstruction and its incidence-associated factors among COVID-19 survivors to better describe the long-term effects of COVID-19. A cross-sectional study was conducted among COVID-19 survivors who less than 50 years at Medan Adventist Hospital between 2020–2022. The data were collected through interview, direct assessment and respiratory examination. A total of 89 COVID-19 survivors were recruited of which the majority of them were female with a mean age of 32.6-year-old with the largest group was 19–30 years. The comorbidities found among the survivors were heart and thyroid disorders, with the most common symptom of post-COVID-19 was fatigue. Most of them had mild COVID-19. The mean forced mid-expiratory flow (FEF25–75%) was 96.3±20.22, with an incidence rate of small airway obstruction was 19.1%. Univariate and multivariate analyses indicated no significant association between age, gender, comorbidities, history of oxygenation during COVID-19 treatment, COVID-19 severity and the type of post COVID-19 syndrome symptoms with the incidence of small airway obstruction. In conclusion, among COVID-19 survivors who were less than 50 years old, those studied variables seems have less association with the incidence of small airway obstruction. Nevertheless, a further study with a bigger sample size is important to be conducted.
Comparative analysis between PUMA and CAPTURE questionnaires for chronic obstructive pulmonary disease (COPD) screening in smokers Sebayang, Risa RB.; Pandia, Pandiaman; Pradana, Andika; Tarigan, Amira P.; Wahyuni, Arlinda S.
Narra J Vol. 4 No. 1 (2024): April 2024
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v4i1.654

Abstract

Chronic obstructive pulmonary disease (COPD) presents a significant global challenge, impacting health systems, economies, and societies. Its prevalence is anticipated to rise owing to an aging demographic. Although the PUMA and CAPTURE questionnaires are available for COPD screening, their comparative effectiveness has not been studied in Indonesia. The aim of this study was to evaluate the effectiveness of the PUMA and CAPTURE questionnaires as screening tools for COPD among smokers. A cross-sectional study was conducted at Universitas Sumatera Utara Hospital and H. Adam Malik General Hospital, Medan, Indonesia, from December 2022 to February 2023. Smokers aged over 40 or above with a history of smoking more than 100 cigarettes in their lifetime and no previous COPD diagnosis were included in the study. To collect the responses to PUMA and CAPTURE questionnaire, face-to-face interviews were conducted, followed by a spirometry test. A total of 76 smokers were included in the study; the predominant age group was 51–60 years (36.8%), with the majority being male (81.6%). Most participants began smoking at ages 15−20 years (65.8%) and had been smoking for 20–30 years (36.8%) at a moderate intensity (44.8%). Spirometry tests indicated obstructive patterns in 50 participants, with 17 classified as severe obstruction. At a cut-off score of ≥6, the PUMA questionnaire yielded a sensitivity of 72.55% and a specificity of 84%. In contrast, the CAPTURE questionnaire, with a cut-off score of ≥4, exhibited a sensitivity of 70.83% and a specificity of 64.29%. These results imply that the PUMA questionnaire could be more efficient in COPD screening compared to the CAPTURE questionnaire.
Role of digital education through smartphones in improving knowledge among asthma patients: A preliminary study Pohan, Indah TS.; Tarigan, Amira P.; Pandia, Pandiaman; Mutiara, Erna
Narra J Vol. 4 No. 2 (2024): August 2024
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v4i2.657

Abstract

Asthma is a chronic inflammatory airway disorder and is among the top ten causes of morbidity and mortality in Indonesia, highlighting the need for effective management strategies. This study aimed to evaluate changes in asthma knowledge levels before and after using the "Paru Sehat" smartphone application for digital education. A quasi-experimental study using a pre- and post-test design was conducted over three months at the outpatient clinic of Universitas Sumatera Utara Hospital, Medan, Indonesia, among asthma patients aged over 18 years. The patients completed the Patient Asthma Knowledge Questionnaire (PAKQ) before installing the "Paru Sehat" application to establish baseline knowledge. Once a week, patients received reminders to access materials covering an asthma overview, peak flow meter use, medication differences, and management techniques. After four weeks of intervention, the participants' knowledge was reassessed using the PAKQ. Data were analyzed using either paired Student's t-test or Wilcoxon test to assess the improvement in knowledge. The results showed increases in knowledge about asthma in general, asthma triggers, and asthma diagnosis domains, with the median score in each domain rising by one point (p=0.003, p=0.001, and p=0.002, respectively). The asthma management domain exhibited the largest change, with a median increase of two points (p<0.001). The total scores increased by an average of five points (p<0.001), indicating an overall improvement in patient knowledge about asthma. The "Paru Sehat" application demonstrated significant potential in enhancing asthma knowledge across multiple domains. Further research is warranted to explore the long-term effectiveness of the application in diverse populations and settings, ultimately contributing to improved asthma management and patient outcomes.
Role of ACE2 and TMPRSS2 polymorphisms on COVID-19 outcome and disease severity in adult patients: A prospective cohort study in a tertiary hospital, Indonesia Yunita, Rina; Wahyuni, Arlinda S.; Sinaga, Bintang YM.; Yamamoto, Zulham; Soebandrio, Amin; Kusumawati, R. Lia; Sembiring, Rosita J.; Pandia, Pandiaman
Narra J Vol. 4 No. 2 (2024): August 2024
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v4i2.919

Abstract

Coronavirus disease 2019 (COVID-19) has led to a significant number of infections and deaths worldwide, yet its pathogenesis and severity remain incompletely understood. Angiotensin-converting enzyme 2 (ACE2) and transmembrane protease, serine 2 (TMPRSS2), play crucial roles as receptors and molecules responsible for the virus's entry into host cells, initiating the infection process. Their polymorphisms have been extensively studied in relation to COVID-19 severity. The aim of this study was to examine the association of ACE2 (rs2074192) and TMPRSS2 (rs12329760) polymorphisms with COVID-19 outcome and severity. A prospective cohort study was conducted in 2022 at Haji Adam Malik Hospital, Medan, Indonesia. We randomly recruited hospitalized adult patients with COVID-19, confirmed by real-time polymerase chain reaction (RT-PCR). The baseline demographic data, disease severity, underlying disease, comorbidities, and COVID-19 vaccination status were collected. The single-nucleotide polymorphism (SNP) was assessed using TaqMan SNP genotyping assay, and the levels of TMPRSS2 and ACE2 proteins were measured using enzyme-linked immunosorbent assay (ELISA). A total of 151 COVID-19 patients were recruited and there were significant associations between age and severity with mortality outcomes. The age, kidney and lung diseases, and vaccination status were associated with severity levels. The results showed the CC genotype of ACE2 had the highest proportion, followed by TT and CT genotypes among patients, while CT was the most prevalent genotype, followed by CC and TT for TMPRSS2. This study did not find a significant association between ACE2 and TMPRSS2 genetic variants with disease severity and outcome but highlighted a specific association of TMPRSS2 SNP with mortality within the group. In addition, ACE2 concentration was significant different between mild-moderate and severe-critical COVID-19 groups (p=0.033).
Co-Authors Abdullah, Muntasir Adida, Fiony Amin Soebandrio Andika Pradana Aritonang, Minarni ES. Bayani, Sri Damanik, Rizki amaliah Dangana, Amos Erna Mutiara Eyanoer, Putri C. Firdaus, Ruby Fotarisman Zaluchu, Fotarisman Jefri, Budi Kusumawati, R. Lia Lingga, Elfia Damaiyanti Br Listyoko, Aditya S. Maryaningsih, Maryaningsih Miranda, Melly Monica, Nanda S. Osakue, Osareniro E. Pohan, Indah TS. Raffael, Frans Rhinsilva, Ella Rina Amelia Rina Yunita Sebayang, Risa RB. Sembiring, Rosita J. Sihombing, Benny Sinaga, Bintang YM. Sinaga, Sudirman P. Tarigan, Amira P. Tarigan, Amira Permatasari Taufik Ashar Triwahyudi, Bibit Vera, Yeni Wahyuni, Arlinda S. Wijanarko, Wahyu Yamamoto, Zulham Zulkarnain Zulkarnain