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"Nyeri merupakan gejala utama pada pasien dengan Osteoartritis OA , dan berdampak terhadap gangguan fungsional serta penurunan kualitas hidup. Latihan isometrik kuadrisep dan Jalan kaki dapat menjadi alternatif latihan pada pasien OA lutut untuk mengurangi keluhan nyeri. Penelitian ini bertujuan untuk mengidentifikasi perbandingan efektifitas jalan kaki dan latihan isometrik kuadrisep terhadap nyeri dan rentang gerak sendi pada pasien dengan osteoartritis lutut. Desain penelitian menggunakan quasi-experimental design dengan pendekatan non equivalent control group before - after. Jumlah sampel terdiri dari 17 responden pada masing-masing kelompok dengan teknik consecutive sampling. Hasil penelitian menunjukkan bahwa latihan jalan kaki efektif menurunkan nyeri dan meningkatkan rentang gerak sendi pasien OA lutut p 0.000. Latihan isometrik kuadrisep efektif menurunkan nyeri dan meningkatkan rentang gerak sendi fleksi lutut pasien OA lutut p 0.000. Namun setelah dibandingkan kedua latihan tersebut menunjukkan bahwa latihan jalan kaki tidak lebih efektif menurunkan nyeri dan meningkatkan rentang gerak sendi fleksi lutut daripada latihan isometrik kuadrisep pada pasien OA lutut p 0.000. Perlu dibuat protap latihan jalan kaki dan latihan isometrik kuadrisep yang terprogram. Pasien dengan obesitas dan derajat OA sedang bisa diarahkan dengan pilihan latihan isometrik kuadrisep. Sedangkan pasien dengan berat badan normal atau indeks masa tubuh kurang dan OA derajat ringan, bisa diarahkan pada latihan jalan kaki, serta pemberian edukasi gaya hidup agar kualitas hidup menjadi lebih baik.

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Pain is known as the main symptom of Osteoarthritis OA which affect on the functional impairment and patient rsquo s quality of life. Alternatively, isometric quadriceps exercise and walking exercise could be employed to reduce the pain among knee OA patients. This study aimed to identify the comparison between walking exercise and isometric quadriceps exercise on pain and joint range of motion in knee osteoarthritis patients. This research was used quasi experimental with non equivalent control group before - after design. The experimental and control group, involved 17 respondents respectively with consecutive sampling technique.

The results showed the walking exercise is significantly reduce pain and increase knee flexion range of motion p 0.000. Similarly, the isometric quadriceps exercise is significantly decrease pain and increase knee flexion range of motion p 0.000. Nevertheless, after being compared showed that walking exercise is no more effective reduce pain and increase knee flexion range of motion rather than isometric quadriceps exercise in knee osteoarthritis patients. A standard operational procedure for walking exercise and isometric quadriceps exercise is programmed. Patients with obesity and moderat OA can be directed by choice of isometric quadriceps exercises. While patients with normal weight or less body mass index and mild OA, can be directed to walking exercise, as well as providing lifestyle education for better quality of life."

"Tujuan: Mengetahui perbandingan efek latihan isokinetik dan isometrik terhadap nyeri, kekuatan otot dan kemampuan fungsional pada pasien osteoarthritis lutut. Disain: Eksperimental paralel. Subjek: 28 orang pasien berusia antara 50-64 tahun, dibagi secara acak menjadi dua kelompok. Tempat: Bagian Ilmu Kedokteran Fisik dan Rehabilitasi. Perjan RS Dr. Hasan Sadikin. Bandung. Intervensi: Pasien menjalani program latihan isokinetik atau isometrik selama 6 minggu. Parameter: VAS, peak torque, indeks Lequesne yang diukur setiap minggu. Hasil: Kedua kelompok menunjukkan penurunan yang bermakna pada intensitas nyeri (p<0,001) dan indeks Lequesne (p<0,001), juga peningkatan yang bermakna pada peak torque (p<0,001) setelah 6 minggu. Tidak terdapat perbedaan yang bermakna antara kedua kelompok. Kesimpulan: Kedua jenis latihan berguna pada pasien osteoarthritis berusia lanjut Pada kelompok isokinetik tidak didapatkan subjek yang mengeluh nyeri yang bermakna.

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Objective: To compare the effect of isokinetic and isometric strengthening exercise on pain, strength and functional capacity of patients with knee osteoarthritis.

Design: Experimental parallel.

Participants: 28 patients, age 50-64 years, were randomly assigned into two groups.

Setting: Department of Physical Medicine and Rehabilitation. Hasan Sadikin Hospital Bandung.

Interventions: Patients received either a regimen of isokinetic exercise or a regimen of isometric exercise for 6 weeks.

Main outcome measure : VAS, peak torque and Lequesne index were measured each week.

Result: Both training groups showed significant decrease in pain score (pc0, 001) and Lequesne index (p<0, 001) and an increase in peak torque (p<0,001). However there is no significant difference of those parameters between groups.

Conclusion: Both exercises can benefit elderly patients with knee osteoarthritis as shown by the increase of strength and functional capacity. In the isokonetic group there were no subjects who experienced an increase in pain."

"Tesis ini disusun untuk mengetahui efektivitas penggunaan elastic taping terhadap intensitas nyeri, kekuatan otot quadriceps dan status fungsi lutut pada pasien obesitas dengan osteoartritis lutut. Penelitian menggunakan desain uji eksperimental Randomized Control Trial. Subjek penelitian merupakan pasien overweight dan obesitas dengan osteoarthritis lutut, yang dibagi menjadi 2 kelompok yaitu kelompok kontrol dan perlakuan. Semua subjek dari kedua kelompok mendapatkan latihan standar berupa latihan aerobik dengan ergocycle, latihan penguatan otot quadriceps dan hamstring dengan NK table dan latihan keseimbangan dengan balance board sesuai dengan prosedur di Poliklinik Obesitas Departemen Rehabilitasi Medik RSCM Jakarta yang dilakukan 2x/minggu selama 2 minggu. Kelompok perlakuan mendapatkan pemasangan 3 elastic taping dengan tarikan 40- 50%, sedangkan kelompok kontrol mendapatkan pemasangan elastic taping dengan arah pemasangan yang sama namun tanpa penarikan. Pemasangan elastic taping dilakukan sebanyak 3 kali dalam waktu 2 minggu. Hasil keluaran penelitian ini berupa intensitas nyeri berdasarkan nilai VAS, kekuatan otot quadriceps yang diukur menggunakan handheld dynamometer serta penilaian kuesioner KOOS pada sebelum, setelah 1 minggu dan setelah 2 minggu pemasangan elastic taping. Analisis statistik dilakukan untuk membandingkan perubahan nilai VAS, kekuatan otot quadriceps dan nilai keusioner KOOS sesudah intervensi pada kelompok perlakuan dan kontrol. Hasil penelitian menyatakan bahwa pemasangan elastic taping sebagai terapi tambahan efektif dalam menurunkan nilai VAS, meningkatkan kekuatan otot quadriceps, dan nilai kuesioner KOOS pada pasien overweight dan obesitas dengan osteoartritis lutut setelah diberikan intervensi selama 2 minggu. Perbaikan nilai median VAS pada kelompok kontrol dan perlakuan masing-masing sebesar3 (1-4) dan 2 (1-3) dan didapatkan perbedaan signifikan dengan nilai p = 0,008. Peningkatan rerata kekuatan otot quadriceps pada kelompok kontrol dan perlakuan masing- masing sebesar 3,44±0,71 kg dan 5,66±1,71 kg, dan didapatkan perbedaan signifikan dengan nilai p< 0,001. Peningkatan rerata nilai kuesioner KOOS pada kelompok kontrol dan perlakuan masing-masing sebesar 12,92±3,51 dan 17,02±5,59, dan didapatkan perbedaan signifikan dengan nilai p=0,023. Diperlukan penelitian lebih lanjut untuk menilai efektivitas elastic taping dalam jangka waktu yang lebih lama serta untuk membandingkan efektivitas aplikasi elastic taping pada otot quadriceps antara metode dua taping dengan tiga taping untuk melihat perbandingan penurunan intensitas nyeri.

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This thesis was aimed to determine the effectiveness of elastic taping on pain intensity, quadriceps muscle strength and knee function status in obese patients with knee osteoarthritis. The study used an experimental randomized control trial design. The subjects were overweight and obese patients with knee osteoarthritis, which was divided into 2 groups: control and intervention groups. All subjects from both groups received standard exercises: aerobic exercise with ergocycle, quadriceps and hamstring muscle strengthening exercises with NK tables and balance exercises with balance board in accordance with procedures at the Obesity Polyclinic, Department of Medical Rehabilitation of RSCM Jakarta, which was conducted 2x/week for 2 weeks. The intervention group received an application of 3 elastic taping with 40-50% stretched, while the control group received an application of elastic taping with the same mounting direction but without stretching. Installation of elastic taping is done 3 times in 2 weeks. The results of this study include pain intensity based on VAS values, quadriceps muscle strength measured using a handheld dynamometer and KOOS questionnaire assessment before, after 1 week and after 2 weeks of elastic taping application. Statistical analysis was performed to compare changes in VAS values, quadriceps muscle strength and KOOS questionnaire values after the intervention in the control and intervention groups. The results stated that the application of elastic taping as an adjunct therapy was effective in reducing the value of VAS, increasing quadriceps muscle strength, and the value of the KOOS questionnaire in overweight and obese patients with knee osteoarthritis after 2 weeks of intervention. Improvements to the median VAS values in the control and intervention groups were 3 (1-4) and 2 (1-3), respectively, and a significant difference was obtained with p value 0.008. The mean increase in quadriceps muscle strength in the control and intervention groups was 3.44± 0.71 kg and 5.66 ± 1.71 kg, respectively, and a significant difference was obtained with p value <0.001. The increase in the average value of the KOOS questionnaire in the control and intervention groups was 12.92 ± 3.51 and 17.02 ± 5.59, respectively, and a significant difference was obtained with p value 0.023. Further research is needed to assess the effectiveness of elastic taping over a longer period of time and to compare the effectiveness of the application of elastic taping in the quadriceps muscle between the two taping and three taping methods to see a comparison of the decrease in pain intensity."

"LATAR BELAKANG: Sendi lutut adalah sendi yang paling sering terkena OA. Stabilitas dinamik sendi lutut dipengaruhi oleh otot-otot kuadrisep dan hamstring. Untuk mengoptimalkan gaya yang dihasilkan oleh otot, program latihan peregangan harus terintegrasi dalam program latihan penguatan pada OA. Namun, belum ada penelitian yang membandingkan efek berbagai teknik peregangan terhadap hasil latihan isotonik pada pasien OA lutut. Tujuan penelitian ini adalah untuk mengetahui apakah terdapat perbedaan efek teknik peregangan statik dibandingkan Proprioceptive Neuromuscular Facilitation PNF terhadap outcome visual analog scale VAS, lingkup gerak sendi LGS, kekuatan otot, dan kemampuan berjalan latihan penguatan isotonik otot kuadrisep dan hamstring pada pasien OA lutut. METODE: Desain penelitian ini adalah quasi experimental. Populasi terjangkau adalah wanita penderita OA lutut berusia 50 ndash; 70 tahun yang berobat ke Poliklinik Rehabilitasi Medik RSUPN Cipto Mangunkusumo Jakarta yang memenuhi kriteria penelitian. Pengambilan sampel dilakukan secara consecutive sampling dan dibagi menjadi dua kelompok secara randomisasi. Pada kelompok pertama, subjek diberi infra red radiation IRR, latihan peregangan statik, dan latihan isotonik otot kuadrisep dan hamstring. Pada kelompok kedua, subjek diberi IRR, latihan peregangan PNF, dan latihan isotonik otot kuadrisep dan hamstring. Intervensi dilakukan selama 6 minggu. Penilaian nyeri menggunakan skor VAS, LGS menggunakan goniometer, kekuatan otot menggunakan hand held dynamometer, dan kemampuan berjalan menggunakan uji jalan 15 meter. HASIL: Sebanyak 30 responden mengikuti program latihan sampai selesai, kelompok pertama dan kedua masing-masing 15 orang. Setelah 6 minggu, didapatkan perbaikan skor VAS, LGS, kekuatan otot kuadrisep dan hamstring serta uji jalan 15 meter dengan perbaikan bermakna didapatkan pada kekuatan otot hamstring pada kedua kelompok. Delta skor VAS dan uji jalan 15 meter lebih tinggi pada kelompok peregangan statik dibandingkan PNF tetapi tidak berbeda bermakna. Delta kekuatan otot kuadrisep didapatkan lebih tinggi pada kelompok peregangan statik dibandingkan PNF dan berbeda bermakna p=0.033 . Delta LGS dan kekuatan hamstring lebih tinggi pada kelompok peregangan PNF dibandingkan statik tetapi tidak berbeda bermakna. KESIMPULAN: Pemberian latihan peregangan statik maupun PNF tidak memberikan efek yang berbeda bermakna secara keseluruhan terhadap outcome latihan penguatan isotonik otot kuadrisep dan hamstring pada pasien OA lutut.

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BACKGROUND. Knee joints are the joints most commonly affected by OA. The dynamic stability of the knee joint is affected by the quadriceps and hamstring muscles. Stretching exercise programs should be integrated into strengthening exercise programs in OA to optimize the force that generated by the muscle. However, there have been no studies comparing the effects of various stretching techniques on the outcome of isotonic exercise in knee OA patients. The aim of this study was to find out whether there is a difference between the effect of static stretching compared to the Proprioceptive Neuromuscular Facilitation PNF to the outcomes visual analog scale VAS, range of motion ROM, muscle strength, and walking ability of quadriceps and hamstring muscle isotonic strengthening exercises in knee OA patients.

METHODS. The design of this study was quasi experimental. The study population is women suffering from knee OA aged 50-70 years who went to the Medical Rehabilitation Clinic RSUPN Cipto Mangunkusumo Jakarta that meet the criteria of the study. Sampling was done using consecutive sampling and divided into two groups by randomization. In the first group, subjects were given infra red radiation IRR, static stretching exercises, and isotonic exercises of quadriceps and hamstring muscles. In the second group, subjects were given IRR, PNF stretching exercises, and isotonic exercises of quadriceps and hamstring muscles. Intervention is done for 6 weeks. Pain assessment using VAS scores, ROM measurement using a goniometer, muscle strength measurement using a hand-held dynamometer, and walking ability measurement using a 50-feet walking test.

RESULTS. Thirty respondents were completed the exercise program, the first and second group consists of 15 people, respectively. After 6 weeks, the improvement of VAS, ROM, quadriceps and hamstring muscle strength and 50 feet walking test with significant improvement was obtained only hamstring muscle strength in both groups. Delta VAS scores and 50 feet walking test were higher in the static stretching group than PNF but not significantly different. Delta quadriceps muscle strength was significantly high er in the static stretch group than in PNF p = 0.033 . Delta ROM and hamstring muscle strength were higher in the PNF stretching group than in static but not significantly different.

CONCLUSIONS. There is no significant difference between the effect of static stretching techniques and the PNF on the outcomes visual analog scale VAS, range of motion ROM, muscle strength, and walking ability of quadriceps and hamstring muscle isotonic strengthening exercises in knee OA patients. "

"Tesis ini disusun untuk mengetahui efektivitas latihan retrowalking dalam meningkatkan kekuatan otot quadriceps pada pasien overweight dan obesitas derajat I dengan osteoarthritis lutut. Penelitian menggunakan desain uji eksperimental Randomized Control Trial. Subjek penelitian merupakan pasien overweight dan obesitas derajat I dengan osteoarthritis lutut, yang dibagi menjadi 2 kelompok yaitu kelompok perlakuan dan kontrol. Semua subjek dari kedua kelompok mendapatkan latihan standar berupa latihan aerobik dengan ergocycle, latihan penguatan otot quadriceps dan hamstring dengan NK table dan latihan keseimbangan dengan balance board sesuai dengan prosedur di Poliklinik Obesitas Departemen Rehabilitasi Medik RSCM Jakarta yang dilakukan 3x/minggu selama 4 minggu. Sebagai tambahan, kelompok perlakuan mendapatkan latihan retrowalking yang dilakukan 15 menit/sesi, 3x/minggu, selama 4 minggu. Hasil keluaran penelitian ini berupa kekuatan otot quadriceps yang diukur menggunakan handheld dynamometer pada sebelum, setelah 2 minggu dan setelah 4 minggu latihan. Analisis statistik dilakukan untuk membandingkan perubahan kekuatan otot quadriceps sesudah intervensi pada kelompok perlakuan dan kontrol. Hasilpenelitian menyatakan bahwa latihan retrowalking sebagai terapi tambahan efektif dalam meningkatkan kekuatan otot quadriceps pada pasien overweight dan obesitas derajat Idengan OA lutut setelah diberikan intervensi selama 4 minggu. Rerata peningkatan kekuatan otot quadriceps pada kelompok perlakuan dan kontrol masing-masing sebesar 3,026±1,33 kg dan 1,72±1,31 kg, dan didapatkan perbedaan signifikan dengan nilai p = 0,004. Diperlukan penelitian lebih lanjut untuk menilai efektivitas latihan retrowalking terhadap aktivitas otot quadriceps secara lebih spesifik menggunakan Surface Electromiography (sEMG) yang menggambarkan rekruitmen motor unit otot.

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This thesis was aimed to determine the effectiveness of retrowalking exercises in increasing quadriceps muscle strength in overweight and obese I patients with knee osteoarthritis. The design was randomized control trial. The subjects were overweight and obese grade I patients with knee osteoarthritis, and divided into 2 groups:

intervention and control groups. The subjects from both groups received standard exercises : aerobic exercise with ergocycle, quadriceps and hamstring muscle strengthening exercises with NK tables and balance exercises with balance board in accordance with procedures at the Obesity Polyclinic, Department of Medical Rehabilitation of RSCM Hospital, which was conducted 3x/week for 4 weeks. In addition, the intervention group received a retrowalking exercise during 15 minutes/session, 3x week, for 4 weeks. Handheld dynamometer were used to measure quadricieps muscle stregth in several time intervals before and after 2 weeks then after 4 weeks of completed training. Statistical analysis was performed to compare changes in quadriceps muscle strength after the intervention between the intervention and control groups. The results

of the study stated that retrowalking exercise as an adjunct therapy is effective in increasing quadriceps muscle strength in overweight and obese grade I patients with knee OA after 4 weeks training. The mean increase in quadriceps muscle strength in the intervention and control groups were 3.026 ± 1.33 kg and 1.72 ± 1.31 kg, respectively, and a significant difference was obtained with p value 0.004. Further research is needed to assess the effectiveness of retrowalking exercises on quadriceps muscle activity more specifically using Surface Electromiography (sEMG) which assesses the recruitment of motor muscle units."

"Penelitian ini bertujuan untuk mengetahui efektivitas latihan terprogram dengan telerehabilitasi di rumah pada pasien obesitas dengan osteoartritis lutut terhadap skor visual analogue scale, indeks massa tubuh dan WOMAC. Penelitian ini adalah penelitian pre-post study pada pasien obesitas dengan osteoartritis lutut. Subjek penelitian melakukan serangkaian program latihan di rumah selama 28 hari. Sebelum program, terdapat penilaian awal dari psikolog dan ahli gizi. Selama program, terdapat teleedukasi, telemonitoring dan telekonsultasi dari dokter. Jumlah subjek penelitian sebesar 26 subjek perempuan. Skor visual analogue scale mengalami penurunan signifikan secara statistik pada setiap minggunya, hingga akhir minggu keempat dibandingkan dengan sebelum intervensi (p<0,001). Skor indeks massa tubuh mengalami penurunan signifikan secara statistik pada akhir minggu keempat dibandingkan dengan sebelum intervensi (p<0,001). Skor WOMAC mengalami penurunan signifikan secara statistik pada akhir minggu keempat dibandingkan dengan sebelum intervensi (p<0,001). Analisis lebih lanjut pada seluruh komponen WOMAC pada kelompok intervensi meliputi nyeri, kaku dan fungsi fisik juga menunjukkan penurunan yang signifikan secara statistik (p<0,001). Latihan terprogram dengan telerehabilitasi di rumah terbukti secara statistik menurunkan skor visual analog scale, indeks massa tubuh dan WOMAC pada pasien obesitas dengan osteoartritis lutut.

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This study aims to determine the effectiveness of programmed exercise with telerehabilitation at home in obese patients with knee osteoarthritis on visual analogue scale scores, body mass index and WOMAC. This research is a pre-post study in obese patients with knee osteoarthritis. Research subjects performed a series of exercise programs at home for 28 days. Before the program, there is an initial assessment from a psychologist and nutritionist. During the program, there is teleeducation, telemonitoring and teleconsultation from doctors. The number of research subjects was 26 female subjects. Visual analogue scale scores decreased statistically significantly every week, until the end of the fourth week compared to before the intervention (p<0.001). Body mass index scores decreased statistically significantly at the end of the fourth week compared to before intervention (p<0.001). WOMAC scores decreased statistically significantly at the end of the fourth week compared to before intervention (p<0.001). Further analysis of all WOMAC components in the intervention group including pain, stiffness and physical function also showed a statistically significant decrease (p<0.001). Programmed exercise with telerehabilitation at home has been statistically proven to reduce visual analog scale scores, body mass index and WOMAC in obese patients with knee osteoarthritis."

"Cedera MCL menjadi sumber nyeri yang sering dijumpai pada OA lutut kompartemen medial. Penelitian ini bertujuan untuk melihat pengaruh terapi kombinasi laser-elastic taping terhadap skor nyeri dan kecepatan berjalan pasien OA lutut dengan cedera MCL non traumatik. Studi double blind, randomized controlled trial ini dilakukan dua kali seminggu selama empat minggu. Skor nyeri diukur dengan VAS dan kecepatan berjalan diukur dengan lintasan 15 meter. Pengukuran outcome dilakukan sebelum penelitian, minggu pertama, kedua, ketiga dan keempat. Total 30 subjek dibagi menjadi dua kelompok, 15 kelompok perlakuan dan 15 kelompok kontrol. Kelompok perlakuan mendapat terapi LLLT dan elastic taping tarikan 75% sedangkan kelompok kontrol mendapat terapi LLLT dan sham taping tanpa tarikan. Kedua kelompok diberikan logbook latihan penguatan di rumah. Hasil penelitian terdapat perbedaan bermakna secara statistik skor VAS antar kelompok (p= 0,015) pada minggu keempat. Tidak ditemukan perbedaan bermakna kecepatan berjalan antar kelompok (p= 0,395). Skor VAS dan kecepatan berjalan pada masing-masing kelompok mengalami perbaikan dan secara statistik bermakna. Kombinasi LLLT-elastic taping dengan atau tanpa tarikan dapat mengurangi nyeri dan memperbaiki kecepatan berjalan pasien OA lutut dengan cedera MCL non traumatik. Kelompok LLLT-elastic taping lebih unggul mengurangi nyeri dibandingkan LLLT-sham taping setelah empat minggu.

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Injury to periarticular structures, namely Medial Collateral Ligament (MCL) sprain is a common cause of pain in medial compartment knee osteoarthritis (OA). This study aims to see the effect of combined LLLT laser therapy and elastic taping in the MCL area on improvement of pain scores and gait speed. This study is a double-blind, randomized controlled trial in patients with knee OA with non-traumatic MCL sprain confirmed by knee ultrasonography. The study was conducted twice a week for four weeks. The pain score was measured with a VAS score and gait speed was measured on a 15-meter track. Outcome measurements were carried out before the study (baseline), during the first, second, third, and fourth weeks. A total of 30 subjects were divided into two groups, 15 in the treatment group (group A) and 15 in the control group (group B). Group A was given LLLT therapy and elastic taping with 75% tension, while group B was given LLLT and sham taping without tension. Both groups were given a logbook for home program strengthening exercises. The results showed that there was a statistically significant difference in the VAS score between group A and group B (p = 0.015) in the fourth week. There was no significant difference in walking speed between groups (p = 0.395). The VAS score and walking speed in each group improved and were statistically significant. The combination of LLLT and elastic taping with or without tension can reduce pain and improve walking speed in knee OA patients with non-traumatic MCL sprain. After four weeks, the LLLT and elastic taping group were superior in reducing pain compared to the LLLT and sham taping group."

"Penelitian ini bertujuan untuk melihat adakah perbedaan intensitas nyeri, kekuatan otot, dan kemampuan fungsional lutut antara penderita obesitas dan tanpa obesitas dengan osteoartritis genu (OA genu). Dilakukan studi potong lintang pada 50 orang perempuan dewasa, terdiri dari 25 orang penderita obesitas dengan OA genu, dan 25 orang tanpa obesitas dengan OA genu yang datang ke poli unggulan Obesitas dan poliklinik muskuloskeletal Departemen Rehabilitasi Medik RSCM. Intensitas nyeri dinilai menggunakan metode Visual Analogue Scale (VAS), kekuatan otot kuadrisep diukur menggunakan dinamometer jinjing, sedangkan kemampuan fungsional lutut dievaluasi menggunakan indeks Laquesne. Hasil penelitian menunjukkan adanya perbedaan intensitas nyeri dan kekuatan otot kuadrisep, terutama antara obesitas derajat II dengan subjek yang memiliki berat badan normal, berat badan lebih maupun obesitas derajat I. Tidak terdapat perbedaan kemampuan fungsional lutut yang bermakna secara statistik antara penderita obesitas dan tanpa obesitas dengan OA genu.

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The aim of the study was to find wheather there were any differences pain intensity, quadriceps muscle strength, and knee functional abilities between obese and non-obese patient with genu osteoarthritis (OA genu). We conducted a cross-sectional study in 50 adult women outward patient in Obesity Vlinic and Musculoskeletal Division of Physical Medicine and Rehabilitation Departement at Cipto Mangunkusumo Hospital, consisted of 25 obese people with osteoarthritis genu, and 25 non-obese people with osteoarthritis genu. The intensity of pain was assessed using the Visual Analogue Scale method (VAS), quadriceps strength was measured using a hand-held dynamometer, while functional ability was evaluated using the index Lequesne.

The study results showed that there were significant differences in pain intensity and quadriceps muscle strength, particularly between obese grade II and subjects with normal weight, overweight or obese first degree. There were no statistically significant difference in functional abilities knee between obese and non-obese patients with osteoarthritis genu."

"Latar Belakang : Obesitas diketahui terkait dengan berbagai gangguan kesehatan di antaranya sistem muskuloskeletal, yaitu Osteoarthritis OA lutut yang menyebabkan nyeri sehingga terjadi penurunan aktivitas dan berdampak pada penurunan kekuatan otot lutut yang pada akhirnya menurunkan kapasitas fungsional seseorang. Penatalaksanaan meliputi edukasi dan terapi latihan merupakan hal penting namun terkadang ada kendala untuk melakukan latihan di darat. Penelitian ini bertujuan untuk membandingkan pengaruh latihan di air dan di darat pada penderita obesitas dengan Osteoarthritis OA lutut terhadap penurunan intensitas nyeri dan peningkatan kekuatan otot lututMetode : Quasi experimental terhadap subjek obesitas dan OA lutut usia 40 ndash; 80 tahun dengan sedentary lifestyle PAL

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Background: Obesity is well known to be associated with various health problems, some of which includes musculoskeletal system, such as knee osteoarthritis OA that causes pain, and thus resulting in decreased activity. These would cause an impact to decrease the knee muscle strength, which ultimately lowers the functional capacity of an individual. Management that includes education and exercise therapy are deemed to be important, however often there are obstacles in doing exercises on land. This study aims to compare the effects of water versus land based exercise for obese patients with knee osteoarthritis OA to reduce pain intensity and improve knee muscle strength.Methods Quasi experimental on obesity and knee OA subjects, age ranging from 40 80 years with sedentary lifestyle PAL "

"Latar Belakang : Otot Kuadrisep pada penderita Osteoarthritis lutut disekitar sendi lutut sering mengalami atrofi, penurunan kekuatan serta fungsi sebagai stabilitas sendi terutama sendi penumpu berat badan. Terapi latihan merupakan salah satu bentuk rehabilitasi untuk peningkatan kekuatan otot sekitar sendi, yang mengalami kelemahan karena nyeri dan tidak digunakan. Volume latihan yang tinggi dapat menyebabkan kerusakan struktural otot skeletal. Secara struktural latihan yang menyebabkan kelemahan sarkomer akibat dari robeknya membran dan rendahnya kadar protein intraseluler (Kreatin Kinase) karena masuk ke dalam aliran darah. Semakin tinggi intensitas latihan penguatan otot semakin tinggi pula terjadinya risiko kerusakan otot, akan tetapi semakin rendah intensitas penguatan otot semakin kurang efektivitas pencapaian penguatan otot. Tujuan : Untuk mengetahui efektivitas latihan penguatan otot intensitas rendah dan sedang untuk mencapai kekuatan otot Kuadrisep dan fungsi yang optimal pada penderita OA lutut serta tidak menyebabkan kerusakan otot yang bermakna. Populasi dan Sampel : Semua pasien OA lutut usia 50-65 tahun di poliklinik Muskuloskeletal Departemen Rehabilitasi Medik RSCM dengan nyeri lutut VAS < 4 dan klinis (kriteria ACR) serta memenuhi kriteria penerimaan. Metode : Dilakukan pengukuran kekuatan otot Kuadrisep dengan dinamometer jinjing, kecepatan jalan 15 meter (detik), dan kadar serum enzim Kreatin Kinase sebelum dan setelah latihan. Responden dibagi menjadi 2 kelompok intensitas ringan (40% dari 10 RM) dan sedang (60% dari 10 RM) dilakukan latihan penguatan otot Kuadrisep isotonik dengan menggunakan NK table 3 set 10 repetisi, frekuensi 3 x/minggu selama 8 minggu dengan kenaikan beban bertahap setiap minggu. Hasil : Terdapat perbedaaan bermakna peningkatan sebesar 27,2 % kekuatan otot Kuadrisep setelah diberikan latihan intensitas ringan (p=0,001) dan sebesar 27,94 % (p <0,001) latihan intensitas sedang. Didapatkan penurunan waktu jalan 15 meter sebesar 39,9 % pada intensitas ringan (p=0,03) dan penurunan sebesar 47,37% pada intensitas sedang (p=0,007). Kedua kelompok tidak menunjukkan perbedaan bermakna pada kekuatan otot, kecepatan jalan, dan kadar enzim Kreatin Kinase. Kesimpulan : Latihan kekuatan otot Kuadrisep intensitas ringan dan sedang efektif mencapai kekuatan otot dan fungsi yang optimal tanpa menyebabkan kerusakan otot yang bermakna.

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Background : Osteoarthritits is rheumatoid disease mostly occurs in knee joint. Quadricep muscle around joint frequently athrophy, reduce strengthening, and functioning as stability joint especially as a role weight bearing joint so that occur deformity and worsen disease. Therapeutic exercise is one of rehabilitation treatment to enhance muscle strengthening around joint that become weakness due to pain and inactivity. Therefore it is important to make exersie prescription to achieve optimal result. High intensity exercise may cause structural damage skeletal muscle. This damage may lead muscle soarness, edema, and weakness. In structural, exercise can lead fraility of sarcomer consequence disruption of membrane and reduction level of protein intraceluller (Creatine Kinase) into bloodstream. Higher intensity of exercise will cause high risk of injury, however lower of intensity of muscle strengthening increasing less effective achievement of muscle strength. Ideally training given to the patient is an effective muscle-strengthening exercises to achieve optimal muscle strength and functional improvement achieved in the absence of muscle damage.

Objective : to find effetctivity of strengthening exercises low and moderate intensity to achieve Quadriceps muscle strength and optimal functional in patient with knee OA without causes significantly muscle damage.

Subject : All of knee OA patient at Inpatient of Musculoskeletal Rehabilitation Departement-Medical Faculty of Indonesia - Cipto Mangunkusumo Hospital, age 50-65 years with knee pain VAS < 4, clinical according American College of Rheumatology, and require inclusion criteria.

Method : Pre and Post Experimental, measurement of Quadriceps muscle strengthening with Hand held Dynamometer before and after exercise, time of walking speed on 15 metre (second), and creatine Kinase enzyme in blood serum. Subject divide to be 2 group, low intensuty (40% of 10 RM) and moderate (60% of 10 RM). Isotonic Quadricep strengthening exercise with NK table, 3 set 10 repetion 3 times in week during 8 week that intensity gradually increase each week.

Result : The study found that significantly increase of 27,2 % muscular strength Quadricep that having given a low intensity exercise ( p = 0,001 ) and significantly increase of muscular strength 27,94 % ( p < 0,001 ) in moderate intensity exercise . Decline significantly time of walking speed on 15 meters of 39,9 % in group low intensity (p = 0.03) and 47,37 % in moderate intensity (p = 0,007). Both of groups did not show the difference activity of Creatine Kinase.This study indicated no difference significantly exercise of muscular strengthen in both groups low and moderate intensity (p = 0,410 ).There was not significantly difference time walking speed both of group (p = 0,514). There were no significantly differences levels of enzyme Creatine kinase in both groups.

Conclusion: Quadriceps muscle exercise low and moderate intensity effective achieve muscle’s strength and functional optimal without causes significantly muscle damage."