Introduction
Health status is an important factor that has a significant impact on the quality of life of an elderly population. The major elements of health status are perceived health, especially psychological well-being, chronic illnesses, and functional status. Various studies have shown that perceived health declines with age, and the effects of ill health impact on many areas of daily activity (Setiabudhi & Hardywinoto, 1999; Roman, Tatemichi, & Erkinjuntti, 1993; Boyle, Paul, Moser, Zawacki, Gordon & Cohen, 2003; Guralnik, La Croix & Abbott, 1993; Harris, Kovar, Suzman, Kleinman, & Feldman, 1989). According to the statistics and uninfected diseases surveillance in 2002 at Depok (BAPPEDA & BPS Kota Depok, 2003, 2004, 2005), diabetes is becoming increasingly prevalent and undertreated in elderly people. Diabetes mellitus as a long-standing illness has been associated with limitations in activities of daily living among elderly people (Ayis, Gooberman-Hill, Ebrahim, MRC Health Services Research Collaboration, 2003; Parmet, 2004).
In older adults, diabetes has been associated with a two- to threefold increased risk of developing physical disability (Gregg, Beckles, Williamson, Leveille, Langlois, Engelgau, & Narayan, 2000; Gregg, Mangione, Cauley, Thompson, Schwartz, Ensrud, & Nevitt, 2002; Ryerson, Tierney, Thompson, Engelgau, Wang, Gregg, & Geiss, 2003; Von Korff, Katon, Lin, Simon, Ciechanowski, Ludman, Oliver, Rutter, & Young, 2005). The Health, Aging, and Body Composition (Health ABC) study has reported the association of diabetes with sub clinical functional limitation (De Rekeneire, Resnick, Schwartz, Shorr, Kuller, Simonsick, Vellas, & Harris, 2003). However, one of the most crucial factors determining functional capacity is mobility. As the musculoskeletal system deteriorates with increasing chronic conditions frequently combined with diabetes, such as coronary heart disease, peripheral artery disease, visual impairment, and depression, partially explained the association, but still 40% of excess risk for physical disability remained unexplained (Ciechanowski, Russo, Katon, Von Korff, Ludman, Lin, Simon, & Bush, 2004; Tanaka1 & Seals, 2003).
Low muscle strength, but not muscle mass, is associated with poor physical function in older men and women (Visser, Deeg, Lips, Harris, Bouter, 2000; Visser, Newman, Nevitt, Kritchevsky, Stamm, Goodpaster, & Harris, 2000. Muscle strength measured in midlife or old age is highly predictive of functional limitations and disability up to 25 years later (Rantanen, Guralnik, Foley, Masaki, Leveille, Curb, & White, 1999; Rantanen, Avlund, Suominen, Schroll, Frandin, & Pertti, 2002; Visser, Goodpaster, Kritchevsky, Newman, Nevitt, Rubin, Simonsick, & Harris, 2005). In the present study, diabetes is associated with lower skeletal muscle strength and quality. These characteristics may contribute to the development of physical disability in older adults with diabetes. The Health ABC Study evaluated hand grip and knee extensor strength and muscle quality in community-dwelling older adults with and without diabetes in. Older adults with diabetes had greater arm and leg muscle mass than those without diabetes because they were bigger in body size (Newman, Haggerty, Goodpaster, Harris, Kritchevsky, Nevitt, Miles, & Visser, 2003). Despite this, muscle strength was lower in men with diabetes and not higher in women with diabetes than corresponding counterparts. Muscle quality, defined as muscle strength per unit regional muscle mass, was significantly lower in men and women with diabetes than those without diabetes in both upper and lower extremities. Furthermore, longer duration of diabetes (>6 years) and poor glycemic control (HbA1c >8.0%) were associated with even poorer muscle quality (Park, Goodpaster, Strotmeyer, de Rekeneire, Harris, Schwartz, Tylavsky, & Newman, 2006).
Low muscle strength is one of the most significant changes that adversely affect the ability of older people to cope independently in their communities and to have contacts with other people. Impaired mobility also greatly increases the need for different kinds of services. Interventions at early stages to reduce dysfunctional capacity may preserve function in community-dwelling older adults with diabetes in (Figaro, Kritchevsky, Resnick, Shorr, Butler, Shintani, Penninx, Simonsick, Goodpaster, Newman, Schwartz, & Harris, 2006). Improved strength has been associated with improved muscle and bone mass, balance, and also mobility (Rhodes, Martin, Taunton, Donnelly, Warren, & Elliot, 2000). All of these factors are important in the prevention of fractures and improved quality of life. Studies have also demonstrated that exercise can delay the normal decline in physical performance associated with diabetes (Sriwijitkamol, Christ-Roberts, Berria, Eagan, Pratipanawatr , DeFronzo, Mandarino, & Musi1, 2006). A typical exercise program includes activities aimed at increasing musculoskeletal flexibility, strength, and quality. Exercise training also has favorable effects on the controlled blood sugar, the regulation of blood pressure, and the prevention of excessive weight gain (Fairey, Courneya, Field, Bell, Jones, & Mackey, 2003; Ciechanowski, Russo, Katon, Von Korff, Ludman, Lin, Simon, & Bush, 2004; Booth, Gordon, Carlson, & Hamilton, 2000).
Purpose of the paper
The purpose of this paper is to explain a promoting functional capacity through increasing muscle strength and quality in older adults with type-2 diabetes.
Objectives of the paper
Health status is an important factor that has a significant impact on the quality of life of an elderly population. The major elements of health status are perceived health, especially psychological well-being, chronic illnesses, and functional status. Various studies have shown that perceived health declines with age, and the effects of ill health impact on many areas of daily activity (Setiabudhi & Hardywinoto, 1999; Roman, Tatemichi, & Erkinjuntti, 1993; Boyle, Paul, Moser, Zawacki, Gordon & Cohen, 2003; Guralnik, La Croix & Abbott, 1993; Harris, Kovar, Suzman, Kleinman, & Feldman, 1989). According to the statistics and uninfected diseases surveillance in 2002 at Depok (BAPPEDA & BPS Kota Depok, 2003, 2004, 2005), diabetes is becoming increasingly prevalent and undertreated in elderly people. Diabetes mellitus as a long-standing illness has been associated with limitations in activities of daily living among elderly people (Ayis, Gooberman-Hill, Ebrahim, MRC Health Services Research Collaboration, 2003; Parmet, 2004).
In older adults, diabetes has been associated with a two- to threefold increased risk of developing physical disability (Gregg, Beckles, Williamson, Leveille, Langlois, Engelgau, & Narayan, 2000; Gregg, Mangione, Cauley, Thompson, Schwartz, Ensrud, & Nevitt, 2002; Ryerson, Tierney, Thompson, Engelgau, Wang, Gregg, & Geiss, 2003; Von Korff, Katon, Lin, Simon, Ciechanowski, Ludman, Oliver, Rutter, & Young, 2005). The Health, Aging, and Body Composition (Health ABC) study has reported the association of diabetes with sub clinical functional limitation (De Rekeneire, Resnick, Schwartz, Shorr, Kuller, Simonsick, Vellas, & Harris, 2003). However, one of the most crucial factors determining functional capacity is mobility. As the musculoskeletal system deteriorates with increasing chronic conditions frequently combined with diabetes, such as coronary heart disease, peripheral artery disease, visual impairment, and depression, partially explained the association, but still 40% of excess risk for physical disability remained unexplained (Ciechanowski, Russo, Katon, Von Korff, Ludman, Lin, Simon, & Bush, 2004; Tanaka1 & Seals, 2003).
Low muscle strength, but not muscle mass, is associated with poor physical function in older men and women (Visser, Deeg, Lips, Harris, Bouter, 2000; Visser, Newman, Nevitt, Kritchevsky, Stamm, Goodpaster, & Harris, 2000. Muscle strength measured in midlife or old age is highly predictive of functional limitations and disability up to 25 years later (Rantanen, Guralnik, Foley, Masaki, Leveille, Curb, & White, 1999; Rantanen, Avlund, Suominen, Schroll, Frandin, & Pertti, 2002; Visser, Goodpaster, Kritchevsky, Newman, Nevitt, Rubin, Simonsick, & Harris, 2005). In the present study, diabetes is associated with lower skeletal muscle strength and quality. These characteristics may contribute to the development of physical disability in older adults with diabetes. The Health ABC Study evaluated hand grip and knee extensor strength and muscle quality in community-dwelling older adults with and without diabetes in. Older adults with diabetes had greater arm and leg muscle mass than those without diabetes because they were bigger in body size (Newman, Haggerty, Goodpaster, Harris, Kritchevsky, Nevitt, Miles, & Visser, 2003). Despite this, muscle strength was lower in men with diabetes and not higher in women with diabetes than corresponding counterparts. Muscle quality, defined as muscle strength per unit regional muscle mass, was significantly lower in men and women with diabetes than those without diabetes in both upper and lower extremities. Furthermore, longer duration of diabetes (>6 years) and poor glycemic control (HbA1c >8.0%) were associated with even poorer muscle quality (Park, Goodpaster, Strotmeyer, de Rekeneire, Harris, Schwartz, Tylavsky, & Newman, 2006).
Low muscle strength is one of the most significant changes that adversely affect the ability of older people to cope independently in their communities and to have contacts with other people. Impaired mobility also greatly increases the need for different kinds of services. Interventions at early stages to reduce dysfunctional capacity may preserve function in community-dwelling older adults with diabetes in (Figaro, Kritchevsky, Resnick, Shorr, Butler, Shintani, Penninx, Simonsick, Goodpaster, Newman, Schwartz, & Harris, 2006). Improved strength has been associated with improved muscle and bone mass, balance, and also mobility (Rhodes, Martin, Taunton, Donnelly, Warren, & Elliot, 2000). All of these factors are important in the prevention of fractures and improved quality of life. Studies have also demonstrated that exercise can delay the normal decline in physical performance associated with diabetes (Sriwijitkamol, Christ-Roberts, Berria, Eagan, Pratipanawatr , DeFronzo, Mandarino, & Musi1, 2006). A typical exercise program includes activities aimed at increasing musculoskeletal flexibility, strength, and quality. Exercise training also has favorable effects on the controlled blood sugar, the regulation of blood pressure, and the prevention of excessive weight gain (Fairey, Courneya, Field, Bell, Jones, & Mackey, 2003; Ciechanowski, Russo, Katon, Von Korff, Ludman, Lin, Simon, & Bush, 2004; Booth, Gordon, Carlson, & Hamilton, 2000).
Purpose of the paper
The purpose of this paper is to explain a promoting functional capacity through increasing muscle strength and quality in older adults with type-2 diabetes.
Objectives of the paper
The objectives of this paper are to:
- Describes the decreasing functional capacity especially strength and quality muscle in older adults with type 2 diabetes.
- Describes a stretching exercise aimed at increasing musculoskeletal strength and quality.
- Describes the implications on promoting functional capacity through increasing muscle strength and quality in older adults with type-2 diabetes exercise program for the community health nursing practice.
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