Physical Therapy Journal of Indonesia

Cosy development: sensory-motor interventions to improve verbal and expressiveness abilities for Down Syndrome children

Anik Dwi Hiremawati — 2025-01-15

Background: Existing interventions to improve verbal expression for children with Down Syndrome (DS) often neglect sensory and motor development. However, these abilities are essential for receiving input from the environment and responding through gestures during intervention. This study aimed to develop interventions through sensory and motor development that enhance the expressive verbal capabilities of DS children in articulating sounds, syllables, and words.

Methods: This study used quantitative methods with an experimental design. Clinician-rated questionnaires measured the pre-test and post-test verbal expressive abilities of DS children who received the Cosy Development (CD) intervention for 12 months. Participants consisted of 8 DS children, ages ranged 4-15 years. This study was conducted at Tridiva Learning House, Bandung, Indonesia. Families of the DS children were trained by researchers regarding the intervention guidelines, and they performed the CD intervention on their children at home.

Results: The Wilcoxon rank test showed a statistically significant improvement in verbal expressiveness among the eight DS children who received the CD intervention for 12 months, with p-values ranging from 0.016 to 0.008.

Conclusion: The CD intervention, which integrated sensory and motor developments, effectively improved the verbal expressiveness of DS children. The CD intervention was practical and comfortable for DS children, making it a promising approach for improving their communication abilities.

Integrating health, sustainability, and vocational competencies in maritime education for future seafarers

Larsen Barasa — 2025-03-12

Background: The maritime industry's increasing emphasis on holistic well-being and environmental responsibility necessitates a reevaluation of traditional training methods. This research evaluates maritime education program effectiveness in preparing cadets for industry demands, uniquely integrating health and sustainability with vocational competencies. This study aimed to evaluate the adequacy of current maritime education in preparing cadets for the physical, mental, and vocational demands of seafaring, and to identify methods for better integrating health and sustainability into the curriculum.

Methods: This qualitative study explored cadet preparedness in maritime education, focusing on health, sustainability, and vocational competencies. Data were collected through semi-structured interviews with 30 participants, including maritime experts, lecturers, and graduates, selected for their diverse perspectives. Classroom and training observations supplemented interview data, providing a holistic view of current practices. Thematic analysis was employed to identify key themes related to competency development and sustainability, allowing for cross-group comparisons. Finally, narrative synthesis integrated findings into a cohesive understanding of how maritime education can better prepare future seafarers. This multi-method approach ensured a comprehensive and triangulated dataset, enhancing the robustness of the research findings.

Results: The results indicate that current programs effectively prepare cadets for physical and vocational challenges, and sustainability practices are incorporated. However, there is a need for enhanced mental health support and deeper integration of contemporary sustainability practices.

Conclusions: To ensure a resilient and sustainable workforce in the evolving maritime industry, it is crucial to refine maritime education by balancing physical, mental, and vocational competencies with comprehensive sustainability training.

Addressing mental and physical well-being in maritime education for future seafarers

Tri Cahyadi — 2025-03-12

Background: This study addresses gaps in maritime education by focusing on integrating sustainability, health management, and competency development, driven by the increasing global emphasis on sustainable operations and the mental and physical demands on seafarers. Uniquely examining the effectiveness of current curricula in meeting these emerging needs, this research provides fresh insights into their integration and highlights areas for improvement. The primary objectives were to explore the extent of this integration and assess whether current training adequately prepares students for evolving industry demands, particularly in environmental sustainability and mental health management.

Methods: To investigate the integration of sustainability, health management, and competency development within maritime education, this study adopted a qualitative methodology. We conducted semi-structured interviews with five experienced lecturers and 25 recent graduates, gathering their insights and experiences. The interview data was then analyzed using thematic analysis, with cross-group comparisons to highlight differing perspectives. Alongside the interviews, observational notes and audio recordings were used to enrich the data. This approach allowed us to evaluate the efficacy of current training programs in preparing future seafarers, pinpointing areas for improvement and suggesting practical recommendations

Results: The findings indicated that although maritime education effectively develops technical competencies, there are significant gaps in the integration of sustainability and health management. Both lecturers and graduates emphasized the need for more practical sustainability training and enhanced mental health support. While competency development was generally rated positively, participants called for curricula to adapt to emerging maritime technologies.

Conclusion: This research underscores the necessity of evolving maritime education to better equip future seafarers for the industry's environmental and psychological demands. Recommendations include strengthening the integration of sustainability and mental health support within the curriculum, as well as ensuring that training remains current with technological advancements in the maritime sector.

The integration of structured physical training and nutrition to enhance seafarer endurance and career preparedness in maritime education

Riyanto Riyanto — 2025-03-12

Background: Maritime professionals face intense physical and mental demands, yet vocational education often overlooks structured fitness and balanced nutrition, focusing primarily on technical skills. This study explored the impact of integrating these elements on cadet endurance, cognitive function, and career sustainability, addressing a gap in existing research that rarely assesses fitness and nutrition systematically. Through qualitative insights from lecturers, graduates, and cadets, this research aimed to identify implementation challenges and evaluate perspectives on fitness scheduling, dietary adequacy, and career preparedness, ultimately offering practical recommendations for enhancing maritime training programs.

Methods: This study employed a qualitative descriptive approach, utilizing semi-structured interviews, focus group discussions, and participant observation to explore the integration of physical training and nutrition in maritime education. Participants included 5 lecturers, 10 graduates, and 25 cadets, providing diverse perspectives. Data analysis followed a thematic qualitative approach, including cross-group comparisons and narrative synthesis, to identify recurring patterns and develop evidence-based recommendations for enhancing maritime training programs. The study assessed cadet performance, endurance, and career preparedness through indicators such as engagement in physical activities and perceived nutritional adequacy. The findings aimed to contribute to a more resilient and health-conscious maritime workforce.

Results: Findings indicate that structured physical training improves cadet endurance and teamwork, while nutritional planning remains inconsistent, affecting energy levels and long-term health. Cadets expressed challenges in balancing fitness with coursework, suggesting the need for optimized scheduling and nutritional education.

Conclusions: To enhance maritime workforce sustainability, institutions should integrate structured physical training, standardized meal plans, and nutritional awareness programs. Future research should assess long-term effects of fitness and dietary habits on seafarer health and career performance.

Light physical activity and vitamin D improve sperm quality of male Rattus norvegicus exposed to cigarette smoke

Meriana Barreto Amaral — 2025-05-11

Background: Male infertility is a significant global health issue, with rising prevalence linked to environmental factors such as secondhand smoke, which impairs sperm quality. This study aimed to examine how light physical activity and vitamin D supplementation improved sperm quality in rats exposed to cigarette smoke.

Methods: This study used a randomized experimental design with 38 rats, divided into two groups. The control group was exposed to cigarette smoke and received vitamin D at 18 IU/kg body weight (BW) daily. The treatment group was exposed to cigarette smoke, received the same vitamin D dose, and underwent light physical activity. The 35-day research period involved the analysis of evaluated parameters. Differences between these parameters were assessed using an independent t-test, with statistical significance set at a P-value < 0.05.

Results: Compared to the control group (p-values< 0.001), the treatment group, receiving light physical activity and vitamin D supplementation, exhibited significantly lower malondialdehyde (MDA) levels (0.96 ± 0.14 nmol/mL), higher vitamin D receptor expression (2.44 ± 0.58 cells/HPF), and increased testosterone levels (4.33 ± 0.76 ng/dL). Sperm quality was also significantly improved in the treatment group, showing higher sperm count (2.24 ± 0.81 × 10⁶/mL), motility (4.20 ± 0.23%), viability (3.07 ± 0.39%), and normal morphology (5.34 ± 0.17%) (p-values< 0.001).

Conclusion: Light physical activity and vitamin D supplementation improved sperm quality in cigarette smoke-exposed male rats, correlating with reduced MDA and elevated vitamin D receptor expression and testosterone. Further clinical trials are warranted to explore human applications.

The effect of reminiscence exercise therapy on functional mobility and psychological well-being among elderly

Fery Agusman Motuho Mendrofa — 2025-05-13

Background: Elderly individuals often experience decline in both physical mobility and psychological well-being. reminiscence exercise therapy (RET) is a novel approach that integrates reminiscence therapy with targeted physical exercises. This study aims to investigate the effect of RET on functional mobility and psychological well-being of elderly residents in a nursing home in Semarang City.

Methods: This pre-experimental study used a one-group pretest-posttest design with 36 elderly participants selected through purposive sampling. Functional mobility was assessed using the timed up and go test (TUG) and elderly mobility scale (EMS), while psychological well-being was measured using the geriatric depression scale (GDS-15) and satisfaction with life scale (SWLS). RET was conducted in 6 sessions over 3 weeks. Data were analyzed using the Wilcoxon Signed Rank Test.

Results: Significant improvements were observed in all parameters after RET intervention. Mean TUG test time decreased from 15.64 to 12.37 seconds (p=0.001), mean EMS score increased from 14.78 to 17.92 (p=0.001), mean GDS-15 score decreased from 7.36 to 4.83 (p=0.002), and mean SWLS score increased from 18.25 to 23.64 (p=0.001).

Conclusion: RET showed potential to improve both functional mobility and psychological well-being in elderly nursing home residents. However, the pre-experimental design limits causal inferences, and further controlled studies are needed.

A 12-week tailored sit-and-reach metrics intervention for archery athletes with flexibility deficits

Hidayat Humaid — 2025-05-17

Background: Flexibility is a critical component of archery performance, where biomechanical demands such as postural stabilization and bow draw-release mechanics require optimal posterior chain mobility. This study aimed to evaluate a 12-week tailored flexibility program in improving posterior chain mobility in elite archers with flexibility deficits.

Methods: This pretest-posttest pre-experimental study involved 30 elite archers (15 males, 15 females; ages 17–43 years) with baseline sit-and-reach deficits (≤25 cm). A 12-week intervention program combined dynamic-progressive stretching, myofascial release, and mobility training based on archery biomechanical profiles. Flexibility was measured using the sit-and-reach test at weeks 0 (pretest), 6 (midtest), and 12 (posttest). Statistical analyses included tests for normality of Shapiro-Wilk, homogeneity of Levene's test, repeated measures ANOVA, and Bonferroni’s post-hoc.

Results: There was a significant increase in sit-and-reach scores from pretest (13.2 ± 4.1 cm) to midtest (18.9 ± 4.7 cm; p< 0.001; d = 1.32) and posttest (22.6 ± 5.3 cm; p< 0.001; d= 2.01), with a large effect size (η² = 0.632). Homogeneous responses were observed across age and body mass index subgroups, indicating the adaptability of the personalized protocol. There was no significant difference between genders (p>0.05).

Conclusion: A 12-week sport-specific flexibility intervention effectively improved posterior chain mobility in elite archers. These findings highlighted the importance of integrating personalized programs that consider biomechanical demands and regular assessment.

Physiotherapy intervention for posture improvement in individual with scoliosis: A case study

Adnan Faris Naufal — 2025-05-21

Background: Scoliosis is a structural spinal deformity marked by an abnormal sideways curvature and a loss of the spine's natural front-to-back alignment, resulting in postural imbalances. This study investigates how physiotherapy interventions improve posture in individuals with scoliosis.

Methods: This qualitative descriptive-analytic case study utilized physiotherapy interventions such as stretching exercises, Pilates, core stability training, myofascial release, and manipulation therapy. Outcome measures included a scoliometer (spinal curvature), goniometer (lumbar range of motion), McGill's Torso Muscular Endurance Test Battery (core endurance), volumetric exerciser (lung capacity), measuring tape (limb length), Clarke's angle method (foot arch assessment), and Zebris FDM (body force pressure and center of pressure movement during stance).

Results: Physiotherapy improved postural alignment, reducing spinal curvature from 9 degrees to 3 degrees and increasing lumbar flexion from 61 degrees to 75 degrees. Core endurance increased, as evidenced by a 1.06-second improvement in the flexion-extension ratio and a 0.90-second bilateral increase in side-bridge endurance. Limb length discrepancy decreased from 2.5 cm to 0.5 cm, enhancing symmetry in both true and apparent lengths. Foot arch asymmetry also improved, with the right arch increasing from 45 degrees to 46 degrees and the left from 39.7 degrees to 42.5 degrees. Conversely, lung capacity declined from 1363 mL to 1238 mL. Force pressure distribution became more asymmetrical in most cases, particularly affecting the longer limb in individuals with scoliosis, and center of pressure movement increased from 51.5 mm to 76.5 mm, indicating altered balance and postural control.

Conclusion: Over two months, physiotherapy effectively improved postural alignment and musculoskeletal function in individuals with scoliosis.

Comparing the effects of dextrose prolotherapy and extracorporeal shockwave therapy on dynamic balance in knee osteoarthritis patients

Fahmi Aulia Rizqi — 2025-05-30

Background: Osteoarthritis (OA) is an age-related degenerative disease affecting the subchondral tissue of articular and bone cartilage, leading to biomechanical changes that cause pain, stiffness, and balance impairment, which increases fall risk and its severe consequences, including fractures, joint dislocations, loss of independence, and even death. Dynamic balance function can be assessed using the four square step test (FSST), a recommended functional test for knee OA patients. Knee OA management continues to develop, introducing regenerative therapies such as dextrose prolotherapy and extracorporeal shock wave therapy (ESWT). Therefore, this study aims to analyze the effects of dextrose prolotherapy and ESWT on dynamic balance outcomes.

Methods: Twenty-one subjects with unilateral knee osteoarthritis (grade II-III) were randomly assigned to either the dextrose prolotherapy or ESWT therapy group. The dextrose prolotherapy group received three injections, with a 3-week interval between each. The ESWT group underwent six sessions of therapy spaced one week apart. FSST was assessed before and after the intervention.

Results: Significant improvements in dynamic balance function, as measured by the FSST (p < 0.05), were observed within each group when comparing pre-and post-intervention results. However, no significant difference (p > 0.05) was found in FSST outcomes between the two groups. No severe adverse effects were reported in patients from either group.

Conclusion: This study demonstrates a positive impact of dextrose prolotherapy and ESWT therapy on the dynamic balance function of patients with knee OA. Both interventions were equally effective in improving dynamic balance function.

Perceptions and experiences of drug-resistant tuberculosis, HIV, and AIDS patients who experience loss to follow-up based on life values and stigma: a phenomenological study

Ikhwan Amirudin — 2025-06-02

Background: Human immunodeficiency virus (HIV), acquired immunodeficiency syndrome (AIDS), and tuberculosis are closely related and remain serious problems despite the implementation of various treatment strategies, but cases continue to increase. This research aimed to explore the perceptions and experiences of drug-resistant tuberculosis people with HIV/AIDS who experience loss of follow-up based on life values and stigma.

Methods: This qualitative study employed a phenomenological approach and (COREQ) guidelines. Researchers purposively sampled participants with HIV/AIDS and tuberculosis in Lampung Province, Indonesia. Data were collected through interviews and analyzed using Colaizzi’s seven-step thematic analysis.

Results: The results of the study described 7 themes related to the perceptions and experiences of drug-resistant tuberculosis HIV/AIDS sufferers who experience loss to follow-up based on life values and stigma, including 1) understanding of HIV/AIDS and tuberculosis; 2) causes of TB and HIV/AIDS clients experiencing loss to follow-up; 3) what happens after experiencing loss to follow-up: economic problems and drug availability; 4) adaptation after experiencing loss to follow-up: comfort; 5) use of herbal medicine as therapy; 6) barriers and support when it comes to control and treatment; 7) hope to recover and regularly taking medication and environmental dilemmas.

Conclusion: HIV/AIDS and tuberculosis sufferers who experienced loss to follow-up provide an understanding of experience, including the process of disease transmission and spread as well as antiretroviral drug treatment, anti-tuberculosis drugs, and the side effects they experience. A further problem is the community’s assessment of the condition of the disease. The support and facilities provided affected the issue of needs, both material and psychological.

Age and ergonomic position as determinants of musculoskeletal disorders among Batik workers: A cross-sectional study

Arif Pristianto — 2025-06-03

Background: Musculoskeletal disorders (MSDs) are complaints that occur in human muscles and bones, which are caused by several factors such as excessive work, lifting heavy loads, age, gender, and others. This study aimed to analyze the relationship between age and ergonomic working positions with the occurrence of MSDs across different divisions and types of batik production.

Methods: This study used a cross-sectional design with cross-divisional analysis based on the type of batik worked on. The study involving 60 respondents selected through purposive sampling from Laweyan Batik Village. Research data was collected using several instruments, including: Nordic body map (NBM), Oswestry disability index (ODI), work ergonomic risk assessment (WERA), and numeric rating scale (NRS).

Results: It was found that age was not related to the cause of changes in waist functional ability, with p-value= 0.342. There is a relationship between the level of waist ergonomics when working and the risk of lower back pain in batik makers, with p-value= 0.030.

Conclusion: There is a relationship between the level of waist ergonomics when working and the risk of lower back pain in batik makers, but age was not related with musculoskeletal disorders in batik workers.

Stroke in Indonesia: An epidemiological overview

Gian Lisuari Adityasiwi — 2025-06-04

Introduction: Stroke is a major cause of illness and death in Indonesia. Understanding its risk factors is essential for effective prevention. This study aimed to identify risk factors associated with stroke incidence in Indonesia.

Methods: This study utilized a literature review approach and analyzed data from national health surveys from year of 2007, 2013, and 2018 and data from Indonesian health profile from year of 2023. The stroke risk factors and sociodemographic variables were examined descriptively to identify regional trends and urban-rural disparities. Additionally, bivariate analysis was conducted using Chi-square test to assess relationships between stroke incidence and various risk factors.

Results: Stroke cases increased from 2007 to 2018 but decreased in 2023. In contrast, diabetes mellitus prevalence increased in 2023, suggesting no direct correlation with the observed decrease in stroke cases (p-value > 0.050).

Conclusion: The findings underscore the necessity of targeted public health interventions to decrease stroke incidence in Indonesia through early detection, lifestyle modifications, and enhanced awareness at both individual and community levels. The outcomes of this review offered a basis for subsequent public health research and strategies focused on decreasing the incidence of stroke in Indonesia.

Prioritization of key areas of the resilience in children with cerebral palsy strategy based on the analytical hierarchy process

Aditya Denny Pratama — 2025-06-05

Background: Children with cerebral palsy (CP) often require various forms of support to fulfill their basic rights and achieve a good quality of life. This research aimed to identify strategies to enhance the resilience and sustainability of children with CP.

Methods: This research used the analytic hierarchy process (AHP) developed by T. Saaty. We identified key elements, such as social, economic, and environmental factors, that enhance resilience in children with CP. This study used expert respondents, including the government, academics, the community, the private sector, society, and people with CP.

Results: The research results indicated that the main strategies were strengthening central and regional regulations, updating integrated data, enhancing the ecosystem of inclusive disability services, increasing the quantity and quality of medical and educational personnel, massive social movements related to disabilities, and building inclusive areas. The government plays a key role in determining policies that would have an overall impact. The potential for the sustainability of children with CP could be realized by paying attention to the key factors crucial for the sustainability of children with CP.

Conclusion: According to this study, local governments should be better equipped to create policies based on reliable disability data. Teachers and medical staff should also get continual training on how to help children with CP. To ensure the strategy's durability, stakeholder collaboration using the Penta Helix approach must be institutionalized. This study suggested that we should increase the public advocacy through social movements and the media to end stigma and promote inclusive public space design.

The effect of non-invasive treatment based on neurodevelopmental treatment on trunk control and upper extremity functional ability in children with spastic diplegia cerebral palsy

Aditya Denny Pratama — 2025-06-05

Background: Children with spastic diplegia cerebral palsy often showed impaired trunk control and upper limb function, which limited their daily activities and independence. Neurodevelopmental treatment (NDT) was used as a physiotherapy approach to improve motor control and reduce abnormal muscle tone. However, the evidence on its effectiveness for upper limb function and trunk control remained limited. This study aimed to examine the effect of non-invasive treatment based on NDT on trunk control and upper extremity functional ability in children with spastic diplegia.

Methods: This pre-experimental one-group pre-test–post-test study involved 20 children aged 5–12 years with spastic diplegia cerebral palsy (gross motor gunction classification system (GMFCS) Level III) who received NDT-based physiotherapy twice a week for eight weeks at Yayasan Ramah Cerebral Palsy (RCP), Bogor. The study excluded children with spastic hemiplegia, quadriplegia, athetoid CP, comorbid conditions such as heart disease, non-active members, and those who did not undergo therapy at RCP. Researchers measured upper extremity function using the quality of upper extremity skills test (QUEST) and assessed trunk control using the trunk control measurement scale (TCMS). They analyzed the data using paired sample t-tests to compare pre- and post-intervention results and applied Pearson’s correlation to examine the relationship between trunk control and upper limb function.

Results: Post-intervention evaluation revealed a significant improvement in upper extremity function (QUEST mean increase: 22.45±3.05, p< 0.001) and trunk control (TCMS mean increase: 16.15±5.01, p< 0.001). The relationship between improved trunk control and enhanced upper extremity function was significant, as indicated by Pearson's correlation of 0.696, p < 0.001.

Conclusion: In children diagnosed with spastic diplegia CP, an 8-week NDT intervention significantly improved upper extremity functional capacity and trunk control. The findings emphasized that the application of NDT in enhancing motor coordination and independence, thereby contributing to an improved quality of life for this population.

Female gender and time from injury to surgery as risk factors for decreased knee functions in ACL injury survivors

Ida Kurniawati — 2025-06-05

Background: Anterior cruciate ligament (ACL) injuries are serious orthopedic conditions that require long-term recovery and significant costs. This study aimed to assess the risk of decreased knee function among ACL injury survivors in the Indonesian ACL community.

Methods: This study used a prospective observational cohort design with a population of all members of the Indonesian ACL community who experienced ACL injury. The primary outcome of this study was a decrease in knee function was measured using the Lysholm knee score. We calculated univariate and multivariate analyses using logistic regression for each variable.

Results: The results showed that female gender and time from injury to surgery were significant factors that influenced poor knee function after ACL reconstruction. Women had a significantly higher risk (odd ratio (OR) = 15.28; adjusted OR (AOR) = 23.47; p-value < 0.010). In addition, the time between injury and surgery significantly affected postoperative knee function (AOR = 1.05; p-value = 0.049). Other factors such as age and body mass index did not show significant associations in either univariate or multivariate analyses.

Conclusion: This study confirmed that female gender and time from injury to surgery were important factors influencing poor knee function after ACL reconstruction. Timely intervention and focused rehabilitation programs are key steps to improve patient functional outcomes.

Effect of additional uphill treadmill exercise combined with standard therapy on walking speed in patients with knee osteoarthritis

Taurisia Kristiani — 2025-06-07

Background: Knee osteoarthritis (OA) is a progressive musculoskeletal condition that limits mobility by reducing walking speed. Exercise therapy can improve walking speed in knee OA patients. This research aimed to demonstrate that the addition of uphill treadmill exercises to standard therapy protocols was more effective in enhancing walking speed in patients with grade II and III knee osteoarthritis compared to standard therapy alone.

Methods: This randomized controlled trial at Dr. Soetomo General Hospital included 36 patients with knee OA grade II-III (Kellgren-Lawrence scale), aged 50-60 years, BMI <30 kg/m², moderate pain (VAS 30-60mm), and independent walking ability. Exclusion criteria included recent knee injuries/surgeries, intra-articular injections, acute inflammation, inflammatory arthritis, significant deformities, uncontrolled cardiovascular/diabetes conditions, respiratory disorders, sensory disturbances, balance disorders, concurrent therapy, pacemaker contraindications, cognitive impairment, and substance abuse. Subjects were randomized into control (n=18) and treatment groups (n=18). Controls received standard therapy (Q-bench strengthening and TENS). The treatment group received identical standard therapy plus uphill treadmill exercise (8-degree inclination, 1.1 m/s, 30 minutes) twice weekly for 5 weeks. Walking speed was assessed using 10-Meter Walk Test at baseline, post-intervention, and 20-day follow-up.

Results: The treatment group demonstrated significantly superior walking speed improvements compared to controls. No baseline differences existed (p-value= 0.680; Cohen's d= 0.14), but significant improvements occurred at post-intervention (p-value= 0.030; Cohen's d= 0.79) and 20-day follow-up (p-value =0.02; Cohen's d= 0.83).

Conclusion: There was a significant improvement in walking speed in post-exercise measurements and follow-up measurements in grade II-III knee OA patients who received additional uphill treadmill training compared to standard exercises.

The short version of the Indonesian falls efficacy scale for older adults

Raditya Kurniawan Djoar — 2025-06-08

Introduction: The short version of the falls efficacy scale–international (FES-I), consisting of seven items, has not yet been adapted for use in Indonesia, although the long version has been validated in Bahasa Indonesia. This study aimed to adapt and validate the Indonesian short version of the FES-I for use in time-limited settings or with frail older adults.

Methods: This cross-sectional study validated the Indonesian Falls Efficacy Scale for older adults through translation, cultural adaptation, expert review, and reliability testing. Content validity was assessed by seven experts, and a field test was conducted with 135 older adults. Data were analyzed using Cronbach’s Alpha in IBM SPSS Statistics 26.

Results: Among the 135 respondents, the majority (82%) were aged between 60 and 74 years, with females comprising 60% of the sample. The shortened questionnaire demonstrated good reliability (Cronbach’s Alpha = 0.8) and excellent validity (item content validity index= 0.857–1; scale-level content validity index= 0.938).

Conclusion: The findings support the reliability and validity of the short Indonesian version of the FES. This version is especially effective and practical for quickly screening older adults with a fear of falling during daily activities and social interactions.

Effects of aerobic exercise and high-intensity interval training on muscle damage in an overtraining rat model

Amriansyah Syetiawinanda — 2025-06-10

Background: Overtraining is commonly associated with elevated oxidative stress, inflammatory responses, and structural damage to muscle fibers, all of which contribute to a decline in physical performance. This study aimed to assess the impact of aerobic exercise on biomarkers including malondialdehyde (MDA), interleukin-6 (IL-6), caspase-3, nitric oxide (NO), superoxide dismutase (SOD), as well as the integrity of the sarcolemma.

Methods: A six-week experimental study was conducted using 24 rats, which were randomly divided into three groups (n = 8 per group): a negative control group (no treatment), an aerobic exercise group, and a high-intensity interval training (HIIT) group. The levels of biochemical markers, including malondialdehyde (MDA), interleukin-6 (IL-6), nitric oxide (NO), and superoxide dismutase (SOD), were measured using the enzyme-linked immunosorbent assay (ELISA) technique. Additionally, the expression of caspase-3 was determined through immunohistochemical (IHC) analysis. Muscle tissue damage was evaluated by means of histopathological examination. The data were analyzed using a one-way analysis of variance (ANOVA), followed by the Mann-Whitney post hoc test to assess differences between groups.

Results: The findings indicated that aerobic exercise did not result in a statistically significant reduction in malondialdehyde (MDA) (p = 0.833), interleukin-6 (IL-6) (p = 0.800), nitric oxide (NO) (p = 0.791), or superoxide dismutase (SOD) (p = 0.520) levels. Nevertheless, the aerobic exercise group exhibited a significantly lower expression of caspase-3 compared to the other groups (p = 0.023). Furthermore, aerobic exercise was associated with a significant reduction in muscle tissue damage (p = 0.001).

Conclusion: The findings of this study indicate that both aerobic exercise and high-intensity interval training (HIIT) have the potential to be utilized as therapeutic approaches for mitigating exercise-induced muscle damage, primarily through their positive influence on sarcolemma stability. However, additional clinical investigations are necessary to confirm these results and establish their relevance for clinical implementation.

The efficacy of kinesiotaping combined with shoulder strengthening and pectoralis minor stretching for improving scapular alignment in tailors with rounded shoulder posture

I Dewa Gede Alit Kamayoga — 2025-06-12

Background: Rounded shoulder posture is marked by forward displacement of the shoulders from their neutral position, commonly caused by prolonged poor sitting habits. Clinically, it manifests as shoulder or scapular pain, restricted range of motion, and increased stiffness of the pectoralis minor. This study aimed to compare the effectiveness of adding kinesiotaping to a shoulder strengthening and pectoralis minor stretching program with that of a conventional exercise therapy protocol commonly used as standard treatment.

Methods: This experimental study used a pretest-posttest two-group design involving 42 respondents selected through purposive sampling. The sample was divided into intervention (shoulder strengthening and pectoralis minor stretching exercises + kinesiotaping) and control (shoulder strengthening and pectoralis minor stretching exercises) groups, and the data were analyzed using an independent sample t-test.

Results: Paired sample t-test analysis in the kinesiotaping and strengthening group showed a significant result (p=0.000). Independent sample t-test revealed significant differences between groups for right scapular alignment (p=0.000) and left scapular alignment (p=0.035), indicating that adding kinesiotaping significantly improved scapular alignment compared to strengthening and pectoralis minor stretching alone.

Conclusion: Both intervention and control groups improved scapular alignment in tailors. However, the intervention group showed a greater effect than control group.

Palliative care outcomes in adult intensive care units: A scoping review of potential quality indicators

Heru Suwardianto — 2025-06-12

Background: While critical care focuses on survival, it may unintentionally overlook aspects of comfort, dignity, and communication that are essential to quality end-of-life care. This scoping review aimed to identify existing outcome indicators, highlight gaps, and propose potential quality indicators for palliative care in ICU settings.

Methods: Fifty-seven databases were searched for relevant publications published between January 2000 and December 31, 2024. The inclusion criteria were full-text, peer-reviewed journal articles in English, consisting of final versions of original or review studies conducted in adult ICUs. Case studies, perspectives, editorials, and reports were excluded. This study used the preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews (PRISMA-ScR) approach. We reviewed the literature across multiple databases, including PubMed, ProQuest, EBSCOhost, Scopus, ScienceDirect, and BASE. We carried out the ScR according to the structure suggested by Arksey and O'Malley.

Results: This review included 57 studies, with a total of 158 codes representing 122 unique codes, which were grouped into 29 sub-themes (categories of palliative care outcomes) within five main themes: communication and palliative care consultation, end-of-life care decisions, symptom management and comfort, psychosocial well-being of patients and families, and ethics and the role of clinicians in palliative care. Additionally, unique categories were identified to reflect each of these themes.

Conclusion: Outcomes have been highlighted as unique and significant palliative care outcomes for adult patients in ICU critical care settings, potentially becoming candidate quality indicators. The candidate outcome indicators for palliative care in the ICU in the future will contribute to more measurable and standardized outcome assessments.