JURNAL

EFFECTS OF GAIT TRAINING ON SAND ON IMPROVING THE WALKING

ABILITY OF PATIENTS WITH CHRONIC STROKE: A RANDOMIZED

CONTROLLED TRIAL

Nama : Ni Putu Novie Astini, S.Fis

NIM : P27226020282

Lokasi Praktek : RSUP Fatmawati Jakarta Selatan

Pembimbing : Didhik Jatmiko,SST.Ftr

No. Telepon : 085933021888

PROGRAM STUDI FISIOTERAPI

PROGRAM PROFESI JURUSAN FISIOTERAPI POLITEKNIK KESEHATAN

KEMENKES SURAKARTA

TAHUN 2020
 HALAMAN PENGESAHAN

LAPORAN JURNAL

EFFECTS OF GAIT TRAINING ON SAND ON IMPROVING THE WALKING

ABILITY OF PATIENTS WITH CHRONIC STROKE: A RANDOMIZED

CONTROLLED TRIAL

Disusun oleh:

NI PUTU NOVIE ASTINI,S.FIS

NIM : P27226020282

Telah diperiksa dan disetujui oleh Pembimbing /Clinical Edukator

Prodi Fisioterapi Program Profesi Jurusan Fisioterapi Poltekkes Kemenkes Surakarta

Mengetahui, Jakarta,Desember 2020

Kaprodi Fisioterapi Program Profesi Clinical Educator

Poltekkes Kemenkes Surakarta Rsup Fatmawati

Ftr. Saifudin Zuhri, SKM, M.Kes Didhik Jatmiko,SST.Ftr

NIP. 19730427200111002 NIP. 197205041997031004
Judul Effects of Gait Training on Sand on Improving the Walking Ability of Patients With
Chronic Stroke: A Randomized Controlled Trial
Jurnal The Journal of Physical Therapy Science

Volume &Halaman Vol. 29 (12), Halaman 2172-2175

Tahun 2017

Penulis Tae Ho Kim, Byoung Ha Hwang

Reviewer Ni Putu Novie Astini, S.Fis (P27226020282)

Tanggal 11 Desember 2020

Tujuan Penelitian Tujuan dari penelitian ini adalah;

Untuk mengetahui bagaimana perbandingan dari pengaruh gait training di permukaan
berpasir dan permukaan keras terhadap walking ability pada pasien dengan stroke kronis?
Subjek Penelitian Subjek pada penelitian ini menggunakan 28 orang dengan diagnosa stroke kronis. Berikut kriteria
inklusi dan eksklusi dalam penelitian ini.
Kriteria inklusi dalam penelitian ini, antara lain;
 1. Dapat berjalan sendiri, termasuk menggunakan alat bantu jalan.
2. Tidak memiliki gangguan muskuloskeletal.
3. Tidak memiliki masalah kognitif.
Metode Penelitian Metode dalam penelitian ini menggunakan penelitian randomized controlled trial.
Definisi Operasional Definisi operasional variabel dependen pada penelitian ini adalah;
Variabel Dependen - Walking ability adalah suatu proses perpindahan menggunakan fungsional tungkai dengan
pola gait (heel strike, foot flat, mid stance, heel off, toe off, mid swing) dari satu tempat ke
tempat lain yang dipengaruhi oleh faktor fisik, yaitu keseimbangan, kekuatan otot, daya
tahan otot, dan daya tahan kardiopulmonal.
Cara & Alat Mengukur Cara & alat mengukur pada variabe dependen, antara lain;
Variabel Dependen - Timed Up and Go Test
Cara pengukuran menggunakan TUG adalah sampel duduk di kursi tanpa penyangga
tangan, perhitungan waktu menggunakan stopwatch yang dimulai ketika sampel berdiri
dan kembali setelah berjalan digaris sepanjang 3 meter, lalu duduk kembali. Lakukan
sebanyak 3 kali tes dan hitung rata-rata dari waktu tersebut. Menurut Shumway et al.
waktu yang ditempuh lebih dari 14 detik maka keseimbangan belum optimal sehingga
memungkinkan untuk resiko jatuh lebih tinggi.
- 6 Minute Walking Test
Cara pengukuran menggunakan 6MWT adalah sampel diinstruksikan untuk berjalan
mengikuti jalur berbentuk persegi sebanyak mungkin selama 6 menit. Panjang jalur yang
 ditentukan yaitu 12 m x 6 m. Plastik cone diletakkan pada setiap sudut untuk menandai
sampel agar mengganti arah berjalan, harus selalu berjalan ke kiri 90 o. Ketika sudah 4 dan
5 menit berjalan, beritahu sampel waktu yang tersisa 2 dan 1 menit. Evaluasi hasil dari
jarak tempuh yang didapat oleh sampel.
Definisi Operasional Definisi operasional variabel Independen pada penelitian ini adalah;
Variabel Independen - Gait training di permukaan berpasir adalah suatu latihan berjalan tanpa menyesuaikan
dengan pola gait normal dengan jarak sepanjang 5 meter pada permukaan berpasir yang
dilakukan secara berulang dengan durasi 30 menit perhari, dilakukan 5 kali perminggu
selama 6 minggu.
- Gait training di permukaan keras adalah suatu latihan berjalan tanpa menyesuaikan
dengan pola gait normal dengan jarak sepanjang 5 meter pada permukaan padat atau kokoh
yang dilakukan secara berulang dengan durasi 30 menit perhari, dilakukan 5 kali
perminggu selama 6 minggu.
-
Langkah–langkah Langkah-langkah dalam melakukan penelitian ini, sebagai berikut;
Penelitian - Penentuan sampel penelitian.
Dari 30 sampel penelitian yang sesuai dengan kriteria inklusi serta menyetujui inform
consent, diperoleh 2 sampel yang drop out saat latihan dikarenakan masuk rumah sakit.
Sehingga, jumlah sampel yang mengikuti penelitian ini hingga akhir berjumlah 28 orang.
Pembagian kelompok pada penelitian ini dibagi menjadi 2 kelompok yaitu kelompok
eksperimental dan kelompok kontrol dengan masing-masing kelompok terdiri dari 14
 sampel.
- Pengukuran
Untuk mengevaluasi walking ability, dilakukan pengukuran sebelum memulai penelitian
dengan menggunakan alat ukur Timed Up and Go (TUG) Test dan 6 Minute Walking Test
(6MWT). Kedua pengukuran dilakukan pada hari yang berbeda, sehingga kedua kelompok
tidak saling membandingkan hasilnya.
TUG adalah alat ukur untuk mengevaluasi keseimbangan dinamis. Pengukuran TUG
dilakukan sebanyak 3 kali dan dicari rata-rata dari hasil yang diperoleh.
6MWT adalah alat ukur untuk mengevaluasi daya tahan gait pada pasien hemiplegi atau
dengan gangguan kardiopulmonal. Pengukuran hanya dilakukan sekali dalam penelitian
ini.
- Intervensi
Perlakuan dilakukan di ruangan treatment. Gait training diberikan kepada kedua kelompok
dengan permukaan yang berbeda dan pola jalan sesuai dengan kemampuan sampel tanpa
harus menyesuaikan dengan pola gait normal. Pada kelompok eksperimen dilakukan pada
permukaan berpasir tanpa menggunakan alas kaki, sedangkan pada kelompok kontrol
dilakukan pada permukaan keras menggunakan sepatu tipis. Durasi gait training yang
diberikan pada kedua kelompok sama yaitu 30 menit per hari, 5 kali perminggu selama 6
minggu.
- Analisis data
 Analisa data menggunakan non-parametrik tes. Untuk mengetahui hasil dari penelitian
sebelum dan sesudah perlakuan menggunakan Wilcoxon signed rank test. Semua data yang
didapat diolah dan dianalisa statistik menggunakan SPSS versi 20.0 dengan nilai signifikan
kurang dari 0,05.
Hasil Penelitian Hasil yang diperoleh dalam penelitian ini adalah;
- Timed Up & Go Test (TUG) hasil yang didapat pada kelompok eksperimen dan kelompok
kontrol yaitu signifikan (p<0,05).
- 6 Minute Walking Test (6MWT) hasil yang didapat pada kelompok eksperimental yaitu
signifikan (p<0,05), sedangkan kelompok kontrol tidak signifikan.
Pembahasan Dalam penelitian ini, membahas tentang perbedaan pengaruh dari gait training pada 2 bidang
yaitu permukaan berpasir dan permukaan keras. Dimana pada hasil pemeriksaan menggunakan
TUG untuk keseimbangan dinamik, kedua kelompok mengalami penurunan waktu tempuh setelah
latihan. Hasil pemeriksaan menggunakan 6MWT untuk mengetahui daya tahan gait, hanya gait
training pada permukaan berpasir yang signifikan mengalami peningkatan. Hal ini menunjukkan
bahwa gait training pada permukaan berpasir lebih efektif meningkatkan daya tahan gait
dibandingkan permukaan keras.
Peningkatan daya tahan gait dipengaruhi oleh faktor fisik, termasuk kekuatan otot, daya tahan
otot, dan daya tahan kardiopulmonal. Seperti hasil penelitian dari Yigit et al, dimana mengatakan
bahwa kekuatan otot dan daya tahan otot tungkai meningkat setelah latihan pada permukaan
berpasir. Begitu pula menurut Davies dan Mackinnon mengatakan maksimal oksigen yang
 dihirup, heart rate, dan ventilasi dari volume oksigen dan karbon dioksida meningkat saat berjalan
di pasir. Sehingga, dalam penelitian ini dapat dikatakan bahwa gait training pada permukaan
berpasir tidak hanya meningkatkan kekuatan otot dan daya tahan otot tetapi juga meningkatkan
fungsi kardiopulmonal.
Penelitian ini tidak mengatakan secara langsung terhadap mobilitas dari ankle pada pasien
hemiplegi. Begitu pula dugaan terhadap latihan di permukaan berpasir dapat meningkatkan fungsi
ankle pada pasien hemiplegi, yang lebih tepatnya latihan ini untuk meningkatkan keseimbangan
dan berjalan.
Kesimpulannya, gait training secara berulang dapat meningkatkan kemampuan keseimbangan
dinamis, gait training secara berulang diperlukan untuk penderita stroke.
Kekuatan Penelitian Kekuatan dalam penelitian ini adalah
- Penelitian ini menggunakan metode penelitian randomized controlled trial.
- Tahun penelitian yang masih dalam kategori 5 tahun terakhir.
- Dapat digunakan sebagai refrensi untuk menangani pasien dengan diagnosa stroke.
- Meningkatkan keseimbangan dinamik saat berjalan.
- Dapat meningkatkan fungsi kardiopulmonal.
- Meningkatkan kecepatan dan kemampuan berjalan.
- Latihan yang mudah dilakukan.
Kelemahan Penelitian Kelemahan dari penelitian ini, antara lain;
- peneliti tidak mengumpulkan data tentang perbedaan kekuatan otot dan mobilitas sendi
pergelangan kaki sisi yang terkena dampak antara permukaan keras dan pasir.
- adanya perbedaan pelatihan berjalan tanpa alas kaki pada kelompok eksperimen dan
pemakaian sepatu kets pada kelompok kontrol.
- Pola gait training tidak dijelaskan.
- Pembagian kedua kelompok tidak dijelaskan.
- Kriteria eksklusi tidak dijelaskan.
 J. Phys. Ther. Sci. 29: 2172–2175, 2017

The Journal of Physical Therapy Science

Original Article

Effects of gait training on sand on improving the

walking ability of patients with chronic stroke:
a randomized controlled trial

Tae-ho Kim, PhD, PT1), Byoung-ha Hwang, MSc, PT1)*

1) Department
of Physical Therapy, College of Rehabilitaion Science, Daegu University:
201 Daegudae-ro, Jillyang, Gyeongsan, Gyeongbuk, Republic of Korea

Abstract. [Purpose] This study examines how difference in sandy ground between firm ground influences the
effects of gait training in patients with chronic stroke. [Subjects and Methods] A total of 28 patients with chronic
stroke were evenly divided into experimental and control groups. Initial evaluation of the subjects was conducted by
Timed Up & Go (TUG) and 6-Minute Walking Test (6MWT). Each patient in both groups received daily, 30-min-
ute gait training on sandy ground and firm ground, five times each week, for a total of six weeks, after which re-
evaluation was conducted. [Results] In TUG, both groups showed significant improvement after the intervention.
In 6MWT, only the experimental group achieved significantly increased distance after the intervention. However,
there was no between-group difference. Improvement in dynamic balancing ability depends on repeated gait train-
ing rather than differences in the ground environment. However, gait endurance showed a difference depending on
the types of ground, regardless of repeated gait training. [Conclusion] This can be attributed to the fact that gait
training on sand requires use of more diverse muscles. Hence, we can confirm the potential of sand as a new mate-
rial for training ground when attempting to improve walking ability, particularly gait endurance, among patients
with chronic stroke.
Key words: Gait training, Stroke, Sand gait
(This article was submitted Jul. 30, 2017, and was accepted Sep. 20, 2017)

INTRODUCTION
Patients with stroke experience many challenges after the onset. Approximately 60% of patients with stroke suffer from
weakened motor ability, and about half of patients with stroke require assistance from other people in their daily lives. Most
are capable of limited participation in social or work activities1, 2). One of the most serious challenges is diminished balancing
ability and decrease or loss of walking ability, resulting from the loss of control3).
Walking ability does not simply refer to movement of the body. From the perspective of the International Classification of
Functioning, Disability and Health (ICF), walking in patients with stroke should be assessed by integrating disability, activ-
ity, participation, and quality of life4). Gait training that simply aims at restoring patients’ ability to walk is insufficient. For
most patients, the goal is not simply walking, but achieving walking ability that allows them to return to active participation
in the community. Hence, recovery of walking ability is the primary goal when planning treatment for patients with stroke5).
Therefore, there are a number of approaches aimed at enhancing walking ability in patients with stroke. However, most
previous literature involves intervention schemes that do not duplicate the actual walking environment encountered by pa-
tients in everyday life. Thus, an approach to gait training that involves a varied ground environment is necessary.
Gait training on unstable ground instead of firm ground requires more diverse movement in the ankle joint as well as
large muscle strength6). Using such environmental characteristics can induce greater ankle mobility and improvement of

*Corresponding author. Byoung-ha Hwang (E-mail: ptkimth@daegu.ac.kr)

©2017 The Society of Physical Therapy Science. Published by IPEC Inc.
This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial No Deriva-
tives (by-nc-nd) License. (CC-BY-NC-ND 4.0: http://creativecommons.org/licenses/by-nc-nd/4.0/)

2172
proprioception. The increased proprioception is effective for enhancing walking ability, as it increases muscle strength and
balancing ability in the affected-side ankle of patients with stroke7). This study chose sand ground instead of firm ground as
a new environment for gait training.
Virtually none of the previous studies used sandy ground for rehabilitating patients with chronic stroke. However, several
studies used sand as a training method for improving athletic performance in athletes.
A study that implemented plyometrics training on sand as a means of improving athletic performance, such as jumping
and sprinting among football players, reported improved athletic performance, including jumping and changing directions8).
Another study reported that muscle injury is less likely when training on sand versus firm ground, due to the characteristics
of sand9). Binnie et al. reported that eight-week sand training was effective in improving Maximal Oxygen Uptake (VO2max)
and that self-awareness of pain and fatigue during training were lower on sandy ground than firm ground10). This study at-
tempted to determine the effects of the walking ability by applying the sandy ground to gait training for patients with chronic
stroke.

SUBJECTS AND METHODS

A total of 30 subjects participated in this study, two of whom were discharged from the hospital during the intervention
period, making the total number of research subjects for the experiment 28.
After explaining the purpose of this study to the patients with chronic stroke who were hospitalized for treatment, those
who submitted voluntary consent and expressed their willingness to participate were randomly assigned to the experimental
group or control group. The patients who were capable of independent walking, including those who used a walking aid and
had no musculoskeletal disease or cognitive problem, were selected as the research subjects.
This study received Institutional Review Board approval from Daegu University (1040621–201507-HR-003–02).
The walking ability of the two groups was evaluated before the experiment by Timed Up & Go evaluation and 6-Minute
Walking Test. The two tests were implemented on different days, so that they did not affect the other’s results. Through the
data collected, the homogeneity of the two subject groups was confirmed. During the daily 30-minute gait training, which
occurred five times each week for a total of six weeks, the control group received gait training on firm ground and the
experimental group received gait training on sand. The control group performed gait training on regular, firm ground, inside
a treatment room, with shoes on. The thin shoes was worn to prevent foot damage by friction of the floor. The experimental
group performed gait training on sand, inside a treatment room, with bare feet. The sandy ground was specially made at a
width of 1 meter, a length of 5 meters, and a depth of 30 centimeters.
No restrictions were put on the walking methods of either group, so that each individual could use the walking habits
and strategy that he/she relearned after the occurrence of stroke. If necessary, the use of a walking aid, such as a cane, was
allowed. Interventions other than walking were prohibited, to exclude additional training influences aside from the environ-
mental characteristics of the walking ground.
To evaluate walking ability, TUG was measured three times, and the average of the three values was used. TUG is an
assessment tool that evaluates dynamic balancing ability. It has a proven reliability, with intra-rater reliability of r=0.99 and
inter-rater reliability of r=0.9811).
6MWT was measured only once, due to the characteristics of the subjects, and the subjects were encouraged to make their
greatest efforts during the measurement. The 6MWT is also a tool that evaluates gait endurance among hemiplegic patients
or those with cardiopulmonary disease. It has proven validity and reliability when applied to patients with stroke12).
As the collected data were not in normal distribution, data were statistically analyzed through a non-parametric test.
Within-group comparison before and after the intervention was conducted by Wilcoxon signed rank test and between-groups
difference, according to the intervention scheme, was analyzed by Mann Whitney U test. All data were statistically analyzed
using SPSS version 20.0, where significance level was set at less than 0.05.

RESULTS
In TUG, both groups showed a significant difference after the intervention. In 6MWT, only the sandy ground training
group showed a significant difference after the intervention. However, neither variable showed a statistically significant
between-group difference before or after the intervention (Tables 1 and 2).

DISCUSSION
This study attempted to identify the effects of difference in ground environment on improving walking ability in patients
with chronic stroke.
In the TUG evaluation of dynamic stability, both groups showed decreased performance time after the intervention.
However, there was no between-group difference. This implies that the repeated gait training increased dynamic stability,
regardless of the difference in the ground.
In 6MWT, which evaluated gait endurance, only the sandy ground training group showed a significant improvement. This

2173
 Table 1. General characteristic of the subject (n=28)

Experimental group Control group

Gender (male/female) 14 (6/8) 14 (5/9)
Age (years) 69.0 ± 10.0a 71.3 ± 10.5
Height (cm) 162.4 ± 5.7 161.8 ± 7.7
Weight (kg) 61.5 ± 8.1 65.9 ± 15.3
Onset time (months) 21.0 ± 13.7 32.1 ± 10.5
Hemi side (right/left) 8/6 7/7
aM ± SD: Mean ± standard deviation.

Table 2. Comparison of walking ability evaluation before and after the intervention (n=28)

Group Pre-test Post-test

TUG Experimental group 27.6 ± 15.7a 21.5 ± 13.2*
(seconds) Control group 30.9 ± 18.5 27.7 ± 18.2*
6MWT Experimental group 162.0 ± 148.9 204.9 ± 158.3*
(meters) Control group 159.5 ± 124.0 182.7 ± 131.1
a M ± SD: Mean ± standard deviation.

*Significant difference p<0.05.

implies that sandy ground training is more effective at enhancing gait endurance than firm ground training. Improvement of
gait endurance is determined by diverse physical factors, including muscle strength, muscle endurance, and cardiopulmonary
endurance. Similar to the results in Yiğit et al., it is conjectured that muscle strength and muscle endurance of the calf and
thigh improved after the sandy ground training13). Moreover, Davies and Mackinnon reported that maximal oxygen uptake,
heart rate, and ventilation volume of oxygen and carbon dioxide increased during walking on sand14). Assuming the same
distance, this implies that walking on sand induces more use of cardiopulmonary function than other ground conditions. In
this study, it is conjectured that the repeated gait training on sand improved not only muscle strength and muscle endurance,
but also cardiopulmonary function, compared to training on firm ground. This ultimately enhanced gait endurance.
This study did not directly assess the mobility of the affected-side ankle joint of the hemiplegic patients. However, it is
conjectured that training on sand induced enhancement of ankle function of the hemiplegic patients, consequently improv-
ing their balancing and walking. Impellizzeri et al. examined the improvement of jumping function of volleyball players
after training on sand. According to their study results, players have to thrust their ankle more forcefully when jumping on
sand, as their feet slip on sand. In this type of situation, more joint mobility and muscle groups are used, due to the stretch-
shortening cycle of the muscles surrounding the ankle. This increases the angular velocity of the ankle, improving the jump-
ing function8). Our study did not implement high-level motion, such as jumping, due to the characteristics of the subjects.
Nevertheless, gait training on sand improved ankle mobility and nerve roots control, thanks to the stretch-shortening cycle
of the muscles surrounding the affected-side ankle joint, which is difficult to voluntarily control. This generated mobility
that is necessary for walking, which consequently helped gait endurance. Pinnington and Dawson reported that training on
sand causes lower accumulation of lactic acid and reduces the metabolic fatigue that results from muscle activity15). As their
study used healthy male adults as a sample, the research subjects differed from our study. Nevertheless, it is conjectured that
similar physiological characteristics that appeared during walking in their study, which experimented with different walking
environments, manifested in our study as well. Hence, training on sand can diminish muscle fatigue, which is expected to
relatively increase gait endurance.
This study has several limitations, one of which is that we could not collect data on actual difference of muscle strength
and joint mobility of the affected-side ankle between firm ground and sand. Moreover, we could not check whether more
muscle activity was actually induced on sandy ground. Hence, future studies are required to examine the actual change in
muscle activity during gait training when using firm ground and sand. Also, there may be differences according to the training
of barefoot walking in the experimental group and the wearing of the sneakers during the gait training of the control group.
Therefore, future studies need to be compared under the same conditions.
In conclusion, considering that repeated gait training can induce improvement of dynamic balancing ability, regardless of
the type of ground, repeated gait training is necessary for patients with stroke. Repeated gait training can improve dynamic
balancing ability, as long as patients can walk, regardless of whether they walk in a correct way or walk well.
In the case of gait training that aims at improving gait endurance, repeated gait training on sand is more effective than on
firm ground.

J. Phys. Ther. Sci. Vol. 29, No. 12, 2017 2174

 This study is the first research that applied gait training on sand to patients with chronic stroke. The study proposes the
possibility of a new approach involving gait training on sand for a variety of subjects, including patients with stroke.

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PRESENTASI JURNAL STASE NEUROLOGI

EFFECTS OF GAIT TRAINING ON SAND ON IMPROVING THE WALKING

ABILITY OF PATIENTS WITH CHRONIC STROKE: A RANDOMIZED
CONTROLLED TRIAL

Ni Putu Novie Astini, S.Fis

(p27226020282)
PRESENTASI JURNAL STASE NEUROLOGI

IDENTITAS JURNAL

VOL. 29 (12), HALAMAN 2017 TAE HO KIM, BYOUNG

THE JOURNAL OF
2172-2175 HA HWANG
PHYSICAL THERAPY
SCIENCE
PRESENTASI JURNAL STASE NEUROLOGI

TUJUAN

SUBJEK DAN
METODE

VARIABEL
Untuk mengetahui bagaimana
LANGKAH perbandingan dari pengaruh
gait training di permukaan
berpasir dan permukaan keras
HASIL terhadap walking ability pada
pasien dengan stroke kronis?

PEMBAHASAN

KEKUATAN

KELEMAHAN
 PRESENTASI JURNAL STASE NEUROLOGI
SUBYEK PENELITIAN

TUJUAN SUBJEK PENELITIAN

28 ORANG
SUBJEK DAN KELOMPOK INTERVENSI KELOMPOK KONTROL
METODE 14 ORANG 14 ORANG

VARIABEL dilakukan pada permukaan dilakukan pada permukaan keras

berpasir

LANGKAH Kriteria inklusi : KRITERIA EKSKLUSI:

1. Dapat berjalan sendiri,

HASIL termasuk
menggunakan alat
bantu jalan.
PEMBAHASAN
2. Tidak memiliki
gangguan
KEKUATAN muskuloskeletal.
3. Tidak memiliki
masalah kognitif.
KELEMAHAN
PRESENTASI JURNAL STASE NEUROLOGI

TUJUAN
METODE PENELITIAN
SUBJEK DAN
METODE

VARIABEL

LANGKAH

HASIL
• Metode: eksperimen dengan
randomized clinical trial.
PEMBAHASAN

KEKUATAN

KELEMAHAN
PRESENTASI JURNAL STASE NEUROLOGI

TUJUAN
VARIABEL DEPENDEN
SUBJEK DAN
METODE • Stroke merupakan kondisi ini yang terjadi ketika pasokan
darah ke otak berkurang akibat adanya penyumbatan
VARIABEL (iskemik) atau pecahnya pembuluh darah (hemoragik)
sehingga mengakibatkan terjadinya penurunan hingga
LANGKAH kehilangan fungsi tubuh seperti penurunan kemampuan
motoric, sensorik, persepsi, komunikasi, visual, kognitif,
HASIL psikologis, dan juga bowel and bladder.

PEMBAHASAN
Kondisi seperti ini tentu akan berpengaruh terhadap
KEKUATAN keseimbangan serta

KELEMAHAN
PRESENTASI JURNAL STASE NEUROLOGI

TUJUAN
VARIABEL DEPENDEN DAN ALAT UKUR
SUBJEK DAN
METODE Timed Up and Go Test
Walking ability
(keseimbangan,
VARIABEL
kekuatan otot, daya
tahan otot, )
LANGKAH

HASIL

PEMBAHASAN

KEKUATAN

KELEMAHAN
PRESENTASI JURNAL STASE NEUROLOGI

TUJUAN
VARIABEL DEPENDEN DAN ALAT UKUR
SUBJEK DAN
METODE Daya Tahan
6 Minute Walking Test
Kardiopulmonal
VARIABEL;
VARIABEL

LANGKAH

HASIL

PEMBAHASAN

KEKUATAN

KELEMAHAN
PRESENTASI JURNAL STASE NEUROLOGI

TUJUAN
VARIABEL INDEPENDEN
SUBJEK DAN
METODE Adalah suatu latihan berjalan tanpa menyesuaikan dengan
Gait training di pola gait normal dengan jarak sepanjang 5 meter pada
permukaan berpasir permukaan berpasir yang dilakukan secara berulang
VARIABEL
dengan durasi 30 menit perhari, dilakukan 5 kali
perminggu selama 6 minggu.
LANGKAH

HASIL

PEMBAHASAN

KEKUATAN

KELEMAHAN
PRESENTASI JURNAL STASE NEUROLOGI

TUJUAN
VARIABEL INDEPENDEN
SUBJEK DAN Gait training di permukaan keras adalah suatu latihan
METODE berjalan tanpa menyesuaikan dengan pola gait normal
Gait training di
dengan jarak sepanjang 5 meter pada permukaan padat
permukaan keras
VARIABEL atau kokoh yang dilakukan secara berulang dengan durasi
30 menit perhari, dilakukan 5 kali perminggu selama 6
minggu.
LANGKAH

HASIL

PEMBAHASAN

KEKUATAN

KELEMAHAN
PRESENTASI JURNAL STASE NEUROLOGI

TUJUAN Penentuan sampel penelitian.

Dari 30 sampel penelitian, 2 sampel yang drop out, jumlah sampel yang mengikuti
SUBJEK DAN penelitian ini hingga akhir berjumlah 28 orang.
METODE

VARIABEL Pengukuran dilakukan

sebelum memulai penelitian dengan menggunakan alat ukur Timed Up and Go (TUG)
Test dan 6 Minute Walking Test (6MWT).
LANGKAH

Pengukuran TUG dilakukan sebanyak 3 kali dan dicari rata-rata dari hasil yang
HASIL diperoleh. 6MWT adalah alat ukur untuk mengevaluasi daya tahan gait pada pasien
hemiplegiPengukuran hanya dilakukan sekali.
PEMBAHASAN
Intervensi
Gait training diberikan kepada kedua kelompok dengan permukaan yang berbeda dan
KEKUATAN Durasi gait training yang diberikan pada kedua kelompok sama yaitu 30 menit per
hari, 5 kali perminggu selama 6 minggu.

KELEMAHAN
PRESENTASI JURNAL STASE NEUROLOGI

TUJUAN Analisa data

Semua data yang didapat diolah dan dianalisa statistik menggunakan SPSS versi 20.0
SUBJEK DAN dengan nilai signifikan kurang dari 0,05.
METODE

VARIABEL

LANGKAH

HASIL

PEMBAHASAN

KEKUATAN

KELEMAHAN
PRESENTASI JURNAL STASE NEUROLOGI

TUJUAN

SUBJEK DAN
METODE Timed Up & Go Timed Up & Go Test (TUG) hasil yang didapat pada kelompok
Test (TUG) eksperimen dan kelompok kontrol yaitu signifikan (p<0,05).
VARIABEL

LANGKAH

6 Minute Walking 6 Minute Walking Test (6MWT) hasil yang didapat pada kelompok
HASIL
eksperimental yaitu signifikan (p<0,05), sedangkan kelompok kontrol
Test (6MWT)
tidak signifikan.
PEMBAHASAN

KEKUATAN

KELEMAHAN
PRESENTASI JURNAL STASE NEUROLOGI

TUJUAN

SUBJEK DAN Dalam penelitian ini, membahas tentang perbedaan pengaruh dari gait training pada 2 bidang yaitu
METODE
permukaan berpasir dan permukaan keras. hasil pemeriksaan menggunakan TUG untuk keseimbangan

VARIABEL dinamik, kedua kelompok mengalami penurunan waktu tempuh setelah latihan Hasil pemeriksaan
menggunakan 6MWT untuk mengetahui daya tahan gait, hanya gait training pada permukaan berpasir
yang signifikan mengalami peningkatan.
LANGKAH

HASIL
hasil penelitian Yigit et al, mengatakan bahwa kekuatan otot dan daya tahan otot tungkai meningkat
setelah latihan pada permukaan berpasir. menurut Davies dan Mackinnon mengatakan maksimal oksigen
PEMBAHASAN
yang dihirup, heart rate, dan ventilasi dari volume oksigen dan karbon dioksida meningkat saat berjalan di
pasir. Sehingga, dalam penelitian ini dapat dikatakan bahwa gait training pada permukaan berpasir tidak
KEKUATAN hanya meningkatkan kekuatan otot dan daya tahan otot tetapi juga meningkatkan fungsi kardiopulmonal.

KELEMAHAN
PRESENTASI JURNAL STASE NEUROLOGI

TUJUAN

SUBJEK DAN
METODE  Penelitian ini menggunakan metode penelitian randomized controlled trial.
 Tahun penelitian yang masih dalam kategori 5 tahun terakhir.
VARIABEL
 Dapat digunakan sebagai refrensi untuk menangani pasien dengan diagnosa stroke.

LANGKAH  Meningkatkan keseimbangan dinamik saat berjalan.

 Dapat meningkatkan fungsi kardiopulmonal.
HASIL  Meningkatkan kecepatan dan kemampuan berjalan.
 Latihan yang mudah dilakukan.
PEMBAHASAN

KEKUATAN

KELEMAHAN
PRESENTASI JURNAL STASE NEUROLOGI

TUJUAN

SUBJEK DAN
METODE • peneliti tidak mengumpulkan data tentang perbedaan kekuatan otot dan
mobilitas sendi pergelangan kaki sisi yang terkena dampak antara permukaan
VARIABEL
keras dan pasir.

LANGKAH • adanya perbedaan pelatihan berjalan tanpa alas kaki pada kelompok
eksperimen dan pemakaian sepatu kets pada kelompok kontrol.
HASIL • Pola gait training tidak dijelaskan.
• Pembagian kedua kelompok tidak dijelaskan.
PEMBAHASAN
• Kriteria eksklusi tidak dijelaskan.

KEKUATAN

KELEMAHAN