skip to main content

EFFECTIVENESS OF ADDING EXPIRATORY MUSCLE STRENGTHENING EXERCISE IN ELDERLY EXERCISE ON FATIGUE COMPLAINTS OF PRE-FRAIL ELDERLY POPULATION

Erma Nihlatul Mufidah  -  , Indonesia
*Erna Setiawati orcid  -  Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Diponegoro University, Semarang, Indonesia, Indonesia
Tanti Ajoe Kesoema orcid  -  , Indonesia
Open Access Copyright 2026 Erna Setiawati, Erma Nihlatul Mufidah, Tanti Ajoe Kesoema
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

Citation Format:
Abstract

Background: The aging process induces changes in the anatomical and physiology of multiple organs and body systems, resulting in gradual reduction in cardiovascular and pulmonary functional capacities. This decline subsequently impairs cardiorespiratory fitness, ultimately leading to complaints of fatigue, that can be assessed by a Fatigue Assessment Scale (FAS). Aerobic exercise, such as elderly exercise, enhances cardiorespiratory fitness by promoting increasing blood flow to muscles. Supplementing these activities with expiratory muscle strengthening exercises using a Positive Expiratory Pressure/PEP threshold device help to reinforce the expiratory muscles, which are commonly weakened with aging. Objective: To prove the effectiveness of adding expiratory muscle-strengthening exercises to elderly exercise the fatigue complaints of the pre-frail elderly. Methods: A randomized controlled trial was used for this research. There were 24 subjects who met the study criteria were randomly divided into an intervention group (n=12) who receive PEP 5 times per week + elderly exercise 3 times per week for 6 weeks, and a control group (n=12) who only had elderly exercise 3 times per week for 6 weeks. Fatigue complaints were measured before and after intervention using the FAS questionnaire. Results: There was an increase in FAS scores before and after treatment in both the intervention group (p<0.001) and the control group (p<0.001). Comparison between groups showed a significant FAS score difference in the intervention group (p=0.010). Conclusion: The addition of expiratory muscle strengthening exercises to elderly exercise for 6 weeks had a better improvement in fatigue complaints compared to only having elderly exercise.

Keywords: Fatigue Assessment Scale, Positive Expiratory Pressure, pre-frail, “senam lansia”

Article Metrics:

Article Info
  1. Girsang APL RK, Nugroho SW, Sulistyowati NP, Putrianti R, Wilson H. . Statistik Penduduk Lanjut Usia 2021 Jakarta. In: Statistik BP, editor. Jakarta: Badan Pusat Statistik; 2021
  2. Darmojo RB MH. Teori Proses Menua. In: Martono HH, Pranarka K, editors. Buku Ajar Boedhi-Darmojo Geriatri (Ilmu Kesehatan Usia Lanjut). . 4 ed. Jakarta: Balai Penerbit FKUI; 2009
  3. Hazzard's geriatric medicine and gerontology Jeffrey B Halter Hazzard's geriatric medicine and gerontology et al McGraw-Hill Medical £154.99 1760pp 9780071488723 [Formula: see text]. Nursing older people. 2010;22(6):10
  4. Siti S. Geriatric Medicine, Sarkopenia, Frailty, dan Kualitas Hidup Pasien Usia Lanjut: Tantangan Masa Depan Pendidikan, Penelitian dan Pelayanan Kedokteran di Indonesia. eJournal Kedokteran Indonesia. 2013;1(3)
  5. HH. M. Kerapuhan dan Gagal Pulih. In: Martono HH, Pranarka K, editors. Buku Ajar Boedhi-Darmojo Geriatri (Ilmu Kesehatan Usia Lanjut). 4 ed. Jakarta: Balai Penerbit FKUI; 2009
  6. HH. M. Aspek Fisiologik dan Patologik Akibat Proses Menua. In: Martono HH, Pranaka K, editors. Buku Ajar Boedhi-Darmojo Geriatri (Ilmu Kesehatan Usia Lanjut). . Jakarta: Balai Penerbit FKUI; 2009
  7. N. N. Medical Exercise in Rehabilitation.Program Studi Pendidikan Dokter Spesialis -1 Ilmu Kedokteran Fisik dan Rehabilitasi Fakultas Kedokteran Universitas Indonesia. 2018
  8. Kalapatapu RK, Cristian A. Assessment of fatigue in adults with disabilities. Physical medicine and rehabilitation clinics of North America. 2009;20(2):313-24
  9. Michielsen HJ, De Vries J, Van Heck GL. Psychometric qualities of a brief self-rated fatigue measure: The Fatigue Assessment Scale. Journal of psychosomatic research. 2003;54(4):345-52
  10. Rida Zuraida HHC. Pengujian Skala Pengukuran Kelelahan (SPK) Pada Responden Di Indonesia. ComTech Vol 5 No 2 Desember 2014: 1012-1020. 2014;5:1012-20
  11. De Vries J, Michielsen HJ, Van Heck GL. Assessment of fatigue among working people: a comparison of six questionnaires. Occupational and environmental medicine. 2003;60 Suppl 1(Suppl 1):i10-5
  12. Basuni DT PH. Uji Latih Beban pada Rehabilitasi Jantung. 1 ed. Jakarta: PB PERDOSRI; 2016
  13. Riebe D. Exercise Prescription for Healthy Populations with Special Consideration and Enviromental Considerations. ACSM’s Guidelines for Exercise Testing and Prescription. 10 ed. Philadelphia2018
  14. Lee SH, Yim SJ, Kim HC. Aging of the respiratory system. kmj. 2016;31(1):11-8
  15. Maki N, Sakamoto H, Takata Y, Kobayashi N, Kikuchi S, Goto Y, et al. Effect of respiratory rehabilitation for frail older patients with musculoskeletal disorders: a randomized controlled trial. Journal of rehabilitation medicine. 2018;50(10):908-13
  16. Emirza C, Aslan GK, Kilinc AA, Cokugras H. Effect of expiratory muscle training on peak cough flow in children and adolescents with cystic fibrosis: A randomized controlled trial. Pediatric pulmonology. 2021;56(5):939-47
  17. Nasution SAS. Tingkat Fatigue Pada Lansia: Universitas Sumatera Utara; 2023
  18. Luawo HP. Efektivitas Home Based Exercise Training dan Senam Lansia Terhadap Kebugaran dan Kelelahan Pada lansia. Surabaya: Universitas Airlangga; 2020
  19. Sri Gunda Fahriana Fahruddin RNI, Inayah Ageng Izza,Ulfa Diya Atiqa, Isfawati Mahmud. Peningkatan Kesehatan Fisik dan Mental Lansia Melalui Program Senam lansia di Komunitas. APMa Jurnal Pengabdian Masyaraka. 2025;5:85-90
  20. Tsukamoto T, Maruyama H. Effect of expiratory muscle training on respiratory muscle fatigue in healthy adults: a randomized controlled trial. Journal of physical therapy science. 2024;36(7):382-91
  21. Hasan H, Maranatha RA. Perubahan Fungsi Paru pada Usia Tua: [Lung Function Alteration in Geriatric Patients]. Jurnal Respirasi. 2017;3(2):52-7
  22. Shoseyov D, Cohen-Kaufman T, Schwartz I, Portnoy S. Comparison of activity and fatigue of the respiratory muscles and pulmonary characteristics between post-polio patients and controls: A pilot study. PLOS ONE. 2017;12(7):e0182036

Last update:

No citation recorded.

Last update:

No citation recorded.