Terapi Kombinasi Motor Relearning Program, Proprioceptive Neuromuscular Facilitation dan Core Stability Exercise Terhadap Peningkatan Keseimbangan Duduk ke Berdiri dan Kekuatan Otot Postural pada Penderita Stroke

Abstract

Common deficiencies in stroke include spasticity, weakness, and loss of balance on the affected side leading to an inability to maintain postural balance. Postural balance is one of the most important indicators of functional recovery after stroke. The occurrence of weakness, postural imbalance, failure of dynamic stability, and difficulty in transferring body weight have a negative impact on the patient's activities so that it affects independence, quality of life and work productivity. This study combines a motor relearning program, proprioceptive neuromuscular facilitation and core stability exercise to solve the problem of sitting to standing balance and muscle strength in stroke patients. The design of this research was one group pretest-posttest. The study was carried out in several hospitals in the city of Makassar with a sample size of 40 stroke patients. The comparison of the result scores in the pretest and posttest phases was analyzed by Wilcoxon test. The results of the analysis for sitting to standing balance obtained p value = 0.00 and for muscle strength obtained p value = 0.000. Furthermore, it was concluded that the combination therapy of motor relearning program, proprioceptive neuromuscular facilitation and core stability exercise was significantly effective in improving sitting to standing balance and postural muscle strength in stroke patients.

Keywords: motor relearning program; proprioceptive neuromuscular facilitation; core stability exercise; stroke

ABSTRAK

Defisiensi umum pada stroke meliputi spastisitas, kelemahan, dan hilangnya keseimbangan pada sisi yang terkena sehingga menyebabkan ketidakmampuan untuk menjaga keseimbangan postural. Keseimbangan postural merupakan  salah satu indikator terpenting dalam pemulihan fungsional setelah stroke. Terjadinya kelemahan,  ketidakseimbangan postural, kegagalan stabilitas dinamis, dan kesulitan dalam mentransfer berat badan berdampak negatif pada aktivitas  pasien sehingga mempengaruhi kemandirian, kualitas hidup dan produktivitas kerja. Penelitian ini mengombinasikan motor relearning program, proprioceptive neuromuscular facilitation dan core stability exercise untuk menyelesaikan problem keseimbangan duduk ke berdiri dan kekuatan otot pasien stroke. Rancangan penelitian ini adalah one  group pretest-posttest. Penelitian di laksanakan di beberapa rumah sakit di kota Makassar dengan ukuran sampel = 40 pasien stroke. Perbandingan skor hasil pada fase pretest dan posttest dianalisis dengan Wilcoxon test. Hasil analisis untuk keseimbangan duduk ke berdiri diperoleh nilai p = 0.00 dan untuk kekuatan otot diperoleh nilai p = 0.000. Selanjutnya disimpulkan bahwa terapi kombinasi motor relearning program, proprioceptive neuromuscular facilitation dan core stability exercise efektif secara signifikan untuk meningkatkan  keseimbangan duduk ke berdiri dan kekuatan otot postural pada  penderita stroke.

Kata kunci: motor relearning program; proprioceptive  neuromuscular  facilitation;  core stability exercise; stroke