Comparison of Hamstrings and Quadriceps Femoris Muscle Thickness Increment between Agonist-Antagonist Paired Set and Traditional Set Resistance Training in Untrained Healthy Subjects

Background: Resistance training is an effective way to increase muscle mass. Resistance training with agonist-antagonist paired set method can be an alternative to increase muscle mass within a relatively short training time.Aim: To compare the increase in hamstrings and quadriceps femoris muscle thickness between agonist-antagonist paired set (APS) and traditional set (TS) resistance training in untrained healthy subjects.Material and Methods: This study was an experimental study on 16 untrained healthy men which were randomly assigned to the APS and the TS group. Each group got leg curl and leg extension exercises with equal training volume for 6 weeks. For the APS group, 1 set of leg curls was followed by 1 set of leg extensions, repeated for 3 sets. For the TS group, 3 sets of leg curls were followed by 3 sets of leg extensions. Muscle thickness was compared from pre- to post-training and between the intervention groups using B-mode ultrasound.Results: Muscle thickness of the hamstrings and quadriceps femoris increased significantly from pre- to post-training in both groups (p<0.05). The increase in muscle thickness between the two groups was not significantly different (p> 0.05).Conclusion: Resistance training with the APS method did not give a higher increment of hamstrings and quadriceps femoris muscle thickness compared to the TS method in healthy untrained subjects.

The Effects of Moderate Intensity Treadmill Exercise with Gradual Increase of Speed and Inclination on VO2max in Men with Type 2 Diabetes Mellitus

Background: The American College of Sport Medicine (ACSM) recommends cardiorespiratory fitness training in people with diabetes mellitus (DM) for 3-7 days a week, total duration 150 minutes a week with moderate intensity using large muscle groups. Treadmill training is the best cardiorespiratory fitness training because it involves large muscle group compared to static cycle and arm crank.Aim: To determine the effect of moderate intensity treadmill exercise with gradual increase of speed and inclination on VO2max in men with T2DM.Material and Methods: Randomized group design in 22 men with T2DM, suitable with inclusion criteria was divided into 2 groups, the experimental and control group. The experimental group received moderate intensity treadmill exercise, 3 times a week with gradual increase of speed and inclination for 4 weeks. The control group underwent standard therapy. Measurement of VO2max was performed before and after program in both groups.Results: A significant increase of VO2max in the experimental group (p = 0.003). Compared to the control group, alteration of VO2max also significant among the experimental group (p = 0.000).Conclusion: Moderate intensity treadmill exercise with gradual increase on speed and inclination for 4 weeks increase VO2max in men with T2DM.

Effectiveness of Deep Cervical Flexor (DCF) Exercise on Neck Functional Scores in Helicopter Crew with Mechanical Neck Pain

Background: Mechanical neck pain is defined as neck pain due to biomechanical dysfunction in the neck or upper back. Exercise can reduce muscle tension and strengthen deep cervical flexor (DCF) muscles by helping to relieve pain. The prevalence of neck pain is considered high in helicopter crews compared to the general population. Aim: To investigate the effectiveness of DCF exercise on neck functional scores (study of helicopter crews with mechanical neck pain).Material and Methods: Experimental one pre and post-test group design. The samples were 14 squadron-31/serbu helicopter crew performing conventional DCF muscle exercise 12 times for 4 weeks with a frequency of 3 times each week. Neck function was assessed using the Neck Outcome Score (NOOS) which consists of domains of mobility, stiffness, symptoms, sleep disturbances, everyday activity and pain, participating in everyday life, and quality of life.Results: This study showed that the mean NOOS score before intervention was 30.64 (SD: 9.44) and the mean NOOS score after intervention was 8.57 (SD: 5.33). There was a significant difference in the NOOS score before and after deep cervical flexor exercise (p = 0.001).Conclusion: DCF exercises are effective for improving neck functionality in helicopter crew with mechanical neck pain.

Rehabilitation Management of Post Palatoplasty in Adolescent: Case Report

The objective of this study is to report comprehensive physical medicine and rehabilitation management of post-palatoplasty in an adolescent patient. The cleft palate repair is usually done in the first year of life in order to gain optimal speech function. To achieve normal communication development, normal hearing, normal oral and pharyngeal structures, adequate stimulation, and reinforcement from the environment for communication efforts are needed. Patient was assessed comprehensively using The International Classification of Functioning, Disability and Health (ICF) and by perceptual assessment for speech. The results showed that after one month intervention, the perceptions of hypernasality in plosive /b/ and affricates /c/ were found reduced significantly. There was improvement in articulation after one month of intervention.

Cardiovascular Responses, Physical Activity Intensity, and Enjoyment Level of Nintendo Switch™ Exergaming, Comparing Different Tempos and Playing Modes: A Pilot Study

Background: Physical activity (PA) has been associated with multiple health benefits. However, the global population does not meet the PA recommendations. Virtual reality exergaming (VR EXG) can become an option to increase PA because it is fun, relatively easy to access and affordable through popular commercial devices.Aim: To investigate the immediate cardiovascular responses(blood pressure, heart rate), quantification of PA intensity(percentage of maximum heart rate (%HRmax), Borg’s rating of perceived exertion (RPE), and the level of enjoyment using visual analog scale (VAS) while playing VR EXG.Material and Methods: Fifteen healthy men (aged 31.87±3.14 years old, body mass index 23.77±2.47 kg/m2) undergone three“Fitness Boxing” Nintendo Switch™ playing modes in the same order: (1) single player-normal tempo, (2) single player-fast tempo and (3) versus. During playing, participant’s HR was monitored using Polar H10 heart rate sensor. Blood pressure was measured before and after playing. Borg’s RPE and VAS were collected after playing.Results: Our results showed significant heart rate and systolic blood pressure increase (p = 0.001) in all three playing conditions, whereas diastolic blood pressure was relatively constant (p > 0.05). The Borg’s RPE were in 12-13 range (moderate) and %HRmax range between 72- 81% (vigorous). The enjoyment level was found greatest in versus mode compared to other playing modes.Conclusion: VR EXG Nintendo Switch™ “Fitness Boxing” can elicit immediate cardiovascular responses and provides an enjoyable moderate to vigorous PA intensity in healthy male adults, and can be used to meet the weekly PA recommendations.

Prevalence of Knee Injury in East Java’s Puslatda Fencing Athletes

Background: Fencing is one of many sports that are held in major sports events, both nationally and internationally. Fencing also has a high risk of injury, and knee injury is the most common injury site according to the authors' observations. Even so, studies on knee injuries in fencing athletes are very scarce, especially in Indonesia.Aim: To ascertain the prevalence of knee injuries and its intrinsic risk profile in fencing athletes at East Java Puslatda (regional training center).Material and Methods: The method used in this study was descriptive observational based on athletes’ health screening data, which were obtained from Sport Clinic Dr. Soetomo Academic General Hospital and athletes’ fitness data obtained from KONI.Results: This research involved 14 fencing athletes that were active in the East Java regional training center. Out of the 14 athletes who were included in this study, it was found that 1 athlete (7.1%) had a knee injury and 13 athletes (92.9%) had no knee injury. The athlete who had injured was a senior overweight female, had history of knee injury, average VO2max, normal knee ROM and alignment, and did 1-2 times leg strengthening exercises every week.Conclusion: The prevalence of knee injuries in fencing athletes at East Java regional training center is 1 in 14 athletes.

Combination of Tramadol-Paracetamol in Palliative Care Pain Management: A Case Report

One of the basic goals of palliative care is to reduce the suffering of the patient, which includes relieving the pain. Some facts show that sometimes a doctor is afraid to give opioid analgesic mono-therapy to his patients because she is worried on one hand about the effect of addiction. In addition, in some cases, NSAID analgesics mono-therapy can also cause a series of side effects or even the patient may be contraindicated against the use of NSAID or paracetamol class drugs. Actually, this can be prevented by giving a combination of opioids and non-opioids analgesic. By providing this combination of therapy, it is hoped that this can accelerate the onset of work, extend the working period which can reduce the dose of drugs consumed, and more importantly minimize the side effects of each drug. The fixed dose combination of Tramadol-Paracetamol (Tramadol 37.5 mg–Paracetamol 325 mg) is an example of a drug combination preparation that has been shown to be effective in the treatment of pain. In this case report, a patient who is currently undergoing palliative therapy for cancer is described. On the way, the patient felt spinal pain as a result of the spread of the disease. The combination of Tramadol-paracetamol was administered twice a day with a dose that adjusted to the VAS Score observations before and after drug administration. And in this case, there was a decrease in the VAS score after being given Tramadol-Paracetamol combination.

Upper Limb Muscles Activity during Punches in Virtual Reality Exergame on Standing and Sitting Position

Background: Physical activity (PA) provides various health benefits. Unfortunately, individuals with disabilities may experience health problems and greater obstacles to PA participation. Boxing exergame (EXG) based on virtual reality (VR) can be an alternative option to increase physical activity level because it is fun, relatively affordable and accessible. Punching in boxing requires complex movements, wherein the lower limbs are contributor for effective punches. An understanding of muscles activity is important to uncover the potential benefits of VR EXG.Aim: To evaluate the differences in upper limb muscles activity of the dominant side in standing compared to sitting position during punches.Material and methods: This was a cross-sectional study involving 15 healthy adult men. Surface electromyography examinations was performed on four upper limb muscles of the dominant side (upper trapezius, anterior deltoid, biceps, triceps) when delivering straight, hook and uppercut punches while playing VR EXG "Fitness Boxing" Nintendo Switch™ in standing and sitting position.Results: Fifteen healthy men (age 31.87±3.14 years old, BMI 23.77±2.47 kg.m-2) were participated in this study. No significant difference found in the percentage of maximum voluntary isometric contraction (%MVIC) values of the upper trapezius, anterior deltoid, biceps and triceps muscles of the dominant sides when the subjects delivered straight, hook and uppercut punches (p>0.05), except for upper trapezius muscle during uppercut punch in standing compared to sitting position (p=0.041).Conclusion: The VR EXG "Fitness Boxing" Nintendo Switch™ can be done in a standing or sitting position to get similar effect on the upper limb muscles.

Risk Estimation of Anterior Cruciate Ligament (ACL) Injury in East Java Puslatda Pencak Silat Athletes

Background: Dr. Soetomo General Hospital Sports Clinic Surabaya reported that the incidence of knee injuries was rather high, particularly in martial art athletes. Injuries in pencak silat athletes are dominated by Anterior Cruciate Ligament (ACL) injuries (16.7%) Several risk factors are thought to influence ones’ propensity for these injuries.Aim: To analyze risk estimation between intrinsic and extrinsic factors in the occurrence of ACL injury in East Java Puslatda Pencak Silat Athletes.Material and Methods: This study was an analytic observational study with a case control design involving 18 pencak silat athletes from East Java Regional Training Centre. Age, gender, body mass index, previous ACL injury, range of motion, laxity, and flat foot were included as intrinsic factors; while duration of each training, training frequency, and sparring frequency were included as extrinsic factors. Data analysis was done using the Chi-Square Test. Odds Ratio was calculated through cross-tabulation.Results: It was found that 3 of 18 athletes (16.7%) had ACL injuries. None of the intrinsic and extrinsic factors significantly affected the incidence of ACL injury (p> 0.05). However, the odds ratio calculation showed that adult athletes older than 25 years-old (OR = 1.4), male (OR = 1.667), obese (OR = 1.4), with laxity (OR = 2.5), and flat foot (OR = 1) had higher risk in having ACL injury.Conclusion: Adult athletes, male, obese, with laxity, and flat foot had a higher risk of ACL injury.

Effect of Strengthening Exercises Using the Agonist- Antagonist Paired Set and Traditional Set Methods on Single-Leg Hop Performance

Background: Functional activities mostly done in daily life such as jumping, walking, running, and stairs ascending-descending require dynamic stability of the knee. The knee joint dynamic stability is required to have effective and efficient functional activities and to avoid injury when performing them. It can be achieved by increasing muscle strength through strengthening exercises with the aim of balancing the agonist muscles (quadriceps femoris) and antagonist muscles (hamstring) using the agonist- antagonist paired set (APS) method.Aim: The aim of this study is to find out the effect of strengthening exercise using APS method, compared to traditional set (TS) method, on single-leg hop performance.Material and Methods: The subjects of this study were 14 untrained healthy men aged 18-40 years old divided into 2 intervention groups, APS group and TS group. The variable evaluated was the distance of single-leg hop (SLH).Results: The results of this study showed a significant increase in SLH distance in APS group (p=0.005) and TS group (p<0.001) with no significant difference between the two groups (p = 0.933).Conclusion: Quadriceps femoris and hamstring muscle strengthening exercises in both APS and TS methods increase SLH distance although there is no difference between them. The APS method has an advantage compared to the TS method in terms of a relatively shorter time with comparable results.