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Tambunan, Edward E.

Efek latihan kekuatan otot yang bersifat non mesin pada karyawan pra usia lanjut = Effect of non machine muscle strength exercises on untrained young older employees

"Latihan kekuatan otot non mesin merupakan latihan yang dapat meningkatkan kemampuan fungsional dalam hal ini otot tungkai. Tujuan: Penelitian ini bertujuan mengetahui efek latihan kekuatan otot non mesin selama 10 minggu terhadap kekuatan otot tungkai, daya tahan otot tungkai, kecepatan berjalan dan keseimbangan berjalan sebagai variabel kemampuan fungsional otot. Penelitian ini juga untuk mengetahui apakah latihan kekuatan otot jenis kombinasi weight bearing dan elastic resistance memberikan peningkatan yang lebih besar dibandingkan dengan latihan jenis weight bearing yang dilanjutkan dengan elastic resistance. Metode: Subyek terdiri dari 36 orang karyawan pra usia lanjut (45-56 tahun) sehat tidak terlatih yang dibagi menjadi 2 kelompok. Kelompok A melakukan latihan jenis kombinasi weight bearing dan elastic resistance sedangkan kelompok B melakukan latihan jenis weight bearing saja dan kemudian dilanjutkan dengan latihan elastic resistance saja. Kedua kelompok tersebut melakukan latihan dengan frekuensi 2-3 xlminggu selama 1 jam dengan intensitas 1-3 setlgerakan dan tiap set terdiri dari 8-12 ulangan/repetisi. Hasil: Hasil menunjukan kedua jenis latihan memberikan peningkatan terhadap kemampuan fungsional otot tungkai (Uji Anova p=0,00), namun jenis kombinasi weight bearing dan elastic resistance memberikan peningkatan yang lebih besar (Uji t p=0,01-0,04). Latihan kekuatan otot tungkai jenis kombinasi weight bearing dan elastic resistance memberikan peningkatan kekuatan otot (59,93%), daya tahan otot (58,42%), kecepatan berjalan (36,88%) dan keseimbangan berjalan (47,12%) sedangkan jenis weight bearing dilanjutkan elastic resistance memberikan peningkatan kekuatan otot (39,66%), daya tahan otot (31,69%), kecepatan bedalan (23,33%) dan keseimbangan berjalan (25,90%). Seluruh variabel kemampuan fungsional tersebut mempunyai korelasi yang kuat satu dengan lainnya (Uji korelasi Pearson p=0,000-0,001). Selain itu melalui kuesioner didapatkan bahwa subyek merasa nyaman dengan latihan jenis kombinasi dan menambah minat mereka terhadap latihan jasmani. Kesimpulan: Dari hasil penelitian dapat disimpulkan bahwa latihan kekuatan otot jenis kombinasi weight bearing dan elastic resistance memberikan peningkatan yang lebih besar terhadap variabel kemampuan fungsional otot pada kelompok karyawan pra usila sehat tidak terlatih.

Non machine muscle strength exercises can be used to increase functional ability, especially the lower limb muscle. Purpose: The purpose of this research was to evaluate the effects of 10 weeks of non machine muscle strength exercises on muscle functional ability. The variables for functional ability will be muscle strength, muscle endurance, speed of walk and balance of walk. And to determine if simultaneously combined weight bearing and elastic resistance exercises will be better than weight bearing followed by elastic resistance exercises on increasing muscle strength. Methods: The subjects were 36 healthy untrained employees aged between 45-56 years. They were divided randomly into 2 groups, groups A and B. Group A was trained with a simultaneous combination of weight bearing and elastic resistance exercises while group B was first trained with weight bearing exercises and then with elastic resistance exercises. Both groups exercised 2-3 times a week for 1 hour with an intensity of 1-3 sets/motion and 8-12 repetitions/set. Results: Results showed both types of exercises increased muscle functional ability (ANOVA test p-0.00), but the simultaneous combination of weight bearing and elastic resistance exercises was better (t test p=O.01-0.04). The simultaneous combination of weight bearing and elastic resistance exercises increased muscle strength (59.93%), muscle endurance (58.42%), speed of walk (36.88%), and balance of walk (47.12%), while the succeeding weight bearing and elastic resistance exercises increased muscle strength (39.66%), muscle endurance (31.69%), speed of walk (23.33%), and balance of walk (25.90%). All muscle functional ability variables were strongly correlated to one other (Pearson correlation test p=0.000-0.001). From the questionnaires given, it was found that the subjects enjoyed the simultaneous combination exercises which increased their motive for physical exercise. Conclusion: It was concluded that muscle strength exercises which simultaneously combined weight bearing with elastic resistance exercises were better in increasing muscle functional ability in healthy untrained young older employees."

Jakarta: Fakultas Kedokteran Universitas Indonesia, 2006

T18008

UI - Tesis Membership Universitas Indonesia Library

Vera

Determinan diagnostik klinis defisiensi vitamin D pada wanita 50 tahun ke atas = Clinical diagnostic determinants of vitamin D deficiency in women aged above 50 years

"Prevalensi defisiensi vitamin D pada wanita 50 tahun ke atas di Indonesia cukup tinggi namun pemeriksaan kadar vitamin D serum sangat mahal. Oleh karena itu, diperlukan alat penyaring defisiensi vitamin D yang cukup ekonomis dan sederhana untuk dikerjakan di layanan kesehatan primer. Penelitian ini menemukan hubungan yang bermakna secara statistik antara diabetes mellitus, skor proteksi matahari, kelemahan otot ekstremitas bawah dengan defisiensi vitamin D. Berdasarkan ketiga determinan tersebut, dapat dibuat sistem skoring yang dapat digunakan untuk menyaring kelompok wanita 50 tahun ke atas yang mempunyai probabilitas besar menderita defisiensi vitamin D.

Prevalence of vitamin D deficiency in Indonesian women aged above 50 years is quite high, but serum vitamin D laboratory examination is very expensive. Therefore, simple and economic screening tool of vitamin D deficiency is required in the primary care setting. This research found a statistically significant correlation between diabetes mellitus, sun protection score, and weakness of lower extremity, with vitamin D deficiency. Based on these three determinants, a scoring system can be created to identify women aged above 50 years with high probability of having vitamin D deficiency."

Jakarta: Fakultas Kedokteran Universitas Indonesia, 2013

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UI - Tugas Akhir Universitas Indonesia Library

Rose Dinda Martini

Prealbumin dan CURB‐65 sebagai prediktor kematian pada pasien usia lanjut dengan pneumonia komunitas = Prealbumin and CURB‐65 as a predictor of mortality in elderly patients with community pneumonia

"Latar Belakang : Skor CURB 65 merupakan salah satu sistem prediksimortalitas akibat pneumonia komunitas yang cukup mudah dan valid namuntingkat prediksinya tidak cukup tinggi. Prealbumin sebagai marka yangsensitif terhadap malnutrisi dapat digunakan sebagai prediktor mortalitaspada pasien usia lanjut dengan pneumonia komunitas.

Tujuan : Mengetahui kemampuan skor CURB 65 dan prealbumin dalam memprediksi mortalitas pada pasien usia lanjut dengan pneumonia komunitas.

Metoda : Penelitian kohort prospektif pada pasien usia lanjut yang dirawat diRS Dr M Djamil dan RS swasta Padang kurun waktu Mei Desember 2012. Pengambilan data untuk menentukan skor CURB 65 dan prealbumin dilakukan pada 24 jam pertama setelah didiagnosis lalu diikuti hingga 30 hari untuk menentukan status mortalitasnya. Kemampuan prediksi mortalitas skor CURB 65 dan prealbumin discriminatory power dinilai dengan menentukan area under receiver operating characteristic curve AUC dan interval kepercayaan 95.

Hasil : Didapatkan 158 subyek usia lanjut dengan mortalitas 30 hari sebesar 50 Skor CURB 65 mempunyai diskriminasi cukup baik dengan AUC skorCURB 65 0 741 IK 95 0 664 0 818. Sedangkan prealbumin mempunyai diskriminasi cukup baik untuk kejadian non mortalitas dengan AUC prealbumin 0 674 IK 95 0 589 0 759. Penambahan prealbumin terhadap skor CURB 65 meningkatkan kemampuan diskriminasi skor CURB 65 sebesar 4 5 AUC 0 786 IK 95 0 716 0 856.

Kesimpulan : Penambahan prealbumin terhadap skor CURB 65 meningkatkan kemampuan diskriminasi mortalitas usia lanjut denganpneumonia komunitas dari 74 1 menjadi 78 6. Nilai prediksi mortalitaspada prealbumin.

Background : CURB-65score is one of mortality prediction systems for community pneumonia that is quite easy and valid , but the predictionlevel is not high enough. Prealbumin , as a sensitive marker of malnutrition can be used as a predictor of mortality in elderly patients with community pneumonia.
Aim : Determine the ability of CURB - 65 score and prealbumin in predicting mortality in elderly patients with community pneumonia.
Method : Prospective cohort study was held in elderly patients that were admitted to Dr. M. Djamil hospital and private hospitals Padang in period of May 2012 - December 2012. Data collection was to determine the CURB - 65 score and prealbumin done in the first 24 hours after diagnosed , and then followed up to 30 days to determine mortality status. Ability of mortality prediction CURB - 65 scores and prealbumin ( discriminatory power ) was assessed by determining the area under the receiver operating characteristic curve ( AUC ) and 95% confidence intervals.
Result : Obtained 158 elderly subjects with 30-day mortality by 50 %. CURB - 65 score had a pretty good discrimination with AUC CURB - 65 score of 0.741 ( 95 % CI 0.664 to 0.818 ). Whereas prealbumin had a pretty good discrimination for non- mortality incident with prealbumin AUC 0.674 ( 95 % CI 0.589-0.759 ). The addition of prealbumin to CURB-65score increased discrimination ability of CURB - 65 score about 4.5 % ( AUC 0.786 [ 95 % CI 0.716-0.856 ] ).
Conclusion : The addition of prealbumin to CURB - 65 score increases discrimination capability of elderly mortality with community pneumonia of 74.1 % to 78.6 %. Prediction of mortality in prealbumin values < 17.75 mg / dl by 67%."

Jakarta: Fakultas Kedokteran Universitas Indonesia, 2013

SP-Pdf

UI - Tugas Akhir Universitas Indonesia Library

Novira Widajanti

Faktor-faktor prediktor mortalitas dalam 6 bulan pada pasien usia lanjut dengan fraktur panggul = The predictor factors of six months mortality in elderly patients with hip fracture

"Latar Belakang: Angka kejadian fraktur panggul meningkat seiring pertambahan jumlah usia lanjut. Fraktur panggul pada usia lanjut meningkatkan risiko mortalitas terutama pada enam bulan pasca fraktur.

Tujuan : menentukan kemampuan faktor prediktor dan model sistem skoring prediksi mortalitas 6 bulan pada usia lanjut dengan fraktur panggul.

Metode : Penelitian dengan desain studi kohort berbasis prognostic research pada paisen usia lanjut ≥ 60 tahun dengan fraktur panggul yang datang ke Rumah Sakit. Subjek diikuti untuk dinilai status mortalitas dalam 6 bulan pasca fraktur. Dilakukan analisis regresi logistik untuk menentukan prediktor yang bermakna dan dilakukan sistem skoring prediktor.

Hasil : Pada 262 subjek, didapatkan wanita 75,6%, pria 24,4%, median usia 74,5 (60-94 tahun). Usia ≥ 80 tahun (RO 3,67, IK95% 1,68–8,0), Pria (RO 2,69, IK95% 1,18-6,13), CCI≥2 (RO5,77, IK95% 2,51-13,26), Malnutrisi (RO 9,30, IK95% 4,35-19,86), dan Tatalaksana Non Operatif (RO 2,79, IK95% 1,34-5,78) merupakan faktor-faktor prediktor mortalitas 6 bulan pada pasien usia lanjut dengan fraktur panggul yang bermakna secara statistik. Didapatkan ambang skor prediktor mortalitas yang terbaik adalah pada skor ≥3 dengan sensitifitas 81% dan spesifitas 83%.

Kesimpulan. Faktor Usia ≥ 80 tahun, Jenis Kelamin Pria, Komorbiditas CCI≥2, Malnutrisi dan Tatalaksana Non Operatif, dengan ambang skor ≥ 3 mempunyai kemampuan prediksi yang baik terhadap mortalitas dalam 6 bulan pada pasien usia lanjut yang datang ke Rumah Sakit.

Backgrounds : The incidence of hip fracture increases as the number of elderly. Hip fractures in the elderly have a risk of mortality.
Aim : To determine factors predictive ability of both models and a scoring system of six-month mortality in elderly patients with hip fracture
Methods : It was a prognostic-based cohort study design in the elderly with hip fracture in the hospital setting. Subjects followed his mortality status assessed within 6 months after the hip fracture. Both of logistic regression analysis and scoring system were performed.
Results : In 262 subjects, 75.6 % female, 24.4 % male, median age 74.5 (60-94 years old). The Age ≥80 years old (OR 3.67, 95%CI, 1.68 to 8.0), Male (OR 2.69, 95%CI, 1.18 to 6.13), CCI ≥ 2 (OR 5.77, 95%CI, 2.51 to 13.26), Malnutrition (OR 9.30, 95%CI, 4.35 to 19.86), and Non-Operative Procedures (OR 2.79, 95%CI, 1.34 to 5.78) was a predictor factor of six-months mortality in the elderly patients with hip fracture statistically significant. The cut of point of a score of ≥ 3 was the best predictor with a sensitivity of 81 % and specificity of 83 %
Conclusion : The age ≥80 years old, Male, CCI ≥ 2, Malnutrition, and Non-Operative procedures with the cut of point score ≥ 3 is a predictive model of sixmonth mortality in elderly patients with hip fracture."

Jakarta: Fakultas Kedokteran Universitas Indonesia, 2013

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UI - Tugas Akhir Universitas Indonesia Library

Petry

Perbedaan kesintasan 30-hari pasien usia lanjut dengan pneumonia komunitas pada berbagai derajat ketergantungan di awal perawatan = The difference of 30 days survival in elderly patients with community acquired pneumonia in various degree of dependency during admission

"[ABSTRAK

Latar Belakang : Pasien usia lanjut seringkali memerlukan rawat inap karena infeksi pneumonia yang disertai dengan penurunan status fungsional. Hubungan antara penurunan status fungsional pada pasien usia lanjut dengan pneumonia komunitas yang dirawat inap dengan kesintasan belum banyak diteliti.

Tujuan : Mendapatkan informasi mengenai perbedaan kesintasan 30-hari pasien pneumonia komunitas berusia lanjut dengan berbagai derajat ketergantungan. Metodologi : Penelitian kohort retrospektif berbasis analisis kesintasan terhadap pasien usia lanjut dengan pneumonia komunitas di ruang rawat akut geriatri RSCM periode Januari 2010-Desember 2013. Dilakukan ekstraksi data dari rekam medik mengenai status fungsional, kondisi klinis dan faktor perancu, kemudian dicari data mortalitasnya dalam 30 hari. Status fungsional awal perawatan dinilai dengan indeks ADL Barthel, kemudian dikelompokkan menjadi tiga kelompok, yaitu mandiri-ketergantungan ringan, ketergantungan sedang-berat dan ketergantungan total. Perbedaan kesintasan antara ketiga kelompok ditampilkan dalam kurva Kaplan Meier. Perbedaan kesintasan antara ketiga kelompok diuji dengan Log-rank test, dengan batas kemaknaan <0,05. Analisis multivariat dengan Cox?s proportional hazard regression untuk menghitung adjusted hazard ratio (dan interval kepercayaan 95%-nya) dengan koreksi terhadap variabel perancu.

Hasil : Dari 392 subjek, sebanyak 79 subjek (20,2%) meninggal dunia dalam waktu 30 hari. Rerata kesintasan seluruh subjek 25 hari (IK95% 24,66-26,49), kelompok mandiri-ketergantungan ringan 28 hari (IK95% 27,38-29,46), ketergantungan sedang-berat 25 hari (IK95% 23,71-27,25), ketergantungan total 23 hari (IK95% 21,46-24,86). Kesintasan 30-hari pada kelompok mandiri- ketergantungan ringan 92,1% (SE 0,029), ketergantungan sedang-berat 80,2% (SE 0,046), ketergantungan total 68,0% (SE 0,041). Crude HR pada ketergantungan sedang-berat 2,68 (p=0,008; IK95% 1,29-5,57), ketergantungan total 4,32 (p<0,001; IK95% 2,24-8,31) dibandingkan dengan mandiri-ketergantungan ringan. Setelah dilakukan adjustment terhadap variabel perancu didapatkan fully adjusted HR pada kelompok ketergantungan total 3,82 (IK95% 1,95-7,51), ketergantungan sedang-berat 2,36 (IK 95% 1,13-4,93).

Simpulan : Terdapat perbedaan kesintasan 30-hari pasien pneumonia komunitas berusia lanjut pada berbagai derajat ketergantungan; semakin berat derajat ketergantungan, semakin buruk kesintasan 30-harinya.

ABSTRACT

Background : Elderly patients often require hospitalization because of pneumonia accompanied by decreased functional status. The relationship between the declines in functional status in elderly patients with community acquired pneumonia who are hospitalized with survival rate has not been widely studied. Objective : To determine the difference of 30-days survival in elderly patients with community-acquired pneumonia in various degree of dependency during admission.

Method : A retrospective cohort study based on survival analysis of the elderly patients with community-acquired pneumonia in acute geriatric ward RSCM from January 2010 to December 2013. Extraction of data from medical records regarding functional status, clinical conditions and confounding factors, then followed up the 30-day mortality. Functional status at the start of hospitalization was assessed by the ADL Barthel index, then grouped into three, which are independent-mild dependence, moderate-severe dependence and total dependence. The difference of survival rate among the three groups is shown in the Kaplan- Meier curves. The difference in survival rate among the three groups were tested with the log-rank test, with a significance limit of <0.05. Multivariate analysis with Cox's proportional hazards regression to calculate adjusted hazard ratio (and its 95% confidence interval) with correction for confounding variables.

Results : Of the 392 subjects, a total of 79 subjects (20.2%) died within 30 days. The mean survival rate of all subjects was 25 days (95%CI 24.66-26.49), independent-mild dependence group was 28 days (95%CI 27.38-29.46), moderate-severe dependence group was 25 days (95%CI 23,71-27.25), the total dependence group was of 23 days (95%CI 21.46-24.86). The 30-day survival of independent-mild dependence group was 92.1% (SE 0.029), moderate-severe dependence group was 80.2% (SE 0.046), total dependence group was 68.0% (SE 0.041). Crude HR of moderate-severe dependence group was 2.68 (p=0.008; 95%CI 1.29-5.57), the total dependence group was 4.32 (p<0.001; 95%CI 2.24- 8.31) compared with independent-mild dependence group. After adjustment for confounding variables, obtained the fully adjusted HR was 3,82 (95%CI 1,95- 7,51) in total dependence group, and 2,36 (95%CI 1,13-4,93) in moderate-severe dependence group.

Conclusion : There are differences in 30-day survival rate of elderly patients with community-acquired pneumonia in various degrees of dependence; the more severe the degree of dependence, the worse its 30-day survival rate.;Background : Elderly patients often require hospitalization because of pneumonia accompanied by decreased functional status. The relationship between the declines in functional status in elderly patients with community acquired pneumonia who are hospitalized with survival rate has not been widely studied. Objective : To determine the difference of 30-days survival in elderly patients with community-acquired pneumonia in various degree of dependency during admission.

Conclusion : There are differences in 30-day survival rate of elderly patients with community-acquired pneumonia in various degrees of dependence; the more severe the degree of dependence, the worse its 30-day survival rate., Background : Elderly patients often require hospitalization because of pneumonia accompanied by decreased functional status. The relationship between the declines in functional status in elderly patients with community acquired pneumonia who are hospitalized with survival rate has not been widely studied. Objective : To determine the difference of 30-days survival in elderly patients with community-acquired pneumonia in various degree of dependency during admission.

Jakarta: Fakultas Kedokteran Universitas Indonesia, 2014

T58723

UI - Tesis Membership Universitas Indonesia Library

Krisma Perdana Harja

Peran akupunktur dalam menurunkan skala nyeri pada pasien geriatri dengan nyeri akut = The role of acupuncture in reducing pain scale scoring in geriatric patients with acute pain

"Nyeri merupakan salah satu permasalahan yang banyak dialami populasi geriatri di dunia dan menimbulkan penurunan kualitas hidup, fungsionalitas, serta beban sosioekonomi yang besar. Polifarmasi, tingginya angka kejadian demensia dan gangguan kognitif lain, serta meningkatnya sensitivitas terhadap obat analgesi menyebabkan rentannya populasi geriatri mendapatkan penanganan nyeri yang tidak adekuat. Penanganan nyeri yang tidak adekuat ini disertai berbagai perubahan fisiologis pada populasi geriatri meningkatkan risiko terbentuknya nyeri kronik, kerentaan, depresi dan ansietas, peningkatan morbiditas, serta penurunan kualitas hidup dan fungsionalitas. Populasi geriatri diperkirakan terus meningkat tiap tahunnya baik di Indonesia dan dunia; hal ini disertai dengan sulitnya pemberian analgesi yang adekuat menyebabkan perlunya penanganan nyeri yang efektif dan aman. Berbagai penelitian menunjukkan akupunktur dapat menurunkan nyeri pada populasi geriatri. Studi berupa telaah sistematis ini bertujuan untuk memaparkan peran akupunktur dalam menurunkan skala nyeri pada pasien geriatri dengan nyeri akut. Dilakukan pencarian literatur secara sistematis pada sumber data Google Scholar dan PubMed menggunakan kata kunci acupuncture, manual acupuncture, electroacupuncture, laserpuncture, laser acupuncture, ear acupuncture, battlefield acupuncture, pain, dan acute pain. Setelah studi yang didapatkan disingkirkan duplikasinya serta dipilah berdasarkan kriteria inklusi dan eksklusi, didapatkan tujuh studi yang digunakan dalam pembahasan; dengan skala nyeri yang digunakan mencakup Visual Analog Scale (VAS), Numeric Rating Scale (NRS), McGill Pain Questionnaire (MPQ), dan Brief Pain Inventory (BPI). Dilakukan penilaian kualitas studi menggunakan Cochrane Risk of Bias Tool ver. 2, dan metode Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) dan didapatkan secara umum studi yang didapatkan memiliki kualitas yang baik. Berdasarkan hasil dari ketujuh studi tersebut didapatkan bahwa pemberian akupunktur dapat menimbulkan penurunan skala nyeri VAS, NRS, MPQ, dan BPI yang signifikan baik secara statistik maupun klinis. Selain itu, didapatkan pula akupunktur dapat menurunkan kebutuhan obat-obat analgesi terutama opioid, serta aman untuk digunakan pada pasien geriatri dengan nyeri akut.

Pain is one of the problems commonly found in geriatric population in the world; pain caused reduction in quality of life and functionality, and increase in socioeconomic burden. Polypharmacy, increase in dementia and other cognitive impairments, and increased sensitivity to analgesics side effects made the geriatric population vulnerable to inadequate analgesia. Inadequate analgesia coupled with various physiological changes in geriatric population increase the risk of forming chronic pain, frailty, depression and anxiety; increase morbidity, and reduce quality of life and functionality. It is estimated that the number of geriatric population will continue to increase in the future, whether in the world or in Indonesia. With the continuously increasing population and difficulty in giving an adequate analgesia, a form of pain management that is effective and safe for geriatric patients with acute pain is required. Many studies showed that acupuncture is effective and safe in the pain management of geriatric patients. This systematic review was done in order to explain the role of acupuncture in reducing pain scale scoring in geriatric patients with acute pain. Systematic literature searching was done using the keyword acupuncture, manual acupuncture, electroacupuncture, laserpuncture, laser acupuncture, ear acupuncture, battlefield acupuncture, pain, and acute pain. with Google Scholar and PubMed as database. After eliminating duplications and applying the inclusion and exclusion criteria, seven studies was found and used for analysis. The studies used in the analysis used Visual Analog Scale (VAS), Numeric Rating Scale (NRS), McGill Pain Questionnaire (MPQ), and Brief Pain Inventory (BPI). Quality assessment of the studies used in analysis was done using Cochrane Risk of Bias Tool ver. 2 and Grading of Recommendations, Assessment, Development, and Evaluations (GRADE); it was found that overall the quality of the studies used was good. Based on the analysis acupuncture was found to reduce pain scale scoring of VAS, NRS, MPQ, and BPI significantly, whether statistically or clinically. Acupuncture was also found to reduce analgesic requirements, especially opioids, and is safe to be given in geriatric patients with acute pain."

Depok: Fakultas Kedokteran Universitas Indonesia, 2020

T-pdf

UI - Tesis Membership Universitas Indonesia Library

Rita Halim

Asupan protein, asupan asam amino rantai cabang, kadar prealbumin serum dan hubungannya dengan kekuatan otot pada lanjut usia = Protein and branched chain amino acids bcaa intakes serum prealbumin level and its relationship with muscle strength among elderly / Rita Halim

"ABSTRAK

Pada lanjut usia terjadi penurunan massa dan kekuatan otot yang memengaruhi

kapasitas fungsional sehingga meningkatkan risiko sarkopenia. Salah satu faktor yang dinilai dapat memengaruhi penurunan massa dan kekuatan otot pada lansia adalah menurunnya asupan protein dan asam amino rantai cabang (AARC) sehingga akan memengaruhi status protein viseral terutama prealbumin. Tujuan penelitian ini adalah untuk menilai hubungan antara asupan protein, AARC dan kadar prealbumin dengan kekuatan otot pada lansia. Metode penelitian ini adalah studi potong lintang pada 52 lansia dari bulan April-Mei 2016. Data asupan makanan yang meliputi asupan energi, kalori non protein, protein dan AARC didapatkan dari food record 2x24 jam. Pengambilan darah dilakukan setelah subjek berpuasa ± 8 jam dan pengukuran kekuatan otot dengan handgrip dynamometer merk Jamar. Hasil penelitian menunjukan tidak terdapat korelasi yang signifikan antara kekuatan genggam tangan dengan asupan protein (r=0,21 dan p=0,11), asupan AARC (r=0,18 dan p=0,19), dan kadar prealbumin serum (r=-0,05 dan p=0,69). Kesimpulan dari penelitian ini didapatkan bahwa asupan protein yang rendah tetapi disertai dengan asupan energi dan AARC yang cukup akan memengaruhi kadar prealbumin serum dan kekuatan otot tetap berada pada nilai normal, walaupun tidak ditemukan hubungan yang bermakna secara statistik.

ABSTRACT

The decrease of muscle mass and strength in elderly people will affect the

functional capacity and increase the risk of sarcopenia. One factor that can affect the loss of mass and muscle strength in elderly is the decrease in protein and branched chain amino acids (BCAA) intakes. This will affect the visceral protein status, especially prealbumin. The purpose of this study is to assess the association between intake of protein, BCAA and serum prealbumin level with muscle strength in elderly people. The methodology of this research is a cross-sectional study with 52 elderly people from April-May 2016. Food intake include energy, non-protein calorie (NPC), protein, and BCAA which is obtained from 2x24 hours food records. Blood sampling was performed after the subjects fasted for ± 8 hours, and muscle strength was measured with a Jamar's handgrip dynamometer. The results show there are no correlation between protein intake with the hand grip strength (r = 0,21 and p = 0,11), as well as AARC intake (r = 0,18 and p = 0,19) and prealbumin serum level (r = -0,056 and p = 0,69). This study concludes that low protein intake but accompanied with sufficient energy intake and BCAA will affect serum prealbumin level and muscle strength will be remained at normal values, however a statistically significant relationship is not found."

2016

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UI - Tesis Membership Universitas Indonesia Library

Paulina Togina

Uji kesahihan dan keandalan simplified nutritional appetite questionnaire dalam menapis risiko penurunan berat badan pada usia lanjut = Validity and reability test simplified nutritional appettite questionnaire for screening the risks of weight lose among the elderly / Paulina Togina

"ABSTRAK

Kehilangan berat badan yang tidak diinginkan merupakan salah satu masalah gizi pada usia lanjut. Untuk itu dibutuhkan alat skrining untuk mendeteksi risiko penurunan berat badan pada usia lanjut. Simplified Nutritional Appettite Questionnaire SNAQ merupakan salah satu alat skrining yang cepat dan mudah. Tujuan dan penelitian ini adalah mengetahui kesahihan dan keandalan SNAQ versi Indonesia. Studi potong lintang dilakukan terhadap 105 subyek berusia 60 tahun keatas dipilih secara konsekutif. Semua subyek menjalani pengukuran antropometri, pemeriksaan hemoglobin, serta skrinning SNAQ dan CNAQ. Analisis Statistik menggunakan uji Cronbach ?, uji korelasi spearman. Hasil Kuesioner SNAQ versi Indonesia mempunyai keandalan Cronbach ? 0.779 dan kesahihan r = 0.709 dan p < 0.001 . Hal ini menunjukan keandalan dan kesahihan SNAQ versi Indonesia dalam menilai risiko penurunan berat badan pada usia lanjut.

ABSTRACT

The purpose of this study is to find out the validity and reliability of the Simplified Nutritional Appetite Questionnaire SNAQ in its Indonesian questionnaire version, to screen the risks of weight loss among subjects of advanced age, so that malnutrition can quickly be recognized, and nutrition supplements be prescribed at an early stage. This research was comprised of a cross section of subjects above the age of 60, who were chosen consecutively. Statistical analysis was conducted using the test Cronbach , and correlated using Spearman. The results of the Indonesian version of the SNAQ questionnaire possessed reliability Cronbach 0.779 and validity r 0.709 dan p 0.001 . These values indicate that the Indonesian version of the SNAQ questionnaire is adequately valid and reliable for gauging the risks of weight loss among the elderly. "

2017

T50310

UI - Tesis Membership Universitas Indonesia Library

Maria Arlene

Pengaruh satu sesi akupunktur ditambah terapi standar dibandingkan terapi standar terhadap penurunan skala nyeri pada pasien geriatri dengan nyeri akut = Effects of one session acupuncture in addition to standard therapy versus standard therapy alone on pain scale reduction in geriatric with acute pain

"Pendahuluan: Nyeri pada lansia masih merupakan tantangan yang besar bagi tenaga kesehatan. Tatalaksana nyeri akut menjadi penting karena penanganan nyeri akut yang inadekuat telah dihubungkan dengan luaran yang lebih buruk selama hospitalisasi, termasuk nyeri persisten, waktu perawatan yang lebih lama, hambatan pada terapi fisik, keterlambatan ambulasi, dan delirium. Penggunaan farmakoterapi harus lebih berhati-hati karena kelompok lansia lebih rentan terhadap efek samping dan interaksi obat, adanya polifarmasi dan komorbiditas yang lebih banyak. Akupunktur telah diketahui efektif untuk menangani berbagai macam nyeri pada geriatri. Tujuan penelitian ini adalah untuk mengetahui bagaimana pengaruh satu sesi akupunktur dalam penurunan skala nyeri pada pasien geriatri dengan nyeri akut.

Metode: Desain studi ini adalah studi uji klinis acak terkontrol tersamar tunggal. Empat puluh lansia > 60 tahun dengan nyeri yang dialami ≤ 6 bulan atau perburukan dalam ≤ 6 bulan terakhir dan NRS ≥ 4 dibagi menjadi 2 kelompok yaitu: kelompok terapi standar dan kelompok kombinasi terapi standar dan akupunktur. Perlakuan akupunktur dilakukan 1 sesi pada titik Battlefield Acupuncture. Seluruh subyek tetap menerima terapi standar yang ditentukan oleh dokter penanggungjawab pasien. Penilaian skor NRS dan VAS dilakukan 30 menit, 1 jam, dan 2 jam setelah menerima perlakuan.

Hasil: Rerata penurunan skor NRS dan VAS pada kelompok yang menerima kombinasi terapi standar dan akupunktur pada ketiga waktu pengukuran lebih baik secara bermakna dibandingkan dengan kelompok terapi standar (p<0,001).

Kesimpulan: Pemberian satu sesi akupunktur dapat mempengaruhi kecepatan penurunan skala nyeri pada pasien lansia dengan nyeri akut.

Introduction: Pain management in elderly still become problematic for health workers. Adequate acute pain treatment is important because ineffective management for acute pain is associated with poorer outcomes throughout hospitalization, such as persistent pain, longer hospitalization period, delayed ambulation, and delirium. The use of pharmacotherapy in this group should be more cautious because elderly is more susceptible to drug interaction and side effects, polypharmacy, and comorbidities. Acupuncture has been found to be effective and safe in treating various kinds of pain in elderly. The aim of this study was to determine the effect of one session acupuncture on pain scale reduction in geriatric with acute pain.
Methods: This was a single blinded, randomized controlled trial of 40 elders with pain experienced ≤ 6 months or worsening in the last 6 months, with NRS ≥ 4. The subjects were divided into 2 groups: the standard therapy group and the combination of standard therapy and acupuncture group. Acupuncture treatment was performed one time using Battlefield Acupuncture points. All subjects continued to receive standard therapy as determined by the doctor in charge of the patient. NRS and VAS scores were assessed 30 minutes, 1 hour, and 2 hours after receiving treatment to evaluate patient’s outcome.
Results: Both NRS and VAS scores showed significant differences between 2 groups at all measurement times (p<0,001), with the mean reduction of pain scales in the group receiving combination of standard therapy and acupuncture was better than in standard therapy group.
Conclusion: The administration of one session acupuncture can affected pain scale reduction in elderly with acute pain"

Depok: Fakultas Kedokteran Universitas Indonesia, 2020

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Audrey Haryanto

Korelasi antara kadar vitamin D serum dengan kadar hsCRP pada usia lanjut = Correlation between serum vitamin D level and hsCRP in elderly

"Prevalensi penyakit kardiovaskuler (PKV) meningkat seiring dengan proses penuaan. Aterosklerosis yang menyebabkan terjadinya inflamasi dan diikuti peningkatan kadar C-reactive protein (CRP). Vitamin D merupakan vitamin yang memiliki efek antiinflamasi dan dapat menurunkan kadar hsCRP. Penelitian ini merupakan penelitian dengan desain potong lintang yang bertujuan untuk mengetahui korelasi antara kadar vitamin D dengan kadar hsCRP pada usia lanjut (usila). Penelitian dilakukan di Pusat Santunan Keluarga (Pusaka) 12 di Tomang dan Pusaka 39 di Senen pada pertengahan bulan Desember 2012 sampai bulan Januari 2013. Pengambilan subyek dilakukan dengan cara cluster random sampling, dan didapatkan 71 orang subyek yang memenuhi kriteria penelitian. Data dikumpulkan melalui wawancara meliputi data usia, asupan vitamin D dengan metode Food Frequency Questionnaire (FFQ) semikuantitatif serta total skor pajanan sinar matahari mingguan. Pengukuran antropometri untuk menilai status gizi dan pemeriksaan laboratorium yang meliputi kadar vitamin D dan hsCRP. Didapatkan median usia 69 (60-85) tahun dan 80,3% subyek adalah perempuan. Malnutrisi terdapat pada 71,8 % subyek. Asupan vitamin D menunjukkan 98,6% subyek memiliki asupan vitamin D kurang dari Angka Kecukupan Gizi (AKG) Indonesia. Sebanyak 97,2% subyek memiliki skor pajanan sinar matahari rendah. Nilai rerata kadar vitamin D 38,02±12,94 nmol/L dan 78% subyek tergolong defisiensi vitamin D. Nilai median kadar hsCRP 1,5 (0,1-49,6) mg/L, dan 67,6% subyek tergolong risiko PKV sedang dan tinggi. Didapatkan korelasi positif tidak bermakna antara kadar vitamin D serum dengan kadar hsCRP pada usila (r=0,168, p=0,162).

The prevalence of cardiovascular disease (CVD) increases in the elderly. Atherosclerosis is a major cause of CVD which stimulate inflammation and followed by increase production of C-reactive protein (CRP). Vitamin D is a vitamin which has anti-inflammatory effects and may reduce level of hsCRP. The aim of this cross sectional study was to find the correlation between serum vitamin D level and hsCRP in elderly. Data collection was conducted during December 2012 to January 2013 on 2 selected Pusaka, Pusaka 12 (Tomang) and Pusaka 39 (Senen). Subjects were obtained using cluster random sampling method. A total of 71 elderly subjects had met the study criteria. Data were collected through interviews including age, vitamin D intake and weekly score of sunlight exposure. Anthropometry measurements to assess the nutritional status and laboratory examination i.e blood levels of vitamin D and hsCRP. Majority of the subjects were female (80,3%), median age was 69 (60-85) years. Malnutrition was occured in 71.8% of the subjects. Intake of vitamin D showed 98.6% of the subjects were less than recommended dietary allowances (RDA). Majority of the subjects had low score of sunlight exposure (97,2%). Mean of vitamin D levels 38,02±12,94 nmol/L, while 78% the of subjects were categorized as vitamin D deficiency. Median of hsCRP levels 1,5 (0,1-49,6) mg/L, while 67,6% subjects were at moderate and high risk of CVD. No significant correlation was found between serum vitamin D levels and hsCRP levels (r=0,168, p=0,162)."

Jakarta: Fakultas Kedokteran Universitas Indonesia, 2013

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