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"Obesitas merupakan suatu trend yang semakin banyak di dunia. Hal ini terjadi karena banyak faktor seperti junk food, globalisasi, dan penurunan aktivitas fisik. Obesitas sendiri merupakan faktor terbesar terjadinya Osteoartritis (OA) lutut. Otot quadriceps adalah salah satu otot yang melindungi sendi lutut. Pasien OA lutut ditemukan memiliki kelemahan otot quadriceps. Hubungan antara obesitas dan OA lutut serta hubungan antara OA lutut dengan kekuatan otot quadriceps sudah banyak diteliti, namun hubungan antara IMT dan kekuatan otot quadriceps masih belum jelas. Penelitian ini diadakan dengan tujuan untuk mengetahui hubungan antara Indeks Massa Tubuh (IMT) dengan kekuatan otot quadriceps pada pasien obesitas dengan OA lutut. Penelitian ini menggunakan desain studi cross-sectional secara analitik. Populasi subjek penelitian merupakan pasien obesitas dengan OA lutut di poli Rehabilitasi Medik RSCM. Data subjek penelitian diambil dari rekam medis elektronik lalu diskrining menggunakan kriteria eligibilitas sehingga didapatkan 18 subjek penelitian berdasarkan jumlah minimum sampel. Analisis data digunakan korelasi spearman di software SPSS. Hubungan dinyatakan bermakna secara statistik apabila p<0.05. Proses analisis data dengan korelasi spearman pada variabel Indeks Massa Tubuh (IMT) dan kekuatan otot quadriceps menghasilkan nilai p<0.05 dengan nilai rho -0,498. Hasil dari analisis data menunjukkan bahwa terdapat inverse correlation antara Indeks Massa Tubuh (IMT) dan kekuatan otot quadriceps yang bermakna secara statistic, maka semakin besar IMT seseorang, semakin lemah kekuatan otot quadriceps subjek pada populasi pasien obesitas dengan OA lutut.

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Obesity is an increasing trend in today’s world. This happens because various factors such as increase in availability of junk food, globalization, and decrease in physical activity. Obesity is one of the biggest risk factor for knee OA. Quadriceps muscle is one of the muscle that protects the knee joint. There is a lot of findings of weakening in quadriceps muscle strength in knee OA patients. There is a lot of evidence for the correlation of obesity and knee OA, there is also a lot of evidence for the correlation of knee OA and quadriceps muscle strength, but there is very little evidence for the correlation between BMI and quadriceps muscle strength. This study is made to find the correlation between BMI and quadriceps muscle strength in obese patients with knee OA. This study has an analytic cross-sectional design. The population of this study’s subject is obese patients with knee OA in the Department of Medical Rehabilitation of dr. Cipto Mangunkusumo Hospital. Subject’s data is acquired through electronic medical records and then screened using a particular eligibility criteria. This study acquired 18 subjects according to the minimum study sample. Data was analysed using spearman correlation in SPSS software. The correlation is stated statistically significant if p<0,05. Data analysis using spearman correlation to search for the correlation between BMI variable and quadriceps muscle strength variable shows a result with p<0.05 and a rho of -0,498. Based on the results of data analysis, it can be concluded that there is an inverse correlation between BMI and quadriceps muscle strength that’s statistically significant. Therefore, in obese patients with knee OA, the higher the BMI means the lower the strength of quadriceps muscle is."

"ABSTRAK Latar Belakang : Malnutrisi merupakan faktor independen yang berhubungan dengan morbiditas, mortalitas dan tingginya biaya pengobatan sirosis hati. Kekuatan Genggam Tangan (KGT) merupakan suatu metode yang sering digunakan untuk mendeteksi malnutrisi dan menilai prognosis pasien. Hubungan KGT dengan Skor Child Pugh (CP) dan massa otot masih dalam kontroversi. Indonesia sampai saat ini belum memiliki data tersebutMetode : Studi potong lintang pada pasien sirosis hati di poliklinik hepatobilier RSCM dari Februari-Juni 2015. Status nutrisi dinilai berdasarkan KGT. Massa otot diukur menggunakan bioimpedans. Analisis statistik menggunakan uji korelasi spearmanHasil : Terdapat 115 pasien yang kontrol di poliklinik hepatobilier RSCM, 112 pasien memenuhi kriteria penelitian, terdiri dari 79 laki-laki dan 33 perempuan. Usia pasien rata-rata 54,15±10,55 tahun, median skor CP 6(5-13) dengan median KGT 26(11-50) kgF, rata-rata massa otot 44,43±8,12 kg. Median asupan energi 1334,82(604,75-3023,7) kkal, median protein 45,87(19-114,5) gram. Prevalensi malnutrisi berdasarkan KGT ditemukan sebanyak 33%. Kekuatan genggam tangan tidak berkorelasi dengan skor CP (p 0,046, r=-0,19) namun berkorelasi dengan massa otot (p <0,001, r= 0,70) Simpulan Terdapat 33% kasus malnutrisi berdasarkan KGT pada pasien sirosis rawat jalan. KGT tidak berkorelasi dengan skor Child Pugh namun berkorelasi dengan massa otot pasien sirosis hati.ABSTRACT Background : Malnutrition is independent factor related to morbidity, mortality and high cost of treatment in liver cirrhosis. Hand grip strength (HGS) is one of the method use for malnutrition detection and prognosis evaluation. The correlation of HGS with liver function (Child Pugh or CP score) and muscle mass is controversial. These important evaluation is not yet avalaible in Indonesia.Method : This is a cross-sectional study in liver cirrhosis patients at Hepatobiliary clinic of Cipto Mangunkusumo Hospital from February to June 2015. Nutritional status was assessed by HGS. Muscle mass was obtained from bioimpedance. Data were analyzed using Spearman correlation test. Results : There were 115 patients liver cirrhosis at Hepatobiliary clinic of Cipto Mangunkusumo Hospital, 112 patients who fit the inclusion criteria, consisted of 79 men and 33 women with mean age 54,15±10,55 years, median CP score 6(5-13) with median HGS 26 (11-50) kgF, mean muscle mass 44,43±8,12 kg. The median intake of energy 1334,82(604,75-3023,7) kkal, median protein 45,87(19-114,5) gram. Prevalence of malnutrition according HGS was 33%. Hand grip strength is not correlated with CP score (p 0,046, r=-0,19) however it is correlated with muscle mass (p<0,001, r= 0,70) Conclusion There are 33% malnutrition cases based on HGS in out patient liver cirrhosis. There is no correlation between hand grip strength with Child Pugh score however HGS is correlated with muscle mass in liver cirrhosis.;Background : Malnutrition is independent factor related to morbidity, mortality and high cost of treatment in liver cirrhosis. Hand grip strength (HGS) is one of the method use for malnutrition detection and prognosis evaluation. The correlation of HGS with liver function (Child Pugh or CP score) and muscle mass is controversial. These important evaluation is not yet avalaible in Indonesia.Method : This is a cross-sectional study in liver cirrhosis patients at Hepatobiliary clinic of Cipto Mangunkusumo Hospital from February to June 2015. Nutritional status was assessed by HGS. Muscle mass was obtained from bioimpedance. Data were analyzed using Spearman correlation test. Results : There were 115 patients liver cirrhosis at Hepatobiliary clinic of Cipto Mangunkusumo Hospital, 112 patients who fit the inclusion criteria, consisted of 79 men and 33 women with mean age 54,15±10,55 years, median CP score 6(5-13) with median HGS 26 (11-50) kgF, mean muscle mass 44,43±8,12 kg. The median intake of energy 1334,82(604,75-3023,7) kkal, median protein 45,87(19-114,5) gram. Prevalence of malnutrition according HGS was 33%. Hand grip strength is not correlated with CP score (p 0,046, r=-0,19) however it is correlated with muscle mass (p<0,001, r= 0,70) Conclusion There are 33% malnutrition cases based on HGS in out patient liver cirrhosis. There is no correlation between hand grip strength with Child Pugh score however HGS is correlated with muscle mass in liver cirrhosis.;Background : Malnutrition is independent factor related to morbidity, mortality and high cost of treatment in liver cirrhosis. Hand grip strength (HGS) is one of the method use for malnutrition detection and prognosis evaluation. The correlation of HGS with liver function (Child Pugh or CP score) and muscle mass is controversial. These important evaluation is not yet avalaible in Indonesia.Method : This is a cross-sectional study in liver cirrhosis patients at Hepatobiliary clinic of Cipto Mangunkusumo Hospital from February to June 2015. Nutritional status was assessed by HGS. Muscle mass was obtained from bioimpedance. Data were analyzed using Spearman correlation test. Results : There were 115 patients liver cirrhosis at Hepatobiliary clinic of Cipto Mangunkusumo Hospital, 112 patients who fit the inclusion criteria, consisted of 79 men and 33 women with mean age 54,15±10,55 years, median CP score 6(5-13) with median HGS 26 (11-50) kgF, mean muscle mass 44,43±8,12 kg. The median intake of energy 1334,82(604,75-3023,7) kkal, median protein 45,87(19-114,5) gram. Prevalence of malnutrition according HGS was 33%. Hand grip strength is not correlated with CP score (p 0,046, r=-0,19) however it is correlated with muscle mass (p<0,001, r= 0,70) Conclusion There are 33% malnutrition cases based on HGS in out patient liver cirrhosis. There is no correlation between hand grip strength with Child Pugh score however HGS is correlated with muscle mass in liver cirrhosis."

"Latar Belakang: Pegawai kantor dengan obesitas memiliki risiko tinggi mengalami diabetes melitus (DM) tipe 2. Pemeriksaan sensitivitas insulin jarang dilakukan karena kendala teknis dan biaya. Berbagai studi sebelumnya menunjukkan adanya hubungan negatif antara massa lemak tubuh dengan HOMA-IR, namun hasil penelitian di Indonesia menunjukkan hasil yang tidak konsisten. Indeks TyG disebut sebagai penanda resistensi insulin yang lebih akurat jika dibandingkan dengan HOMA-IR pada populasi Asia. Belum ada penelitian yang menilai hubungan massa lemak tubuh dengan Indeks TyG di Indonesia.Metode: Studi potong lintang dilakukan pada 89 pekerja kantor dengan obesitas (IMT ≥25 kg/m2) tanpa riwayat DM di RSUPN Dr. Cipto Mangunkusumo, Jakarta, pada bulan Agustus hingga Oktober tahun 2022. Dilakukan pengambilan data demografis (usia, jenis kelamin, riwayat DM, kebiasaan merokok), antropometri, analisis asupan menggunakan 24-hour food recall 3x24 jam, serta penilaian tingkat aktivitas fisik berdasarkan Global Physical Activity Questionnaire Score. Pengukuran persentase lemak tubuh total dan massa lemak viseral menggunakan multi-frequency bioelectrical impedance analysis (BIA) SECA mBCA-525. Sensitivitas insulin dinilai menggunakan kadar HOMA-IR dan Indeks TyG serum. Analisis korelasi menggunakan uji Spearman dan dilakukan analisis multivariat untuk menilai faktor-faktor yang paling berhubungan dengan sensitivitas insulin.Hasil: Didapatkan sebanyak 89 subjek dengan proporsi perempuan:laki-laki sekitar 2:1, median usia 40 (21-59) tahun, dan mayoritas memiliki tingkat aktivitas sedang, tidak memiliki riwayat DM pada keluarga, tidak merokok, serta memiliki persentase kecukupan asupan melebihi kebutuhan energi individual dengan persentase makronutrien masih masuk dalam rentang normal. Korelasi persentase lemak tubuh total dengan HOMA-IR menunjukkan korelasi positif lemah yang bermakna (r=0,262, p=0,013). Korelasi massa lemak viseral dengan Indeks TyG menunjukkan korelasi positif lemah yang bermakna (r=0,234, p=0,027). Hasil korelasi persentase lemak tubuh total dengan indeks TyG dan korelasi massa lemak viseral dengan HOMA-IR menunjukkan hasil yang tidak signifikan secara statistik. Persentase lemak tubuh total tidak berhubungan signifikan dengan HOMA-IR setelah disesuaikan dengan variabel jenis kelamin, tingkat aktivitas fisik, indeks massa tubuh, lemak viseral, trigliserida, HDL, lingkar pinggang, dan persentase asupan karbohidrat. Massa lemak viseral tidak berhubungan signifikan dengan Indeks TyG setelah disesuaikan dengan variabel usia, jenis kelamin, lemak viseral, persentase asupan protein, dan HDL.Kesimpulan: Didapatkan korelasi positif lemah antara persentase lemak tubuh total dengan HOMA-IR dan korelasi positif lemah antara massa lemak viseral dengan Indeks TyG pada pegawai kantor obesitas di RSUPN Cipto Mangkunsumo.

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Background: Obese office workers have a high risk of developing type 2 diabetes mellitus (DM). Insulin sensitivity tests are rarely performed due to technical and cost constraints. Previous studies have shown a negative relationship between body fat mass and HOMA-IR. However, the results of research in Indonesia have shown inconsistent results. No study has assessed the relationship between body fat mass and the TyG index in Indonesia. In contrast, some research showed that The TyG index is a more accurate marker of insulin resistance in Asian populations.

Methods: A cross-sectional study was conducted on 89 office workers with obesity (BMI ≥25 kg/m2) without a history of DM at RSUPN Dr. Cipto Mangunkusumo, Jakarta, on August-October 2022. Demographic data were collected (age, gender, history of DM, smoking habits), anthropometry, analysis of energy intake and macronutrients using a 3- days 24-hour food recall, as well as an assessment of the level of physical activity based on the Global Physical Activity Questionnaire Score. The total body fat percentage and visceral fat mass were measured using a multi-frequency bioelectrical impedance analysis (BIA) SECA mBCA-525. Insulin sensitivity was assessed using HOMA-IR levels and serum TyG Index. Correlation analysis used the Spearman test, and multivariate analysis was performed to assess the factors most related to insulin sensitivity.

Results: There were 89 subjects with a proportion of women: men around 2:1, the median age was 40 (21-59) years, and the majority had moderate activity levels, had no family history of DM, did not smoke, and had intakes exceeding individual energy needs with the percentage of macronutrients within normal range. The total body fat percentage correlation with HOMA-IR showed a significant positive correlation with weak strength (r=0.262, p=0.013). The correlation of visceral fat mass with the TyG index showed a significant positive correlation with weak strength (r=0.234, p=0.027). The results of the correlation of total body fat percentage with the TyG index and the correlation of visceral fat mass with HOMA-IR showed results that were not statistically significant. The total body fat percentage was not significantly related to HOMA-IR after adjusting for variables such as gender, level of physical activity, body mass index, visceral fat, triglycerides, HDL, waist circumference, and percentage of carbohydrate intake. Visceral fat mass did not have a significant relationship with the TyG index after adjusting for age, sex, visceral fat, percentage of protein intake, and HDL.

Conclusion: A weak positive correlation was found between the percentage of total body fat and HOMA-IR and a weak positive correlation between visceral fat mass and the TyG index in obese office workers at Cipto Mangkunsumo General Hospital."

"Latar Belakang: Obesitas merupakan masalah global yang prevalensinya terus meningkat, terutama pada individu sedenter.  Peningkatan lemak viseral pada obesitas berperan penting dalam terjadinya kelainan metabolik, seperti hiperurisemia. Hiperurisemia dapat mengakibatkan disfungsi endotel yang menyebabkan aterosklerosis. Studi ini bertujuan untuk mengetahui korelasi antara lemak viseral dan asam urat pada pekerja kantor di RSUPN Dr. Cipto Mangunkusumo.Metode: Studi potong lintang ini dilakukan pada 92 pekerja kantor dengan obesitas (IMT ≥25 kg/m2) di RSUPN Dr. Cipto Mangunkusumo, Jakarta. Pengukuran lemak viseral menggunakan bioelectrical impedance analysis (BIA) seca mBCA 525, dengan lemak viseral ≥2,3 L pada laki-laki; ≥1,7 L pada perempuan menunjukkan peningkatan lemak viseral. Faktor komorbiditas juga diobservasi pada studi ini.Hasil: 29% subjek dengan hiperurisemia dan 86% subjek dengan lemak viseral yang tinggi. Median lemak viseral 2,8 L dan rerata asam urat serum 5,7 mg/dL. Komorbid tertinggi, yaitu dislipidemia, disusul dengan hipertensi, merokok, dan DM. Terdapat korelasi positif yang signifikan dengan kekuatan lemah antara lemak viseral dan asam urat serum (r=0,363; p<0,001).Kesimpulan: Ditemukan korelasi positif yang signifikan dengan kekuatan lemah antara lemak viseral dan asam urat serum pada pekerja kantor dengan obesitas

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Background: Obesity is an increasing, global public health issue, largely in sedentary lifestyle. Increased visceral fat in obesity has an important role in metabolic disorders, including hyperuricemia. Hyperuricemia can result in endothelial dysfunction that causes atherosclerosis. This study examined correlation between visceral fat and uric acid in obese office workers at Dr. Cipto Mangunkusumo Hospital.

Method: This cross sectional study involving 92 office workers with obesity (BMI ≥25 kg/m2) at Dr. Cipto Mangunkusumo Hospital, Jakarta. Visceral fat (VF) was measured using bioelectrical impedance analysis (BIA) seca mBCA 525, and VF ≥2,3 L in men; ≥1,7 L in women was defined as increased VF. The frequencies of comorbidity were also investigated.

Results: 29% of subjects with hyperuricemia and 86% of subjects with increased VF. Median VF was 2.8 L and mean serum uric acid was 5.7 mg/dL. The highest comorbidity is dyslipidemia, followed by hypertension, smoking, and DM. There is a significant positive weak correlation between visceral fat and serum uric acid (r=0.363; p<0.001).

Conclusion: This study shows a significant positive weak correlation between visceral fat and serum uric acid in office workers with obesity."

"ABSTRAKStroke merupakan penyebab kematian nomor tiga di banyak negara dan penyebab utama kecacatan pada usia dewasa. Dua pertiga pasien stroke mengalami kelemahan salah satu sisi anggota gerak. Perbaikan pasca stroke dapat dilakukan dengan memberikan stimulasi pada anggota gerak yang mengalami kelemahan, misalnya dengan latihan range of motion (ROM) dengan bola karet. Penelitian ini bertujuan untuk mengidentifikasi pengaruh ROM ekstremitas atas dengan bola karet terhadap kekuatan otot pasien stroke. Penelitian menggunakan disain quasi eksperimen dengan pendekatan control group pre-test and post-test. Intervensi yang dilakukan pada kelompok perlakuan adalah ROM ektremitas atas dengan bola karet dan latihan ROM standar untuk kelompok kontrol pada pasien stroke hemiparesis fase pasca akut. Latihan dilakukan 3 kali sehari selama 6 hari, dengan penilaian kekuatan otot pada hari pertama sebelum latihan dan hari keenam setelah latihan. Pasien yang dirawat di ruang perawatan nerurologi RSUPN Dr. Cipto Mangunkusumo Jakarta dengan jumlah 36 pasien digunakan sebagai sampel (18 pasien kelompok kontrol dan 18 pasien kelompok perlakuan). Hasil paired t test menunjukkan ada perbedaan yang signifikan rata-rata kekuatan otot sebelum dan sesudah latihan baik pada kelompok perlakuan (p=0.000) maupun kelompok kontrol (p=0.002). Hasil pooled t test membuktikan ada perbedaan yang signifikan rata-rata peningkatan kekuatan otot antara kelompok kontrol dan perlakuan (p=0.047). Dapat disimpulkan bahwa latihan ROM ekstremitas atas dengan bola karet lebih berpengaruh dari pada ROM standar dalam meningkatkan kekuatan otot pasien stroke. Rekomendasi hasil penelitian adalah latihan ini dapat dilanjutkan sebagai intervensi di rumah sakit dan sebagai bahan pertimbangan untuk melakukan upaya peningkatan kemampuan perawat terutama yang bekerja di ruang perawatan neurologi dalam memberikan latihan ROM pasien stroke.

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ABSTRACTStroke is the third caused of death in many countries. It is the main cause of handicaps in adult age. Two-third of stroke patient suffer a weakness of one of extremities side. Post stroke recovery can be done by giving a stimulation on the affected side, for example by implementing range of motion (ROM) with rubber ball. This research aimed to identifying the effect of upper extremity ROM with rubber ball on the muscle strength of stroke patient. The design of the research was a quasi experiment with control group pre-test and post-test. The upper extremity ROM with rubber ball are provided for treatment group and the standard ROM for control group 3 times a day for 6 days. The assessment of muscle strength was at the first day before intervention and sixth day after intervention. The research was conducted at RSUPN Dr. Cipto Mangunkusumo Jakarta and 36 patients were participated as subjects for both the control and intervention groups. The result of the paired t test showed that there is a significant difference on the average of muscle strength before and after intervention for the treatment group (p=0.000) and the control group (p=0.002). The result of the pooled t test revealed that there is a significant difference on the average of increasing of muscle strength between control and treatment groups (p=0.047). Based on the result, it can be concluded that upper extremity ROM with rubber ball has more effect than the standard ROM in increasing muscle strength of stroke patients. Recommendation of this research is that the practice of ROM can be continued as an intervention in the hospital and considered to improve nurse ability especially for those who work in neurology department in giving ROM exercise to patients with stroke."

"ABSTRAKStroke merupakan penyebab kematian nomor tiga di banyak negara dan penyebab utama kecacatan pada usia dewasa. Dua pertiga pasien stroke mengalami kelemahan salah satu sisi anggota gerak. Perbaikan pasca stroke dapat dilakukan dengan memberikan stimulasi pada anggota gerak yang mengalami kelemahan, misalnya dengan latihan range of motion (ROM) dengan bola karet. Penelitian ini bertujuan untuk mengidentifikasi pengaruh ROM ekstremitas atas dengan bola karet terhadap kekuatan otot pasien stroke. Penelitian menggunakan disain quasi eksperimen dengan pendekatan control group pre-test and post-test. Intervensi yang dilakukan pada kelompok perlakuan adalah ROM ektremitas atas dengan bola karet dan latihan ROM standar untuk kelompok kontrol pada pasien stroke hemiparesis fase pasca akut. Latihan dilakukan 3 kali sehari selama 6 hari, dengan penilaian kekuatan otot pada hari pertama sebelum latihan dan hari keenam setelah latihan. Pasien yang dirawat di ruang perawatan nerurologi RSUPN Dr. Cipto Mangunkusumo Jakarta dengan jumlah 36 pasien digunakan sebagai sampel (18 pasien kelompok kontrol dan 18 pasien kelompok perlakuan). Hasil paired t test menunjukkan ada perbedaan yang signifikan rata-rata kekuatan otot sebelum dan sesudah latihan baik pada kelompok perlakuan (p=0.000) maupun kelompok kontrol (p=0.002). Hasil pooled t test membuktikan ada perbedaan yang signifikan rata-rata peningkatan kekuatan otot antara kelompok kontrol dan perlakuan (p=0.047). Dapat disimpulkan bahwa latihan ROM ekstremitas atas dengan bola karet lebih berpengaruh dari pada ROM standar dalam meningkatkan kekuatan otot pasien stroke. Rekomendasi hasil penelitian adalah latihan ini dapat dilanjutkan sebagai intervensi di rumah sakit dan sebagai bahan pertimbangan untuk melakukan upaya peningkatan kemampuan perawat terutama yang bekerja di ruang perawatan neurologi dalam memberikan latihan ROM pasien stroke.

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ABSTRACTStroke is the third caused of death in many countries. It is the main cause of handicaps in adult age. Two-third of stroke patient suffer a weakness of one of extremities side. Post stroke recovery can be done by giving a stimulation on the affected side, for example by implementing range of motion (ROM) with rubber ball. This research aimed to identifying the effect of upper extremity ROM with rubber ball on the muscle strength of stroke patient. The design of the research was a quasi experiment with control group pre-test and post-test. The upper extremity ROM with rubber ball are provided for treatment group and the standard ROM for control group 3 times a day for 6 days. The assessment of muscle strength was at the first day before intervention and sixth day after intervention. The research was conducted at RSUPN Dr. Cipto Mangunkusumo Jakarta and 36 patients were participated as subjects for both the control and intervention groups. The result of the paired t test showed that there is a significant difference on the average of muscle strength before and after intervention for the treatment group (p=0.000) and the control group (p=0.002). The result of the pooled t test revealed that there is a significant difference on the average of increasing of muscle strength between control and treatment groups (p=0.047). Based on the result, it can be concluded that upper extremity ROM with rubber ball has more effect than the standard ROM in increasing muscle strength of stroke patients. Recommendation of this research is that the practice of ROM can be continued as an intervention in the hospital and considered to improve nurse ability especially for those who work in neurology department in giving ROM exercise to patients with stroke."