Strengthening Program Research Articles

Evaluation of the National Values Construction Program for National Resilience Institute Republic of Indonesia (LEMHANNAS RI)

The Program for Strengthening National Values was established by Presidential Regulation Number 67 of 2007 addressing Lemhannas RI. This study's goal is to assess Lemhannas RI's national values building initiative from 2007. This research used the CIPP program assessment paradigm and included observation, interviews, questionnaires, Focus Group Discussions, and document examination. The research included 220 national values strengthening graduates, 4 (four) RI Lemhannas officials who implemented the stabilization program, 3 (three) Lemhannas RI Professional Staff who became resource people for the stabilization program, and 10 (ten) alumni. The findings of the context assessment indicated that Lemhannas RI's implementation of the Program for the Consolidation of National Values had a strong legal foundation, clear and realistic aims and objectives, and significant community needs. For example, inadequate cost support, inadequate curriculum support, inadequate human resource (HR) support, inadequate infrastructure support, and inadequate recruitment participants were found in the Input evaluation. The program may be carried out as intended, and the process monitoring and assessment can offer an overview of quantifiable outcomes. The effect of the strengthening program on alumni is excellent, as shown by changes in attitudes, motives, and actions.

Minimum Service Standard: A Hospital Strengthening Program that Facilitates Hospitals' Attainment of Quality-of-Care Standards.

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Repair of Quadriceps and Patellar Tendon Tears

Tears of the quadriceps or patellar tendon usually occur after a sudden eabccentric contraction and are diagnosed by a palpable gap at the injury site combined with an inability to perform a straight leg raise. Bilateral knee radiographs may demonstrate patella alta with patellar tendon tears and patella baja with quadriceps tendon tears compared with the uninjured knee. Ultrasound and magnetic resonance imaging can be helpful when there is uncertainty in the diagnosis. Surgical treatment is indicated for complete tears and some high-grade, partial tears. Nonabsorbable high-strength sutures or suture tape are placed in running locking fashion along the injured tendon and secured to the patella with bone tunnels (i.e., transosseous) or suture anchors. The transosseous technique requires exposure of the length of the patella to drill 3 bone tunnels to shuttle the sutures and tie over either pole of the patella. The suture anchor technique allows for a smaller incision and less soft-tissue dissection and may use a knotted or knotless technique. Biomechanical testing with load to failure is not statistically different between the transosseous and anchor techniques, although anchors have been shown to have less gap formation at the repair site. Repair augmentation with a graft may be beneficial in mid-substance injuries, chronic tears, and in cases of compromised tissue quality. Rehabilitation usually can be initiated immediately with protected weight-bearing in an orthosis, safe-zone knee passive range of motion, and avoidance of active extension. After a period of 6 weeks, rehabilitation can progress with full range of motion and a concentric strengthening program.

The Integration of Muscle Strengthening in the Improvement of Muscular and Technical Parameters of Young Footballers

Summary The study aimed to evaluate the effect of an integrated muscle strengthening program on the improvement of muscular and technical parameters in young football players. There were two objectives, scientifically to measure the impact of integrated muscle strengthening on young players, and practically to present an educational tool for coaches and students to understand this concept of training. To carry on this research, we proceeded to a development of the 8-week program applied to a sample of 24 well-trained players of the first division under 18 years. The hypotheses put forward, were confirmed through the educational intervention and the results obtained were significant. Our results have increased the importance of strength training integrated into the training of young footballers. The margin progress of the experimental group was significant compared to the control group, and the impact of this concept proved to be positive in the approach to the physical preparation of young footballers. It is recommended to pay attention to the concept of integrated muscle building, with all its technical components.

Effect of hip adductor strengthening on performance in young male cricket players

Cricket is a dynamic sport in which muscle strength, agility and aerobic capacity play vital role in sports performance. Weak hip adductor muscles are an intrinsic risk factor for groin injuries so this study evaluated effect of hip adductor strengthening on performance in cricketers.Methodology: 30 Young male cricketers included in the study. Group A and Group B was given routine cricket training programme and Group A was given additionally hip adductor strengthening programme. Results: Intragroup comparison showed statistically significant improvements in Vertical jump, Agility T-Test and 20-m Multistage shuttle run test in the both groups (p

The Implementation of Balanced Literacy Approach To Early Childhood Education Units As An Effort To Strengthen Learning: A Phenomenological Study After The Covid-19 Pandemic In Indonesia

Research by Indonesian Ministry of Education, Culture, Research, Technology in 2020-2021 found a significant decrease of learning outcomes in the first grade of elementary school students as a result of the Covid-19 pandemic. The Early Childhood Education as the foundation phase plays a crucial role in the learning recovery, especially literacy. This study explores and analyzes the experiences of Early Childhood Education (PAUD) teachers in applying balanced literacy approach as an effort to strengthen learning. This research refers to the literary processing theory by Clay (Ronning, 2020: 17) regarding the acquisition of literacy skills in early childhood. The method used is qualitative phenomenology with 10 teachers from several regions of Indonesia as informants. The analysis was about the experience of teachers applying balanced literacy before and during the pandemic, the obstacles faced, and the solutions carried out. These findings become the basis for designing the product of this study, namely a conceptual model of early literacy strengthening program with balanced literacy in PAUD. This model is expected to be a contextual alternative solution for strengthening effective literacy in the post-pandemic period and minimizing the impact of learning loss in Indonesia.

A Tale of 2 Countries: Implementation of the Cold Chain Equipment Optimization Platform in Guinea and Kenya.

In 2016, the Gavi Cold Chain Equipment Optimization Platform (CCEOP) was approved and launched in recognition of the fact that functional cold chain equipment (CCE) is essential to strengthening vaccine supply chains and ultimately achieving Gavi's immunization equity and coverage goals. Through CCEOP, Gavi committed to investing US$250 million between 2016 and 2021 to commission CCE in more than 63,000 facilities to upgrade and expand their CCE footprint while stimulating the market to provide affordable, technologically advanced, and accessible equipment. We present case studies from Guinea and Kenya, both of which received CCEOP support, that highlight 2 ways for countries to prioritize investments and implement activities through a large funding and support mechanism. The studies explore the different ways that each country implemented CCEOP and consider how aspects of leadership and technical capacity influence country priorities and results. They also uncover key lessons on sustainability of a large immunization supply chain effort. The experiences of Guinea and Kenya can help other countries embarking on similarly large health system interventions, especially related to supply chain strengthening and immunization programs. In particular, these experiences offer important lessons in leadership, processes and systems, country ownership, technical capacity, and sustainability.

A Randomised Controlled Trial of YOGa and Strengthening Exercise for Knee OsteoArthritis: Protocol for a Comparative Effectiveness Trial (YOGA Trial).

Osteoarthritis (OA) is a common joint disorder for which there is no cure. Current treatments are suboptimal. Exercise is a core treatment for knee OA, with muscle strengthening exercise commonly recommended. Yoga is a mind-body exercise intervention that can improve flexibility, muscle strength, balance, and fitness and potentially reduce symptoms of OA. However, there is a scarcity of robust, high-quality conclusive evidence on the efficacy of yoga in knee OA. We are currently conducting the first randomised comparative effectiveness and cost-effectiveness trial of a yoga program compared with a strengthening exercise program in patients with symptomatic knee OA. This study protocol describes the design and conduct of this trial. The YOGA study is a phase III, single-centre, parallel, superiority, randomised, active-controlled trial which will be conducted in Hobart, Australia. One hundred and twenty-six participants (63 in each arm) aged over 40 years with symptomatic knee OA will be recruited from the community and randomly allocated to receive either a 24-week yoga program (3×/week) or a strengthening exercise program (3×/week). The primary outcome will be change in knee pain over 12 weeks, assessed using a 100 mm visual analogue scale (VAS). The secondary outcomes include change in knee pain, patient global assessment, physical function, quality of life, gait speed, biomarkers, and others over 12 and 24 weeks. We will also assess whether the presence of neuropathic pain moderates the effects of yoga compared to strengthening exercise. Additional data, such as cost and resource utilization, will be collected for the cost-effectiveness analysis. The primary analysis will be conducted using an intention-to-treat approach. Adverse events will be monitored throughout the study. Once completed, this trial will contribute to the knowledge of whether yoga can be used as a simple, effective, low-cost option for the management of knee OA, thus saving economic costs in the healthcare system.

Exploring the Effects of a Neck Strengthening Program on Purposeful Soccer Heading Biomechanics and Neurocognition.

BackgroundCervical (neck) strengthening has been proposed as an important factor in concussion prevention. The purpose of the study was to determine if a six-week cervical strengthening program affected neurocognition and purposeful soccer heading biomechanics. The hypothesis was that the neck strengthening program would improve strength, maintain neurocognition, and alter purposeful soccer heading biomechanics.Study DesignRandomized controlled trial.MethodsTwenty collegiate soccer athletes (8 males, 12 females, age=20.15±1.35 years, height=171.67±9.01 cm, mass=70.56±11.03 kg) volunteered to participate. Time (pre, post) and group (experimental, control) served as the independent variables. Four composite scores from the CNS Vital Signs computer based neurocognitive test (CNSVS; verbal memory, visual memory, executive function, reaction time) and aspects of heading biomechanics from inertial measurement units (xPatch; peak linear acceleration, peak rotational acceleration, duration, Gadd Severity Index [GSI]) served as the dependent variables. Each athlete completed a baseline measure of neck strength (anterior neck flexors, bilateral anterolateral neck flexors, bilateral cervical rotators) and CNSVS after heading 10 soccer balls at two speeds (11.18 and 17.88 m/s) while wearing the xPatch. The experimental group completed specific cervical neck strengthening exercises twice a week for six weeks using a Shingo Imara™ cervical neck resistance apparatus while the control group did not. After six weeks, the participants completed the same heading protocol followed by measurement of the same outcome variables. The alpha value was set to p<0.05 a priori.ResultsThe interaction between time and group was significant for visual memory (F1,17=5.16, p=0.04, η2=0.23). Interestingly, post hoc results revealed visual memory decreased for the control group from pretest (46.90±4.46) compared to posttest (43.00±4.03; mean difference=3.90, 95% CI=0.77-7.03, p=0.02). Interactions for all other dependent variables were not statistically significant (p>0.05).ConclusionsThe cervical neck strengthening protocol allowed maintenance of visual memory scores but did not alter other neurocognitive measures or heading biomechanics. The link between cervical neck strengthening and concussion predisposition should continue to be explored.Level of EvidenceLevel 1b

A framework for managing health research capacity strengthening consortia: addressing tensions and enhancing capacity outcomes

There has been a steady increase in health research capacity strengthening (HRCS) consortia and programmes. However, their structures and management practices and the effect on the capacity strengthening outcomes have...

Pembentukan Kelompok Belajar Sebagai Strategi Untuk Meningkatkan Minat Belajar Siswa SD di Desa Binaan Sos Children Village Medan Kelurahan Kwala Bekala

Community service as a manifestation of one of the Tri Dharma of Higher Education carried out by Students of the Social Welfare Study Program, Faculty of Social and Political Sciences, the University of North Sumatra through Practicum II activities at SOS children's village medan, through the family strengthening program carried out in kwala bekala aimed at increasing the interest of students at the time of the pandemic, to increase their interest in learning through the formation of study groups. The method the author uses in this devotion program is community intervention by zastrow, which consists of: intake and contract, deals, planning/planning, intervention and formulation of programs, evaluations, and terminations. The results of the program can be seen from the attainment of the goals and impact students obtained during the program. Where students who participate in the program are able to follow the writer's well applied set of activities and are thus helpful in increasing their interest in learning. It is seen at the rate of their presence in group meetings each week and the results of weekly quizzes that show their willingness to repeat each home lesson.

Impact of Pilates mat-based exercises on knee kinematics during running

IntroductionCore strengthening, balance, and flexibility programs such as Pilates have been advocated to positively impact running mechanics and prevent lower extremity injuries. The purpose of this study was to assess the effects of a 12-week mat-based Pilates exercise program on dynamic knee valgus alignment in runners. MethodsThirty-four novice runners, including young male and female adults performed a running protocol at baseline. The protocol consisted of the participants running on a treadmill at a constant five miles per hour (mph) for 4 min. Post-examination, participants were randomly assigned to a Pilates or control group (n = 16 and n = 18, respectively). A certified Pilates instructor gave the Pilates group a 12-week home-based program. To ensure participants in the Pilates group performed exercises correctly, the Pilates instructor conducted the first session, and provided feedback to each participant. Participants in both groups performed the same running testing protocol every four weeks. Knee valgus was measured as the medial displacement of the knee joint center during the running stance phase. Repeated measures Analysis of Variance (RepANOVA) was calculated at baseline and 4-, 8-, and 12-weeks post examinations to compare knee valgus during running. ResultsAlthough a reduction in dynamic knee valgus was observed within the Pilates group, the RepANOVA analysis revealed this change was not statistically significant. ConclusionsPilates mat-based exercises may improve knee valgus after 12 weeks but a larger sample size, longer intervention duration, or a supervised program should be considered for future research to evaluate its effectiveness.

Exercise adherence Mobile app for Knee Osteoarthritis: protocol for the MappKO randomised controlled trial

BackgroundIn people with knee osteoarthritis (OA), ongoing exercise participation, particularly with strengthening exercises, is central to management. Patient adherence to prescribed exercise typically declines once consultations with a clinician have ceased. Mobile applications (apps) can incorporate behaviour change techniques that may assist adherence, potentially optimising clinical outcomes.MethodsThis is a two-arm, pragmatic, superiority randomised trial. One hundred and eighty two Australians with chronic knee pain (clinical knee OA) and who have at least a mild level of physical dysfunction are being recruited. Participants are randomly allocated i) exercise (physiotherapist-prescribed exercise) or; ii) exercise plus app (physiotherapist-prescribed exercise plus access to the ‘My Exercise Messages’ mobile app). Exercise care comprises two videoconferencing consultations with a physiotherapist over two weeks (30 min each) for a strengthening exercise program, which is then conducted independently at home for 24 weeks without any further physiotherapist consultations. Participants are also provided with exercise resources to facilitate home-based exercise. Those randomised to exercise plus app will download the app after completing the two weeks of physiotherapy consultations and will be instructed by research staff to use the app for the 24 weeks of unsupervised home-based exercises. The app works by tracking completion of weekly exercise sessions, providing regular messages to facilitate weekly exercise and providing personalised messages to help overcome individual barriers to exercise participation. The two primary outcomes are i) self-reported physical function; and ii) number of days strengthening exercises were performed (previous fortnight), with a primary endpoint of 26 weeks and a secondary endpoint of 14 weeks. Secondary outcomes include knee pain severity; knee-related quality of life; global change; exercise program satisfaction; exercise self-efficacy; physical activity; sport and recreation function; another measure of exercise adherence; and willingness to undergo joint replacement. Process measures are also included.DiscussionFindings will determine if a theory-informed mobile app improves exercise adherence and physical function in people with knee OA who have received a home-based strengthening program.Trial RegistrationAustralian New Zealand Clinical Trials Registry, ACTRN12621000724875. Prospectively registered 9/06/2021.

Adductor Strengthening Programme is successfully adopted but frequently modified in Norwegian male professional football teams: a cross-sectional study

ObjectivesGroin injuries represent a substantial problem in male football, with the Adductor Strengthening Programme (ASP) being the only exercise programme demonstrated to significantly reduce the risk of groin problems. We...

Effects of High and Low Training Volume with the Nordic Hamstring Exercise on Hamstring Strength, Jump Height, and Sprint Performance in Female Football Players: A Randomised Trial.

The evidence-based hamstring strengthening programme for prevention of hamstring injuries is not adopted by football teams because of its high training volume. This study on female football players investigated if high-volume training with the Nordic hamstring exercise is more effective on hamstring strength, jump height, and sprint performance than low-volume training. We also examined the time course of changes in muscle strength during the intervention period. Forty-five female football players were randomised to a high- (21 sessions, 538 total reps) or low-volume group (10 sessions, 144 total reps) and performed an 8-week training intervention with the Nordic hamstring exercise during the preseason. We tested hamstring strength (maximal eccentric force with NordBord and maximal eccentric torque with isokinetic dynamometer), jump height, and 40 m sprint before and after the intervention. The NordBord test was also performed during training weeks 4 and 6. Both groups increased maximal eccentric force (high-volume: 29 N (10%), 95% CI: 19-38 N, p < 0.001, low-volume: 37 N (13%), 95% CI: 18-55 N, p = 0.001), but there were no between-group differences (p = 0.38). Maximal eccentric torque, jump height, and sprint performance did not change. Maximal eccentric force increased from the pretest to week 6 (20 N (7%), 95% CI: 8 to 31 N, p < 0.001), but not week 4 (8 N (3%), 95% CI: -2 to 18 N, p = 0.22). High training volume with the Nordic hamstrings exercise did not lead to greater adaptations in strength, jump height, or speed than a low-volume programme. Players in both groups had to train for at least 6 weeks to improve maximal eccentric force significantly.

The role of principal transformational leadership based on Lonto Leok culture Manggarai community for strengthening student character

The role of the principal is crucial to optimize the implementation of the student character strengthening program. Unfortunately, the role of the principal is experiencing obstacles because he has not found the appropriate form of role and approach to make the student character strengthening program effective. This study examines the principal's transformational leadership role based on a local cultural system. A qualitative approach is used in this study, the case study design with the subjects studied were school principals. Participants in this study include three principals, three senior teachers, one parent, and one cultural figure. Data were collected through in-depth interviews, participant observation, and documentation studies to achieve the research objectives. Data analysis employed a modified analytical analysis method. Meanwhile, the validity of the data was based on the level of credibility, transferability, dependence, and confirmability. The study results prove that the principal's transformational leadership role with a local cultural approach has a positive impact on the optimization of character strengthening programs and positive changes in students' moral behavior. The study concludes that the transformational leadership role of local culture-based principals impacts optimizing student character strengthening programs.

Resident Case Series: Blood Flow Restriction as an Adjunct to Strengthening Exercises in Two Patients with Subacromial Impingement and High Irritability

Introduction Evidence informed management of individuals presenting with subacromial impingement syndrome (SAIS) includes strengthening exercises directed at the shoulder musculature. Patients with subacromial impingement syndrome (SAIS) can present with pain during and after completion of heavy resistance training limiting the applicability of this recommended treatment approach. Blood flow restriction (BFR) training is indicated for patients who have pain while completing heavy resistance training and may represent an important treatment modification for patients with SAIS unable to fully participate in a strengthening exercise program. The purpose of this case series is to describe the inclusion of BFR in the treatment of two patients with SAIS. Case descriptions Two middle aged, non-operative patients with signs and symptoms consistent with SAIS and high levels of irritability were included. Treatment over one month consisted of three commonly used exercises in the treatment of SAIS in conjunction with a standard BFR protocol: 75 reps broken up into sets of 30,15,15,15 with the BFR cuff placed over proximal humerus. Outcomes Immediate within session improvements beyond measurement error were observed in resting pain and pain pressure thresholds at three sites. At the end of the course of treatment, clinically meaningful improvements were observed in patient reported outcomes including the PENN Score, ASES score, and the patient-specific functional scale. Clinically meaningful improvements and change beyond measurement error were also observed in range of motion and strength which (assessed via a handheld dynamometer). Discussion The incorporation of low load resistance training with BFR may be a useful adjunct for treating patients with SAIS to promote exercise-induced hypoalgesia, decrease pain, and increase function in the upper extremity. Level of Evidence 5

Effects of a Core Strengthening Program on Muscle Activity Patterns, Strength, and Endurance in People with and without a History of Low Back Pain: A Randomized Controlled Trial

Background of Study: Altered patterns of abdominal and low back muscle activity have been reported in people in the sub-acute phase of low back injury. Specifically, higher overall muscle activity and less ability to match activity to task demands have been found. Objective: This study determined if an 8-week group exercise intervention would alter muscle activity, strength, and endurance in people with/without a history of low back pain (LBP). Method: In this randomized controlled trial 46 participants (age 19-55) with a history of LBP were randomized to exercise (LBPEx, n=24) and no-exercise (LBPCon, n=22) groups. 27 participants without a history of LBP (NoLBP) also exercised. 17 LBPEx and 19 NoLBP participants completed the intervention. 19 LBPCon were tested at 8-week follow-up. The exercise intervention was an 8-week, choreographed, 30-minute group exercise intervention (Les Mills CoreTM) focused on building core strength, stability, and endurance. Pre and post-intervention surface electromyograms from abdominal and low back muscles were recorded during a trunk stability task (TST), and analyzed using Principal Component Analysis to extract patterns corresponding to overall amplitude and relative activation during the TST loading phase. Abdominal and back extensor strength and endurance were also measured. Results: It was found that overall abdominal activity decreased for left anterior external oblique (p=0.019 for TST level 3), left lateral external oblique (p=0.012 for TST level 3), and right posterior external oblique (p=0.035 for TST level 3) in LBPEx and for right lateral external oblique (p=0.009 for TST level 2 and p=0.004 for TST level 3) and left posterior external oblique (p=0.014 for TST level 2 and p=0.011 for TST level 3) in NoLBP during the TST. Abdominal strength and endurance, and back extensor endurance increased for LBPEx and NoLBP (p0.05). Back extensor strength increased for NoLBP (p0.05). Relative abdominal activation during the TST level 2 loading phase increased for right upper rectus abdominus (p=0.05), right lateral external oblique (p=0.002), and left posterior external oblique (p=0.006) for NoLBP, and for left anterior external oblique (p=0.042) for LBPEx. Conclusion: Les Mills CoreTM is readily available and may be recommended as a safe, accessible, and effective intervention to increase abdominal strength and endurance, and back extensor endurance, even for people with a history of LBP.

Implementasi Program Penguatan Pendidikan Karakter Siswa Melalui Cerita Rakyat

Character Education Strengthening Program (PPK) in schools can be done one of them through learning local folklore. This paper discusses the implementation of strengthening student character education through local folklore. The method used is observation, interviews and classroom action research with a sample of SMAN 13 Maros class XII. The results of the study were concluded through three stages, namely: 1) the results of observations of the Indonesian language learning textbook material used showed that the material for strengthening character education through local folklore had not been included. 2) After carrying out literary learning modeling with local folklore material, it shows an increase in students' understanding of several folklore titles, characters, various characters, story content, and setting. 3) there is an increase in students' understanding of the story text regarding the characters of the story characters such as brave characters, patient characters, loyal characters, and intelligent characters.

Effectiveness of a telehealth physiotherapist-delivered intensive dietary weight loss program combined with exercise in people with knee osteoarthritis and overweight or obesity: study protocol for the POWER randomized controlled trial

BackgroundObesity is associated with knee osteoarthritis (OA). Weight loss, alongside exercise, is a recommended treatment for individuals with knee OA and overweight/obesity. However, many patients cannot access weight loss specialists such as dietitians. Innovative care models expanding roles of other clinicians may increase access to weight loss support for people with knee OA. Physiotherapists may be well placed to deliver such support. This two-group parallel, superiority randomized controlled trial aims to compare a physiotherapist-delivered diet and exercise program to an exercise program alone, over 6 months. The primary hypothesis is that the physiotherapist-delivered diet plus exercise program will lead to greater weight loss than the exercise program.Methods88 participants with painful knee OA and body mass index (BMI) > 27 kg/m2 will be recruited from the community. Following baseline assessment, participants will be randomised to either exercise alone or diet plus exercise groups. Participants in the exercise group will have 6 consultations (20–30 min) via videoconference with a physiotherapist over 6 months for a strengthening exercise program, physical activity plan and educational/exercise resources. Participants in the diet plus exercise group will have 6 consultations (50–75 min) via videoconference with a physiotherapist prescribing a ketogenic very low-calorie diet with meal replacements and educational resources to support weight loss and healthy eating, plus the intervention of the exercise only group. Outcomes are measured at baseline and 6 months. The primary outcome is percentage change in body weight measured by a blinded assessor. Secondary outcomes include self-reported knee pain, physical function, global change in knee problems, quality of life, physical activity levels, and internalised weight stigma, as well as BMI, waist circumference, waist-to-hip ratio, physical performance measures and quadriceps strength, measured by a blinded assessor. Additional measures include adherence, adverse events, fidelity and process measures.DiscussionThis trial will determine whether a physiotherapist-delivered diet plus exercise program is more effective for weight loss than an exercise only program. Findings will inform the development and implementation of innovative health service models addressing weight management and exercise for patients with knee OA and overweight/obesity.Trial registrationNIH US National Library of Medicine, Clinicaltrials.gov NCT04733053 (Feb 1 2021).