THE EFFECTIVENESS OF COMBINED VISUAL CUE TRAINING AND CORE STABILITY EXERCISE TO PREVENT RISK OF FALLS IN POST STROKE-INDIVIDUALS
Abstract
Penelitian ini bertujuan untuk mengetahui efektivitas kombinasi Visual Cue Training (VCT) dengan Core Stability Exercise (CSE) untuk mencegah risiko jatuh pada individu pasca stroke. Penelitian ini merupakan quasi eksperimen dengan menggunakan pre-post test randomized control design. Kelompok perlakuan I terdiri dari 8 orang yang diberikan VCT kombinasi dengan CSE, sedangkan pada kelompok perlakuan II ada 8 orang yang diberi CSE. Penelitian ini dilakukan di Klinik Fisioterapi Sri Mulyani selama 4 minggu dari bulan Februari hingga April 2023. Instrumen pengukuran risiko jatuh menggunakan Dynamic Gait Index (DGI). Hasil penelitian menggunakan instrumen DGI menunjukkan bahwa pada kelompok perlakuan I terdapat penurunan risiko jatuh yang signifikan pada individu pasca stroke (p<0,05 atau p=0,0004***) dan pada kelompok perlakuan II terdapat penurunan risiko jatuh yang signifikan (p<0,05 atau p=0,0011**). Kesimpulan dari hasil penelitian ini menunjukkan bahwa VCT dan CSE dapat menjadi rekomendasi untuk mengurangi risiko jatuh pada individu pasca stroke. Namun, dari hasil statistik tampak bahwa kombinasi keduanya akan lebih efektif.
References
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[6] Joyce WL, Zukri IM, Ching S, Devaraj N. (2020). Factors associated with falls among the elderly attending a government clinic in Kuala Lumpur. Mal J Med Health Sci. 16:183–90.
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[12] Simpson L, Miller W, Eng J. (2011). Effect of stroke on fall rate, location and predictors: a prospective comparison of older adults with and without stroke. PLoS ONE. 6:e19431. doi: 10.1371/journal.pone.0019431
[13] Tilson J, Wu S, Cen S, Feng Q, Rose D, Behrman A, et al. (2012). Characterizing and identifying risk for falls in the LEAPS study: a randomized clinical trial of interventions to improve walking poststroke. Stroke. 43:446– 52. doi: 10.1161/STROKEAHA.111.636258
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[15] Purnamasari, N., Bachtiar, F., & Puspitha, A. (2019). The Effectiveness of Motoric Cognitive Dual-Task Training in Reducing Risk of Falls on Elderly. Jurnal Mkmi. 284–291.
[16] Peraturan Menteri Kesehatan Republik Indonesia Nomor 65 Tahun 2015 Tentang. Standar Pelayanan Fisioterapi.
[17] Hollands et al. (2013). Visual cue training to improve walking and turning after stroke: a study protocol for a multi-centre, single blind randomised pilot trial. Trials. 14:276.
[18] Nam, S.-M.; Lee, D.-Y. (2022). Effects of Visual Cue Deprivation Balance Training with Head Control on Balance and Gait Function in Stroke Patients. Medicina. 58, 629. https://doi.org/10.3390/ medicina58050629
[19] Bonan IV, Yelnik AP, Colle FM, Michaud C, Normand E, Panigot B, Roth P, Guichard JP, Vicaut E. (2004). Reliance on visual information after stroke. Part II: Effectiveness of a balance rehabilitation program with visual cue deprivation after stroke: a randomized controlled trial. Arch Phys Med Rehabil. 85(2):274–278
[20] Noorratri, E. D., Mei Leni, A. S., & Kardi, I. S. (2020). Deteksi Dini Resiko Jatuh Pada Lansia Di Posyandu Lansia Kentingan, Kecamatan Jebres, Surakarta. GEMASSIKA : Jurnal Pengabdian Kepada Masyarakat. 4(2), 128. https://doi.org/10.30787/gemassika.v4i2.636
[21] Maratis J., Fatria I., Meidian A.C., Abdurrasyid., Syah. (2020). Pelatihan Rhythmic Auditory Stimulation (RAS) dan Visual Cue Training (VCT) Memperbaiki Kemampuan Berjalan Pasien Stroke. Fisiomu. Vol 1(2):68-75 DOI : 10.23917/fisiomu.v%vi%i.11428
[22] Amatachaya, S., Keawsutthi, M., Amatachaya, P., & Manimmanakorn, N. (2009). Effects of external cues on gait performance in independent ambulatory incomplete spinal cord injury patients. Spinal Cord. 47(9), 668–673. https://doi.org/10.1038/sc.2008.168.
[23] Faries MD, Greenwood M. 92007). Core training: stabilizing the confusion. Strength Cond J. 29:10–25. doi: 10.1519/1533-4295200729[10:CTSTC]2.0.CO2
[24] Haruyama K, Kawakami M, Otsuka T. (2017). Effect of core stability training on trunk function, standing balance, and mobility in stroke patients. Neurorehabil Neural Repair. 31:240–9. doi: 10.1177/1545968316675431
[25] Key J. (2013). ‘The core’ Understanding it retraining its dysfunction. J Bodyw Mov Ther. 17:541–59. doi: 10.1016/j.jbmt.2013.03.012
[26] Kisner, Carolyn and Colby Lynn A. (2013). Theraupetic Exercise Fuundation and Techniques Six Edition. Philadelphia : F.A. Davis Company.
[27] Reid Trombetti and R. A. Fielding. (2016). Age-associated declines in muscle mass, strength, power, and physical performance: impact on fear of falling and quality of life. PMC Osteoporos Int. 27(2): 463–471.
[28] Ryan, S. (2020). Dynamic-Gait-Index. Retrieved from https://www.sralab.org/rehabilitation measures/dynamic-gait-index.
[29] Irfan, M. (2010). Fisioterapi Bagi Insan Stroke. Yogyakarta: Graha Ilmu.
[30] Cooper, Kejonen L, et al. (2009). A Randomised Controlled Trial of Proprioceptive and Balance Training After Surgical Recontruction of The Anterior Cruciate Ligament. Research in Sport Medicine, 3: 217-230.
[31] Azulay, J. P., Mesure, S., Blin, O. 2006. Influence of Visual Cues on Gait in Parkinson’s Disease: Contribution to Attention or Sensory Dependence. Journal of the Neurological Science. 248 :192-95
[32] Amatachaya, S., Keawsutthi, M., Amatachaya, P., & Manimmanakorn, N. (2009). Effects of external cues on gait performance in independent ambulatory incomplete spinal cord injury patients. Spinal Cord. 47(9), 668–673. https://doi.org/10.1038/sc.2008.168.
[33] Jiang Y, Normam KE. (2006). Effects of visual and auditory cues on gait initiation in people with Parkinson’s disease. Clin Rehab. 20: 36–45
[34] Van Hedel HJ, Dietz V, Curt A. (2007). Assessment of walking speed and distance in subjects with an incomplete spinal cord injury. Neurorehabil Neural Repair. 21: 295–301
[35] Reynolds RF, Day BL. (2005). Visual guidance of the human foot during a step. J Physiol. 569: 677–684.
[36] Sidaway, B., Anderson, J., Danielson, G., Martin, L., Smith, G. (2006). Effects of Long-Term Gait Training Using Visual Cues in An Individual with Parkinson disease. PHYS THER. 86(2): 186-94
[37] Vasseljen O, Fladmark AM. (2010). Abdominal muscle contraction thickness and function after specific and general exercises: a randomized controlled trial in chronic low back pain patients. Man Ther. 15(5):482-489. doi: 10.1016/j. math.2010.04.004
[38] Ko Dae-Sik, Dae-In Jung and Mi-Ae Jeong. (2014). Analysis of Core Stability Exercise Effect on the Physical and Psychological Function of Elderly Women Vulnerable to Falls during Obstacle Negotiation. Journal of Physical Therapy Science. 26(11): 1697-1700
[39] Sumakul, Vione D. O. et al. (2023). Pengaruh Core Stability Exercise Terhadap Keseimbangan Berjalan Pasien Pasca Stroke di RSU Gunung Maria Tomohon. AKSARA: Jurnal Ilmu Pendidikan Nonformal. DOI: http://dx.doi.org/10.37905/aksara.9.1.303-312.2023
[40] Chen X, Gan Z, Tian W, Lv Y. (2020). Effects of rehabilitation training of core muscle stability on stroke patients with hemiplegia. Pak J Med Sci. 36(3):461-466. doi: https://doi.org/10.12669/pjms.36.3.1466
[2] Krishnamurthi V, Moran A, Feigin V, Barker-Collo S, Norrving B et al. (2015). Stroke prevalence, mortality and disability-adjusted life years in adults aged 20– 64 years in 1990–2013: data from the global burden of disease 2013 study. Neuroepidemiology. 45:190–202. doi: 10.1159/000441098.
[3] Feigin V, Roth G, Naghavi M, Parmar P, Krishnamurthi R, Chugh S, et al. (2016). Global burden of stroke and risk factors in 188 countries, during 1990–2013: a systematic analysis for the global burden of diseases study 2013. Lancet Neurol. 15:913–24. doi: 10.1016/S1474-4422(16)30073-4.
[4] Gue’niat J, Brenie‘re C, Graber M, Garnier L, Mohr S, Giroud M, et al. (2018). Increasing burden of stroke. The dijon stroke registry (1987–2012). Neuroepidemiology. 50:47–56. doi: 10.1159/000486397.
[5] Lecoffre C, Peretti Cd, Gabet A, Grimaud O, Woimant F, Giroud M, et al. (2017). L’accident vasculaire ce’re’bral en France : patients hospitalise’s pour AVC en 2014 et e’volutions 2008– 2014. BEH. 7:84–94.
[6] Joyce WL, Zukri IM, Ching S, Devaraj N. (2020). Factors associated with falls among the elderly attending a government clinic in Kuala Lumpur. Mal J Med Health Sci. 16:183–90.
[7] Chang V, Do M. (2015). Risk factors for falls among seniors: implications of gender. Am J Epidemiol. 1817:521–31. doi: 10.1093/aje/kwu268.
[8] Denissen S, Staring W, Kunkel D, Pickering RM, Lennon S, Geurts ACH, Weerdesteyn V, Verheyden GSAF. (2019). Interventions for preventing falls in people aer stroke. Cochrane Database of Systematic Reviews. Issue 10. Art. No. : CD008728. DOI: 10.1002/14651858.CD008728.pub3.
[9] Andersson AG, Kamwendo K, Appelros P. (2008). Fear of falling in stroke patients: relationship with previous falls and functional characteristics. International Journal of Rehabilitation Research. Internationale Zeitschri2 fur Rehabilitations for schung. Revue Internationale de Recherches de Readaptation. 31(3):261-4.
[10] Weerdesteyn V, deNiet M, vanDuijnhoven H, Geurts A. (2008). Falls in individuals with stroke. J Rehabil Res Dev. 45:1195-213. doi: 10.1682/JRRD.2007.09.0145
[11] Pouwels S, Lalmohamed A, Leufkens B, Boer AD, Cooper C, Staa TV, et al. (2009). Risk of hip/femur fracture after stroke. A population-based case-control study. Stroke. 40:3281–5. doi: 10.1161/STROKEAHA.109.554055
[12] Simpson L, Miller W, Eng J. (2011). Effect of stroke on fall rate, location and predictors: a prospective comparison of older adults with and without stroke. PLoS ONE. 6:e19431. doi: 10.1371/journal.pone.0019431
[13] Tilson J, Wu S, Cen S, Feng Q, Rose D, Behrman A, et al. (2012). Characterizing and identifying risk for falls in the LEAPS study: a randomized clinical trial of interventions to improve walking poststroke. Stroke. 43:446– 52. doi: 10.1161/STROKEAHA.111.636258
[14] Weerdesteyn V, De Niet M, Van Duijnhoven HJ, Geurts AC. (2008). Falls in individuals with stroke. Journal of Rehabilitation Research and Development. 45(8):1195-213
[15] Purnamasari, N., Bachtiar, F., & Puspitha, A. (2019). The Effectiveness of Motoric Cognitive Dual-Task Training in Reducing Risk of Falls on Elderly. Jurnal Mkmi. 284–291.
[16] Peraturan Menteri Kesehatan Republik Indonesia Nomor 65 Tahun 2015 Tentang. Standar Pelayanan Fisioterapi.
[17] Hollands et al. (2013). Visual cue training to improve walking and turning after stroke: a study protocol for a multi-centre, single blind randomised pilot trial. Trials. 14:276.
[18] Nam, S.-M.; Lee, D.-Y. (2022). Effects of Visual Cue Deprivation Balance Training with Head Control on Balance and Gait Function in Stroke Patients. Medicina. 58, 629. https://doi.org/10.3390/ medicina58050629
[19] Bonan IV, Yelnik AP, Colle FM, Michaud C, Normand E, Panigot B, Roth P, Guichard JP, Vicaut E. (2004). Reliance on visual information after stroke. Part II: Effectiveness of a balance rehabilitation program with visual cue deprivation after stroke: a randomized controlled trial. Arch Phys Med Rehabil. 85(2):274–278
[20] Noorratri, E. D., Mei Leni, A. S., & Kardi, I. S. (2020). Deteksi Dini Resiko Jatuh Pada Lansia Di Posyandu Lansia Kentingan, Kecamatan Jebres, Surakarta. GEMASSIKA : Jurnal Pengabdian Kepada Masyarakat. 4(2), 128. https://doi.org/10.30787/gemassika.v4i2.636
[21] Maratis J., Fatria I., Meidian A.C., Abdurrasyid., Syah. (2020). Pelatihan Rhythmic Auditory Stimulation (RAS) dan Visual Cue Training (VCT) Memperbaiki Kemampuan Berjalan Pasien Stroke. Fisiomu. Vol 1(2):68-75 DOI : 10.23917/fisiomu.v%vi%i.11428
[22] Amatachaya, S., Keawsutthi, M., Amatachaya, P., & Manimmanakorn, N. (2009). Effects of external cues on gait performance in independent ambulatory incomplete spinal cord injury patients. Spinal Cord. 47(9), 668–673. https://doi.org/10.1038/sc.2008.168.
[23] Faries MD, Greenwood M. 92007). Core training: stabilizing the confusion. Strength Cond J. 29:10–25. doi: 10.1519/1533-4295200729[10:CTSTC]2.0.CO2
[24] Haruyama K, Kawakami M, Otsuka T. (2017). Effect of core stability training on trunk function, standing balance, and mobility in stroke patients. Neurorehabil Neural Repair. 31:240–9. doi: 10.1177/1545968316675431
[25] Key J. (2013). ‘The core’ Understanding it retraining its dysfunction. J Bodyw Mov Ther. 17:541–59. doi: 10.1016/j.jbmt.2013.03.012
[26] Kisner, Carolyn and Colby Lynn A. (2013). Theraupetic Exercise Fuundation and Techniques Six Edition. Philadelphia : F.A. Davis Company.
[27] Reid Trombetti and R. A. Fielding. (2016). Age-associated declines in muscle mass, strength, power, and physical performance: impact on fear of falling and quality of life. PMC Osteoporos Int. 27(2): 463–471.
[28] Ryan, S. (2020). Dynamic-Gait-Index. Retrieved from https://www.sralab.org/rehabilitation measures/dynamic-gait-index.
[29] Irfan, M. (2010). Fisioterapi Bagi Insan Stroke. Yogyakarta: Graha Ilmu.
[30] Cooper, Kejonen L, et al. (2009). A Randomised Controlled Trial of Proprioceptive and Balance Training After Surgical Recontruction of The Anterior Cruciate Ligament. Research in Sport Medicine, 3: 217-230.
[31] Azulay, J. P., Mesure, S., Blin, O. 2006. Influence of Visual Cues on Gait in Parkinson’s Disease: Contribution to Attention or Sensory Dependence. Journal of the Neurological Science. 248 :192-95
[32] Amatachaya, S., Keawsutthi, M., Amatachaya, P., & Manimmanakorn, N. (2009). Effects of external cues on gait performance in independent ambulatory incomplete spinal cord injury patients. Spinal Cord. 47(9), 668–673. https://doi.org/10.1038/sc.2008.168.
[33] Jiang Y, Normam KE. (2006). Effects of visual and auditory cues on gait initiation in people with Parkinson’s disease. Clin Rehab. 20: 36–45
[34] Van Hedel HJ, Dietz V, Curt A. (2007). Assessment of walking speed and distance in subjects with an incomplete spinal cord injury. Neurorehabil Neural Repair. 21: 295–301
[35] Reynolds RF, Day BL. (2005). Visual guidance of the human foot during a step. J Physiol. 569: 677–684.
[36] Sidaway, B., Anderson, J., Danielson, G., Martin, L., Smith, G. (2006). Effects of Long-Term Gait Training Using Visual Cues in An Individual with Parkinson disease. PHYS THER. 86(2): 186-94
[37] Vasseljen O, Fladmark AM. (2010). Abdominal muscle contraction thickness and function after specific and general exercises: a randomized controlled trial in chronic low back pain patients. Man Ther. 15(5):482-489. doi: 10.1016/j. math.2010.04.004
[38] Ko Dae-Sik, Dae-In Jung and Mi-Ae Jeong. (2014). Analysis of Core Stability Exercise Effect on the Physical and Psychological Function of Elderly Women Vulnerable to Falls during Obstacle Negotiation. Journal of Physical Therapy Science. 26(11): 1697-1700
[39] Sumakul, Vione D. O. et al. (2023). Pengaruh Core Stability Exercise Terhadap Keseimbangan Berjalan Pasien Pasca Stroke di RSU Gunung Maria Tomohon. AKSARA: Jurnal Ilmu Pendidikan Nonformal. DOI: http://dx.doi.org/10.37905/aksara.9.1.303-312.2023
[40] Chen X, Gan Z, Tian W, Lv Y. (2020). Effects of rehabilitation training of core muscle stability on stroke patients with hemiplegia. Pak J Med Sci. 36(3):461-466. doi: https://doi.org/10.12669/pjms.36.3.1466
Published
2023-08-09
How to Cite
Fatria, I. (2023). THE EFFECTIVENESS OF COMBINED VISUAL CUE TRAINING AND CORE STABILITY EXERCISE TO PREVENT RISK OF FALLS IN POST STROKE-INDIVIDUALS. Jurnal Inovasi Pendidikan Dan Sains, 4(2), 123-128. https://doi.org/10.51673/jips.v4i2.1704
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