Physical Therapy Journal of Indonesia

Effectiveness of rehabilitation programs in acute post-stroke: A systematic review

2025-07-16T05:36:03+00:00

Introduction: The effectiveness of rehabilitation programs during the acute phase of stroke remain unclear. This study aimed to identify and analyze the forms of exercise education available for post-stroke patients based on a review of existing literature.

Methods: This review was conducted in accordance with the preferred reporting items for systematic reviews and meta-analyses guidelines (PRISMA). This study included research articles related to rehabilitation programs for post-acute stroke patients that were published between 2019 and 2024. Literature searches were performed using PubMed, ScienceDirect, and Google Scholar.

Results: Among the 10 eligible studies, effective programs involved collaboration among medical teams, caregivers, and families. Hospital-based training with early mobilization was often combined with home-based programs supported by technologies such as telehealth for remote monitoring to enhance mobility. In addition, the iron level assessments and vitamin supplementation were important to support the rehabilitation process for patients with acute stroke.

Conclusion: Acute-phase rehabilitation has proven effective in enhancing physical recovery and function in stroke patients. However, methodological variations highlight the need for further research to develop region-specific protocols based on sociodemographic factors.

The effects of overtraining protocol on markers of oxidative stress and inflammation

2025-07-22T16:50:09+00:00

Background: Overtraining can elevate reactive oxygen species (ROS), suppress endogenous antioxidant activity, and trigger systemic inflammation. Monitoring oxidative stress and inflammation is essential to prevent muscle damage. This study aimed to examine the effects of an overtraining protocol on oxidative stress and inflammatory markers MDA, IL-6, NO, and SOD in male Wistar rats.

Methods: The experimental was conducted over two weeks using male Wistar rats at the Bioscience Institute Laboratory, Universitas Brawijaya, Malang, Indonesia as a preliminary study. Three rats were examined to assess the effects of overtraining on MDA, IL-6, NO, and SOD levels. Observations were made one day after overtraining protocol for the intervention group value (KP) and six weeks after overtraining for the control group value (K1).

Results: Three male rats underwent an overtraining protocol, and blood samples were collected one day post-overtraining (KP) to assess MDA, IL-6, NO, and SOD levels. The mean values at KP were MDA: 370.3 ± 10.3, IL-6: 5.9 ± 0.7, NO: 61.0 ± 8.4, and SOD: 0.05 ± 0.03. At six weeks post-overtraining (K1), MDA (192.8 ± 10.3), IL-6 (3.3 ± 1.9), and NO (41.7 ± 21.6) levels were lower, while SOD (0.3 ± 0.2) was higher compared to KP.

Conclusion: Overtraining can elevate ROS and inflammatory responses, as indicated by increased MDA, IL-6 levels, and NO, along with reduced SOD expression.

Diagnostic performance of ultrasound in detecting early occult scaphoid fractures: A systematic review

2025-07-22T16:50:09+00:00

Background: The diagnosis of scaphoid fractures is further confounded by the fact that up to 16% may be occult on initial plain radiographs. Clinicians have faced a diagnostic dilemma. It is essential to diagnose quickly and accurately, as delayed or missing diagnoses can result in substantial complications. High-frequency ultrasound has emerged as an option for the early detection of occult scaphoid fractures. There are numerous perks to this modality, such as the capacity to conduct dynamic examinations, the absence of ionizing radiation, the relatively low cost, and the broad availability.

Methods: The preferred reporting items for systematic reviews and meta-analyses (PRISMA) was followed for conducting a literature search utilizing PubMed, Cochrane, Science Direct, and Springer Link. The search term “acute occult scaphoid fracture” AND “ultrasound” OR “ultrasonography” was employed. Articles that contained prospective evaluations of the sensitivity and specificity of the use of ultrasonography to diagnose scaphoid fractures were considered.

Results: We have obtained 69 studies, after a full-text review, nine studies are suitable for systematic review. The total sample size was around 572 patients with an average age. of 18-41,2. Male patients were higher than female. The article’s quality ranged from moderate to high, based on the MINOR Score. Some studies repeated other imaging modalities (plain radiographs, CT Scan, MRI) to validate the ultrasound results. The mean sensitivity was 77.38% (standard deviation of 22.76) and the mean specificity was 84.74% (standard deviation of 14.71).

Conclusion: High-resolution ultrasound performed by experienced operators can achieve sensitivity and specificity comparable to advanced imaging modalities.

Battery of tests for return-to-sport assessment after knee injury in athletes

2025-07-22T16:50:09+00:00

Background: Knee injury is a common sports injury, and exercise therapy can be guided by functional and biological tests to assess healing and readiness to return to sport. This study aimed to develop a test battery to identify the most predictive functional test in determining the success of an exercise therapy program for sports injury.

Methods: A test construction methodology was used, incorporating 8 field test instruments and TGF-β1 as a biological marker. Statistical methods, including multiple correlation and Wherry Doolittle test selection, were applied to develop a functional test model supporting post-injury sports therapy.

Results: This study found no significant correlation between TGF-β1 and the single leg stance (p=0.160), single leg calf raise (p=0.902), vertical jump (p=0.344), shuttle run (p=0.794), and hop tests (p=0.555). However, significant correlations were found with the sit and reach test (p<0.001; r=0.471) and hexagonal agility test (p=0.019; r=-0.318). Multivariate linear regression showed that the single leg stance, sit and reach, and hexagonal agility tests were predictors of TGF-β1, with the single leg stance and sit and reach tests explaining 23% of its variance.

Conclusion: Test battery arrangement for functional tests that were considered predictive include single leg stance and sit and reach tests, with low correlation values, which two tests in the form of single leg balance and sit and reach tests have a relationship with tissue healing. Additionally, several other tests were designed to determine the ability of athletes to RTS.

A scoping review of educational methods to optimize parental self-efficacy and health literacy in improving the quality of life among children with thalassemia: Evidence from Asian studies

2025-07-22T16:50:09+00:00

Background: The success of parents in managing thalassemia in children is influenced by several important aspects, including self-efficacy and health literacy. Educational programs specifically designed for parents and children with thalassemia have been shown to improve the quality of life of children significantly. This scoping review aimed to identify and map family-centered educational interventions that enhanced parental self-efficacy and health literacy to improve the quality of life for children with thalassemia.

Methods: This research employs a scoping review method, following the preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews (PRISMA-ScR) guidelines. A literature search was conducted across four databases: EBSCO, PubMed, Scopus, and Taylor & Francis, as well as the search engine Google Scholar. Inclusion criteria included full-text articles in English, primary studies discussing educational interventions related to self-efficacy and health literacy, and studies with a quality score ≥70% based on the Joanna Briggs Institute (JBI) assessment. Exclusion criteria consisted of secondary research such as literature reviews and editorials, as well as studies with a JBI score below 70%. The study selection strategy used the PICO (population, intervention, comparison, and outcome) approach. Total of 17 articles were finally included in the analysis.

Results: A total of 17 articles were found and included in the study. There are two types of interventions, conventional and digital-based educations. The media used in conventional education include booklets, pamphlets, posters, and PowerPoint presentations, along with methods such as lectures, group discussions, and training sessions. In addition, digital-based education in this study was a smartphone app and mobile learning.

Conclusion: Conventional and digital-based educations have the potential to be effective methods in optimizing parental self-efficacy, health literacy, and knowledge, which can improve the quality of life for children with thalassemia.

The role of the psychoeducation for family preparedness application on psychological preparedness and functional activities of families post-disaster: A community intervention study

2025-08-12T19:37:24+00:00

Background: Families residing in disaster-prone areas are at increased risk of psychological and functional disruption during and after disasters. This study aimed to evaluate the effectiveness of the psychoeducation for family preparedness (PEKA) application in improving psychological preparedness and family functional activities among households in disaster-prone communities.

Methods: A quasi-experimental pretest-posttest control group design was conducted with 60 purposively selected families. The intervention group utilized the PEKA application for 4 weeks, a practical and user-friendly tool that comprises six interactive modules covering disaster education, emotional regulation, evacuation planning, communication, daily functionality, and journaling. Validated instruments measured psychological preparedness and functional activity. Data were analyzed using paired t-tests and ANCOVA.

Results: After the intervention, the intervention group showed significant improvements in both psychological preparedness (Mean ± SD: 66.2 ± 7.8 to 81.4 ± 6.9; p < 0.001) and functional activities (62.0 ± 6.3 to 75.6 ± 7.1; p < 0.001), while the control group did not show significant changes. ANCOVA revealed significant between-group differences for both psychological preparedness (F (1,57) = 18.96; p < 0.001; η² = 0.248) and functional activity (F (1,57) = 12.21; p = 0.001; η² = 0.176). Application engagement was high, with 85% of participants completing more than 80% of the modules.

Conclusion: The PEKA application was an effective digital intervention that enhances both the psychological preparedness and functional capacity of families in disaster-prone areas. Integrating psychoeducational content with interactive tools and professional support can strengthen family resilience and serve as a scalable model for community-based disaster risk reduction.

The correlations between kinesiophobia and shoulder pain, joint position sense, quality of life, and functional performance in patients with shoulder instability: A cross-sectional study

2025-08-12T19:37:24+00:00

Introduction: Shoulder pain significantly affects quality of life and functional performance. Psychological factors, particularly kinesiophobia, fear of movement due to anticipated pain or injury, are crucial to consider, as they can intensify pain and hinder recovery. This study aimed to explore the relationship between kinesiophobia and various dimensions of shoulder pain, including pain intensity, functional limitations, and quality of life.

Methods: A cross-sectional study was conducted with 80 participants (60 males, 20 females) experiencing shoulder pain. Participants completed the Tampa Scale for Kinesiophobia (TSK), the Shoulder Pain and Disability Index (SPADI), and the Quality of Life Index (QOL). Spearman's correlation and regression analyses were used to assess the relationships between kinesiophobia, pain, and function. Significance was set at p ≤ 0.05.

Results: A weak but statistically significant positive correlation was found between TSK and SPADI (ρ = 0.237, p = 0.027). No significant correlations were observed between TSK and QOL (ρ = −0.058, p = 0.617) or JPS at 50°, 90°, and 125° of flexion (all p > 0.05). TSK significantly predicted SPADI scores (β = 0.260, p = 0.015), with each unit increase in TSK corresponding to a 0.574-point increase in SPADI.

Conclusion: Our findings indicated that higher TSK scores were associated with increased SPADI scores in individuals with shoulder instability and pain, but show little correlation with QOL or JPS.

The relationship of routine exercise and body mass index to dysmenorrhea severity among young women

2025-08-12T19:37:24+00:00

Background: There are several risk factors for dysmenorrhea, including high body mass index (BMI) and lack of exercises. The study's goal was to determine the relationship between routine exercises and body mass index with the levels of primary dysmenorrhea pain in young women.

Methods: This study was conducted among 514 young women in Surakarta used a cross-sectional design. Inclusion criteria were females aged 15–24 years with regular menstruation and no use of medications affecting the menstrual cycle, while exclusion criteria included a history of reproductive organ surgery, ongoing treatments affecting the cycle, or abnormal uterine bleeding. This study used questionnaires developed by the researcher to collect patients’ characteristics, pain level, and frequency of exercise data. Data were analyzed using the Chi-Square Test.

Results: The majority of respondents were aged 17–18 years, experienced menarche at 12–14 years, had normal BMI, and reported primary dysmenorrhea with moderate pain intensity. The Chi-square test between routine exercises and degrees of dysmenorrhea showed a value of p-value < 0.001, and between BMI and degrees of dysmenorrhea showed a value of p-value = 0.537, where the results of the Chi-square test was different between them. The routine exercise was related to the levels of primary dysmenorrhea pain, but the BMI was not related to the levels of primary dysmenorrhea pain.

Conclusion: There was a significant relationship between routine exercises with the degrees of primary dysmenorrhea pain, but no significant relationship was found between BMI and degrees of primary dysmenorrhea pain.

Using the Strava application for walking physical activities to control the risk of pre-eclampsia

2025-09-26T02:59:18+00:00

Background: Pre-eclampsia affects approximately 2–10% of pregnancies worldwide and remains a leading cause of maternal morbidity and mortality. Its occurrence is strongly associated with pregnancy-related risk factors, including elevated blood pressure and excessive maternal weight. This study aimed to evaluate the effectiveness of walking activity, monitored using the Strava application, in controlling blood pressure and reducing the risk of pre-eclampsia among women in their second and third trimesters of pregnancy.

Methods: This study employed a quasi-experimental design with a pretest–posttest control group. Thirty pregnant women in their second and third trimesters who were at risk of pre-eclampsia due to elevated blood pressure were purposively recruited, with 15 participants assigned to the intervention group and 15 to the control group. Data collection, conducted between April and May 2024 in Jagakarsa District, South Jakarta, utilized a demographic questionnaire, a blood pressure monitoring sheet, and the Strava application to track physical activity. Blood pressure outcomes were analyzed using paired and independent t-tests.

Results: The data followed a normal distribution (p > 0.05). The participants had a mean age of 30.6 years (SD = 5.87), with 46.7% primiparous, 53.3% multiparous, 90% overweight, and 10% normal body weight. Before the intervention, 80% of participants exhibited insufficient physical activity. After the walking intervention monitored via Strava, significant reductions were observed in the intervention group’s systolic blood pressure (from 143.3 to 130.9 mmHg) and diastolic blood pressure (from 92.9 to 86.7 mmHg) (p < 0.05), with mean decreases of 12.4 mmHg and 6.1 mmHg, respectively. By contrast, no significant changes were observed in the control group. Subgroup analysis confirmed significant reductions in blood pressure across confounding factors, including age, parity, and body weight status.

Conclusion: Regular walking activity, monitored using the Strava application, was effective in reducing blood pressure and mitigating the risk of pre-eclampsia among women in their second and third trimesters of pregnancy. Incorporating structured physical activity programs during pregnancy, in conjunction with the management of maternal age, parity, and weight, may contribute to the prevention of pre-eclampsia.

High-intensity interval training was more effective than moderate-intensity interval training in lowering creatine kinase and interleukin 6 levels among sports students

2025-09-26T02:59:18+00:00

Background: This study aimed to prove that high-intensity interval training (HIIT) is superior to medium-intensity continuous training (MICT) in reducing creatine kinase and interleukin 6 (IL-6) levels in sports students after 4 weeks of exercise.

Methods: The study examined the effects of two different training methods—MICT and HIIT. This study included 30 students aged 19-22 years, using a pretest-posttest control group design. Participants were randomly assigned to MICT, HIIT, or control groups (no training) and trained three times a week for four weeks. Creatine and IL-6 levels were analyzed by blood sampling. Data analysis included descriptive statistics, normality tests, and ANOVA tests to evaluate group differences.

Results: HIIT was found to be more effective than MICT and the control group in reducing CK and IL-6 levels in sports students after 4 weeks of training (p< 0.001).

Conclusion: The HIIT and MICT reduced creatine kinase and IL-6 levels compared to the control group, but HIIT was more effective in reducing creatine kinase and IL-6 levels than MICT in sports students after 4 weeks of exercise.

Clinical efficacy of bone marrow mesenchymal stem cells in chronic spinal cord injury: A single-arm meta-analysis of clinical trials

2025-09-27T08:57:55+00:00

Background: Chronic spinal cord injury (SCI) leads to irreversible neurological deficits with limited therapeutic options, making it a major challenge in neuroregenerative medicine. This study aimed to evaluate the clinical efficacy of bone marrow mesenchymal stem cells (BMMSC) therapy in patients with chronic SCI using a single-arm meta-analysis.

Methods: This research was conducted using the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines, covering studies up to August 2024 in PubMed, CENTRAL, and ScienceDirect. Included trials applied BMMSC therapy in patients ≥1 year post-injury. A random-effects model was employed using R software. Outcomes included changes in the American Spinal Injury Association (ASIA) impairment scale, somatosensory evoked potentials (SSEP), motor evoked potentials (MEP), infralesional voluntary muscle contraction (IVMC), active muscle reinnervation (AMR), and urodynamic parameters. Heterogeneity was assessed with the I² statistic, and study quality was evaluated via ROBINS-I. This study has been registered on PROSPERO with registration number CRD42024577161.

Results: Seven studies comprising 133 patients were included. AIS grade improvement was observed in 0.37 (95% CI: 0.24–0.52). Improvements were also seen in SSEP at 0.40 (95% CI: 0.18–0.67), MEP at 0.37 (95% CI: 0.25–0.51), IVMC at 0.47 (95% CI: 0.34–0.60), and AMR at 0.74 (95% CI: 0.39–0.92). Urodynamic outcomes demonstrated increased maximum cystometric capacity [0.48 (95% CI: 0.30–0.67)], improved bladder compliance [0.73 (95% CI: 0.55–0.85)], and reduced detrusor pressure [0.61 (95% CI: 0.43–0.76)].

Conclusion: BMMSC therapy was associated with clinically meaningful neurological and urodynamic improvements in chronic SCI. Standardized administration protocols and randomized controlled trials are necessary to validate efficacy and optimize treatment paradigms.

Exercise therapy for preventing physical and psychological trauma in earthquake-prone areas: A systematic review

2025-09-27T08:57:55+00:00

Background: Earthquakes impose both physical injuries and psychological disorders such as post-traumatic stress disorder (PTSD), depression, and anxiety. This study aimed to evaluate the effectiveness of exercise therapy in preventing and managing physical and psychological trauma among populations in these regions.

Methods: The protocol was registered in PROSPERO (registration number: CRD420251130734) and followed the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. A literature search was conducted in PubMed, ScienceDirect, and ProQuest (January 2014–August 2025) using MeSH terms and Boolean operators. Eligible studies included the randomized control trial (RCT), quasi-experimental, cohort, and controlled field trials examining exercise interventions for trauma-related outcomes in earthquake settings. Two reviewers independently screened studies, extracted data, and assessed quality using the PEDro scale.

Results: Nine studies met the criteria, covering adolescents, older adults, disaster survivors, and refugees. Interventions ranged from yoga and aerobic training to strengthening and community-based rehabilitation. Exercise therapy consistently improved physical (pain, mobility, function) and psychological outcomes (PTSD, anxiety, depression), but methodological flaws, lack of blinding, concealed allocation, and intention-to-treat analysis limited the evidence to moderate quality.

Conclusion: Exercise therapy supports both physical recovery and psychological resilience in earthquake-affected populations, but more high-quality RCTs with standardized protocols are needed to strengthen evidence and inform its integration into disaster management.

Development of therapy aids with electromyography technology for post-stroke patients

2025-10-14T03:46:00+00:00

Background: The prevalence of stroke in Indonesia has been increasing and has had a significant impact on individuals, families, and society. There is a pressing need for innovative assistive devices that support independent therapy and enhance patient motivation to improve post-stroke productivity. This study aimed to design and develop a post-stroke rehabilitation assistive device utilizing electromyography (EMG) technology.

Methods: This study employed a research and development (R&D) design. Data were collected through documentation studies, interviews with physiotherapists, observations, and focus group discussions (FGDs). A documentation study was conducted using the medical records of stroke patients. Interviews were conducted with physiotherapists, and observations were carried out to understand patients’ therapeutic activities.

Results: This study provided alternative therapy by developing post-stroke rehabilitation aids with EMG technology. Based on the documentation study, 88% of patients experienced ischemic stroke with a good level of consciousness (E4V5M6), indicated by the Glasgow Coma Scale (GCS) score of 15.

Conclusion: This phenomenon supported the development of electrical therapy innovations to accelerate stroke recovery. This study successfully designed a hand therapy device using EMG technology to improve patients’ motor function, particularly among those with E4V5M6 levels of consciousness and limited motor skills.

The development of a harmony multisensory space based on reminiscence therapy to improve quality of life for older adults with dementia: A qualitative study

2025-10-14T03:46:00+00:00

Introduction: Dementia significantly impacts elderly quality of life, necessitating innovative non-pharmacological approaches. This study aimed to identify key design elements for multisensory environments integrated with reminiscence therapy in Indonesian contexts.

Methods: This qualitative study used an exploratory descriptive design through focus group discussions with 10 elderly participants, 2 family caregivers, and 5 healthcare professionals. Participants were selected through purposive sampling based on inclusion criteria established for this research protocol. Data were analyzed using Braun and Clarke's six-phase thematic analysis framework to identify key patterns related to the development of multisensory environments.

Results: This study revealed five main themes from a comprehensive data analysis of therapeutic environments for the Indonesian population. These themes are: 1) the importance of positive reminiscence triggers to effectively stimulate memory, 2) the personal space requirements for comfort and safety as essential environmental design considerations, 3) the need for multisensory integration as a critical component of therapeutic environmental interventions, 4) the vital role of family support and communication strategies in a comprehensive care approach, and 5) the relevance of cultural and spiritual considerations in design to provide contextual meaning.

Conclusion: The development of Harmony multisensory spaces should integrate reminiscence therapy principles with personalized design elements, emphasizing safety parameters, comfort metrics, and cultural sensitivity to effectively improve the quality of life for elderly individuals with dementia. Implementation requires multidisciplinary collaboration between healthcare professionals, designers, and family caregivers to ensure optimal therapeutic outcomes.

Impact of cycle ergometer based low-intensity aerobic exercise on quadriceps femoris strength in breast cancer patients receiving chemotherapy

2025-10-14T03:46:00+00:00

Background: Breast cancer and chemotherapy can reduce muscle strength through systemic and neuromusculoskeletal effects. This study aimed to evaluate the effect of low-intensity cycle ergometer exercise on quadriceps femoris strength in patients receiving chemotherapy.

Methods: A randomized controlled trial was conducted at the medical rehabilitation outpatient clinic, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia, from May to November 2024. Twenty female patients aged 18–59 years with stage II–III breast cancer who had completed at least three chemotherapy cycles were enrolled. Eligible participants had normal echocardiography findings (left ventricular ejection fraction ≥ 50%) and oncologist approval. Exclusion criteria included hemodynamic instability, hematologic abnormalities, arrhythmia, pulmonary disease exacerbations, recent surgery or radiotherapy, severe pain, or cognitive disorders. Participants were randomly assigned to either an intervention group or a control group. The intervention group performed low-intensity cycle ergometer training twice weekly for eight, while the control group performed breathing exercises only. Quadriceps femoris strength was measured before and after the intervention using a handheld dynamometer. Data were analyzed using paired and independent t-tests, with significance set at p-value < 0.05.

Results: After eight weeks, the intervention group showed significantly greater increases in quadriceps femoris strength compared with the control group (right leg: p = 0.006; left leg: p= 0.020). Mean strength gains were 4.38 ± 2.3 kg (right) and 3.22 ± 1.9 kg (left), whereas the control group showed significant declines. Large effect sizes (Cohen’s d > 1) indicated clinically meaningful improvements in the exercise group.

Conclusion: The intervention group showed significantly greater preservation and improvement of quadriceps femoris strength than the control group. Low-intensity cycle ergometer exercise appears to be a safe and effective rehabilitation strategy for maintaining muscle strength, functional capacity, and quality of life in breast cancer patients undergoing chemotherapy.

Pelvic floor exercises to improve low back pain and activities of daily living for the elderly

2025-10-18T09:57:53+00:00

Background: Lower back pain is a prevalent health concern on a global scale, particularly among female and elderly demographics. The objective of this study was to assess the impact of regular pelvic floor exercises on the severity of low back pain and the enhancement of daily functioning in postmenopausal women.

Methods: The present study employs a quasi-experimental design, incorporating a pre-post-test approach and a control group. Based on the extant data, 18 postmenopausal women will be distributed between the control group and the intervention group. The control group will participate in pelvic floor exercises thrice weekly for three weeks, while the intervention group will engage in pelvic floor exercises daily for three consecutive weeks. The collected data will be subjected to a paired sample t-test to make a pre-and post-intervention comparison, while an independent t-test will be employed to compare the groups at a significant level of p<0.05.

Results: The average numeric rating scale (NRS) and modified Oswestry low back pain disability index (MODI) values in the control group after performing pelvic floor exercises were recorded as (6.0±1.4) and (20.3±7.3), respectively, while in the intervention group, they were (2.6±1.7) and (9.44±7.9). These data show a significant difference with a p-value < 0.000 (p < 0.05). A comparison between the control and intervention groups after performing pelvic floor exercises with different frequencies also revealed significant differences, with p-values of 0.000 and 0.008 (p<0.05), respectively. However, a larger difference was observed in the intervention group performing pelvic floor exercises daily, showing a much higher delta compared to the group exercising three times a week, with NRS values of (4.4±0.5) and MODI values of (19.7±1.7).

Conclusion: In postmenopausal women, the group that performed pelvic floor exercises daily exhibited a significant reduction in NRS and MODI values compared to the group that performed exercises three times a week.