Jurnal Kesehatan Komunitas Indonesia (JKKI) Volume 4 Issue 2.
August 2024, pp 169-178 https://ebsina.
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php/jkki eISSN 2503-2801, pISSN 2985-3435 Application of Progressive Muscle Relaxation Technique to Reduce Blood Glucose Levels in Elderly with Diabetes Mellitus Ricky Aprileo Pratama Putra1*.
Latifa Aini Susumaningrum2 .
Hanny Rasni2 .
Ni Ketut Ardani3 1 Faculty of Nursing.
Universitas Jember.
Indonesia 2 Department of Community.
Family and Gerontic Nursing.
Faculty of Nursing.
Universitas Jember.
Indonesia 3 Health office of Jember.
Indonesia Article History Submitted: 27-06-2024 Revised: 28-07-2024 Accepted: 16-08-2024 org/10.
58545/jkki.
Copyright .
2024 Authors This is an open-access article under the CC-BY-SA License.
Abstract Diabetes mellitus is a metabolic disease which is often found in the elderly caused by a degenerative process.
Progressive muscle relaxation technique is one of the non-pharmacological therapy to decrease blood glucose levels in diabetes mellitus.
This case study aimed to analyzed the effect of progressive muscle relaxation technique on problem of instability of blood glucose levels in elderly.
This research design is case The sample of this research is one elderly who had diabetes mellitus type 2.
The data collection by measuring blood glucose levels during pre-intervention in the morning and post-intervention in the The elderly had intervention twice a day for 20 minutes and forward until 5 days.
Data collected and processed by using statistical T-test dependent.
The elderly with diabetes mellitus type 2 given progressive muscle relaxation technique experienced a decrease in blood glucose levels from pre to post intervention with p-value 0.
which means it is significant.
The application of progressive muscle relaxation technique given to the elderly affect to decrease blood glucose levels in the outcome of pre and post intervention.
Keywords: Diabetes Mellitus type 2.
Elderly.
Progressive MuscleRelaxation Technique Correspondence Ricky Aprileo Pratama Putra Faculty of Nursing.
Universitas Jember Jl.
Kalimantan No.
Sumbersari.
Kabupaten Jember.
East Java 68121 Indonesia Email: Pratamaricky048@gmail.
How to cite:
Putra.
Susumaningrum.
Rasni.
, & Ardani.
Application of Progressive Muscle Relaxation Technique to Reduce Blood Glucose Levels in Elderly with Diabetes Mellitus.
Jurnal Kesehatan Komunitas Indonesia, 4.
, https://doi.
org/10.
58545/jkki.
BACKGROUND
disease found by the elderly is diabetes Diabetes mellitus is a metabolic mellitus type 2.
As many as 90% of type 2 disease condition characterized by an diabetes mellitus is the most common type increase in glucose levels in the blood of diabetes found or found in humans, (Forouhi & Wareham, 2.
This disease especially in the elderly over 65 years old is often found in the elderly group caused (Milita et al.
, 2.
Data from the by the degenerative process (Longo et al.
International Diabetes Federation (IDF) in The most common diabetes mellitus 2019 showed that as many as 19.
3% of the Putra .
Jurnal Kesehatan Komunitas Indonesia (JKKI) Volume 4 Issue 2.
August 2024, pp 169-178 https://ebsina.
id/journals/index.
php/jkki eISSN 2503-2801, pISSN 2985-3435 elderly aged 65-99 years in the world suffer there were 924 people in Wonosari District from type 2 diabetes mellitus with the with type 2 diabetes mellitus, and 190 of number of elderly people amounting to them were elderly people with type 2 5 million.
In 2030, it is predicted that diabetes mellitus (Azizah et al.
, 2.
the elderly aged >65 years with type 2 Aging is one of the phases of the diabetes mellitus will experience an developmental stage.
At this stage, there increase of 195.
2 million elderly people will be a process of change in the physical with diabetes.
Then in 2045 it is predicted and psychological and the behavior that to increase to 276.
2 million elderly people will be aimed at (Longo et al.
, 2.
The with diabetes.
China ranks first in the elderly will experience a deterioration in country with 78.
1 million elderly people their body functions which can be with type 2 diabetes mellitus.
Then the characterized by a decrease in fitness level.
United States of America (USA) ranks a decrease in the body's ability to maintain second with type 2 diabetes mellitus with 5 million elderly people with type 2 diabetes mellitus (Sinclair et al.
, 2.
surrounding environment, decreased body inability to adapt to the Indonesia itself is the Southeast complexity structure processes and body Asian region which occupies the 10th anatomical structures, and increased risk position of the elderly with type 2 diabetes of death (Williams, 2019.
Astuti Reini et al, mellitus, namely 10.
7 million elderly people The older a person gets, the more with type 2 diabetes mellitus.
Based on hormone levels in the body will experience data from the health profile of Southeast changes in their production, as well as the Sulawesi Province, especially in Bau-Bau production of the hormone insulin in the City, in 2019 as many as 1,642 elderly body which plays an important role in the people .
%) experienced type 2 diabetes stability of blood glucose levels which will mellitus out of a total of 17,225 elderly cause problems resulting in diabetes (Kennedy-Malone et al.
, 2.
(Meilani et al.
The percentage of diabetes mellitus incidence Treatment of diabetes mellitus can be in Bondowoso in 2022 is based on data from the Bondowoso Regency Health pharmacological methods.
One of the non- Office as many as 12,717 people (Dinas pharmacological therapies that can be Kesehatan Bondowoso, 2.
In 2020, given is the Progressive Muscle Relaxation Progressive Muscle Relaxation Technique to Reduce Blood Glucose Levels in Elderly with Diabetes Mellitus Jurnal Kesehatan Komunitas Indonesia (JKKI) Volume 4 Issue 2.
August 2024, pp 169-178 https://ebsina.
id/journals/index.
php/jkki eISSN 2503-2801, pISSN 2985-3435 (ROP) technique.
The progressive muscle METHODS relaxation technique is one of the non- This study uses a pre-test and post- pharmacological techniques that uses test case study research design.
This muscles as the main ingredient in research was conducted at UPT PSTW performing the technique.
This technique Bondowoso from 1 to 5 March, 2024.
This involves muscles in the body so that study used one respondent, namely the elderly who experienced type 2 diabetes condition of the muscles when tensioned The selection of respondents was and the muscles when relaxed so that it can carried out based on inclusion criteria.
The provide a relaxing effect (Himmah et al.
inclusion criteria are the elderly who are This technique is able to provide a willing to participate in a series of research lot of oxygen consumption in the body, activities or research procedures from start increase metabolic processes in the body, to finish, the elderly who experience type 2 speed up digestion, relax muscle tension, diabetes mellitus, the elderly who have a balance systolic and diastolic blood glucose level value of Ou 200 mg/dl, the pressure, lower glucose levels in the blood, elderly who take oral antidiabetic drugs.
and increase alpha brain waves (Nurfadilah Data collection was carried out using a et al.
, 2.
The researcher provided a non- The intervention is given pharmacological intervention in the form twice a day at morning 09.
00 a.
00 p.
m for 5 days.
Then, the techniques in overcoming the problem of measurement results are documented on instability of blood glucose levels in the the blood sugar observation sheet every elderly with type 2 diabetes mellitus.
This intervention, in addition to being able to stabilize the blood glucose levels of the RESULTS elderly, can also increase the relaxing effect The elderly before the progressive on the elderly so that the output produced muscle relaxation technique is given, blood by the elderly blood glucose levels can sugar is checked with the result of a blood become normal again (Putri et al.
, 2.
glucose value of 389 mg/dl.
This proves that the elderly have type 2 diabetes mellitus with blood glucose results above 200 (>200 Putra .
Jurnal Kesehatan Komunitas Indonesia (JKKI) Volume 4 Issue 2.
August 2024, pp 169-178 https://ebsina.
id/journals/index.
php/jkki eISSN 2503-2801, pISSN 2985-3435 mg/d.
The complaints felt by the elderly intervention at each meeting.
The results of at that time were that they were tired the blood glucose examination of the easily, often felt thirsty, and often went to elderly at each meeting for 5 meetings and the bathroom for urination.
10 interventions are listed in the following The elderly are checked for blood glucose before and after being given Table 1.
Results of blood glucose value checks at each pre-test and post-test meeting of elderly at UPT PSTW Bondowoso Meeting Blood Glucose Levels Pre-test Post-test 431 mg/dl 306 mg/dl 225 mg/dl 175 mg/dl 356 mg/dl 179 mg/dl 380 mg/dl 280 mg/dl 267 mg/dl 144 mg/dl Difference 125 mg/dl 50 mg/dl 177 mg/dl 100 mg/dl 123 mg/dl Table 2.
Difference in blood glucose level values pre-test and post-test for elderly at UPT PSTW Bondowoso Blood Glucose Level Mean P Value Pre -mplementation Post-Implementation The provision of interventions for progressive muscle relaxation techniques progressive muscle relaxation techniques every day.
It was stated at each meeting was carried out in 5 meetings, 2 that there was a change in the value of interventions each meeting with a pre-test blood glucose levels before and after the was carried out before being given intervention was given.
The first blood progressive muscle relaxation techniques sugar check was on March 1, 2024 at 09.
00 WIB, then the elderly carried out WIB before the intervention, then the the intervention given, after which a post elderly intervened twice at each meeting test was carried out after being given an and then at 15.
00 WIB a blood sugar check intervention at 15.
00 WIB.
It can be seen in was carried out after the intervention was the graph that there is a decrease in blood carried out and so on for 5 meetings.
glucose before and after the intervention of Progressive Muscle Relaxation Technique to Reduce Blood Glucose Levels in Elderly with Diabetes Mellitus Jurnal Kesehatan Komunitas Indonesia (JKKI) Volume 4 Issue 2.
August 2024, pp 169-178 https://ebsina.
id/journals/index.
php/jkki eISSN 2503-2801, pISSN 2985-3435
Time Intervention 05-03-24
04-03-24
03-03-24
Pre Test
02-03-24
Post Test
01-03-24
Blood Glucose Level Figure 1.
Blood Glucose Level The elderly in this study are female DISCUSSION The aging process experienced by the and are currently entering the menopausal elderly causes their condition to gradually A phase where he no longer deteriorate, ranging from a decrease in experiences menarche or menstruation.
fitness levels, a decrease in the ability to This is due to a decrease in the production of the estrogen and progesterone.
The progressive decline in organ function, a loss decrease in hormone production turns out of physiological complexity in the body and to have an effect on the insulin sensitivity the anatomical structure of the body (Astuti et al, 2.
Most people with type decrease in sensitivity and its response in 2 diabetes mellitus are most commonly the body will decrease (Arania et al.
, 2.
found in the age range of >40 years.
This In addition, the decrease in the production condition is related to the process of of these hormones causes the accumulation deterioration of the body's physiological of fat distribution in the body, potentially functions as we age.
The ability of the resulting in obesity (Rosita et al.
, 2.
pancreas to produce insulin will decrease.
The accumulation of fat in the body is the In addition, increasing age also increases cause of impaired insulin performance in the risk factors for insulin resistance in the the body due to abnormal integration body and decreased insulin secretion, between the insulin receptor complex and causing suboptimal blood glucose control glucose delivery (Vadila et al.
, 2.
(Oktavia et al.
, 2.
insulin will experience The weight of the elderly is currently 70 kg and TB: 155 cm.
Putra .
Jurnal Kesehatan Komunitas Indonesia (JKKI) Volume 4 Issue 2.
August 2024, pp 169-178 https://ebsina.
id/journals/index.
php/jkki eISSN 2503-2801, pISSN 2985-3435 calculated based on BMI, the elderly have a statistical test that has been carried out.
BMI of 29.
According to PERKENI .
, the significance value of the p value is 0.
BMI classification is categorized as less BB (<0.
This can be interpreted that there (BMI<18.
Normal BB (BMI 18.
is a difference in the value of blood glucose More weight (Ou.
, risk .
Obesity levels before and after the intervention of I .
Obesity II (Ou.
Based on BMI classification, the elderly are included in the Obesity I category with a BMI of 29.
The progressive muscle relaxation The obesity condition experienced by the technique is one of the light activities that elderly contributes to the occurrence of can be done in daily life and is easy to do.
type 2 diabetes mellitus that he is currently The results of the evaluation after the This is because there is an progressive muscle relaxation technique accumulation of fat in the body which was carried out to Mrs.
S showed that there results in an increase in the number of was a decrease in the value of blood glucose insulin receptors in cells throughout the Research conducted by Anggun et al This condition results in the elderly .
showed that the progressive muscle body not responding to full insulin in the relaxation technique was able to reduce body so that the elderly experience insulin blood glucose levels in the elderly with resuscitation which is the cause of type 2 diabetes mellitus.
This technique has a diabetes mellitus (Suwinawati et al.
, 2.
positive effect on the body of the elderly.
The results showed that there was The elderly will feel more relaxed.
The a difference in blood glucose level values parasympathetic nervous system in the before and after the intervention of the body will stimulate the hypothalamus in progressive muscle relaxation technique during 5 meetings.
The average value of Releasing Hormone (CRH).
This decrease blood glucose levels before the intervention in hormone will also decrease the secretion 80 and the average value of blood of the hormone ACTH.
This condition will glucose levels after the intervention was inhibit the adrenal cortex in producing the Based on the results of the average hormone cortisol which plays a role in value before and after the intervention, stressful situations.
Decreased production there was a significant decrease in the value of the hormone cortisol will inhibit the of blood glucose levels.
In the results of the process of gluconeogenesis and increase Corticotropin Progressive Muscle Relaxation Technique to Reduce Blood Glucose Levels in Elderly with Diabetes Mellitus Jurnal Kesehatan Komunitas Indonesia (JKKI) Volume 4 Issue 2.
August 2024, pp 169-178 https://ebsina.
id/journals/index.
php/jkki eISSN 2503-2801, pISSN 2985-3435 the use of glucose in cells.
So that glucose research activities and respondents who levels in the blood can decrease (Bistara & crontribute the information in research.
Susanti, 2.
CONFLICT OF INTEREST
The authors declare no conflict of CONCLUSION There was a difference in the value of interest for this publication.
blood glucose levels before and after the DATA AVAILABILITY STATEMENT The data that support the findings of relaxation techniques to the elderly with a significance value of 0.
005 (<0.
This can be interpreted that the application of corresponding author upon reasonable progressive muscle relaxation techniques can lower blood glucose levels when people with type 2 diabetes mellitus suffer.
This REFERENCES study is expected to be able to be used as a Arania.
Triwahyuni.
Esfandiari.
, &
reference material in developing other Nugraha.
Hubungan research on progressive muscle relaxation Antara Usia.
Jenis Kelamin, dan technique interventions in overcoming the Tingkat problem of instability of blood glucose Kejadian Diabetes Melitus di Klinik levels in the elderly with type 2 diabetes Mardi Waluyo Lampung TengaIh.
Jurnal Medika Malahayati, 5.
, 146Ae Pendidikan Dengan AUTHOR CONTRIBUTIONS The author contribute all research https://doi.
org/10.
33024/jmm.
activity such as conceptualization, data curation, analysis, writing & editing, manuscript revisions.
ACKNOWLEDGMENT