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Granting Intervention Gymnastics Elderly With Knee Pain

in the Elderly
Abstract
Aging is a process of eliminating the network's ability to repair itself gradually.
Elderly tend to get the decreased on the musculoskeletal system. The decreased of the
musculoskeletal system is characterized by pain in the joints, for example the knee joint. Knee
pain is a regenerative joint diseaseand also one signs and symptoms of osteoarthritis.
One way to reduce the knee pain is using the non-pharmacologic therapy with elderly
gymnastic. The purpose of this research is to provide elderly exercise intervention in older
adults with knee pain to reduce the pain. The benefit of this research is to train the ability of
muscles and joints to reduce the knee pain scale in the elderly. The method used a quantitative
research design with experimental and one type of group pre-post test design. The population in
this study were elderly men and women in the Social Rehabilitation Unit "Margo Mukti"
Rembang District.The instrument used a VAS pain scale or Baourbanis and observation sheet.
Sampling used a minimum number of samples for quantitative experimental studies as many as
15respondents. Implementation of the elderly gymnastic can be done in the morning before
breakfast for about 15 - 45 minutes. The research was conducted on February 27, 2012 until
March 3, 2012 at the Social Rehabilitation Unit "Margo Mukti Rembang District. This study
used a statistical test of Wilcoxon. The resultof this research showed that the significance pvalue 0.001, which means the sig < = (0.05). The results after therapy elderly exercisers
showed that 86.7% of the elderly have a pain scale of 0 or no pain and 13.33% elderly have a
pain scale of 1 or mild pain scale. It was concluded that elderly gymnastic are effectively
overcome the knee pain in elderly at the Social Rehabilitation Unit"Margo Mukti"
Rembang District and this elderly gymnastic is expected to help community to reduce the knee
joint pain.
Key words: knee pain, elderly gymnastics, elderly

JOURNAL OF NURSING STUDIES, in 2012

Preliminary
The number of elderly in 2000 is projected at 7.28% and in 2020 amounted to 11.34%
(BPS, 1992). Data from USA-Bureau of the Census, even Indonesia is expected to increase by
the largest senior citizens all over the world, between the years 1990-2025, which amounted to
41.4% (Maryam, 2008).
The more a person gets older then the person would be susceptible to a disease due to a
decrease in his system. Elderly tend to decrease in the musculoskeletal system. The decrease in
the musculoskeletal system can affect physical mobility in the elderly and may even lead to
disturbance in physical mobility in the elderly. Knee pain is one of the signs and symptoms of
osteoarthritis (Taslim, 2001).
Changes in the structure functions, both physical and mental affects a person's ability to
remain active. Elderly with the aging process will affect the appearance, illness, healing and
rehabilitation process requires. Elderly have a distinctive appearance as the signs and symptoms
of elderly in walking due to a decrease in the joints, causing regenerative elderly experiencing
physical immobility. Many cases with symptoms such as degenerative musculoskeletal pain.
Geriatric syndrome of musculoskeletal pain is the most common and are associated with health
problems in the elderly (Taslim, 2001).
Musculoskeletal disorders in the general symptoms or complaints of pain, from mild to
severe. Complaints of pain arising that may interfere with the patient, the patient is unable to
work or move comfortably even also not be able to feel comfortable in his life. Therefore,
treatment of musculoskeletal untukgangguan the first time we have to do is reduce the pain or
symptoms caused (Martono, 2009).
Research by Harvard Osteras, Tom Arild Torstensen and Berit Osteras entitled "HighDosage Medical Exercise Therapy in Patients with Longterm Subacromial Shoulder Pain" with
the results obtained medical exercise therapy there was a decrease in shoulder pain scale using a
measuring scale VAS (Visual Analog Scale ) (Harvard, 2009).
Benefits of this research is to assist the elderly in reducing pain or reduce the scale of the
elderly with knee pain.
Of related research on the researcher intends to carry out a study to assess the provision
of elderly exercise intervention in older adults with knee pain.

JOURNAL OF NURSING STUDIES, in 2012

Method
This research is quantitative research using experimental research design and design onegroup pretest-post test. This research involving 15 elderly who be the respondent in accordance
with criteria inclusive, size-exclusion and willing become respondents and signed the letter of
approval. Sampling in accordance with the requirements for experimental research. This study
was conducted on February 27, 2012 until March 3, 2012 at the Unit of Social Rehabilitation
"Margo Mukti" Rembang. Means of data collection using the VAS pain scale or Bourbanis and
observation sheets (Halimul, 2008). Data collection was research done by measuring the scale of
pain in the elderly prior to therapy gymnastics elderly and after therapy gymnastics elderly
measured pain scale again for 6 days. This research was done during 6 days. Test satistik using
the Wilcoxon test. Before the Wilcoxon test normality test data using the Shapiro-Wilk because
the sample size is less than 50 respondents.
Research
Table 1.
Frequency Distribution Characteristics of Respondents in Unit
Social Rehabilitation "Margo Mukti" Rembang district in March (n = 15)
Characteristics of

Frequency

Percentage (%)

40

9
15

60

100

55-60

20

61-75

12

80
100

Respondents
Sex
Man
Woman
Total
Age (years)

Total

15

Table 1. showed that respondents with the highest gender are as many as nine elderly
women (60%), as many as 6 seniors (40%) male sex. Respondents aged 61-75 years were 12
respondents (80%) and as many as 3 respondents (20%) of respondents aged 55-60 years.

JOURNAL OF NURSING STUDIES, in 2012

Table 2.
Pain Measurement Scale Before and After Intervention Gymnastics Elderly
At the Elderly in Social Rehabilitation Unit "Margo Mukti" District
Apex (n = 15)
No

Pain Scale

Frequency
Before
After
0
13

Percentage (%)
Before
After
0
86,7

1.

0 (no pain)

2.

1-3 (mild pain)

13

73,33

13,33

3.

4-6 (moderate pain)

13,33

15

15

100

100

Total

Table 2. indicates that the scale of pain in elderly with knee pain before therapy is given
elderly exercisers were 13 respondents (73.33%) with pain scale of 1-3 (mild pain), and as many
as 2 respondents (13.33%) with scale 4 pain (moderate pain). Scale pain after exercise therapy
elderly as many as 13 respondents (86.7%) pain scale 0 (no pain) and as much as 2 elderly
(13.33%) pain scale of 1-3 (mild pain).
Table 3
Gymnastics effectiveness Elderly In Elderly with Knee Pain Rehabilitation Unit
Social "Margo Mukti" Rembang (n = 15)
Variable
Before
After

N
15
15

Mean

Standard

Standard Error of

p-value

0,213
0,27

deviation
0,352
0,704

mean
0,091

0,001
0,182

Table 3 shows that the results of statistical tests using the Wilcoxon obtained p-value of
0.001 which means the sig < (0,05). Significance value 0.001 < 0.05 meaning that the
hypothesis is accepted. The conclusion of the study therapy the elderly exercise effectively
overcome knee pain in older adults in the Rehabilitation Unit Social "Margo Mukti" Rembang.
Study

JOURNAL OF NURSING STUDIES, in 2012

Elderly with female gender tend to risk injury. In women over the age of 50 years was
reduced in muscle flexibility. This can be addressed by improving the ability of elderly muscle
with exercise. Elderly exercisers can train the muscles ability joints. Ability of trained muscle
more often when the synovial fluid will increase or increases. That is, the addition of synovial
fluid in the joint may reduce the risk of injury in the elderly and prevent the onset of knee pain in
the elderly (Taslim, 2001).
The increasing age of the person then, someone will lose bone mass in men by 20-30%
and in women by 40-50%. Elderly tend to decrease in musculoskeletal function. Decreasing
function of joint cartilage so, cartilage thinning and lead to joint stiffness. Stiffness of the joints
if not treated immediately, it can interfere with physical mobility in the elderly. Muscles move
joints when used for the synovial fluid will increase and increase so that, elderly activity well. If
the ligaments are not used to perform the activity, the synovial fluid will remain so, no increase
(Sudoyo, 2006).
The results given the scale measuring pain after exercise therapy elderly are consistent
with theories that have been presented that the elderly are a gymnastic exercise a good influence
to improve the ability of muscle joints. The ability of the muscles or joints when seringmdilatih
driven synovial fluid in the joints increases. Synovial fluid serves as a lubricant in the joint.
Increased synovial fluid can reduce the risk of joint injury in the elderly (Taslim, 2001).
Gymnastics elderly also can provide physical fitness and increase endurance (Ambar, 2009).
Disorders of the musculoskeletal system can impact physical immobility in the elderly.
To prevent physical immobility in the elderly, the elderly are encouraged to perform physical
activities such as gymnastics elderly, walking and others. Physical activity can be a good
influence for health in the elderly one of which is the ability to train muscles in elderly joints to
prevent joint stiffness (Martono, 2009).
Related research has been conducted olehHavard Osteras, Tom Arild Torstensen and
Berit Osteras entitled "High-Dosage Medical Exercise Therapy in Patients with Long-Term
Subacromial Shoulder Pain" with the results obtained medical exercise therapy there was a
decrease in shoulder pain scale using VAS scale measuring (Visual Analog Scale) and also
hasinya medical exercise therapy can overcome shoulder pain in patients (Harvard, 2009). This
is consistent with research that has been conducted by the researchers that the elderly gymnastics
therapy can overcome knee pain in the elderly from mild to no pain scale pain.

JOURNAL OF NURSING STUDIES, in 2012

Conclusions and Recommendations


Giving elderly gymnastics intervention in elderly with knee pain in the Social
Rehabilitation Unit "Margo Mukti" This Rembang effective for knee pain in the elderly. The
results by gender shows that elderly women with sex as much as 9 seniors (60%) and men as
much as 6 seniors (40%). The results showed that the elderly by age with 61-75 years of age
were 12 elderly (80%) and elderly with 55-60 years of age as much as 3 seniors (20%). The
results after therapy elderly exercisers showed that 86.7% of the elderly have a pain scale of 0 or
no pain and 13.33% elderly have a pain scale of 1 or mild pain scale.
Wilcoxon statistical test results obtained p-value of 0.001 which means the sig < =
(0,05). Significance value 0.001 <0.05 means that the hypothesis is accepted. In conclusion
elderly gymnastic therapy effectively overcome knee pain in the elderly.
Elderly exercise therapy can be used by anyone without spending any money. As a
community nurse elderly gymnastics therapy can be applied to improve the quality of health care
in an institution elderly. Elderly exercise therapy is effective in reducing knee pain in the elderly.

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JOURNAL OF NURSING STUDIES, in 2012

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