Introduction: For the elderly to live independently and productively, good fine motor skill is needed. It is well known that exercise can preserve fine motor skills. Still, the effect of practices in Bhakti Luhur Orphanage and Nursing Home: Oma-oma’s gym and tai chi haven’t been explored before. Aim: The goal of this research is to analyze the correlation between the median of the exercise duration and fine motor skills represented by the average of finger tapping test on trial three to trial five.  Methods: This cross-sectional research employed purposive sampling yielding 22 elderly (≥60 years old) who understood the order given, agreed to join the research, and also free from motor impairment due to cerebrovascular accidents, parkinsonism, pain or arthritis on the dominant hand, and nil from psychiatric drugs as samples. Result: There was a slight correlation between the two variables, which is insignificant (r=0,341, p=0,120) between the duration of the exercises and motor speed. Conclusion: There is no significant correlation between exercise duration and fine motor skills
in the elderly in Bhakti Luhur Orphanage and Nursing Home

Konginan, Agustina

Kurniawati, Nita

Suhardi, Maria A

English

Journal Widya Mandala Catholic University Surabaya / Jurnal-Jurnal yang diterbitkan Universitas Katolik Widya Mandala Surabaya

 Mean Excercise Duration and …          Suhardi MA , Kurniawati N, Konginan A 102	 MEAN EXERCISE DURATION AND FINE MOTOR SPEED IN ELDERLY LIVING IN BHAKTI LUHUR TROPODO ORPHANGE AND NURSING HOME  Maria A Suhardi 1), Nita Kurniawati 2), Agustina Konginan 3)  ABSTRACT Introduction: For the elderly to live independently and productively, good fine motor skill is needed. It is well known that exercise can preserve fine motor skills. Still, the effect of practices in Bhakti Luhur Orphanage and Nursing Home: Oma-oma’s gym and tai chi haven’t been explored before. Aim: The goal of this research is to analyze the correlation between the median of the exercise duration and fine motor skills represented by the average of finger tapping test on trial three to trial five.  Methods: This cross-sectional research employed purposive sampling yielding 22 elderly (≥60 years old) who understood the order given, agreed to join the research, and also free from motor impairment due to cerebrovascular accidents, parkinsonism, pain or arthritis on the dominant hand, and nil from psychiatric drugs as samples.  Result: There was a slight correlation between the two variables, which is insignificant (r=0,341, p=0,120) between the duration of the exercises and motor speed.  Conclusion: There is no significant correlation between exercise duration and fine motor skills in the elderly in Bhakti Luhur Orphanage and Nursing Home.  Keywords: elderly, exercise duration, fine motor skill       1) Student of Faculty of Medicine Widya Mandala Catholic University Surabaya, Kalisari Selatan 1 Surabaya     Email : ameliasuhardi@gmail.com 2) Neurology Department Faculty of Medicine Widya Mandala Catholic University Surabaya, Kalisari Selatan 1    Surabaya 3) Psychiatry Department Dr Soetomo General Hospital, Mayjend Prof. Dr. Moestopo No. 6-8 Surabaya  Online-ISSN 2565-1409  Journal of Widya Medika Junior Vol. 2 No. 2 April 2020 103 INTRODUCTION The elderly population, according to Law no. 13 of 1998, is defined as a population over the age of 60 years. In 2017, the proportion of older people was 9.03% of Indonesia's population and was predicted to increase to 15.77% in 20351. This makes Indonesia into a country with an aging population because the proportion of the elderly population is more than 7%. In order not to become a burden on the country, it is essential that the elderly live healthy, independent, and productive lives. The independence and productivity of the elderly are reflected in the Activities of Daily Living (ADL) and the Instrumental Activities of Daily Living (IADL). A critical component in ADL and IADL is fine motor skills, where 6 out of 10 ADL functions according to the Barthel scale2, and 7 out of 8 IADL functions according to the Lawton scale 3 require useful fine motor functions. Fine motor functions, which include strength, stability, and control, are reflected in motor speed. In the elderly, it was found that motor speed will decrease with age4 due to various changes in the nervous system, especially in motor pathways 5,6. Sports is one of the cheap and easy activities to maintain motor function, both in the young and elderly population7,8,9. However, according to a 2015 Central Statistics Indonesia survey, only 10.5% of the elderly exercised during the past week 1. This is unfortunate because a lack of exercise can increase morbidity and mortality 10, including a decrease in fine motor function. From this study, it is expected to provide insight into the relationship between sports and motor function in the elderly, so sports can be a routine part of elderly activities so that the elderly can live healthy, independent, and productive lives. This study aims to analyze the correlation between the average duration of exercise per week with the fine motor speed in the elderly in the Orphanage and Nursing Home of the Bhakti Luhur Tropodo.  METHODS This study uses analytical research methods and is carried out with cross-sectional study design. The sample of this study is all the elderly in the orphanage and the Bhakti Luhur Tropodo Nursing Home who meet the criteria of 22 people from 66 total population. The inclusion criteria of this study are the elderly (aged ≥ 60 years), willing to follow the research by signing informed consent, and can follow the  Mean Excercise Duration and …     Suhardi MA , Kurniawati N, Konginan A 104	instructions given and cooperative. The exclusion criteria of this study are: having a motor injury in accordance with the task of the Motricity Index of Motor Impairment on the dominant hand, having symptoms of parkinsonism on the dominant hand, having arthritis in the dominant hand, taking drugs that directly work by influencing the neurotransmitter of the brain, such as anxiolytic, antidepressant, antipsychotic, and antiepileptic, there is a pain in the dominant hand when doing the Finger Tapping Test. The sampling technique used in this study was the purposive sampling technique. For samples that meet the inclusion and exclusion criteria, the researcher collects data in the form of average exercise duration per week made by the board of the Orphanage and Nursing Home Bhakti Luhur, conducts a finger tapping test through the HLTapper application, and collects other data that are potential to be a nuisance variable in the form of age, history of diabetes, history of hypertension, medications taken, depressive symptoms, and history of coffee consumption. Then the collected data is entered into the SPSS application and tested for correlation using the Spearman correlation test.  RESULT Characteristics of research subjects can be seen in table 1.Table 1 Characteristics of research subjects  Variable Classification Freq (n) Avg ± Std. Dev / Percentage (%) Age   69,05± 7,53 Level of Education Does not go to school 1 4,55 Elementary 4 18,20 Junior High School 7 31,85 Senior High School 10 45,50 History of diabetes Have Diabetes 6 27,27 No Diabetes 16 72,73 History of hypertension Have Hypertension 10 45,45 No Hypertension 12 54,55 Drugs taken Glucosamine 1 4,55 Metformin 4 18,20 Amlodipine 3 13,65 Captopril 2 9,09 Vitamin B complex 6 27,30 Dexamethasone 1 4,55 Meloxicam 1 4,55 Aspilet 1 4,55 Depression Symptoms  Positive 2 9,09 Negative 20 90,91 Coffee consumption in the last 24 hours Yes 2 9,09 No 20 90,91 Online-ISSN 2565-1409  Journal of Widya Medika Junior Vol. 2 No. 2 April 2020 105 Based on Table 1, it can be seen that the average age of the study subjects was 69.05 (± 7.53) years. In addition, ten research subjects (45.45%) had the last high school education. The rest, there are seven people (31.85%) research subjects who have a junior high school education, four people (18.20%) who have an elementary school education, and one person (4.55%) who have never attended school. Also, it was also known that six people (27.27%) had a history of diabetes, and 10 study subjects (45.45%) had a history of hypertension. Most of the 20 study subjects (90.91%) did not have symptoms of depression based on PPDGJ III. Most of the research subjects totaling 20 people were also known not to consume coffee in the last 24 hours. The most widely consumed drug is the B complex vitamin, which is taken as many as six research subjects. Table 2 The average duration of exercise per week for 12 weeks and the third-fifth finger tapping test  From Table 2, it was found that the duration of exercise varied with an average of 78.41 (± 90.4) minutes, and the fine motor speed of the study subjects was 31.50 (± 10.83) beats per 10 seconds. From Table 3, it was found that there was a slight correlation between exercise duration per week and fine motor speed (r = 0.341). The correlation is not significant (p = 0.120).        Table 3 Spearman’s Rank Correlation test results to find a correlation between the duration of exercise per week with fine motor speed.     Fine Motor Speed Duration of exercise per week (minutes) Correlation Coefficients (r) 0,341 Significance (p) 0,120 Note: Statistically significant if p <0.05           Variable Avg ± Std. Dev Duration of exercise per week (minutes) 78,41 ± 90,40 Fine motor speed (beat / 10 seconds) 31,50 ± 10,83  Mean Excercise Duration and …     Suhardi MA , Kurniawati N, Konginan A 106	Table 4 The results of the analysis of variable data that have the potential to be a confounding variable.  From the results of the analysis in Table 4, there are no variables that have a significant relationship to the two main variables to be analyzed, namely the duration of exercise per week and fine motor speed so that it can be concluded that these variables cannot be said to be confounding variables.  DISCUSSION  The results of finger tapping in research subjects were lower than in previous studies using the same measuring instrument (HL Tapper), where the average finger tapping in previous studies was 54.50 ± 11.53 times / 10 seconds11. This might occur because the average age of the study subjects was younger (53.4 ± 14.8 years), and there were male subjects where the results of male tapping were indeed faster than that of women3,4. There are no epidemiological studies that examine the duration of exercise per week, especially in the elderly population of Indonesia.  In this study, there was an insignificantly weak positive correlation Variables that Potentially Become Disturbing Variables The average duration of exercise per week for 12 weeks Average finger tapping results in the third-fifth experiment Mean ranks Positive Mean ranks Negative or r value p Mean ranks Positive Mean ranks Negative or r value p Age  0,015 0,986  0.017 0,941 Level of education  0,21 0,404  0,085 0,737 History of diabetes 10,92 11,72 0,783 11,42 11,53 0,971 History of hypertension 10,65 12,21 0,549 11,05 11,88 0,767 Depression 12 11,45 0,903 13,5 11,30 0,648 Metformin Usage 8,7 12,32 0,241 11,9 11,38 0,875 Glucosamine Usage 6 11,76 0,354 22 11 0,098 Amlodipine Usage 14,5 11,03 0,357 15,33 10,89 0,271 Captopril Usage 18 10,85 0,112 11,75 11,48 0,954 Vitamin B-complex Usage 12 11,39 0,856 11,5 11,40 0,932 Dexamethasone Usage 6 11,76 0,354 10 11,57 0,813 Meloxicam Usage 6 11,76 0,354 10 11,57 0,813 Aspilet Usage 6 11,76 0,354 11 11,52 0,937 Coffee Consumption 9 11,75 0,541 2,5 12.4 0,040 Note: Statistically significant if p <0.05 Online-ISSN 2565-1409  Journal of Widya Medika Junior Vol. 2 No. 2 April 2020 107 between the average duration of exercise per week with the fine motor speed in the elderly at the Tropodo Bhakti Luhur Nursing Home (r = 0.341, p = 0.120). This is different from the results of other studies 7,8, where the study found a significant relationship between exercise with fine motor speed. These differences may occur due to population differences. The population tested in the study were adults with controlled movements. In contrast, this study was a cross-sectional study that had deficiencies which we felt were the most important deficiencies, i.e., we could not control the movements of gymnastic participants, and the researchers did not know whether the research subjects gymnastics seriously or lazy every time the gymnastics. The cross-sectional research design also cannot control other activities carried out by the research subjects. From the results of the questions and answers during the study, there were research subjects who usually did not attend gymnastics, but he walked to the church near the nursing home every day. This has the potential to be a confounder, which is also a limitation in research.  In addition to the research design, the weakness of this study is the validity of existing data. We entrust the absenteeism entirely to the management of the orphanage, and the data in the form of education level and history of drinking coffee that is not recorded in the master book are asked directly to the subject of research and caregiver based solely on memory alone. However, the ratio of caretakers and residents of each homestead is 1:3, so caregivers should remember whether the residents of the orphanage drink coffee or not.  Another weakness of the research is that we cannot control the motivation of the research subjects. The results of finger tapping are influenced by motivation12. The thing that also influences the motivation of the research subjects is because the research conducted is a joint study of five students so that one research subject takes approximately 30 minutes. This can trigger the boredom of the research subject.  The research population is quite a lot, with a total of 66 people, but those who meet the inclusion criteria and meet the exclusion criteria are only 22 people. The sample taken could be more, but we were not given access to the study population living in the home of Ignacia. With the number of samples, the power of this research is less than the conventional  Mean Excercise Duration and …     Suhardi MA , Kurniawati N, Konginan A 108	research power, which is 80 percent. Less power makes research sensitivity lower.  Another possibility that causes the results of the study is not significant is the type of exercise in the form of a combination of the Oma-oma's gym, and tai-chi does not have an effect on fine motor skills, and/or the duration of the exercise is not enough to affect the fine motor skills of the study subjects. But this can only be proven if the research is in the form of experimental with an adequate number of samples.  CONCLUSION There was no significant correlation between the average weekly duration of exercise for 12 weeks with the average finger tapping test results of the third-fifth trial in the elderly at the Bhakti Luhur Nursing Home (r = 0.341, p = 0.120).  REFERENCES 1. Badan Pusat Statistik Indonesia. Statistik Penduduk Lanjut Usia. 2015;  2. Tjokroprawiro A. Buku Ajar Ilmu Penyakit Dalam edisi 2. 2nd ed. Surabaya: Airlangga University Press; 2015. h. 750.  3. Graf C. The Lawton Instrumental Activities of Daily Living Scale. Am J Nurs [Internet]. 2008;108(4):52–62. Diunduh dari: http://hpcare.taiwan-pharma.org.tw/Downloads/IADL_English1021025.pdf 4. Aoki T, Fukuoka Y. Finger tapping ability in healthy elderly and young adults. Med Sci Sports Exerc. 2010;42(3):449–55.  5. Bartzokis G, Lu PH, Tingus K, Mendez MF, Richard A, Peters DG, et al. Lifespan trajectory of myelin integrity and maximum motor speed. Neurobiol Aging [Internet]. 2010;31(9):1554–62. Diunduh dari: http://dx.doi.org/10.1016/j.neurobiolaging.2008.08.01 6. NIH. Health ABC Operation Manual [Internet]. Vol. III. 1997. 5 p. Diunduh dari: https://healthabc.nia.nih.gov/sites/default/files/fingertap.om1_0.pdf 7. Sysoeva O V., Wittmann M, Mierau A, Polikanova I, Strüder HK, Tonevitsky A. Physical exercise speeds up motor timing. Front Psychol. 2013;4(SEP):1–7.  8. Dash M, Telles S. Yoga training and motor speed based on a finger tapping task. Indian J Physiol Pharmacol. 1999;43(4):458–62. 9. Blumenthal JA, Emery CF, Madden DJ, Schniebolk S, Walsh-Riddle M, George LK, et al. Long-term effects of exercise on psychological functioning in older men and women. Journals Gerontol. 1991;46(6):P352–61. 10. Scully T, Rey-López JP, Matsudo VKR, Luiz O do C, Scully T, Dishman R, et al. Sedentary behavior and health outcomes among older adults: a systematic review. Nature [Internet]. 2012;492(7427):S2–3. Diunduh dari: http://www.nature.com/doifinder/10.1038/492S2a 11. 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Mean Exercise Duration And Fine Motor Speed In Elderly Living In Bhakti Luhur Tropodo Orphange And Nursing Home

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Mean Exercise Duration And Fine Motor Speed In Elderly Living In Bhakti Luhur Tropodo Orphange And Nursing Home

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