Physical Therapy Journal of Indonesia

Estimation-based joint position sense: comparing self-rated and measured accuracy across sexes

Wootaek Lim — Wed, 14 Jan 2026 00:00:00 +0000

Background: The validity of self-rated joint position sense (JPS) remains inconclusive. Moreover, previous experimental designs for JPS assessment often failed to reflect real-life movement execution, and studies addressing sex differences in JPS are limited. Therefore, this study aimed to investigate the relationship between perceived JPS (self-rated JPS) and actual joint position error (JPE), and examine sex-based differences in JPE.

Methods: Thirty-three apparently healthy adults participated in the study and performed an elbow flexion to 90°, relying on proprioceptive inference rather than memorized reproduction. Ordinal logistic regression was used to analyze the relationship between the perceived JPS and JPE. JPS acuity was evaluated using constant error and absolute error (AE), while the reliability of repeated measures was assessed using the intraclass correlation coefficient (ICC).

Results: Ordinal logistic regression revealed that higher JPE values are associated with lower self-ratings of JPS ability. In the analysis of sex differences, females exhibited significantly greater AEs than did males, indicating lower proprioceptive accuracy. However, ICC values showed slightly higher reliability in females, suggesting more consistent performance across repeated trials despite larger deviations from the target angle.

Conclusion: This study provides new evidence on the relationship between self-perceived and measured JPS, as well as sex-related differences in proprioceptive performance. The findings underscore the importance of considering sex and individual self-awareness in proprioceptive training strategies. Therefore, incorporating cognitive feedback may enhance JPS self-perception and improve training outcomes in clinical and sporting contexts.

Comparison of mirror therapy and constraint-induced movement therapy on motor recovery and functional outcomes in post-stroke patients

Wed, 14 Jan 2026 11:22:27 +0000

Background: Mirror therapy (MT) and constraint-induced movement therapy (CIMT) are rehabilitative techniques for improving upper limb function after stroke; however, direct comparisons of their effectiveness are limited. This study aimed to evaluate and compare the effects of MT and CIMT on upper limb recovery in stroke patients.

Methods: A randomized controlled trial of 30 post-stroke patients was undertaken from June to September 2023. Participants were randomly assigned to either the MT or CIMT groups. The primary objective was the Fugl-Meyer assessment for upper extremities (FMA-UE), whereas the secondary outcomes were surface electromyography biofeedback (sEMG-B) and the box and block test (BBT).

Results: CIMT significantly improved FMA-UE and BBT scores (p < 0.001), along with sEMG measurements of the middle, anterior, and posterior deltoid, biceps, triceps, wrist extensors, and wrist flexors (p < 0.001). MT also led to significant improvements in FMA-UE, BBT, and sEMG (all p < 0.001). Intergroup comparisons showed greater BBT score gains with CIMT (11) than MT (10), while differences in FMA-UE and sEMG were not significant.

Conclusion: Both CIMT and MT enhance upper limb motor function in stroke patients, whereas CIMT results in higher increases in hand dexterity.

Does omega-3 supplementation added to exercise attenuate inflammaging? Effects on circulating interleukin-6 in older adults: A meta-analysis of randomized controlled trials

Wed, 14 Jan 2026 11:26:46 +0000

Background: Low-grade systemic inflammation (inflammaging) characterizes older adults, with circulating interleukin-6 (IL-6) as a key biomarker linked to frailty, physical decline, and cardiometabolic risk. Exercise repeatedly elicits anti-inflammatory myokine responses, while long-chain omega-3 (eicosapentaenoic Acid (EPA)/ docosahexaenoic acid (DHA)) promotes resolution of inflammation via membrane remodelling and specialized pro-resolving mediators. This study aimed to determine whether adding omega-3 supplementation to structured exercise reduces resting IL-6 more than exercise alone in older adults.

Methods: A systematic search was undertaken in PubMed using a pre-specified medical subject headings (MeSH) strategy that combined terms for long-chain omega-3 fatty acids, structured exercise/physical activity, Interleukin-6, the aged population, and randomized/clinical trial filters; animal-only studies were excluded. This search yielded 22 records. Complementary searches in Scopus (14 records) and ResearchGate (18 records) were pooled with PubMed results and deduplicated prior to screening. Four RCTs (duration 8–18 weeks) met all criteria. Pooled effects were estimated with a random-effects model using restricted maximum likelihood (REML). Between-study heterogeneity was summarized by Q, I², and τ² summarized between-study heterogeneity. Potential small-study effects were explored visually using a funnel plot.

Results: Pooled analysis using a REML model shows that post-intervention IL-6 was lower by 0.77 pg/mL when omega-3 supplementation was added to exercise versus exercise alone (MD = −0.77 pg/mL; 95% CI −1.46 to −0.08; p = 0.03; k = 4), indicating a statistically significant, directionally consistent attenuation of resting inflammation. Between-study heterogeneity was moderate (Q = 7.04, df = 3, p = 0.07; I² = 55%; τ² = 0.26), suggesting that differences in trial characteristics (e.g., duration 8–18 weeks, exercise mode, and omega-3 dose/form) contributed to variability in effect sizes. Funnel-plot analysis did not reveal marked asymmetry.

Conclusion: Across randomized trials in older adults, omega-3 supplementation added to exercise achieves a modest but statistically significant reduction in resting IL-6 versus exercise alone, consistent with attenuation of inflammaging.

Improving family caregiver understanding of range of motion exercises for community-based stroke care: A pre-experimental study within the clinical pathway

Mira Asmirajanti, Rini Handayani, Dwi Nurmawaty, Yulhendri — Mon, 19 Jan 2026 02:32:15 +0000

Background: Family caregivers play a crucial role in the recovery of stroke patients, especially in community settings. An adequate understanding of the range of motion (ROM) exercises enables caregivers to actively support rehabilitation and prevent complications. This study aimed to analyze the improvement of family caregivers' understanding of ROM exercises after training.

Methods: This pre-experimental one-group pretest-posttest study involved 25 families with stroke patients for ≥1 month, selected through consecutive sampling in the working area of Puskesmas Tambora, West Jakarta, in July 2025. Interventions included active and passive ROM exercises based on standard operating procedures (SOPs), also it was used to simulate the manual muscle testing (MMT). Measurement instruments used the validity and reliability questionnaires and MMT observation sheets. Data were analyzed by the Wilcoxon test at a significance level of p<0.05.

Results: The results showed a significant increase in family caregiver understanding of ROM (p= 0.000). Before the training, 88% of respondents (22 people) had sufficient knowledge, and 12% (3 people) had good knowledge. After the training, the proportion of good knowledge increased to 56% (14 people), while moderate knowledge decreased to 44% (11 people).

Conclusion: Structured training effectively enhanced family caregivers' understanding of ROM exercises, supporting their active participation in patient care. These findings suggest that such education can be integrated into community-based non-digital clinical pathways to prevent complications in stroke patients.

Integrating simulation, role-play, and technology in physiotherapy education: A narrative review on teaching methods for patient education

Mon, 26 Jan 2026 00:00:00 +0000

Physiotherapists play a crucial role in patient education, as effective communication and educational strategies directly influence treatment adherence, functional outcomes, patient satisfaction, and trust in healthcare services. The increasing global burden of musculoskeletal and neurological disorders has intensified the demand for physiotherapy services, emphasizing the need for graduates who are not only clinically competent but also proficient in patient-centered education. This narrative review aims to synthesize evidence from 2015 to 2025 regarding the integration of simulation, role-play, and educational technology in physiotherapy education, with a particular focus on teaching methods that enhance patient education competencies. Relevant peer-reviewed literature was identified from major academic databases, including PubMed, Scopus, and Google Scholar, and analyzed thematically to examine educational outcomes related to communication skills, learner engagement, confidence, empathy, and clinical preparedness. The findings indicate that simulation-based learning and structured role-play provide safe and experiential environments for students to practice patient communication and education, while technology-enhanced approaches such as virtual simulations and digital learning platforms offer scalable and flexible learning opportunities. Collectively, these methods demonstrate consistent benefits in improving students’ ability to deliver clear, structured, and empathetic patient education, thereby supporting readiness for clinical practice. Integrating simulation, role-play, and technology within physiotherapy curricula represents a strategic approach to strengthening patient education competencies and preparing graduates to deliver high-quality, patient-centered, and trusted physiotherapy care in response to contemporary healthcare demands.

Effect of low-intensity aerobic exercise using a cycle-ergometer on insomnia level and quality of life in breast cancer patients undergoing chemotherapy

Mon, 02 Feb 2026 01:00:35 +0000

Background: Patients undergoing chemotherapy are two to three times more likely to experience insomnia, with the highest prevalence reported among breast cancer patients. This condition markedly reduces quality of life. This study aimed to assess whether a low-intensity aerobic exercise program using a stationary bicycle could alleviate insomnia and improve patients’ quality of life.

Methods: A randomized controlled trial was conducted at Dr. Soetomo General Academic Hospital, Surabaya, Indonesia, involving female breast cancer patients undergoing chemotherapy. Participants were assigned to either a treatment group, which performed low-intensity cycling twice weekly for eight weeks, or a control group with no exercise intervention. Changes in insomnia severity and quality of life were assessed using validated questionnaires before and after the intervention.

Results: Among the 20 participants who completed the study, the treatment group showed a significant reduction in insomnia severity (p < 0.001) and greater improvements in physical function, symptom management, and overall well-being compared to the control group.

Conclusion: Low-intensity aerobic exercise on a cycle ergometer is a safe and effective way to reduce insomnia and improve quality of life in breast cancer patients undergoing chemotherapy.

Mapping scientific knowledge and future directions on exercise and depression: A bibliometric study

Mon, 02 Feb 2026 00:00:00 +0000

Background: Exercise is widely recognized as a supplementary or alternative treatment for depression, yet comprehensive scientific mapping in this area remains limited. This study aimed to explore the current research landscape, key findings, and future trends related to exercise and depression across all age groups.

Methods: We used the Web of Science database to collect articles on exercise and depression from 2002 to 2022. Eligible data were extracted and analyzed using R Studio with the Bibliometrix package to generate descriptive summaries, annual trends, country and institution outputs, journal impact, and research hotspots.

Results: The majority of publications on the subject of exercise and depression originate from the United States and China, with 258 and 161 publications, respectively. Notably, Chongqing Medical University and Harvard University stand out as leading institutions in this field, each contributing 48 publications. The Journal of Affective Disorders, recognized for its high impact and Q1 status, serves as a foundational resource in the exploration of exercise and depression. The thematic map and topic trend analysis highlight aerobic exercise and tai chi as promising exercises, potentially targeting the hippocampus and BDNF in the context of depression. Furthermore, it is noteworthy that PHQ-9 and HADS are frequently utilized measurements in ongoing research endeavors.

Conclusion: This study provides a summary of the field about exercise and depression, highlighting emerging trends, sources, prominent institutions, and key topics using bibliometric analysis and network visualization. Our findings offer valuable insights that can guide future research directions and inform clinical practice.

Comparison of modified hybrid strength training and neuromuscular electrical stimulation on joint position sense in healthy untrained individuals: A randomized controlled trial

Anastrinia Syafiqah Hanun, Damayanti Tinduh, Nurul Kusuma Wardani — Mon, 02 Feb 2026 00:00:00 +0000

Background: Low physical activity reduces muscle strength and proprioception, increasing injury risk. Neuromuscular electrical stimulation (NMES) and hybrid training aim to enhance proprioception by strengthening muscles. This study compared the effects of a modified hybrid strength training program and Russian protocol NMES on knee joint position sense (JPS) in healthy, untrained men.

Methods: Sixteen untrained males were randomly allocated to either the hybrid training group or the NMES group. Both groups exercised three times a week for four weeks. An isokinetic dynamometer was used to measure JPS at 30° and 60° on both dominant and non-dominant legs before and after the intervention.

Results: Both interventions significantly improved JPS across all tested angles. In the hybrid group, improvements were observed in the dominant leg at 30° (p = 0.028) and 60° (p = 0.009), and in the non-dominant leg at 30° (p = 0.033) and 60° (p = 0.008). The NMES group showed similar improvements at 30° and 60° in both legs (p < 0.05). No significant differences were found between groups.

Conclusion: Modified hybrid strength training and Russian protocol NMES both enhanced knee JPS in healthy, untrained men, with neither proving superior. Larger trials are needed to confirm comparative effectiveness and explore clinical applications.

Evaluation of dextrose prolotherapy versus extracorporeal shock wave therapy for pain relief and functional improvement in patients with knee osteoarthritis

Thu, 12 Feb 2026 06:56:47 +0000

Background: Knee osteoarthritis (OA) remains a leading degenerative joint disease and a primary driver of chronic pain and disability among older adults. This condition is clinically defined by progressive cartilage degradation, joint stiffness, and a significant loss of functional mobility. Because standard conservative treatments often fail to provide adequate relief, there has been growing interest in regenerative approaches such as extracorporeal shock wave therapy (ESWT) and dextrose prolotherapy (DP). While their clinical use is increasing, direct comparative evidence regarding their relative effectiveness is still largely missing from some studies. This study aimed to evaluate the differences between ESWT and DP affect patients with knee OA in terms of functional improvement as measured by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and pain reduction as measured by the Visual Analogue Scale (VAS).

Methods: This quasi-experimental study employed a pre-test–post-test randomised group design. Twenty patients with grade II–III knee OA who were not improving with traditional therapy were recruited and randomly assigned to two groups: ESWT (n=11) and DP (n=9). The interventions lasted for six weeks. Both before and after the intervention, the WOMAC and the VAS for pain were assessed as outcome measures. A statistical study was conducted to find differences both within and between groups.

Results: Both the ESWT and DP groups had statistically significant improvements in all metrics, including pain (VAS), WOMAC pain, stiffness, disability, and total scores (p<0.05). However, there were no significant differences between the two groups for any of the evaluated outcomes (p>0.05).

Conclusion: ESWT and DP were equally effective in reducing pain and improving functional outcomes in patients with knee OA. These findings indicate their role as a successful alternative therapy for people who don't receive enough relief from conventional medical therapies. Additional randomized controlled research are required to confirm these conclusions.

Early screening diagnostic test in adolescents with a family history of thalassemia

Tue, 03 Mar 2026 00:00:00 +0000

Background: Thalassemia is a major public health concern in Indonesia, particularly in families with a known history of the ailment. This study aimed to assess the validity, reliability, sensitivity, and specificity of a thalassemia screening instrument that included a questionnaire and a scoring model.

Methods: A cross-sectional study was conducted in Tegal, Central Java (November 2024–April 2025), involving 64 adolescents aged 10–24 years from extended families with a history of thalassemia, selected through purposive sampling. Inclusion criteria included willingness to participate, ability to communicate, and signed informed consent, while exclusion criteria included incomplete participation, other blood disorders, medical complications, or withdrawal. Screening consisted of a structured questionnaire and physical examination (score 0–8), followed by CBC and HbA2 testing. Statistical analyses included the Kolmogorov–Smirnov test, chi-square tests, Pearson or Spearman correlations, and diagnostic accuracy measures (sensitivity, specificity, PPV, NPV) using a 2×2 table.

Results: The screening instrument showed a sensitivity of 76.5%, a specificity of 85.6%, and an AUC of 0.76. It demonstrated acceptable internal consistency and significant construct validity, indicating moderate diagnostic accuracy for identifying thalassemia trait.

Conclusion: The screening tool established in this study was appropriate for teenagers with a family history of thalassemia and had modest diagnostic performance. Integration into existing public health systems is both achievable and recommended.

The role of physiotherapy in a health maintenance strategy for retirees in Indonesia to support total defense

Thu, 05 Mar 2026 06:12:53 +0000

Background: Retirement represents a critical transitional phase for members of the Indonesian military and civil servants, often accompanied by post-power syndrome and retirement depression, which adversely affect psychological stability, musculoskeletal function, and social participation. This study aimed to empirically analyze the effectiveness of physiotherapy interventions based on physical activity combined with psychosocial support in mitigating post power syndrome and retirement depression, while also assessing their alignment with the job demands-resources model and the successful aging theory.

Methods: This study employed a quantitative analytical survey involving 200 retired Indonesian military personnel and civil servants (≥1 year post-retirement) selected through simple random sampling. Data were collected using structured Likert-scale questionnaires covering physiotherapy interventions, post-power syndrome symptoms, and mental health indicators. Validity and reliability were confirmed through pilot testing. Data were analyzed using structural equation modelling with partial least squares (SEM-PLS 4) to assess relationships and model fit through outer and inner model evaluations.

Results: The results indicate that all constructs met the criteria for validity and reliability (outer loading > 0.70; AVE > 0.50; CR > 0.80; HTMT < 0.85). Physiotherapy interventions demonstrated a significant effect in reducing PPS (β = -0.62; t = 8.522; p < 0.001) and retirement depression (β = -0.67; t = 7.274; p < 0.001), with musculoskeletal function and physical activity engagement acting as significant partial mediators (t = 5.275; p < 0.001). These findings affirmed that integrated physiotherapy interventions enhance retirees’ physical resilience and psychosocial well-being, while also holding strategic relevance for national health policies and strengthening the role of retirees as supportive components within the national defense and security system.

Conclusion: This research contributes to advancing physical and mental well-being among the elderly through integrated physiotherapy interventions; however, its cross-sectional design presents a limitation, suggesting future studies adopt longitudinal approaches with broader contextual variables.

Differences in the effects of square stepping exercise and Otago exercise on dynamic balance based on body mass index in the elderly

Wijianto, Muchsin Doewes, M. Furqon Hidayatullah, Febriani Fajar Ekawati — Thu, 05 Mar 2026 06:29:48 +0000

Background: The increasing elderly population in Indonesia face higher risks of balance disorders and falls, threatening independence. Exercise interventions, such as strength and balance training, can improve dynamic balance. This study aimed to analyze the differences in dynamic balance improvement between square stepping exercise and Otago exercise in older adults based on body mass index (BMI).

Methods: The sample was randomly divided into two groups: square stepping exercise (SSE group) and Otago exercise (OT group). Dynamic balance was assessed using the timed up and go (TUG) test, conducted before and after the intervention. This study used a 2×3 factorial experimental design with purposive sampling. Older adults aged 60–75 years with good cognitive and walking ability were included, while those with sensory impairments, mobility limitations, or lower extremity disorders were excluded. Sixty eligible participants were randomly assigned to either the SSE group (n = 30) and the OT Group (n = 30). Data were analyzed using a 2×3 factorial ANOVA, with statistical significance set at p < 0.05.

Results: This study found that both SSE and OT interventions significantly improved dynamic balance in older adults, as measured by pre- and post-intervention TUG test. Both groups showed reduced TUG test times: the OT group from 13.76 to 11.84 seconds, and the SSE group from 14.48 to 11.13 seconds. ANOVA analysis indicated that the type of exercise significantly affected dynamic balance (F(1.54) = 4.515; p=0.038), while BMI and its interaction showed no significant effect (p> 0.05).

Conclusion: Both exercises improved dynamic balance in older adults. However, the SSE group showed greater effectiveness than the OT group. Exercise type significantly influenced balance outcomes, while BMI had no significant effect.