The Effect of Multimodal Exercise on Fall Risk and Functional Ability in the Elderly with Frailty Syndrome with Type 2 Diabetes Mellitus

Article History

Submited : December 23, 2023
Published : December 26, 2023

Elderly with Frailty Syndrome with Type 2 Diabetes Mellitus (T2DM) often experience loss of muscle mass and skeletal muscle function, causing a risk of falls and reduced functional abilities. To determine the effect of multimodal exercise on the risk of falls and functional ability in the elderly who experience frailty syndrome with T2DM. This research is quasi-experimental with a pretest-posttest design of 2 paired groups. A total of 50 older adults experiencing frailty syndrome with T2DM were divided into two groups of 25 people each. The T-Dependent Test and Wicoxon Test were used to determine changes before and after exercise administration, and the Mann-Whitney Test was used to determine the comparison between the intervention group and the control group. There was a reduced fall risk level and improved functional ability in the intervention group with Multimodal Exercise and in the control group (p=0.000). Multimodal Exercise had a difference in decreasing (Timed Up and Test) TUGT value higher than Elderly Gymnastics (p=0.001), and a higher increase in SPPB value was obtained in Multimodal Exercise than in the control group (p = 0.000). Multimodal Exercise intervention program was more effective in reducing fall risk and increasing functional ability.

Aryana S, Astika N & Kuswardhani T, 2018. Geriatric Opinion 2018. Geriatric opinion 2018, (December), p.11.
Budiwibowo F & Setiowati A, 2015. Unsur indeks massa tubuh dan kekuatan otot tungkai dalam keseimbangan. Journal of Sport Science and Fitness, 4(2).
Formiga MF, Fay R, Hutchinson S, Locandro N, Ceballos A, Lesh A, et al., 2020. Effect of aerobic exercise training with and without blood flow restriction on aerobic capacity in healthy young adults: a systematic review with meta-analysis. International journal of sports physical therapy, 15(2), p.175.
Ginter E & Simko V, 2013. Women live longer than men. Bratislavske lekarske listy, 114(2), pp.45–49.
He W, Goodkind D & Kowal PR, 2016. An aging world: 2015.
Hedayatpour N & Falla D, 2015. Physiological and neural adaptations to eccentric exercise: mechanisms and considerations for training. BioMed research international, 2015.
Jang HC, 2016. Sarcopenia, frailty, and diabetes in older adults. Diabetes & metabolism journal, 40(3), pp.182–189.
Krentz AJ, Viljoen A & Sinclair A, 2013. Insulin resistance: a risk marker for disease and disability in the older person. Diabetic medicine, 30(5), pp.535–548.
Lee SB, Oh JH, Park JH, Choi SP & Wee JH, 2018. Differences in youngest-old, middle-old, and oldest-old patients who visit the emergency department. Clinical and Experimental Emergency Medicine, 5(4), p.249.
Lima Filho BF de, Gama AGD, Dias V da N, Silva EMT da, Cavalcanti FA da C & Gazzola JM, 2020. The frailty syndrome in older adults with type 2 diabetes mellitus and associated factors. Revista Brasileira de Geriatria e Gerontologia, 23(1).
Liu C, Chang W-P, Araujo de Carvalho I, Savage KEL, Radford LW & Amuthavalli Thiyagarajan J, 2017. Effects of physical exercise in older adults with reduced physical capacity: meta-analysis of resistance exercise and multimodal exercise. International Journal of Rehabilitation Research, 40(4), pp.303–314.
Marlita L, Saputra R & Yamin M, 2018. Faktor-Faktor yang Mempengaruhi Tingkat Kemandirian Lansia dalam Melakukan Activity Daily Living (ADL) di UPT PSTW Khusnul Khotimah. Jurnal Keperawatan Abdurrab, 1(2), pp.64–68.
Maryani H & Kristiana L, 2018. Pemodelan angka harapan hidup (AHH) laki-laki dan perempuan di Indonesia tahun 2016. Buletin Penelitian Sistem Kesehatan, 21(2), pp.71–81.
Muszalik M, Stępień H, Puto G, Cybulski M & Kurpas D, 2022. Implications of the Metabolic Control of Diabetes in Patients with Frailty Syndrome. International Journal of Environmental Research and Public Health, 19(16), p.10327.
Naderi A, Shaabani F, Esmaeili A, Salman Z, Borella E & Degens H, 2019. Effects of low and moderate acute resistance exercise on executive function in community-living older adults. Sport, Exercise, and Performance Psychology, 8(1), p.106.
Nisa Q & Maratis J, 2019. Hubungan keseimbangan postural dengan kemampuan berjalan pada pasien stroke hemiparesis. Jurnal Fisioterapi, 19(2), pp.83–89.
du Plessis R, Dembskey N & Bassett SH, 2022. Effects of an isometric exercise training program on muscular strength, ankle mobility, and balance in patients with diabetic peripheral neuropathy in the lower legs in South Africa. International Journal of Diabetes in Developing Countries, pp.3–8.
Pytel A, Beszlej JA, Biercewicz M, Roszmann A, Krówczyńska D & Kołtuniuk A, 2022. The Effect of Frailty Syndrome on the Quality of Life of Individuals with Parkinson’s Disease: A Pilot Observational and Multicenter Study on the Polish Population. International Journal of Environmental Research and Public Health, 19(22), p.15226.
Rizka A, Setiati S, Harimurti K, Sadikin M & Mansur IG, 2018. Effect of alfacalcidol on inflammatory markers and T cell subsets in elderly with frailty syndrome: a double blind randomized controlled trial. Acta Med Indones, 50(3), pp.215–221.
Rodriguez-mañas L, Laosa O, Vellas B, Paolisso G, Topinkova E, Oliva-moreno J, et al., 2019. Effectiveness of a multimodal intervention in functionally impaired older people with type 2 diabetes mellitus. , (April), pp.721–733.
Sanz-Cánovas J, López-Sampalo A, Cobos-Palacios L, Ricci M, Hernández-Negrín H, Mancebo-Sevilla JJ, et al., 2022. Management of Type 2 Diabetes Mellitus in Elderly Patients with Frailty and/or Sarcopenia. International Journal of Environmental Research and Public Health, 19(14).
Seto E, Setiati S, Laksmi PW & Tamin TZ, 2015. Diagnostic test of a scoring system for frailty syndrome in the elderly according to cardiovascular health study, study of osteoporotic fracture and comprehensive geriatric assessment based frailty index compared with frailty index 40 items. Acta Medica Indonesiana, 47(3).
da Silveira Langoni C, de Lima Resende T, Barcellos AB, Cecchele B, Knob MS, do Nascimento Silva T, et al., 2019. Effect of exercise on cognition, conditioning, muscle endurance, and balance in older adults with mild cognitive impairment: a randomized controlled trial. Journal of Geriatric Physical Therapy, 42(2), pp.E15–E22.
Syah I & Susy Purnawati S, 2016. Efek Pelatihan Senam Lansia Dan Latihan Jalan Tandem Dalam Meningkatkan Keseimbangan Tubuh Lansia Di Panti Sosial Tresna Kasih Sayang Ibu Batusangkar Sumatra Barat. Sport and Fitness Journal, 5(1), pp.8–16.
Thomas E, Battaglia G, Patti A, Brusa J, Leonardi V, Palma A, et al., 2019. Physical activity programs for balance and fall prevention in elderly: A systematic review. Medicine, 98(27).
Uyainah A, Bahar A, Pramantara DP, Wahyudi ER, Harimurti K, Legiawati L, et al., 2015. Management of Frailty As a New Geriatric Giant : How To Deal With Dilemmatic Health Problems in Elderly Patient,
Yoon SJ & Kim K Il, 2019. Frailty and disability in diabetes. Annals of Geriatric Medicine and Research, 23(4), pp.165–169.
Halmu, R., Ariyandy, A., & Sinrang, A. (2023). The Effect of Multimodal Exercise on Fall Risk and Functional Ability in the Elderly with Frailty Syndrome with Type 2 Diabetes Mellitus. Ghidza: Jurnal Gizi Dan Kesehatan, 7(2), 316-325.