OPTIMIZING BALANCE AND COORDINATION THROUGH INTEGRATED PHYSICAL EXERCISE IN PATIENTS FOLLOWING FRACTURE SURGERY
Abstract
Background: The high incidence of traffic accidents has led to a significant increase in fractures, particularly of the lower extremities, many of which require treatment through Open Reduction and Internal Fixation (ORIF) procedures. Post-ORIF patients commonly experience pain and fear in performing daily activities, including impaired balance and coordination. To address this condition, a structured and progressive integrated physical exercise intervention is necessary. This study aims to evaluate the impact of an integrated intervention that combines physical activity, pain management, and enhancement of fall efficacy on the functional status of patients recovering from lower extremity fracture surgery using the Open Reduction and Internal Fixation (ORIF) procedure.
Methods: The study was conducted using a pre-experimental design with a single-group pretest-posttest approach to 53 post-ORIF patients with lower extremity fractures treated in the inpatient ward of Sragen Regional General Hospital, Surakarta. Instruments used included the Barthel Index to assess functional status, the Fall Efficacy Scale, and a clinical observation sheet to evaluate physical ability. Data were analysed using the Wilcoxon test.
Results: Data showed an improvement in balance function, coordination, and overall functional status in post-ORIF patients with lower extremity fractures after receiving the integrated activity training intervention. The Wilcoxon test showed a p-value of 0.001, indicating a statistically significant effect.
Conclusion: The study demonstrates that an integrated physical exercise program combined with pain management and fall efficacy enhancement has a significant impact on improving balance, coordination, and functional status in patients recovering from fractures.
References
Abedi, A., Malmirian, M., & Khan, S. S. (2025). Cross-Modal Video to Body-Joints Augmentation for Rehabilitation Exercise Quality Assessment. Communications in Computer and Information Science, 2136 CCIS, 320–327. https://doi.org/10.1007/978-3-031-74640-6_24
Agusrianto, & Rantesigi, N. (2020). Penerapan Latihan Range of Motion (ROM) Pasif terhadap Peningkatan Kekuatan Otot Ekstremitas pada Pasien dengan Kasus Stroke Application of Passive Range of Motion (ROM) Exercises to Increase the Strength of the Limb Muscles in Patients with Stroke Cases. Jurnal Ilmiah Kesehatan (JIKA), 2(2), 61–66.
Asplin, G., Carlsson, G., Zidén, L., & Kjellby-Wendt, G. (2017). Early coordinated rehabilitation in acute phase after hip fracture - A model for increased patient participation. BMC Geriatrics, 17(1), 1–12. https://doi.org/10.1186/s12877-017-0640-z
Bolovan, A. D., Onofrei, R. R., Hogea, G. B., Abu-Awwad, A., Lazarescu, E. A., Abu-Awwad, S. A., Tapardea, A. R., Suba, M. I., & Amaricai, E. C. (2023). Comparison between Exercise Program–Foot Orthoses Treatment and Exercise Program Alone after Pilon Fracture Surgery: Study Protocol for a Randomized Controlled Trial. Life, 13(11), 1–14. https://doi.org/10.3390/life13112187
Chevalley, T., & Rizzoli, R. (2022). Acquisition of peak bone mass. Best Practice and Research: Clinical Endocrinology and Metabolism, 36(2), 1–15. https://doi.org/10.1016/j.beem.2022.101616
Ersoy, T., Kaya, P., Hocaoglu, E., & Unal, R. (2024). I-BaR: integrated balance rehabilitation framework. Frontiers in Neurorobotics, 18, 1–37. https://doi.org/10.3389/fnbot.2024.1401931
Faidah, N., Kuswardhani, T., & Artawan E.P, I. W. G. (2020). Pengaruh Latihan Keseimbangan Terhadap Keseimbangan Tubuh Dan Risiko Jatuh Lansia. Jurnal Kesehatan, 11(2), 100. https://doi.org/10.35730/jk.v11i2.428
Fauziah, E., Zulfah, K., & Oktaviani, Y. E. (2021). Penatalaksanaan Fisioterapi untuk Meningkatkan Keseimbangan Dinamis Lansia dengan Teknik Core Stability Exercise dan Tandem Walking Exercise. FISIO MU: Physiotherapy Evidences, 3(1), 16–22. https://doi.org/10.23917/fisiomu.v3i1.14126
Fujikawa, T., Takahashi, S., Shinohara, N., Mashima, N., Koda, M., Takahashi, H., Yasunaga, Y., Sankai, Y., Yamazaki, M., & Miura, K. (2022). Early Postoperative Rehabilitation Using the Hybrid Assistive Limb (HAL) Lumbar Type in Patients With Hip Fracture: A Pilot Study. Cureus, 14(2). https://doi.org/10.7759/cureus.22484
Gao, Y., Zhong, F., Zhan, X., Bao, Y., & Zhu, X. (2024). Postoperative rehabilitation exercise experiences of geriatric patients with femoral neck fractures based on the perspective of medical staff: a qualitative study. BMC Geriatrics, 24(1). https://doi.org/10.1186/s12877-024-05266-w
Howell, D. F., Malmgren Fänge, A., Rogmark, C., & Ekvall Hansson, E. (2023). Rehabilitation Outcomes Following Hip Fracture of Home-Based Exercise Interventions Using a Wearable Device—A Randomized Controlled Pilot and Feasibility Study. International Journal of Environmental Research and Public Health, 20(4). https://doi.org/10.3390/ijerph20043107
Huang, M. Z., Rogers, M. W., Pizac, D., Gruber-Baldini, A. L., Orwig, D., Hochberg, M. C., Beamer, B. A., Creath, R. A., Savin, D. N., Conroy, V. M., Mangione, K. K., Craik, R., Zhang, L. Q., & Magaziner, J. (2023). Effect of Multicomponent Home-Based Training on Gait and Muscle Strength in Older Adults After Hip Fracture Surgery: A Single Site Randomized Trial. Archives of Physical Medicine and Rehabilitation, 104(2), 169–178. https://doi.org/10.1016/j.apmr.2022.08.974
Li, X., Chen, W., Chen, Q., Li, F., Chen, C., Li, P., Li, F., Guo, S., Chen, P., Yuan, W., Liu, D., Wang, S., & Hu, Z. (2023). Effects of resistance and balance exercises for athletic ability and quality of life in people with osteoporotic vertebral fracture: Systematic review and meta-analysis of randomized control trials. Frontiers in Medicine, 10(March). https://doi.org/10.3389/fmed.2023.1135063
Pratiwi. (2023). Program Fisioterapi Pada Kondisi Pasca Operasi Fraktur Radius Ulna : Case Report. Journal of Physiotherapy, 2(April), 216–223.
Sornette, P.-E., & Sornette, D. (2025). Harnessing the “Reactive Falling Effect” for rehabilitation and performance boosting. http://arxiv.org/abs/2506.13959
Soukkio, P. K., Suikkanen, S. A., Kukkonen-Harjula, K. T., Kautiainen, H., Hupli, M. T., Aartolahti, E. M., Kääriä, S. M., Pitkälä, K. H., & Sipilä, S. (2022). Effects of a 12-month home-based exercise program on functioning after hip fracture – Secondary analyses of an RCT. Journal of the American Geriatrics Society, 70(9), 2561–2570. https://doi.org/10.1111/jgs.17824
Syafitri, P. K., Hayuningrum, C. F., Apriliani, T., & Utomo, D. H. (2025). Penatalaksanaan fisioterapi pada kasus Post ORIF Fraktur1/3 Proximal Tibia Dextra dengan menggunakan terapi latihan di RS Hermina Daan Mogot. Indonesian Journal of Health Science, 5(1), 101–109. https://doi.org/10.54957/ijhs.v5i1.1342
Widiastuti, A., Rahmasari, I., Budiati, D., Ermawati Ulkhasanah, M., & Yuli Kartikasari, A. (2023). the Effect of Early Mobilization Exercise on the Level of Independence on Patients After Post Operative Fracture Femur. Proceeding of International Conference on Science, Health, And Technology, 309–315. https://doi.org/10.47701/icohetech.v4i1.3408
Wu, J. Q., Mao, L. B., & Wu, J. (2019). Efficacy of balance training for hip fracture patients: A meta-analysis of randomized controlled trials. Journal of Orthopaedic Surgery and Research, 14(1), 1–11. https://doi.org/10.1186/s13018-019-1125-x
Yu, M., Zhou, P., Che, Y., & Luo, Y. (2025). The efficacy of exercise prescription in patients with osteoporotic fractures: a systematic review and meta-analysis. Journal of Orthopaedic Surgery and Research, 20(1), 250. https://doi.org/10.1186/s13018-025-05636-z
Copyright (c) 2025 Jurnal Kesehatan Kusuma Husada
This work is licensed under a Creative Commons Attribution 4.0 International License.
The copyright of the published articles belongs to Jurnal Kesehatan Kusuma Husada.
This work is licensed under a Creative Commons Attribution 4.0 International License.
