Majalah Ilmiah Fisioterapi Indonesia (MIFI) — Indonesian Scientific Journal of Physiotherapy is a peer-reviewed scientific journal published by the Undergraduate and Professional Physiotherapy Study Program, Faculty of Medicine, Udayana University, in collaboration with the Indonesian Physiotherapy Association (IFI). The journal publishes original research articles, literature reviews, case reports, and systematic reviews in the fields of physiotherapy, rehabilitation, public health, and related health sciences. MIFI aims to serve as a platform for disseminating scientific knowledge, fostering the development of physiotherapy science, and strengthening collaboration among practitioners, academics, and researchers at both national and international levels.
Program Studi Sarjana Fisioterapi dan Profesi Fisioterapi, Fakultas Kedokteran, Universitas Udayana bersama Ikatan Fisioterapi Indonesia
Multimodal Physiotherapy for Cervical Disc Herniation: A Case Report
Background: Cervical disc herniation is a common cause of neck pain, reduced cervical mobility, muscle weakness, and functional disability. Multimodal physiotherapy may provide comprehensive benefits by addressing pain, movement limitation, and muscle dysfunction simultaneously. Objective: To evaluate the effects of a multimodal physiotherapy program consisting of Transcutaneous Electrical Nerve Stimulation (TENS), therapeutic ultrasound, McKenzie exercises, and scapular strengthening in a patient with cervical disc herniation at the C5–C6 level. Methods: A single case report was conducted on a 59-year-old male diagnosed with cervical disc herniation. The patient received four physiotherapy sessions including TENS (100 Hz, 100 μs, 10–15 minutes), ultrasound therapy (1 MHz, 1.5 W/cm², continuous mode, 5 minutes), McKenzie exercises, and scapular strengthening exercises. Outcomes included Numeric Rating Scale (NRS), cervical range of motion (ROM), Manual Muscle Test (MMT), Neck Disability Index (NDI), and Shoulder Pain and Disability Index (SPADI). Data were analyzed descriptively by comparing pre- and post-intervention findings. Results: After four treatment sessions, pain decreased from 7/10 to 3/10 on the NRS. Cervical ROM improved by 15–20° across movement directions. Muscle strength increased from MMT grade 3 to grade 4. NDI decreased from 46% to 24%, while SPADI decreased from 60% to 32%. Statistical testing, p values, and confidence intervals were not applicable due to the single-case design. Conclusion: A multimodal physiotherapy approach combining TENS, ultrasound, McKenzie exercises, and scapular strengthening produced clinically meaningful improvements in pain, cervical ROM, muscle strength, and functional outcomes in a patient with cervical disc herniation.
Transcutaneous Electrical Nerve Stimulation
Copyright (c) 2025 Ainindia Khoiridatul Ilmiyah, Diah Rosyida Maulidina, Yeni Tri Nurhayat (Author) https://creativecommons.org/licenses/by/4.0
Randomized Controlled Trial of Aerobic Exercise on Body Mass Index Reduction in Women Using Injectable Contraceptives
Background: Injectable contraceptive use is frequently associated with body mass index (BMI) increase due to progesterone-induced fat accumulation. Aerobic exercise may help counteract these effects by enhancing energy expenditure and fat oxidation. Objective: To determine the effect of moderate-impact aerobic exercise on BMI reduction among overweight women using injectable contraceptives. Methods: A randomized controlled trial with a two-group pretest–posttest design was conducted among 32 overweight women aged 25–35 years using injectable contraceptives. Participants were randomly assigned to an intervention group (n=16) or control group (n=16). The intervention group performed moderate-impact aerobic exercise three times weekly for four weeks, while the control group maintained usual activities. BMI was measured before and after the intervention. Data were analyzed using paired and independent t-tests with a significance level of 0.05. Results: The intervention group demonstrated a significant BMI reduction from 27.4 ± 1.2 to 26.6 ± 1.1 kg/m², with a mean change of −0.84 ± 0.41 (p<0.001). The control group showed no significant change (−0.06 ± 0.29; p=0.326). Between-group analysis revealed a significantly greater BMI reduction in the intervention group (mean difference −0.78; 95% CI −1.02 to −0.54; p<0.001). Conclusion: Moderate-impact aerobic exercise significantly reduced BMI among overweight women using injectable contraceptives and may serve as an effective non-pharmacological weight management strategy.
Copyright (c) 2025 Lintang Layl Naslachu, Rizky Wulandari, Siti Khotimah (Author) https://creativecommons.org/licenses/by/4.0
Effect of Elderly Exercise on Visual Coordination in Straight Walking: A Pre-Experimental Study
Background: Aging is associated with progressive declines in musculoskeletal and sensorimotor functions, leading to impaired balance, slower reaction time, and increased fall risk. Elderly exercise is commonly recommended to maintain functional ability and mobility in older adults. Objective: To determine the effect of elderly exercise on visual coordination during straight walking among older adults aged 60–65 years. Methods: A pre-experimental one-group pretest–posttest study was conducted among 20 older adults recruited through purposive sampling. Participants completed an elderly exercise program twice weekly for four weeks. Visual coordination was assessed using the Human Benchmark Reaction Time Test, while walking performance was measured using the 4-Meter Walking Test. Data were analyzed using paired-sample t-tests with a significance level of p<0.05. Results: Significant improvements were observed following the intervention. The mean difference in 4-Meter Walking Test performance was 2.56 seconds (95% CI: 2.20–2.92; t=14.85; p<0.001). Visual reaction time improved by 325.50 ms (95% CI: 186.88–464.12; t=4.92; p<0.001). Reaction time improved by 23.24%, while walking performance improved by 30.36% after four weeks of elderly exercise. Conclusion: Elderly exercise significantly improves visual coordination and walking performance in older adults. Regular participation in elderly exercise may serve as an effective physiotherapy strategy to enhance dynamic balance and reduce fall risk among community-dwelling older adults.
Copyright (c) 2026 I Putu Risa Pradnya Dipa, I Gede Arya Sena, Ni Luh Made Reny Wahyu Sari, Ni Putu Dwi Larashati (Author) https://creativecommons.org/licenses/by/4.0
Manual Therapy Combined with Exercise for Neck Pain: A Scoping Review of Randomized Controlled Trials
Background: Neck pain is one of the leading causes of disability worldwide and substantially affects quality of life and work productivity. Manual therapy and exercise are among the most commonly used physiotherapy interventions, yet evidence regarding their combined application remains heterogeneous. Objective: To map the existing evidence on neck pain types, pain assessment instruments, and combinations of manual therapy and exercise used in randomized controlled trials (RCTs). Methods: A scoping review was conducted according to PRISMA-ScR guidelines. Electronic searches were performed in PEDro, PubMed, and ScienceDirect for RCTs published between January 2016 and August 2025. Eligible studies included adults with non-pathological neck pain receiving combined manual therapy and exercise. Data were extracted and synthesized narratively. Results: Twenty RCTs involving sample sizes ranging from 18 to 619 participants were included. Chronic non-specific neck pain and mechanical neck pain were the most frequently investigated conditions. High-velocity low-amplitude manipulation combined with craniocervical flexion or stabilization exercises was the most common intervention. Sixteen of 20 studies reported significant pain reduction following combined interventions (p<0.05). Notable findings included greater improvements in pain, disability, and cervical mobility compared with exercise alone, with effect sizes reaching d=2.21 for cervical rotation and d=1.33 for disability outcomes. The Visual Analogue Scale was the most frequently used pain assessment tool (12 studies). Conclusion: Combined manual therapy and exercise generally demonstrate favorable effects on pain and function in adults with neck pain. However, substantial heterogeneity in intervention protocols and outcome measures highlights the need for standardized approaches and further high-quality research.
Copyright (c) 2026 Salsabila Malikatul Jannah, Taufik Eko Susilo (Author) https://creativecommons.org/licenses/by/4.0
Integrated Infrared, Electrical Stimulation, and Mirror Therapy in Bell’s Palsy Rehabilitation: A Case Report
Background: Bell’s palsy is an acute unilateral facial nerve paralysis that causes facial muscle weakness, impaired facial expressions, difficulty closing the eyes, and psychosocial limitations. Physiotherapy interventions are commonly used to facilitate functional recovery; however, evidence regarding integrated multimodal approaches remains limited. Objective: To describe the effectiveness of a multimodal physiotherapy program consisting of infrared therapy, electrical stimulation, and mirror exercise in improving facial function in a patient with Bell’s palsy. Methods: This case report involved a 52-year-old male diagnosed with Bell’s palsy presenting with facial asymmetry, incomplete eye closure, and cheek muscle weakness. The patient underwent a four-week physiotherapy program combining infrared therapy, electrical stimulation, and mirror exercise. Outcomes were evaluated periodically using the UGO Fisch classification, Manual Muscle Testing (MMT), and the Facial Disability Index (FDI). Descriptive analysis was used to compare pre- and post-intervention outcomes. Results: Following four weeks of intervention, facial function showed substantial improvement. The UGO Fisch grade improved from V to III, indicating better facial nerve function. Muscle strength increased from MMT grade 1 to grade 3, while the FDI score improved from 52 to 80, representing a 53.8% increase in functional status. Improvements were also observed in facial symmetry, eye closure, self-confidence, and social participation. Conclusion: The combination of infrared therapy, electrical stimulation, and mirror exercise was associated with improved muscle strength, facial function, and quality of life in a patient with Bell’s palsy. These findings suggest that multimodal physiotherapy may be an effective rehabilitation strategy to support functional recovery and enhance patient outcomes.
Copyright (c) 2026 Aisyah Bintang Syahirah, Dimas Arya Nugraha, Nurma Auliya Hamidah (Author) https://creativecommons.org/licenses/by/4.0
Physical Activity and Sleep Quality in Pregnant Women: A Cross-Sectional Study
Background: Sleep disturbances are common during pregnancy due to physiological, psychological, and hormonal changes. Poor sleep quality may adversely affect maternal health and fetal development, increasing the risk of preterm birth, low birth weight, and delivery complications. Physical activity has been suggested as a modifiable factor that may influence sleep quality during pregnancy. Objective: To determine the association between physical activity and sleep quality among pregnant women. Methods: This quantitative cross-sectional study involved 100 pregnant women attending Posyandu in the Kartasura area. Physical activity was assessed using the Pregnancy Physical Activity Questionnaire (PPAQ), while sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI). Bivariate analysis was performed to examine the association between physical activity and sleep quality. Results: A significant association was found between physical activity and sleep quality among pregnant women (p < 0.001). Moderate physical activity was more frequently associated with good sleep quality, with 26% of participants reporting favorable sleep outcomes. In contrast, poor sleep quality was predominantly observed among women engaging in high levels of physical activity, accounting for 59% of cases. These findings suggest that the intensity of physical activity may influence sleep quality during pregnancy. Conclusion: Physical activity is significantly associated with sleep quality in pregnant women. Moderate physical activity is linked to better sleep quality, whereas high levels of physical activity may contribute to poorer sleep outcomes. Appropriate monitoring and adjustment of physical activity intensity during pregnancy are recommended to support optimal maternal sleep health.
Copyright (c) 2026 Putri Maharani Anindita, Tiara Fatmarizka (Author) https://creativecommons.org/licenses/by/4.0
Cross-Sectional Study on Sitting Posture, Kyphosis, and Scoliosis in Elementary Students
Background: Non-ergonomic sitting posture in school-aged children may increase the risk of spinal deformities, such as kyphosis and scoliosis. This study analyzes the relationship between sitting posture, assessed using the Rapid Entire Body Assessment (REBA), and kyphosis and scoliosis in students at SD Negeri 1 Renon. Methods: This cross-sectional study involved 90 participants selected through purposive sampling. Sitting posture was evaluated using REBA via the ErgoFellow application, with posture documentation recorded at the 1st, 3rd, and 5th minutes and subsequently analyzed using Kinovea software. Kyphosis was measured using a flexible curve ruler, while scoliosis was assessed with a scoliometer. Results: Chi-square analysis revealed a significant relationship between sitting posture and spinal deformities (p = 0.000). Spearman’s rho test indicated a positive correlation between sitting posture and kyphosis (r = 0.646, p = 0.000) and scoliosis (r = 0.400, p = 0.000). Conclusion: There is a significant relationship between sitting posture and the occurrence of kyphosis and scoliosis in elementary school students. These findings emphasize the importance of ergonomic education and interventions to prevent spinal deformities in school-aged children.
Copyright (c) 2026 Ni Kadek Nova Milani Dewi, I Putu Yudi Pramana Putra, Luh Putu Ratna Sundari, I Made Jawi (Author) https://creativecommons.org/licenses/by/4.0
Multimodal Physiotherapy for Functional Recovery and Pain Reduction in L1 Spinal Cord Injury: A Case Report
Background: Spinal cord injury (SCI) leads to motor, sensory, and autonomic dysfunction, resulting in long-term disability. Multimodal physiotherapy is a key component of rehabilitation; however, evidence on long-term outcomes in complete SCI at the L1 level remains limited. Objective: To describe the longitudinal clinical outcomes of multimodal physiotherapy in a patient with traumatic L1 SCI classified as ASIA Impairment Scale (AIS) grade A. Methods: This study was a case report (n=1) involving a 24-year-old male with traumatic L1 SCI. The patient received multimodal physiotherapy 3–4 sessions per week for 18 months. The program included range of motion exercises, muscle strengthening, balance training, functional mobility training, transcutaneous electrical nerve stimulation, and infrared therapy. Outcomes were assessed using Manual Muscle Testing (MMT), Numeric Rating Scale (NRS), and Barthel Index at baseline and at 1, 3, 6, 12, and 18 months. Absolute changes were calculated descriptively. Results: After 18 months, proximal muscle strength improved from MMT grade 1 to 4, while distal muscles improved from 0–1 to 3. Pain decreased from NRS 4 to 0–1 (−3 to −4 points), and the Barthel Index increased from 30 to 90 (+60 points). Improvements were most evident within the first 3–6 months, followed by gradual stabilization. The patient progressed from total dependence to assisted ambulation. Conclusion: Multimodal physiotherapy over 18 months was associated with meaningful improvements in strength, pain, and functional independence. Residual limitations in balance and distal function persisted, indicating partial recovery and the need for continued rehabilitation.
Copyright (c) 2026 Luh Dwi Erna Krismawati, Luh Kadek Asri Junita Dewi Negara (Author) https://creativecommons.org/licenses/by/4.0
Cognitive Decline and ADL Independence in Older Adults: A Systematic Review
Background: Cognitive decline is prevalent among older adults and is associated with decreased independence in activities of daily living (ADL). Objective: To systematically review the association between cognitive decline and ADL independence in older adults. Methods: This systematic review followed PRISMA 2020 guidelines. Literature searches were conducted in PubMed, ScienceDirect, and Google Scholar for studies published between 2021 and 2026. Eligible studies included older adults aged ≥60 years assessing cognitive function and ADL independence. A qualitative synthesis was performed due to heterogeneity. Risk of bias was assessed using an adapted Newcastle–Ottawa Scale for cross-sectional studies. Results: Five cross-sectional studies with sample sizes ranging from approximately 60 to over 10,000 participants were included. Cognitive function was assessed using standardized tools such as the Mini-Mental State Examination (MMSE), while ADL was measured using instruments such as the Barthel Index. All studies reported a consistent association between cognitive impairment and reduced ADL independence. However, quantitative effect measures (e.g., odds ratios, confidence intervals) were not consistently reported. Risk of bias assessment indicated moderate to high risk across most studies. Conclusion: Cognitive decline is associated with reduced ADL independence in older adults. However, the strength of evidence is limited due to study design, lack of quantitative synthesis, and risk of bias in included studies.
Copyright (c) 2026 Zahra Gusna Putri (Author) https://creativecommons.org/licenses/by/4.0
Early Physiotherapy After Surgery for Infected Distal Humerus Nonunion: A Case Report
Background: Infected nonunion of distal humerus fractures is a complex condition requiring infection control, stabilization, and rehabilitation to prevent stiffness and functional decline. Evidence regarding early physiotherapy during the acute postoperative phase remains limited. Objective: To describe the clinical outcomes of early physiotherapy following surgery in a patient with infected distal humerus nonunion. Methods: This case report involved a 32 year old male who underwent debridement, implant removal, antibiotic bone cement placement, and external fixation. Physiotherapy was initiated on postoperative day 1 and conducted over four sessions during hospitalization. Outcomes included pain using the Numeric Rating Scale (NRS), range of motion (ROM), muscle strength using Manual Muscle Testing (MMT), edema by limb circumference, and functional ability using the Patient Specific Functional Scale (PSFS). Elbow ROM was not assessed during the protective phase. Results: Active movement pain decreased from 5/10 to 3/10, while passive movement pain decreased from 6/10 to 4/10. Wrist edema reduced from 19 cm to 18 cm. Shoulder ROM improved from 40° to 90°, and wrist ROM increased from 60° to 70°. Muscle strength improved from 3− to 3 at the shoulder and from 3− to 4 at the wrist. PSFS scores improved in finger movement and self care activities. Conclusion: Early physiotherapy may help reduce pain and edema while preserving upper limb function during the postoperative protective phase in infected distal humerus nonunion.
Copyright (c) 2026 Arini Ishmah Rose Haryanto, Arif Pristianto, Prihantoro Larasati (Author) https://creativecommons.org/licenses/by/4.0
Effect of TENS and Exercise on Balance and Strength in Diabetic Neuropathy: A Case Report
Background: Diabetic peripheral neuropathy (DPN) is a common complication of diabetes mellitus characterized by sensory impairment, neuropathic pain, muscle weakness, and balance dysfunction, which collectively increase the risk of functional limitations and falls. Objective: To describe the clinical outcomes of a combined Transcutaneous Electrical Nerve Stimulation (TENS) and exercise intervention on pain, balance, and muscle strength in a patient with DPN. Methods: This case report describes one female patient (n = 1), aged 59 years, diagnosed with DPN who received physiotherapy intervention for three weeks (two sessions per week). The intervention consisted of TENS and lower-extremity strengthening exercises based on the FITT principle. Outcome measures included pain intensity using the Numeric Rating Scale (NRS), muscle strength using Manual Muscle Testing (MMT), and functional mobility using the Timed Up and Go Test (TUG). Results: After three weeks of intervention, pain intensity decreased from 6/10 to 4/10 for tenderness and from 5/10 to 3/10 for movement pain (Δ = −2). Muscle strength improved from 3/5 to 4/5 in both knee and ankle muscle groups. Functional mobility also improved, as indicated by a reduction in TUG time from 20 seconds to 16 seconds (Δ = −4 seconds), suggesting enhanced balance and mobility. Conclusion: A combined TENS and exercise intervention may contribute to improvements in pain, muscle strength, and functional mobility in patients with DPN. These findings suggest that a combined TENS and exercise approach may support short-term improvements in functional mobility and pain management in clinical practice, although further evidence is required.
Transcutaneous Electric Nerve Stimulation
Copyright (c) 2026 Chrisnami Ika Safira, Umi Budi Rahayu, Yunita Nur Rochmah (Author) https://creativecommons.org/licenses/by/4.0
Exercise-Based Interventions for Balance and Motor Function in Cerebral Palsy: A Systematic Review
Background: Cerebral palsy (CP) is the leading cause of childhood physical disability, characterized by impairments in balance, postural control, and motor function that limit functional independence. Evidence comparing different exercise-based interventions remains limited. Objective: To synthesize evidence on the effects of exercise-based interventions on balance, trunk control, gross motor function, and functional performance in children with CP. Methods: A systematic review was conducted in accordance with PRISMA 2020 guidelines. Electronic databases (PubMed, Scopus, ScienceDirect, SAGE, Cochrane Library, and Wanfang Data) were searched up to March 2025. Randomized controlled trials involving children with CP were included. A total of 10 studies comprising 288 participants were analyzed. Data were synthesized narratively due to heterogeneity in interventions and outcome measures. Risk of bias was assessed using the Cochrane RoB 2 tool. Results: Core stability training improved balance and gait parameters (knee flexion 81% vs 41%; p<0.05). Swiss ball stabilization showed significant improvements in trunk control (η²p=0.86; p<0.001) and gross motor function. Task-oriented training demonstrated consistent improvements in gross motor function and balance (p<0.0001). Pilates, dual-task training, and sit-to-stand interventions also resulted in significant functional gains. Conclusion: Exercise-based interventions improve motor and functional outcomes in children with CP. Task-oriented training shows the most consistent evidence, while core stabilization and Swiss ball training provide additional benefits. However, heterogeneity and methodological limitations restrict definitive conclusions regarding comparative effectiveness.
Copyright (c) 2026 Chalvina Radisa Nafti, Sri Novia Fauza (Author) https://creativecommons.org/licenses/by/4.0
Multimodal Physiotherapy in Sciatica: A Case Report on Pain and Functional Improvement
Background: Sciatica is a neuropathic pain condition characterized by radiating pain along the sciatic nerve, often associated with lumbar nerve root compression and functional disability. Although physiotherapy is recommended as first-line management, evidence regarding structured multimodal interventions in clinical settings remains limited. Objective: This study aimed to evaluate the effects of multimodal physiotherapy on pain and functional outcomes in a patient with sciatica. Methods: A single-subject case report (n=1) was conducted following CARE guidelines. A 46-year-old female presented with a 3-month history of left-sided radiating pain. The patient underwent eight physiotherapy sessions over four weeks, including Transcutaneous Electrical Nerve Stimulation, Shortwave Diathermy, myofascial release, nerve gliding, and William flexion exercises. Outcomes were assessed using the Numerical Rating Scale (NRS), range of motion, Manual Muscle Testing, and Oswestry Disability Index (ODI). Clinical significance was evaluated using minimal clinically important difference thresholds (NRS ≥2; ODI ≥10). Results: Pain intensity decreased from NRS 8 to 3 (Δ=5), exceeding the MCID. Functional disability improved from ODI 40% (moderate disability) to 18% (mild disability) (Δ=22 points), also exceeding the MCID. Range of motion increased across all directions, and trunk muscle strength improved from grade 4 to grade 5. Conclusion: This case suggests that multimodal physiotherapy may provide clinically meaningful improvements in pain and functional outcomes in patients with sciatica. These findings highlight the potential benefit of combining electrotherapy and exercise-based interventions in clinical practice.
Copyright (c) 2026 Candra Arung Ariyani, Wahyu Tri Sudaryanto, Yunita Nur Rochmah3 (Author) https://creativecommons.org/licenses/by/4.0
Effect of Fartlek Training on VO₂max in Adolescent Athletes: A Systematic Review
Background: Maximal oxygen uptake (VO₂max) is an important indicator of cardiorespiratory fitness and athletic performance in adolescents. Fartlek training, which combines variable-intensity exercise within continuous activity, is commonly used to improve aerobic capacity; however, evidence regarding its effectiveness in adolescent athletes remains limited and inconsistent. Objective: To evaluate the effectiveness of fartlek training in improving VO₂max among adolescent athletes. Methods: This systematic review followed the PRISMA 2020 guidelines. Literature searches were conducted in Google Scholar, Semantic Scholar, and Crossref for studies published between 2015 and 2025. Experimental and quasi-experimental studies involving adolescent athletes aged 12–18 years were included based on predefined PICOS criteria. Two independent reviewers performed study selection and data extraction. Due to heterogeneity in study design and outcome measurement, findings were synthesized narratively. Risk of bias was assessed using standardized criteria. Results: Of 1,187 identified records, nine studies involving approximately 186 participants met the inclusion criteria. All included studies reported improvements in VO₂max following fartlek training, with increases ranging from 1.0 to 11.6 mL/kg/min. Greater improvements were generally observed in interventions lasting 4–8 weeks with frequencies of 2–4 sessions per week. Comparative studies showed that fartlek training produced effects comparable to or greater than other training methods. However, variability in protocols and measurement methods limited quantitative synthesis. Conclusion: Fartlek training appears effective in improving VO₂max among adolescent athletes, although the certainty of evidence remains low to moderate due to methodological limitations and heterogeneity.
Copyright (c) 2026 Afwaza Nakhla Chairy Batubara, Dela Fariha Fuadi (Author) https://creativecommons.org/licenses/by/4.0
Effects of Aerobic Exercise on VO₂max in Overweight and Obese Adolescents: A Systematic Review
Background: Overweight and obesity in adolescents are associated with reduced cardiorespiratory fitness (CRF) and increased cardiometabolic risk. Although aerobic exercise is widely recommended, its effectiveness in improving maximal oxygen consumption (VO₂max) in this population remains inconsistent. Objective: To systematically evaluate the effects of aerobic exercise on VO₂max in overweight and obese adolescents. Methods: This systematic review followed PRISMA guidelines and the PICOS framework. Literature searches were conducted in Scopus, PubMed, Semantic Scholar, and Google Scholar up to March 2026. Studies were screened independently by two reviewers. Eligible studies included experimental and quasi-experimental designs involving adolescents (10–19 years) with overweight or obesity, receiving aerobic exercise interventions, and reporting VO₂max or VO₂peak outcomes. Risk of bias was assessed using standard tools. Due to heterogeneity, a narrative synthesis was performed. Results: Six studies were included. Aerobic exercise improved VO₂max across all studies, with increases ranging from +2.12 to +6.10 mL/kg/min in intervention groups compared to +0.34 to +1.70 mL/kg/min in controls. High-Intensity Interval Training (HIIT) consistently produced greater improvements than moderate-intensity continuous training (p < 0.05). Reductions in body fat and body mass index were also reported. Methodological limitations and moderate risk of bias were observed. Conclusion: Aerobic exercise, particularly HIIT, improves VO₂max in overweight and obese adolescents. The overall strength of evidence is moderate, supporting the use of structured, time-efficient aerobic exercise programs in this population.
Copyright (c) 2026 Lintang Zerlina Arsa Wibowo, Dela Fariha Fuadi (Author) https://creativecommons.org/licenses/by/4.0
Multimodal Physiotherapy for Calcaneal Spur: A Case Report
Background: Calcaneal spur is a bony outgrowth commonly associated with plantar heel pain, leading to functional limitations in standing and walking. Multimodal physiotherapy combining electrotherapy and exercise has been widely used; however, evidence from detailed clinical case reports remains limited. Objective: To evaluate the clinical effectiveness of a multimodal physiotherapy program in reducing pain and improving functional ability in a patient with calcaneal spur. Methods: This case report describes a 54-year-old female with left calcaneal spur who underwent six physiotherapy sessions over three weeks in an outpatient rehabilitation setting. Interventions included therapeutic ultrasound (1 MHz, 1.2 W/cm², 5 minutes), conventional transcutaneous electrical nerve stimulation (TENS; 80–100 Hz, 15 minutes), and structured exercise therapy (stretching, strengthening, balance, and gait training). Outcomes were assessed using the Numeric Rating Scale (NRS) for pain, ankle range of motion (ROM), and the Foot and Ankle Disability Index (FADI) for functional ability. Results: Pain intensity decreased from NRS 5 to 2, indicating a clinically meaningful reduction. Ankle dorsiflexion improved from 15° to 20°. Functional ability increased substantially, with FADI scores improving from 52% to 90% (absolute improvement: 38%). Clinically, the patient demonstrated improved gait pattern and reduced pain during weight-bearing activities. No adverse events were reported. Conclusion: A structured multimodal physiotherapy program demonstrated clinically meaningful improvements in pain, joint mobility, and functional performance in this case. These findings highlight the potential benefit of combined interventions; however, further studies with larger samples and long-term follow-up are required.
Transcutaneous electrical nerve stimulation
Copyright (c) 2026 Alreda Fitriana, Tiara Fatmarizka, Kingkinarti (Author) https://creativecommons.org/licenses/by/4.0
Effect of Chair-Based Exercise on Lower Limb Strength and Dynamic Balance in Older Adults: A Systematic Review
Background: Aging is associated with declines in muscle mass, strength, postural control, and dynamic balance, increasing fall risk and reducing functional independence in older adults. Chair-based exercise (CBE) is a safe and accessible intervention for individuals with limited mobility. Objective: To evaluate the effects of chair-based exercise on lower limb muscle strength and dynamic balance in older adults. Methods: This systematic review followed PRISMA 2020 guidelines. Literature searches were conducted in PubMed, Scopus, ScienceDirect, and Google Scholar for studies published between 2021 and 2025. Keywords included chair-based exercise, older adults, lower limb strength, dynamic balance, Timed Up and Go, and the 30-second chair stand test. Studies were selected using PICOS criteria. Risk of bias was assessed using the PEDro scale. Due to heterogeneity in study design, interventions, and outcomes, a narrative synthesis was performed. Results: Eight studies were included. Chair-based and sit-to-stand exercises consistently improved lower limb muscle strength, particularly in the 30-second chair stand test. Improvements in dynamic balance were also reported, commonly measured using the Timed Up and Go test and Berg Balance Scale. However, the evidence strength was limited by small sample sizes, heterogeneous protocols, and variable methodological quality. Conclusion: Chair-based exercise is a safe and feasible intervention with the potential to improve lower limb strength and dynamic balance in older adults. However, findings should be interpreted cautiously due to the moderate-to-high risk of bias.
Copyright (c) 2026 Angelita Annundra Engkalma Balowahani (Author) https://creativecommons.org/licenses/by/4.0
Comparison of Static and Dynamic Stretching on Hamstring Flexibility in Adolescents: A Systematic Review
Background: Hamstring flexibility is an important component of musculoskeletal fitness that contributes to movement efficiency, postural control, and injury prevention. Reduced hamstring flexibility is frequently observed in adolescents, particularly among those with sedentary lifestyles. Static stretching (SS) and dynamic stretching (DS) are commonly used to improve flexibility; however, evidence regarding their comparative effectiveness in adolescents remains inconsistent. Objective: This systematic review aimed to compare the effects of SS and DS on hamstring flexibility in adolescents. Methods: This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. Literature searches were conducted in PubMed, Scopus, and Google Scholar for studies published between 2019 and 2025. Eligible studies included adolescents with reduced hamstring flexibility who received SS and/or DS interventions. Randomized controlled trials and quasi-experimental studies published in English were included. Due to heterogeneity in intervention protocols and outcome measures, data were synthesized narratively. Results: Six studies met the inclusion criteria. Both SS and DS significantly improved hamstring flexibility. DS generally produced greater short-term improvements in flexibility and functional performance, whereas SS showed beneficial effects when performed consistently over longer periods. Flexibility outcomes were mainly assessed using the sit and reach test and the Active Knee Extension Test. Conclusion: Both SS and DS are effective for improving hamstring flexibility in adolescents. DS may provide greater short-term benefits, while SS remains effective for long-term flexibility improvement. Further high-quality randomized controlled trials with standardized protocols are needed.
Copyright (c) 2026 Ananda Sakinah Istanti, Pipin Suparmi (Author) https://creativecommons.org/licenses/by/4.0
Physiotherapy Management of Quadriplegic Cerebral Palsy Following Tuberculous Meningitis: A Case Report
Background: Cerebral palsy (CP) is a non-progressive motor disorder resulting from early brain injury. Tuberculous meningitis (TBM) is a severe central nervous system infection that can lead to permanent neurological impairment, including spastic quadriplegic CP. Early physiotherapy is essential to optimize functional outcomes in affected infants. Objective: To describe the clinical outcomes of a structured physiotherapy program in an infant with quadriplegic cerebral palsy following tuberculous meningitis. Methods: A case report was conducted on a 7-month-old male infant diagnosed with quadriplegic CP secondary to TBM. Baseline assessment included Modified Ashworth Scale (MAS), Hammersmith Infant Neurological Examination (HINE), Gross Motor Function Classification System (GMFCS), Manual Ability Classification System (MACS), Communication Function Classification System (CFCS), and Eating and Drinking Ability Classification System (EDACS). The patient received physiotherapy based on Neurodevelopmental Treatment (NDT), including positioning, sensory stimulation, head and trunk control exercises, hand function training, and spasticity inhibition. The intervention was delivered three times per week for four weeks. Results: Spasticity decreased across multiple joints, particularly in finger flexors (MAS 3 to 2) and knee extensors (MAS 3 to 2). The HINE score improved from 33 to 42, indicating enhanced neurological function. Functional classifications remained unchanged (GMFCS IV, MACS IV, CFCS IV, EDACS I), reflecting persistent severe functional limitations. Conclusion: A structured physiotherapy program based on NDT may improve neuromotor outcomes in infants with quadriplegic CP following TBM. However, findings should be interpreted cautiously due to the single-case design.
Copyright (c) 2026 Ifa Aulia Musyarifah Putri, Wahyuni, Ika Hayati (Author) https://creativecommons.org/licenses/by/4.0
Physiotherapy Exercise in Osgood–Schlatter Disease: A Case Report
Background: Osgood–Schlatter Disease (OSD) is a traction apophysitis of the tibial tuberosity commonly occurring in physically active adolescents, particularly in sports involving repetitive jumping and rapid directional changes. This condition may lead to anterior knee pain and functional limitations. Objective: To describe the clinical outcomes of a structured physiotherapy exercise program in a badminton athlete with OSD. Methods: A case report was conducted on a 14-year-old male badminton athlete diagnosed with OSD in the progressive loading phase. The patient underwent six physiotherapy sessions over two weeks. The intervention included functional and plyometric exercises such as runner’s climb exercise, single-leg squat, squat jumps, box jumps, single-leg hop, and speed skaters. Outcome measures included pain intensity using the Visual Analog Scale (VAS), knee range of motion (ROM), muscle strength assessed by Manual Muscle Testing (MMT), and functional performance using the Kujala Anterior Knee Pain Scale. Results: Pain decreased from VAS 1 (palpation) and 2 (movement) to 0 and 1, respectively. Knee flexion improved from 110° to 125°, while muscle strength remained at 5/5. Functional performance increased, with the Kujala score improving from 65 to 76 points. Conclusion: A structured physiotherapy program incorporating functional and plyometric exercises may improve pain, joint mobility, and functional performance in adolescents with OSD. Findings should be interpreted cautiously due to the single-case design.
Copyright (c) 2026 Kusumandari Nur Shafana, Suryo Saputra Perdana, Hakny Kusuma Maulana Arkan (Author) https://creativecommons.org/licenses/by/4.0
Physiotherapy Management of Post-Tuberculosis Lung Disease with Cardiopulmonary Comorbidity: A Case Report
Background: Post-tuberculosis lung disease (PTLD) is associated with persistent respiratory impairment, which may be exacerbated by cardiopulmonary comorbidities such as cardiomegaly and pleural effusion. These conditions contribute to dyspnea, reduced thoracic expansion, and limited functional capacity. Physiotherapy plays an important role in improving respiratory efficiency and functional performance. Objective: To provide clinically relevant insight into physiotherapy management in a patient with PTLD and cardiopulmonary comorbidity. Methods: This study was a single-case report based on a clinical physiotherapy record. A 59-year-old male presented with a 3-month history of persistent cough, dyspnea, and difficulty expectorating sputum. Assessment included physical examination, thoracic expansion measurement, Borg Dyspnea Scale, modified Medical Research Council (mMRC), vital signs, chest radiography, laboratory findings, and medication review. The intervention consisted of nebulizer therapy, breathing exercises, and chest mobility exercises with symptom-based progression. Clinical outcomes were monitored descriptively across six sessions. Results: Baseline findings showed respiratory rate 24 breaths/min, heart rate 108 beats/min, thoracic expansion 2.0–2.1 cm, mMRC grade 2, and walking tolerance <10 m. Across six sessions, respiratory rate decreased from 24 to 20 breaths/min and heart rate from 108 to 92 beats/min. Thoracic expansion improved from 2.0–2.1 cm to 2.4–2.5 cm. Blood pressure remained stable. These changes indicate a clinically meaningful improvement in breathing control and chest wall mobility. Conclusion: Individualized physiotherapy incorporating breathing exercises, chest mobility training, and graded functional activity may improve respiratory parameters and functional tolerance in patients with PTLD and cardiopulmonary comorbidity.
Old pulmonary tuberculosis; pleural effusion; cardiomegaly; dyspnea; chest mobility exercise; breathing exercise; physiotherapy.
Copyright (c) 2026 Fadyah Khoirunnisa, Isnaini Herawati, Mulatsih Nita Utami (Author) https://creativecommons.org/licenses/by/4.0
Multimodal Physiotherapy for Spasticity and Motor Function in Diplegic Cerebral Palsy: A Case Report
Background: Spastic diplegic cerebral palsy is a neurodevelopmental disorder characterized by lower limb spasticity and impaired gross motor function. Although physiotherapy is widely applied, evidence regarding the clinical effectiveness of multimodal interventions remains limited, particularly in individual case contexts. This case highlights the short-term effects of a structured multimodal physiotherapy approach in a real-world clinical setting with limited resources. Objective: To evaluate the clinical outcomes of a multimodal physiotherapy program on spasticity and gross motor function in a child with spastic diplegic cerebral palsy. Methods: This study employed a single-case report design. A 3-year-8-month-old male with spastic diplegic cerebral palsy received a 4-week multimodal physiotherapy intervention consisting of passive range of motion, neurosensory stimulation, stability and proprioception training, and gait training. Spasticity was assessed using the Modified Ashworth Scale (MAS), and functional ability was measured using the Gross Motor Function Measure (GMFM-88). Outcomes were recorded across five time points (T1–T5) and analyzed descriptively. Results: Spasticity decreased from grade 3 to 2 in the knee and ankle joints, while remaining stable at grade 2 in the hip. No changes were observed in muscle strength, which remained dominated by reflex and passive tone patterns. The GMFM total score increased from 34.3% to 36.6%, with improvements across all dimensions, particularly in standing and mobility-related activities. Conclusion: Multimodal physiotherapy demonstrated gradual improvements in spasticity and gross motor function; however, no transition from reflexive to voluntary motor control was observed. These findings should be interpreted cautiously due to the single-case design and limited generalizability.
Copyright (c) 2026 Tri Novaliano Rechtsi Medistianto, W. Wahyuni, Ika Hayati (Author) https://creativecommons.org/licenses/by/4.0
Early Physiotherapy in a Post-Coronary Artery Bypass Grafting Patient with Hypertension and Diabetes: A Case Report
Background: Coronary artery disease is a leading cause of morbidity requiring Coronary Artery Bypass Grafting (CABG). Patients undergoing CABG commonly present with comorbidities such as hypertension and type 2 diabetes mellitus, which may impair postoperative recovery, particularly pulmonary function and functional capacity. Objective: To evaluate the clinical effects of early physiotherapy on oxygen saturation, thoracic expansion, pain, and functional recovery in a post-CABG patient with multiple comorbidities. Methods: This study was conducted as a case report following CARE guidelines. A 53-year-old male with triple-vessel coronary artery disease underwent CABG and had comorbid hypertension, type 2 diabetes mellitus, and dyslipidemia. Early physiotherapy was initiated during the acute postoperative phase, including diaphragmatic breathing, pursed-lip breathing, active range of motion exercises, and progressive mobilization. Outcomes were assessed at three time points (T1–T3), including oxygen saturation (SpO₂), thoracic expansion, pain using the Numeric Rating Scale (NRS), and vital signs. Results: SpO₂ increased from 95% to 99% (Δ+4%). Thoracic expansion improved from 1 cm to 2 cm at the axillary level. Pain during movement decreased from NRS 4 to 2 (Δ−2), while resting pain decreased from 2 to 1. Vital signs remained stable, and no adverse events were observed. Conclusion: Early physiotherapy in a post-CABG patient with hypertension and diabetes demonstrated improvements in pulmonary function, pain reduction, and functional capacity. Structured and individualized rehabilitation appears safe and beneficial in the acute postoperative phase.
Copyright (c) 2026 Pandu Tirto Hutomo, Tiara Fatmarizka, Purnomo Gani, Diani Qomara Dewi (Author) https://creativecommons.org/licenses/by/4.0
Phase II Cardiac Rehabilitation in NYHA Class II Heart Failure After Mitral Valve Replacement: A Case Report
Background: Patients with heart failure following mitral valve replacement (MVR) frequently experience reduced functional capacity and exercise intolerance. Phase II cardiac rehabilitation is recommended to improve aerobic capacity; however, evidence in post-MVR heart failure patients remains limited in real-world settings. Objective: To evaluate the safety and effectiveness of structured phase II cardiac rehabilitation in a patient with NYHA class II heart failure following MVR. Methods: This single-case report followed CARE guidelines. A 40-year-old female underwent baseline assessment at week 3 after post-operative stabilization and completed a 4-week supervised rehabilitation program (12 sessions, 3–5 sessions/week). The intervention consisted of FITT-based aerobic exercise (walking, treadmill, ergocycle) at 60–70% HRmax. The primary outcome was the Six-Minute Walk Test (6MWT), while secondary outcomes included metabolic equivalents (METs), Borg scale, heart rate, and blood pressure. Results: The 6MWT distance increased from 407 m to 438 m (Δ +31 m; +7.6%), approaching the minimal clinically important difference, indicating clinically meaningful improvement. METs increased from 4.6 to 4.9, and Borg scale decreased from 7 to 6, reflecting reduced perceived exertion. Hemodynamic parameters remained stable throughout the intervention, with no adverse events observed. Conclusion: Phase II cardiac rehabilitation was safe and demonstrated functional improvement in this case of post-MVR heart failure. These findings suggest potential clinical benefits, although further controlled studies are required.
Copyright (c) 2026 Fauzia Shafa Rachmania, Farid Rahman, Kadek Agustini Aryani (Author) https://creativecommons.org/licenses/by/4.0
Multimodal Physiotherapy After Fifth Proximal Phalanx ORIF: A Case Report
Background: Postoperative fifth proximal phalanx fractures treated with open reduction and internal fixation (ORIF) commonly result in pain, joint stiffness, reduced range of motion (ROM), muscle weakness, and impaired hand function. Physiotherapy plays a crucial role in restoring functional capacity. Objective: To evaluate the clinical outcomes of a multimodal physiotherapy intervention on pain, ROM, muscle strength, and functional ability in a patient following ORIF of the fifth proximal phalanx. Methods: This study was a single-case report involving a 22-year-old female patient with a left fifth proximal phalanx fracture following ORIF. The intervention was conducted over three weeks (three sessions per week), with assessments performed at baseline (T0) and weekly until T3. Outcome measures included the Numeric Rating Scale (NRS) for pain, goniometric measurement for ROM, Manual Muscle Testing (MMT) for muscle strength, and the Wrist Hand Disability Index (WHDI) for functional ability. Data were analyzed descriptively. Results: Pain at rest decreased from 2/10 to 0/10, movement pain from 5/10 to 3/10, and tenderness from 6/10 to 4/10. MCP joint ROM improved from S 10°–0°–60° to 15°–0°–70°. Muscle strength increased from grade 3/5 to 4/5. Functional disability improved from 54% (moderate disability) to 40% (minimal disability). These findings indicate clinically meaningful improvement despite residual limitations. Conclusion: A multimodal physiotherapy program consisting of infrared therapy, ultrasound, paraffin bath, and active-assisted exercise was effective in improving clinical outcomes and hand function in a patient following ORIF of the fifth proximal phalanx.
Copyright (c) 2026 Amara Kurnia Fitri, Arif Pristianto, Leo Muchamad Dachlan (Author) https://creativecommons.org/licenses/by/4.0
Physiotherapy Management After Total Hip Replacement at PKU Muhammadiyah Yogyakarta: A Case Report
Background: Early physiotherapy after hip arthroplasty aims to reduce pain, prevent immobility-related complications and restore basic mobility, it helps to return to daily activities as quick as possible. Objective: To describe early physiotherapy management and short-term clinical changes after left hip arthroplasty at RSU PKU Muhammadiyah Yogyakarta. Methods: A case report based on an inpatient record covering three physiotherapy sessions. The patient was a 65-year-old woman who underwent left total hip replacement with the AMP method after traumatic caput femoris fracture. The patient underwent surgery 3 days ago. Data included symptoms, examination findings, pain scores, manual muscle testing, hip range of motion, modified Trendelenburg findings, Harris Hip Score and the FITT-based treatment plan. Outcomes were summarized descriptively across T1-T3. Results: Main problems were intermittent left groin pain, restricted hip motion, gluteal/quadriceps weakness, hip-flexor spasme, dyspnea during prolonged sitting, and poor function of lower extrimity. Treatment comprised breathing exercise, muscle activation, stability-proprioception training, walker-assisted gait training, education, and hip precautions. Across three sessions, rest pain decreased from 2 to 1, passive pain from 8 to 6, active-exercise pain from 10 to 6, sagittal hip motion from 8°-0°-85° to 12°-0°-90°, frontal motion from 0°-0°-0° to 20°-0°-5°, partial weight bearing progressed to 40%, and Harris Hip Score improved from 18 to 28. Conclusion: Early physiotherapy was associated with lower pain and better mobility, protected weight-bearing tolerance, and functional readiness.
Copyright (c) 2026 Aida Nur Faizah, Totok Budi Santoso, Galih Adhi Ishak Setiawan (Author) https://creativecommons.org/licenses/by/4.0
Effect of McKenzie Cervical Exercise on Neck Pain in Forward Head Posture: A Systematic Review
Background: Forward Head Posture (FHP) is a common postural disorder characterized by anterior displacement of the head, resulting in increased mechanical stress on the cervical spine and neck musculature. The widespread use of smartphones and computers has contributed to the increasing prevalence of FHP and associated neck pain. McKenzie Cervical Exercise, based on the Mechanical Diagnosis and Therapy (MDT) approach, is frequently used to improve posture, reduce pain, and restore cervical function. However, evidence regarding its effectiveness in individuals with FHP remains inconsistent. Objective: This study aimed to systematically review the effectiveness of McKenzie Cervical Exercise in reducing neck pain among individuals with FHP. Methods: This systematic review followed the PRISMA 2020 guidelines. Literature searches were conducted through PubMed, PEDro, and Google Scholar for studies published between 2016 and 2025. Eligible studies included randomized controlled trials, experimental, and quasi-experimental studies involving individuals with FHP who received McKenzie Cervical Exercise and reported neck pain outcomes. A total of 12 studies met the inclusion criteria and were analyzed narratively. Results: Most studies reported statistically significant reductions in neck pain (p < 0.05), accompanied by improvements in cervical range of motion, craniovertebral angle, posture, and functional outcomes. Several studies also demonstrated increased cervical flexibility and reduced muscle tension following intervention. Conclusion: McKenzie Cervical Exercise appears effective in reducing neck pain and improving cervical function in individuals with FHP. Further high-quality randomized controlled trials are recommended to strengthen the evidence base.
Copyright (c) 2026 Nur Hamida, Rizky Wulandari, Lailatuz Zaidah (Author) https://creativecommons.org/licenses/by/4.0
Physiotherapy Management After ORIF in Proximal Humerus Fracture: A Case Report
Background: Proximal humerus fractures are common upper-extremity injuries that often require surgical intervention such as open reduction and internal fixation (ORIF). Postoperative complications frequently include pain, limited range of motion (ROM), decreased muscle strength, and impaired functional ability, which necessitate structured rehabilitation. Objective: To describe the clinical outcomes of a physiotherapy program in a patient with proximal humerus fracture following ORIF. Methods: This case report followed CARE guidelines and involved a 65-year-old female with a right proximal humerus fracture (Neer 2-part) post-ORIF. The physiotherapy intervention consisted of Transcutaneous Electrical Nerve Stimulation (TENS), active and active-assisted range of motion exercises, and progressive resisted exercises targeting the shoulder muscles. The program was conducted over three sessions within three weeks. Outcomes were assessed using Numerical Pain Rating Scale (NPRS), goniometric ROM, Manual Muscle Testing (MMT), and Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire. Results: Active shoulder ROM improved from 50–0–110° at baseline to 50–0–115° at the final session, while passive ROM increased from 50–0–150° to 50–0–155°. Muscle strength improved from grade 3− to grade 5. Functional ability showed substantial improvement, with DASH scores decreasing from 47 to 15. Conclusion: A short-term physiotherapy program combining pain modulation and progressive exercise improved joint mobility, muscle strength, and functional outcomes in a patient following ORIF for proximal humerus fracture.
Copyright (c) 2026 Asti Damaningtyas, Totok Budi Santoso, Prihantoro Larasati (Author) https://creativecommons.org/licenses/by/4.0
Multimodal Physiotherapy Management for Adhesive Capsulitis: A Case Report
Background: Adhesive capsulitis is a musculoskeletal disorder characterized by progressive shoulder pain and restricted range of motion, resulting in functional limitations. Multimodal physiotherapy is commonly used in clinical practice; however, reports remain limited, particularly in describing detailed short-term clinical outcomes of structured multimodal physiotherapy programs in real-world clinical settings. Objective: This case report aims to describe the clinical outcomes of a multimodal physiotherapy program on pain, range of motion (ROM), and functional ability in a patient with adhesive capsulitis. Methods: A 69-year-old male presented with a 5-month history of left shoulder pain and stiffness. The patient underwent four physiotherapy sessions over two weeks. The intervention consisted of Transcutaneous Electrical Nerve Stimulation (TENS), Short Wave Diathermy (SWD), manual therapy, and a structured home exercise program. Outcomes were assessed using the Numeric Rating Scale (NRS), ROM measurement, and the Shoulder Pain and Disability Index (SPADI). Results: Pain during movement decreased from 5/10 to 2/10, while tenderness decreased from 4/10 to 3/10. ROM improved in flexion (80° to 100°), extension (20° to 30°), abduction (70° to 90°), and adduction (20° to 30°). The SPADI score improved from 62% to 45%, indicating reduced disability. Conclusion: Multimodal physiotherapy was associated with short-term improvements in pain, ROM, and functional ability in this patient. However, these findings are limited to a single case and should be interpreted with caution.
Copyright (c) 2026 Hafidz Taqiudien Amrullah, Arif Pristianto, Widyo Bintoro (Author) https://creativecommons.org/licenses/by/4.0
Exercise Interventions for Pain and Function in Older Adults with Low Back Pain: A Systematic Review
Background: Chronic low back pain (LBP) is highly prevalent among older adults and contributes to functional decline and reduced quality of life. Exercise therapy is widely recommended; however, the effectiveness of different exercise modalities remains unclear. Objective: To evaluate the effectiveness of exercise interventions on pain, physical function, and muscle strength in older adults with chronic low back pain. Methods: This systematic review followed PRISMA 2020 guidelines. Four databases (Scopus, PubMed, Google Scholar, and Semantic Scholar) were searched from January 2015 to January 2026. Randomized controlled trials involving adults aged ≥60 years were included. Study selection and data extraction were conducted by two independent reviewers. Methodological quality was assessed using the Physiotherapy Evidence Database (PEDro) scale. Data were synthesized narratively due to heterogeneity. Results: Five randomized controlled trials involving 473 participants were included. PEDro scores ranged from 6 to 7, indicating good methodological quality. Exercise interventions, including Dynamic Neuromuscular Stabilization (DNS), corrective exercises, neuromuscular electrical stimulation (NMES), and biofeedback-based training, improved functional outcomes such as gait speed, balance (Timed Up and Go), and disability indices. However, quantitative effect sizes, confidence intervals, and p-values were not consistently reported across studies, limiting direct comparison of intervention effectiveness. No intervention demonstrated consistent superiority across all outcomes. Conclusion: Exercise interventions improve physical function and reduce disability in older adults with chronic LBP, although effects on pain vary. The overall certainty of evidence is moderate due to heterogeneity and methodological limitations. Individualized exercise programs are recommended.
Copyright (c) 2026 Dilfu Ahsan Zahrudin, Andrew Wijaya Saputra (Author) https://creativecommons.org/licenses/by/4.0