THE RELATIONSHIP OF AGE, BODY MASS INDEX (BMI),AND FREQUENCY OF REPETITIVE MOVEMENTS WITH THE INCIDENT OF CARPAL TUNNEL SYNDROME (CTS)IN WOMEN WITH THE HABIT OF WASHING CLOTHES BY HAND IN MUARA UNTU VILLAGE, MURUNG RAYA DISTRICT, CENTRAL KALIMANTAN PROVIN
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ISSN: 2597-8012 JURNAL MEDIKA UDAYANA, VOL. 13 NO.01, JANUARI, 2024
Received: 2023-11-30Revision: 2023-12-10 Accepted: 25-12-2023
THE RELATIONSHIP OF AGE, BODY MASS INDEX (BMI), AND FREQUENCY OF REPETITIVE MOVEMENTS WITH THE INCIDENT OF CARPAL TUNNEL SYNDROME (CTS) IN WOMEN WITH THE HABIT OF WASHING CLOTHES BY HAND IN MUARA UNTU VILLAGE, MURUNG RAYA DISTRICT, CENTRAL KALIMANTAN PROVINCE
Noor Reza Indah Lestari1, Sintha Nugrahini2, Dian Mutiasari3, Abi Bakring Balyas4, Nisa Kartika Komara5
1Medical Education Study Program, Faculty of Medicine, Palangka Raya University, Palangka Raya
2Department of Anatomy and Histology, Faculty of Medicine, Palangka Raya University, Palangka Raya 3Department of Community Health Sciences, Faculty of Medicine, Palangka Raya University, Palangka Raya 4,5Department of Physiology, Faculty of Medicine, Palangka Raya University, Palangka Raya e-mail: nrrezaindah13@gmail.com
ABSTRAK
Sebagian besar wanita di Desa Muara Untu masih mencuci pakaian menggunakan tangan hampir setiap hari. Kecepatan tangan, posisi tangan yang ekstrim, gerakan berulang dengan tekanan dalam waktu yang lama dan genggaman pada saat mengucek pakaian yang menggunakan kekuatan adalah salah satu faktor resiko terjadinya Carpal Tunnel Syndrome. Penelitian ini bertujuan untuk mengetahui hubungan usia, Body Mass Index, dan frekuensi gerakan repetitif dengan kejadian Carpal Tunnel Syndrome pada wanita yang mencuci pakaian menggunakan tangan di Desa Muara Untu Kabupaten Murung Raya Provinsi Kalimantan Tengah. Penelitian ini merupakan studi korelasi yang menggunakan desain Cross Sectional. Instrumen dalam penelitian ini adalah kuesioner Boston-Carpal Tunnel Questionare (BCTQ) dan kuesioner pemeriksaan fisik Phalen’s test. Berdasarkan analisis bivariat ditemukan bahwa hubungan usia dengan Carpal Tunnel Syndrom menghasilkan koefisien korelasi 0,318 dengan probabilitas 0,001, hubungan Body Mass Index dengan kejadian Carpal Tunnel Syndrome menghasilkan koefisien korelasi 0,111 dengan probabilitas 0,210, dan hubungan frekuensi gerakan repetitif dengan kejadian Carpal Tunnel Syndrome menghasilkan koefisien korelasi 0,077 dengan probabilitas 0,385. Kesimpulannya adalah terdapat hubungan yang signifikan antara usia dengan kejadian Carpal Tunnel Syndrome dan tidak terdapat hubungan yang signifikan antara Body Mass Index dan frekuensi gerakan repetitif dengan kejadian Carpal Tunnel Syndrome.
Kata kunci : Carpal Tunnel Syndrome., Usia., Body Mass Index., Gerakan Repetitif.
ABSTRACT
Most women in Muara Untu Village still wash clothes by hand almost every day. Hand speed, extreme hand positions, repetitive movements with pressure for a long time and grip when rubbing clothes using force are one of the risk factors for Carpal Tunnel Syndrome. This study aims to determine the relationship between age, Body Mass Index, and frequency of repetitive movements with the incidence of Carpal Tunnel Syndrome in women who wash clothes by hand in Muara Untu Village, Murung Raya Regency, Central Kalimantan Province. This research is a correlation study using a cross sectional design. The instruments in this study were the Boston-Carpal Tunnel Questionnaire (BCTQ) and the Phalen's test physical examination questionnaire. Based on bivariate analysis, it was found that the relationship between age and Carpal Tunnel Syndrome produced a correlation coefficient of 0.318 with a probability of 0.001, the relationship between Body Mass Index and the incidence of Carpal Tunnel Syndrome produced a correlation coefficient of 0.111 with a probability of 0.210, and the relationship between the frequency of repetitive movements and the incidence of Carpal Tunnel Syndrome produced a correlation coefficient of 0.077 with a probability of 0.385. The conclusion is that there is a significant relationship between age and the incidence of Carpal Tunnel Syndrome and there is an insignificant relationship between Body Mass Index and frequency of repetitive movements and the incidence of Carpal Tunnel Syndrome.
Keywords : Carpal Tunnel Syndrome., Age, Body Mass Index., Repetitive Movements.
INTRODUCTION
Indonesia is a maritime country and the largest archipelagic country in the world, so of course activities carried out at sea and in rivers have become part of people's daily lives. If we explore further, many villages in Indonesia are built along rivers. Kalimantan Island itself has 63 rivers covering 73% of the total island. The longest rivers in Indonesia are also found on Kalimantan Island, namely the Kapuas River, Mahakam River and Barito River. Muara Untu Village is a village located in Murung District, Murung Raya Regency, Central Kalimantan Province. Muara Untu Village is one of the villages built along the river, namely the Barito River. Most women in this village still wash clothes by hand almost every day, both morning and evening. Hand speed, extreme hand positions, repetitive movements with pressure for a long time and grip when rubbing clothes using force are one of the risk factors for Carpal Tunnel Syndrome. Carpal Tunnel Syndrome is a condition where pressure occurs when the median nerve passes through the carpal tunnel in the wrist. Pressure on the median nerve causes motor and sensory disorders in the hand and finger area. Motor disorders that can occur include weakening of the muscles at the base of the thumb, resulting in loss of grip strength and hand skills. Sensory disorders that occur include tingling and decreased touch sensitivity on the sides of fingers I, II, III and IV. Carpal Tunnel Syndrome can occur in all circles, both among the general public and among workers. According to the National Health Interview Study (NHIS), the prevalence of Carpal Tunnel Syndrome is 1.55%, this is what makes it one of the three most common groups of Cumulative Trauma Disorder (CTD) in the upper limbs. According to the International Labor Organization (ILO), it shows that in every case of occupational disease, Carpal Tunnel Syndrome is almost always found in several countries. In 2010 the number of cases of Carpal Tunnel Syndrome due to work increased by around 30% compared to 2001. The prevalence of Carpal Tunnel Syndrome due to work in Indonesia is still unknown because not much research has been conducted on this topic in Indonesia. However, studies showing high risk wrist and hand occupations report a prevalence of Carpal Tunnel Syndrome ranging from 5.6% to 15%.
Carpal Tunnel Syndrome occurs more often in women than men with an age range of 25-64 years. The highest age for this syndrome to occur is >55 years, with the most susceptible age being 40-60 years. Women who do not have symptoms of Carpal Tunnel Syndrome at a vulnerable age are less likely to have symptoms of this syndrome at an older age. The prevalence of this syndrome among the general population is 5% of women and 0.6% of men. A study shows that Carpal Tunnel Syndrome is closely related to a person's Body Mass Index, which is said to mean that Carpal Tunnel Syndrome, which is caused by compression of the median nerve under the transverse carpal ligament, is related to an increase in a person's weight. This research also shows that someone with an abnormal Body Mass Index is at greater risk of experiencing symptoms of Carpal Tunnel Syndrome than someone with a normal Body Mass Index with a ratio of 5:1. Repetitive movement frequency is a risk factor
for Carpal Tunnel Syndrome. Repetitive movements or repeated movements carried out for a long period of time without rest can cause fatigue and tension in the muscle tendons, this reduces blood flow in the peripheral blood vessels and reduces the function of the blood vessels in the wrist, causing symptoms of Carpal Tunnel Syndrome.
This study aims to determine the relationship between age, Body Mass Index, and frequency of repetitive movements with the incidence of Carpal Tunnel Syndrome in women who wash clothes by hand in Muara Untu Village, Murung Raya Regency, Central Kalimantan Province.
MATERIALS AND METHODS
The research was conducted in Muara Untu Village, Murung Raya Regency, Central Kalimantan Province in June-July 2023 using an observational method with a quantitative approach and a Cross Sectional design, namely looking at the relationship between age, Body Mass Index, and frequency of repetitive movements with the incidence of Carpal Tunnel Syndrome. The population of this study were all women with the habit of washing clothes by hand in Muara Untu Village, Murung Raya Regency, Central Kalimantan. The sample for this study was all women with the habit of washing clothes by hand who had symptoms of Carpal Tunnel Syndrome during the Phalen's test in Muara Untu Village, Murung Raya Regency, Central Kalimantan. The sample was taken using the Purposive Sampling Technique and calculated using the Slovin formula which makes the total sample in the study This numbered 130 people. The independent variables in this study were age, Body Mass Index, and frequency of repetitive movements. Meanwhile, the dependent variable is Carpal Tunnel Syndrome.
The materials and tools in this research are Body Mass Index measuring instruments (microtoise, bathroom scale, and calculator), and a stopwatch. Meanwhile, the research instruments used in this study were questionnaires (respondent characteristics questionnaire and the Boston-Carpal Tunnel Questionnaire (BCTQ)), and the Phalen's test physical examination questionnaire.
Respondents will be asked to sign Informed Consent after listening to the explanation, then respondents will carry out a physical examination of the Phalen's test for a maximum of 1 minute. Respondents who had symptoms of Carpal Tunnel Syndrome then filled out a respondent characteristics questionnaire, took Body Mass Index measurements, filled out the Boston-Carpal Tunnel Questionnaire (BCTQ), and finally measured the frequency of repetitive movements. Data analysis was carried out using a computer and the SPSS for Windows version 26 application, after which the researcher carried out hypothesis testing and independence testing using the Spearman Rank test.
This research was approved by the Research Ethics Committee of the Faculty of Medicine, Palangka Raya University No. 77/UN24.9/LL/2023
|
RESULTS Table 1 Analisis Deskriptif Variabel Usia | ||
|
Age |
Frequency |
Percentage |
|
Late teens |
21 |
16,2% |
|
Early adulthood |
23 |
17,7% |
|
Late adulthood |
45 |
34,6% |
|
Early seniors |
24 |
18,5% |
|
Late seniors |
17 |
13,1% |
|
Total |
130 |
100,0% |
Table 1 is a descriptive analysis of the age variable based on filling out the respondent characteristics questionnaire for the age variable. Based on the results from table 1, it can be said that the majority of women with the habit of washing clothes by hand in Muara Untu Village, Murung Raya Regency, Central Kalimantan who were involved in this research were of late adulthood.
|
Table 2 Descriptive Analysis of Body Mass Index Variables | ||
|
BMI |
Frequency |
Percentage |
|
Heavy skinny |
4 |
3,1% |
|
Light skinny |
5 |
3,8% |
|
Normal |
54 |
41,5% |
|
Light grease |
18 |
13,8% |
|
Heavy fat |
49 |
37,7% |
|
Total |
130 |
100,0% |
Table 2 analysis is a descriptive of the Body Mass Index variable based on filling out the questionnaire on the characteristics of Body Mass Index respondents. Based on table 2, it can be said that the majority of women with the habit of washing clothes by hand in Muara Untu Village, Murung Raya Regency, Central Kalimantan who were involved in this research had a Body Mass Index in the normal category.
|
Table 3 Descriptive Analysis Movements |
of Frequency |
of Repetitive |
|
Movement Frequency Frequency Repetitive |
Percentage | |
|
30 – 60 times/minute |
2 |
1,5% |
|
61 – 100 times/minute |
37 |
28,5% |
|
101 – 130 times/minute |
58 |
44,6% |
|
> 131 times/minute |
33 |
25,4% |
|
Total |
130 |
100,0% |
Table 3 is a descriptive analysis of the variable frequency of repetitive movements based on filling out the questionnaire on the characteristics of respondents for the variable frequency of repetitive movements. Based on table 3, it can be said that the majority of women with the habit of
washing clothes using their hands in Muara Untu Village, Murung Raya Regency, Central Kalimantan who were involved in this research carried out repetitive movement frequencies of 101 – 130 times/minute.
|
Table 4 Descriptive Analysis of Carpal Tunnel Syndrome | ||
|
CTS |
Frequency |
Percentage |
|
Normal |
5 |
3,8% |
|
Light |
58 |
44,6% |
|
Currently |
45 |
34,6% |
|
Heavy |
14 |
10,8% |
|
Very Heavy |
8 |
6,2% |
|
Total |
130 |
100,0% |
Table 4 is a descriptive analysis of the variable incidence of Carpal Tunnel Syndrome based on filling in the Boston Carpal Tunnel Questionnaire (BCTQ). Based on table 4, it can be said that most women with the habit of washing clothes by hand in Muara Untu Village, Murung Raya Regency, Central Kalimantan who were involved in this research experienced symptoms of Carpal Tunnel Syndrome in the light category.
|
Table 5 Analysis of the Relationship between Age, Body Mass Index, and Frequency of Repetitive Movements and the Incidence of Carpal Tunnel Syndrome | ||
|
Variable Relationships |
ρ |
Correlation Coefficient |
|
Age with CTS |
0,001 |
0,318 |
|
BMI with CTS |
0,210 |
0,111 |
|
FGR with CTS |
0,385 |
0,077 |
Table 5 is an analysis of the relationship between age, Body Mass Index, and frequency of repetitive movements and the incidence of Carpal Tunnel Syndrome. Based on probability <alpha (5%), it can be stated that there is a significant relationship between age and the incidence of Carpal Tunnel Syndrome with a weak level of closeness and there is no significant relationship between Body Mass Index and frequency of repetitive movements and the incidence of Carpal Tunnel Syndrome with a level of very weak relationship
This study shows that there is a significant relationship between age and the incidence of Carpal Tunnel Syndrome with a weak level of relationship. This means that increasing age is followed by an increase in Carpal Tunnel Syndrome, conversely, decreasing age is followed by a decrease in Carpal Tunnel
Syndrome. This is because starting from the age of 30 years, degeneration occurs such as tissue damage, tissue changes to scar tissue, fluid loss, bones and muscles become less stable, thereby increasing the risk factors for Carpal Tunnel Syndrome. Research by Richard says that the older a person is, the higher the risk of experiencing Carpal Tunnel Syndrome. The average age for this syndrome to occur is 25-64 years, with the most susceptible age being 40-60 years. This is because age directly affects a person's physical capacity starting from the age of 25 years, which is proven by the age of 50 to 60 years, muscle strength decreases by 25% and sensory and motor abilities decrease by 60%. Research by Dede et al. and Moutasem said that Carpal Tunnel Syndrome can also occur because starting from the age of 30 there is an increase in lysyl oxidase activity which results in thickening and stiffness of the collagen fibers so that the elasticity of the flexor retinaculum decreases and makes it unable to withstand changes in the pressure it receives.
This research shows that there is no significant relationship between Body Mass Index and the incidence of Carpal Tunnel Syndrome with a very weak level of relationship. The results of this study are inversely proportional to research by Fanny et al. which states that there is a significant relationship between Body Mass Index and the incidence of Carpal Tunnel Syndrome with a significance value of <0.05, this is caused by excessive Body Mass Index causing a buildup of fluid so that the contents of the carpal tunnel increase which then increases the risk factor for Carpal Tunnel Syndrome. Other research was conducted by Faisal et al. stated that there is a significant relationship between Body Mass Index and the incidence of Carpal Tunnel Syndrome with a significance value of 0.018, this is because an abnormal Body Mass Index is a risk factor for the occurrence of Carpal Tunnel Syndrome in the general population. Based on research conducted by Nadhifah et al. said that the more a person's weight increases, the more pressure the median nerve under the transverse carpal ligament will have, thereby increasing the risk factor for Carpal Tunnel Syndrome so that obese people have a 50% higher risk of developing Carpal Tunnel Syndrome than thin people.
This study shows that there is no significant relationship between the frequency of repetitive movements and the incidence of Carpal Tunnel Syndrome with a very weak level of relationship. The results of this research are inversely proportional to research by Ahmad which was conducted on stone crushing workers who worked for 7-8 hours/day, stating that there was a significant relationship between the frequency of repetitive movements and the incidence of Carpal Tunnel Syndrome with a significance value of 0.001 and a correlation the strong one. Subsequent research conducted by Indriani on workers in the crab production section who worked for 8-10 hours/day also stated that there were 80.6% of respondents who were at risk of experiencing Carpal Tunnel Syndrome. Subsequent research also conducted by Cindy on repair veneer workers who worked for 10-12 hours/day stated that there was a relationship between the frequency of repetitive movements and the incidence of Carpal Tunnel Syndrome with the probability that the frequency of repetitive movements on the right hand was 0.003 and on the left hand was 0.005. Based on the results of research conducted by Ahmad, Indriani, and Cindy, it appears that there is a strong relationship between the duration of a person's repetitive movements and the http://ojs.unud.ac.id/index.php/eum doi:10.24843.MU.2024.V13.i01.P18
incidence of Carpal Tunnel Syndrome, this is the reason why in research conducted in Muara Untu Village, Murung Raya Regency, Central Kalimantan Province did not show a significant relationship because the frequency of repetitive movements carried out by women washing clothes by hand in Muara Untu Village, Murung Raya Regency, Central Kalimantan Province was less than 1 hour/day. Research by Richard and Moore states that the frequency of repetitive movements is a risk factor for Carpal Tunnel Syndrome. It is also said that the higher the frequency of repetitive movements in the hands, the higher the risk of Carpal Tunnel Syndrome. Direct pressure on soft muscle tissue also increases the risk of Carpal Tunnel Syndrome.
This research entirely used the researcher's own funds and no research conflicts were found in this research.
The conclusion of this study is that there is a significant relationship between age and the incidence of Carpal Tunnel Syndrome with a weak level of relationship and there is no significant relationship between Body Mass Index and frequency of repetitive movements and the incidence of Carpal Tunnel Syndrome with a very weak level of relationship.
Suggestions for future researchers are to add certain criteria related to Body Mass Index classification and duration of repetitive movement frequency in the inclusion criteria.
REFERENCE
-
1. Kementerian Pekerjaan Umum dan Perumahan Rakyat. Wilayah Sungai Dalam Satu Kabupaten/Kota. 2020
-
2. Kalra S, Bhatnagar B. Prevalence of Musculoskeletal Disorder among Housewives. International Research Journal of Engineering and Technology.2017;4(5):566–8.
-
3. Rada NS. Proporsi dan Faktor Risiko Kejadian Carpal Tunnel Syndrome (CTS) pada Pekerja Buruh Cuci. Jurnal Repository Universitas Muhammadiyah Palembang. 2016;1(1):9–34.
-
4. Setyawan H. Risk factors of carpal tunnel syndrome among food-packing workers in Karanganyar. Jurnal Kesehatan Masyarakat. 2017;11(3):123–6.
-
5. Ahmad IL. Determinan gejala Carpal Tunnel Syndrome (CTS) pada Pekerja Pemecah Batu. Jurnal Repository Universitas Jember. 2016;1(1):8–45.
-
6. Nadhifah J., Hartanti RI., Indrayani R. Keluhan Carpal Tunnel Syndrome pada Pekerja Sortasi Daun Tembakau. Jurnal Kesehatan. 2018;6(1):18–26.
-
7. Rizky TU., Bina K., Ida W. Literature Review: Faktor Risiko Kejadian Carpal Tunnel Syndrome (CTS) pada Pekerja. Jurnal Kesehatan Masyarakat. 2020;8(5):601–8.
-
8. Selviyati V., Camelia A., Sunarsih E. Analisis Determinan Kejadian Carpal Tunnel Syndrome (CTS) pada Petani Penyadap Pohon Karet. Jurnal Ilmu Kesehatan Masyarakat. 2016 Nov 3;7(3):198–208.
-
9. Dede SAK, Subhan ZA. Hubungan Antara Usia, Durasi Kerja dan Gerakan Repetitif Menekan Nozzle dengan Keluhan Subyektif Carpal Tunnel Syndrome (CTS) Pada
THE RELATIONSHIP OF AGE, BODY MASS INDEX (BMI), AND FREQUENCY OF REPETITIVE MOVEMENTS WITH THE INCIDENT OF CARPAL TUNNEL SYNDROME (CTS) IN WOMEN…
Petugas Operator Pengisi BBM. Jurnal Repository Universitas Ahmad Dahlan. 2019;1(1).
-
10. Fanny SF., Aisyah AK. Faktor-faktor yang Mempengaruhi Timbulnya Carpal Tunnel Syndrome pada Pengendara Ojek. Jurnal Manajemen Kesehatan yayasan RS Dr Soetomo . 2018 Oct;4(2):123–33.
-
11. Faisal AA., Mashael A., Fadwa A., Alanoud A., Bassam A., Emad M., et al. Prevalence of carpal tunnel syndrome symptoms among dentists working in Riyadh. Ann Saudi Med. 2019 Mar;39(2):104–11.
-
12. Indriani L. Gambaran Faktor Risiko Kejadian Carpal Tunnel Syndrome pada Pekerja Wanita Pengupas Kepiting. Jurnal Repository UIN Alauddin Makassar. 2017;1(1):16–40.
-
13. Cindy IS. Karakteristik Individu dan Faktor Pekerjaan dengan Keainan CTS Pekerja Bagian Repair Veneer. Jurnal Repositor Universitas Jember. 2019;1(1):7–42.
http://ojs.unud.ac.id/index.php/eum
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