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Effect of Low Impact Aerobic Exercise on Functional Balance and Quality of Life in Type 2 Diabetes Mellitus Patients. Peni Hardjanti; Bayu Santoso; Nuniek Nugraheni; Agung Pranoto
Indonesian Journal of Physical Medicine & Rehabilitation Vol 2 No 01 (2013): Indonesian Journal Of Physical Medicine and Rehabilitation
Publisher : Indonesian Journal of Physical Medicine & Rehabilitation

Objectives: To determine the effect of low impact aerobic exercise on functional balance and the quality of life in type 2 Diabetes Mellitus (DM) patientsMethods: This is an experimental study. Participants were recruited from outpatient Diabetes Clinic in Dr. Soetomo General Hospital, Surabaya, Indonesia. Subjects of this study are men and women aged 30-70 years whose diagnosed with type 2 DM, with A1c less than 10%, have been using oral anti diabetic drug or subcutaneous insulin less than 30 IU daily, blood glucose level before exercise less than 250mg%, and Berg Balance Scale between 41-56. Subjects were randomized into 2 groups with 38 subjects in the exercise group and 37 in the control group. The exercise group followed 25-30 minutes diabeticaerobic low impact exercise 3 times a week for 3months, while the control group did not. Functional balance and quality of life before and after exercise were assessed using Berg Balance Scale (BBS) andthe Sickness Impact Profile (SIP) questionnaire. Difference in BBS and quality of life improvement measured by SIP questionnaire were analyzed after 3 months of exercise.Results: Mann Whitney test showed significant difference of the total score of BBS in the exercise group (p 0.02; α < 0.05). Chi Square test revealed significant improvement in four of the twelve parameters ofthe quality of life: sleep and rest (SR) (p 0.044), body care and movement (BCM) (p 0.017), ambulation (A) (p 0.001), and work (W) (p 0.000) in the exercise group.Conclusions: Low impact aerobic exercise in type 2 Diabetes Mellitus patients may improve functional balance and the SR, BCM, A, and W parameters of the quality of life.Key words: Low impact aerobic exercise, type 2 diabetic mellitus, functional balance, quality of life.

Effect of Low Impact Aerobic Exercise on Functional Balance and Quality of Life in Type 2 Diabetes Mellitus Patients. Peni Hardjanti; Bayu Santoso; Nuniek Nugraheni; Agung Pranoto
Indonesian Journal of Physical Medicine & Rehabilitation Vol 2 No 01 (2013): Indonesian Journal Of Physical Medicine and Rehabilitation
Publisher : Indonesian Journal of Physical Medicine & Rehabilitation

Objectives: To determine the effect of low impact aerobic exercise on functional balance and the quality of life in type 2 Diabetes Mellitus (DM) patientsMethods: This is an experimental study. Participants were recruited from outpatient Diabetes Clinic in Dr. Soetomo General Hospital, Surabaya, Indonesia. Subjects of this study are men and women aged 30-70 years whose diagnosed with type 2 DM, with A1c less than 10%, have been using oral anti diabetic drug or subcutaneous insulin less than 30 IU daily, blood glucose level before exercise less than 250mg%, and Berg Balance Scale between 41-56. Subjects were randomized into 2 groups with 38 subjects in the exercise group and 37 in the control group. The exercise group followed 25-30 minutes diabeticaerobic low impact exercise 3 times a week for 3months, while the control group did not. Functional balance and quality of life before and after exercise were assessed using Berg Balance Scale (BBS) andthe Sickness Impact Profile (SIP) questionnaire. Difference in BBS and quality of life improvement measured by SIP questionnaire were analyzed after 3 months of exercise.Results: Mann Whitney test showed significant difference of the total score of BBS in the exercise group (p 0.02; α < 0.05). Chi Square test revealed significant improvement in four of the twelve parameters ofthe quality of life: sleep and rest (SR) (p 0.044), body care and movement (BCM) (p 0.017), ambulation (A) (p 0.001), and work (W) (p 0.000) in the exercise group.Conclusions: Low impact aerobic exercise in type 2 Diabetes Mellitus patients may improve functional balance and the SR, BCM, A, and W parameters of the quality of life.Key words: Low impact aerobic exercise, type 2 diabetic mellitus, functional balance, quality of life.

Comparing Walking age, Receptive and Expressive Language Profiles between Speech Delay Children with and without Hearing Loss Aulia Sakinah; Nyilo Purnami, Thtkl K; Nuniek Nugraheni S; Sulistiawati
Indian Journal of Forensic Medicine & Toxicology Vol. 16 No. 2 (2022): Indian Journal of Forensic Medicine & Toxicology
Publisher : Institute of Medico-legal Publications Pvt Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37506/ijfmt.v16i2.17940

Objectives : The study aimed to investigate whether walking age, receptive, and expressive languageprofiles differ between speech delay children with hearing loss and speech delay children withouthearing loss; to identify walking age, receptive, and expressive profiles between speech delay childrenwith hearing loss and speech delay children without hearing loss.Methods : The study is an observational analytic with retrospective cross-sectional design usingmedical records data for two years. Data was collected using a total sampling technique.Results : The study involved 92 children with speech delay, consisting 72 children in the hearing lossgroup and 20 children in the normal hearing group. The average age at walk as gross motoric profileshows that speech delays children with hearing loss have an average age that is later than speech delayschildren without hearing loss. Also, walking age significantly differs between children with speechdelay in hearing loss group and normal hearing group. Both receptive and expressive language profilesshow no different between the groups.Conclusions : Findings have consequences for consideration motor developmental delay in children withspeech delay, especially in hearing loss group. So that, the findings can be a reference to considerationin further management basis for speech delay interventions with and without hearing loss in children.

Immediate Effect of Vibrating Foam Roller on the EMG Amplitude of Muscle Hamstring of Healthy Subject with Hamstring Tightness Ahmad Arif Ridha; Nuniek Nugraheni; Imam Subadi
Indian Journal of Forensic Medicine & Toxicology Vol. 15 No. 3 (2021): Indian Journal of Forensic Medicine & Toxicology
Publisher : Institute of Medico-legal Publications Pvt Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37506/ijfmt.v15i3.15594

Comparison of Sarcopenia Diagnostic Component Between Two Age Groups in Men Yahya Taqiuddin Robbani; Novira Widajanti; Nuniek Nugraheni Sulistiawaty
Health Notions Vol 4, No 6 (2020): June
Publisher : Humanistic Network for Science and Technology (HNST)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33846/hn40604

Sarcopenia is a condition which characterized by loss of muscle mass, muscle strength and muscle function due to aging. Some study found that sarcopenia prevalence was more common in men than women. This study aims to determine the comparison of sarcopenia diagnostic component between two group ages in men by observing and comparing muscle mass, handgrip strength and usual gait speed according to Asian Working Group on Sarcopenia (AWGS) diagnostic criteria that analyzed by Independent Sample T Test. The sample size with consecutive sampling technique was 149 mens which divided into two groups based on ages of elderly over 60 years (n = 73) and young adult between 18-40 years (n = 76). From the independent sample t test results, there was significant difference of muscle mass mean, handgrip strength mean and gait speed mean between elderly group and young adult group by 2.467 (SD ± 0.1454) kg/m2 (t(98.350) = -16.969; p = 0.000), 10.455 (SD ± 1.0983) kg (t(147) = -9.519; p = 0.000) and 0.4753 (SD ± 0.2808) m/s (t(11.636) = -16.747; p = 0.000) which means along with increasing age, sarcopenia diagnostic components value, i.e. muscle mass, muscle strength, and physical performance will also decrease. Keywords: sarcopenia; bioelectric impedance analysis; handgrip strength; gait speed; AWGS

Comparison of Acute Level of CK After Five Weeks Eccentric vs Concentric High Intensity Strength Exercise in Healthy Subject Hasni Hasni; Hening Laswati Putra; Nuniek Nugraheni
Surabaya Physical Medicine and Rehabilitation Journal Vol. 1 No. 2 (2019): SPMRJ, Agustus 2019
Publisher : Faculty of Medicine, Universitas Airlangga

Background: Musculoskeletal injuries both in sport and recreational activities, at each age level, can lead to immobilization. Injury and immobilization can lead to muscle strength decrease and deconditioning. These conditions can be addressed by provision of strength training therapy especially for people with low exercise tolerance such as the elderly and patients with chronic disease. Existing studies stated eccentric exercise can increase muscle strength with less energy expenditure compared to concentric exercise. However eccentric exercise can lead to muscle damage indicated with an acute CK level increase, and eccentric exercise has not been carried out regularly for post muscle injuries and deconditioned patients. The American College of Sport Medicine (ACSM) stated strength increase and muscle hypertrophy require high intensity load strengthening exercise with a minimum load of 70% 1 Maximum Repetition. The recommended load was given to the subjects in this research. Our pleriminary study intervention was well tolerated by healthy subjects.Aim: Comparing acute CK level alteration in high intensity eccentric and concentric muscle strengthening exercise on untrained healthy subjects.Methods: Randomized pre test and post test group design. Subjects of the study (n = 16) were untrained healthy males. CK level was evaluated by laboratory test.Results: Our study showed decline of acute CK level in both groups with p value 0.65 and 0.76, respectively. No significant differences found on both groups.Conclusion: The increase of acute CK level after five weeks of eccentric strengthening exercise is not higher than that in concentric strengthening exercise.

Efektivitas Terapi Latihan pada Pasien Parkinson dengan Barthel Index Skor Salma Maha Rhani; Nuniek Nugraheni; Novira Widajanti
Jurnal Ilmiah Kesehatan (JIKA) Vol. 3 No. 3 (2021): Volume 3 Nomor 3 Desember 2021
Publisher : Sarana Ilmu Indonesia (salnesia)

Parkinson’s disease is the second most neurodegenerative disease after Alzheimer. This disease attacks approximately 1% of total world population. The proportion of the elderly population (?60 years) in Indonesia is increasing. This increase has a consequence, as a result of the decline in bodily functions causing increasingly the number of degenerative diseases in this age group. Until now, there has been no definitive treatment that can cure this disease thoroughly. Despite optimal medical treatment and neurosurgical intervention, people with Parkinson still experience progressive disability. The role of rehabilitation to maximize motoric and cognitive abilities as well as independence was suggested to improve the quality of life. This study aimed to determine the effectiveness of the exercise therapy in handling of Parkinson's patients in medical rehabilitation installation of RSUD Dr. Soetomo evaluated with Barthel Index. This research was a retrospective-analytic with a cross-sectional study design. The number of subjects was 24 with the criteria Parkinson patients who undergo exercise therapy for 3 months, had comorbid degenerative diseases, and did routine therapy twice a week. Subjects who met the criteria are interviewed using the Barthel Index questionnaire as an instrument. Statistical analysis was done with Wilcoxon-Signed Rank Test. P value of ? 0.05 was considered statistically significant. There was significant result of the effectiveness of exercise therapy in Parkinson's patients at the Medical Rehabilitation Installation at RSUD Dr . Soetomo (p=0,001). Exercise therapy is effective in treating Parkinson's patients at the Medical Rehabilitation Installation at RSUD Dr. Soetomo.

The Relationship between Age and Activity of Daily Living withthe Fall Risk of Patients in Geriatric Outpatient Installation Deniro, Agustin Junior Nanda; Sulistiawati, Nuniek Nugraheni; Widajanti, Novira
Jurnal Penyakit Dalam Indonesia Vol. 4, No. 4
Publisher : UI Scholars Hub

Show Abstract | Download Original | Original Source | Check in Google Scholar

Introduction. Fall is one of the physical problems that happened quite frequently and resulted in morbidity and mortality of old people. There are several factors related to fall risk, among others are age and independence in activity of daily living. Methods. This research is an observational analytical study with cross sectional approach, by collecting free variable data (age and activity of daily living) through interview and Barthel index score, dependent variable (fall risk) by direct observation using Timed Up and Go test that analyzed by Rank Spearman correlation test. The number of samples with incidental sampling technique was 55 patients in Geriatric Outpatient Installation RSUD Dr Soetomo Surabaya for the period of August – October 2017. Results. Bivariate analysis showed that there was a correlation between age and fall risk (r = 0.334, p <0.05) and there was a relationship between activity of daily living with fall risk (r = - 0.460, p <0.05 ) of patient in Geriatric Outpatient Installation RSUD Dr Soetomo Surabaya period August - October 2017. Conclusion. There is a significantly low and equivalent relationship between age and fall risk and significantly low and unequal relationship between activity of daily living and fall risk of patients in Geriatric Outpatient Installation RSUD Dr Soetomo Surabaya for the period of August – October 2017.

Knee Pain and Quality of Life among the Elderly Melati, Akilla Nathania; Nugraheni, Nuniek; Djuari, Lilik; Yulianti, Erikavitri; Romadhon, Pradana Zaky
Current Internal Medicine Research and Practice Surabaya Journal Vol. 5 No. 2 (2024): CURRENT INTERNAL MEDICINE RESEARCH AND PRACTICE SURABAYA JOURNAL
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/cimrj.v5i2.50751

Introduction: The aging process can lead to knee pain in the elderly, which negatively impacts their quality of life by decreasing their physical functioning and potentially affecting their psychological well-being over time. This study aimed to determine the association between knee pain and the quality of life of the elderly. Methods: This analytical study involved elderly patients aged 60 years and over who presented with complaints of knee pain at the Geriatric Outpatient Clinic of Universitas Airlangga Hospital, Surabaya, Indonesia, from September 2022 to March 2023. The participants were selected by consecutive sampling until a total of 50 samples were collected using the interview method. The independent variable was knee pain, while the dependent variable was quality of life. The instruments used were the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) to measure knee pain and the Barthel Index for Activities of Daily Living (ADL) to assess the quality of life. The data were analyzed using Spearman's rho, with p<0.01 indicating a significant correlation. Results: The majority of the elderly were female (54%) and fell within the age group of 66–70 years. The most prevalent complaint was mild knee pain (52%). A total of 50% of the elderly had an independent quality of life. A strong correlation was found between the degree of knee pain and quality of life in the elderly (p=0.000). The correlation coefficient indicated an inverse relationship between the degree of knee pain and quality of life in the elderly. Conclusion: The findings suggest that the higher the pain degree suffered by the elderly, the lower their quality of life. Highlights: 1. This study evaluated the factors that influence the quality of life of elderly individuals with knee pain, an issue that has been relatively overlooked in Indonesia. 2. The results of this study will hopefully assist scholars and stakeholders, enabling them to optimize the quality of life for elderly individuals experiencing knee discomfort.

Comprehensive Multimodal Rehabilitation for Chronic Musculoskeletal Problems in Geriatric Patient: A Case Study Ramadhan, Nanda Aulya; Nugraheni, Nuniek
Jurnal Medis Islam Internasional Vol 6 No 1 (2024): June
Publisher : UNUSA Press

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33086/iimj.v6i1.6136

Introduction: Musculoskeletal problems are a major cause of morbidity in the geriatric population. These issues can decrease independence, increase functional decline and mortality, and negatively affect the psychological well-being and overall quality of life of elderly individuals. Returning to full function in such cases is highly challenging and requires comprehensive management. Case: A 67-year-old married female housewife presented with sharp, localized chronic pain in her left wrist for one year. The pain was non-radiating, without any tingling sensation, and aggravated by movements such as ulnar deviation and lifting objects (pain scale: 8/10). Tenderness was observed in the lateral anatomical snuffbox of the left wrist, with a positive Finkelstein test. The patient also experienced sharp, localized pain in her left shoulder for seven months following a coronary artery bypass graft (CABG) surgery for coronary artery disease. The shoulder pain worsened with overhead activities (pain scale: 6/10) and improved with rest (pain scale: 3/10). The patient exhibited limited active range of motion (ROM) in flexion, extension, abduction, and external rotation, with positive Neer and Hawkins tests. Her metabolic equivalent of task (METs) score was 3.46, and she scored 5 on the Geriatric Depression Scale. The Barthel Index was 75, and she was diagnosed with several geriatric syndromes: instability (standing balance), impaired vision (cataract), isolation (depression), iatrogenesis (polypharmacy), and impotence (menopause). The patient had difficulties performing daily activities and participating in the community. A multimodal rehabilitation program was implemented, including therapeutic exercise, pharmacotherapy, kinesiotaping, thumb splint, physical modalities, and consultations with an internist and psychiatrist. After several sessions, the patient's pain decreased significantly to 1/10 (wrist) and 0/10 (shoulder). Active ROM improved to near normal, METs increased to 5.27, and she regained full independence in daily activities (Barthel Index 100). Discussion: Chronic musculoskeletal problems, especially when coupled with geriatric syndromes, are particularly challenging to manage. A comprehensive geriatric assessment, combined with a thorough multimodal rehabilitation approach, is key to successful outcomes. Improvements in pain, ROM, depression, and METs can lead to better functional performance, thereby reducing disability and enhancing the patient's quality of life. A supportive caregiver also plays a crucial role in achieving satisfactory results. Conclusions: This case highlights that comprehensive multimodal rehabilitation is crucial for the successful management of chronic musculoskeletal problems in the geriatric population.

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