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Atikah Rahayu - 2070826100
Atikah Rahayu - 2070826100
Atikah Rahayu - 2070826100
Oleh:
ATIKAH RAHAYU
NIM 20708261007
Atikah Rahayu
Correspondence:
Atikah Rahayu
Student of study program doctoral of sports science, Faculty of Sports Sciences,
Universitas Negeri Yogyakarta, Indonesia
Jl.Colombo Yogyakarta 55281, Indonesia
Tel/Fax: +62-81225331538
E-mail: atikahrahayu.2020@student.uny.ac.id
Abstract
Density of bone mass can be changed by physical activity, due to the formation of enzymes
in bone, resulting in enlargement/compaction of bones (hypertrophy). For new bone
formation to occur, continuous design is needed on the bone through muscle training. Low
bone mass density illustrates low bone quality. The study design used cross sectional design.
The subjects of the study were all teenagers in junior high schools selected along the
Martapura riverbank, Banjar Regency, South Borneo. Sampling by measuring physical
activity, level of knowledge, and protein intake as well as family characteristics such as
mother and father education, family income, and number of family members. The research
instrument used quantitative ultrasound bone densitometry to measure bone mass density,
Baecke questionnaire to measure physical activity, 24-hour food recall form to measure
protein intake and structured questionnaire to determine the characteristics of respondents
and families. The results showed a relationship between low bone mass density and physical
activity p=0,001, with Exp (B) =12,981. It can be concluded that less active physical activity
is at risk of causing low bone mass density.
Introduction
Low bone mass density is a description of the state of bone with low quality can be
identified after a period of perfect development. An early sign of low bone mass density is
low is osteopenia, while further osteoporosis. Osteoporosis is bone loss, especially in the
spine, upper arm and pelvis. The symtomatic of osteoporosis are difficult to detect, most are
only realized when there has been a swelling of the spine, cracks or broken bones, pinched
nerves. Some risks of osteopenia and osteoporosis are lack of protein intake in physical
activity. Lack of consumption of fish-sourced protein in adolescents will be related to bone
mass density, this is because teenagers often limit their consumption of food, and their
consumption patterns often violates the rules of nutrition (1).
These results are supported from the results of previous studies that the majority of
adolescents with low protein intake causes low bone mass density, which is 53,7%. When a
person reaches the peak of growth, the body's protein needs become stable. Protein in
adolescence is relatively high, because muscular, skeletal/skeletal acceleration and endocrine
development are greater than childhood and adulthood (2,3).
Bone mass density can be altered by physical activity. This occurs because physical
activity causes the formation of enzymes in bone, so enlargement/compaction of bones
(hypertrophy). For new bone formation to occur, continuous design is needed on the bone
through muscle training. Based on national data and data in South Kalimantan aged ≥10 years
included in the category of lack of physical activity. The less category is defined as
cumulative physical activity less than 150 minutes a week. The amount of age that lacks
physical activity is 33,5% (4). It is important to keep physical activity active so that bone
mass density is maintained (5,6).
Ethics Approval
This study was approved by the Ethics Committee faculty of Medical (ethic code 4/56).
Statistical Analysis
The data obtained were analyzed using univariate, bivariate, and multivariate. The results
of the univariate analysis are presented in the form of a frequency distribution table
(percentage) to find out the distribution of low bone mass density risk, bivariate analysis
using Chi-Square if not met followed by using the Fisher's Exact Test to find out the
relationship between risk factors and bone mass density and multivariate analysis using
logistic regression to find out the most dominant risk factor associated with low bone mass
density in adolescents.
.
Results
Univariate Analysis
Table 1 shows the distribution of variables according to categories that are likely related
to low bone mass density of respondents.
Table 1. Frequency distribution of respondent and family characteristics
Bone mass density categories Frequency (people) Percentage (%)
a. Low Bone mass
65 79,3
density/osteopenia/osteoporosis
b. Normal 17 20,7
Physical activity
a. Less active 51 62,2
b. Active 31 37,8
Father's Education Level
a. Not graduated from Junior High
62 74,6
School
b. High school - college 20 24,4
Mother's Education Level
a. Not graduated from Junior High
61 74,4
School
b. High school - college 21 25,6
Level of Family Income
a. < employee minimum wage 62 75,6
b. ≥ employee minimum wage 20 24,4
Number of Family Members
a. ≥ 5 people 54 65,9
b. < 5 people 28 34,1
Knowledge Level
a. Low 20 24,4
b. Good 62 75,6
Protein Intake
a. Inadequate 52 63,4
b. Adequate 30 35,6
Employment status of head of household
a. Does not work 10 12,2
b. Work 72 87,8
Source: Primary Data, 2019
Table 1 shows that the majority of respondents had osteopenia, 65 people (79,3%). Some
other potential variables have a relationship with the incidence of osteopenia in respondents,
namely physical activity, father's education level, mother's education level, family income,
number of family members, protein intake, level of knowledge, work status of parents. Table
1 shows that adolescents who have less active physical activity categories are more numerous
than adolescents with active physical activity that is equal to 51 people (62,2%), fathers and
mothers who have not completed primary education until junior high school are greater in
number each a total of 61 people (74,6%) and 62 people (74,4%). With the level of education
of parents low category resulted in incomes earned by parents/family also became inadequate
to meet the needs of family food consumption.
The results of this study indicate that the majority of family income is still below the
employee minimum wage of 60 people (75,6%). This employee minimum wage refers to the
employee minimum wage Regency of Banjar in the amount of Rp.2,248,000.00. In addition,
a factor that contributes to the incidence of osteopenia is the number of family members. The
results of this study found that the majority of respondents had a relatively large number of
family members (>5 people) namely 54 people (65,9%). It is likely that the relatively large
number of family members will affect the food distribution of family members.
The results of this study indicate that the level of knowledge of respondents still have
knowledge of less than 24,4%. It is potential that most of the protein intake is lacking due to
the low level of respondents' knowledge to meet their body's need for protein. The number of
respondents who have low protein intake is equal to 63,4%. The magnitude of the frequency
distribution between each of these variables has not been able to show the relationship
between the variable characteristics of respondents and families with low bone mass density,
so it needs bivariate analysis so that the relationship between the two variables (free and
bound) is known for their significance, in detail can be seen in Table 2.
Bivariate Analysis
Table 2. Relationship between respondent and family characteristics with Bone Mass Density
Bone Mass Density
Low Bone Mass Normal PR
Characteristics Category
Density (95% CI)
p
n % n %
Physical activity Less active 47 90,4 5 9,6 1,506 0,000*
Active 18 60,0 12 40,0 (1,110-2,044)
Father's Education Level Not graduated from 52 83,9 10 16,1 1,290 0,110
Junior High School- 13 65,0 17 35,0 (0,919-1,812)
Mother's Education Level college
52 85,2 9 14,8 3,556 0,032*
Not graduated from
Junior 13 61,9 8 38,1 (1,15-7,005)
Level of Family Income
High School- college 53 85,5 9 14,5 3,396 0, 024*
< employee minimum wage 12 60,0 8 40,0 (1,126-6,258)
Number of Family Members
> employee minimum wage 42 77,8 12 22,2 0,947 0,644
> 5 people 23 82,1 5 17,9 (0,757-1,185)
Protein intake
< 5 people 48 66,3 3 33,7 1,716 0,001*
inadequate 17 33,7 14 66,3 (1,238-2,380)
Knowledge Level
adequate 16 80,0 4 20,0 1,012 1,000
Employment status of head of Low 49 79,0 13 21,0 (0,785-1,305)
household Good 9 90,0 1 10,0 1,157 0,679
Does not work 56 77,8 16 22,2 (0,909-1,472)
Work
*p value (<0,05)
Table 2 shows that several variables show a relationship with bone mass density in
respondents. These variables are physical activity with p=0,000 and PR=1,506 (1,110-2,044),
mother's education level with p=0,032 and PR=3,556 (1,15-7,005), number of family
members with p=0,024 and PR=3,396 (1,126-6,258), protein intake with p=0,001. This
analysis uses the Che-Square test with a 95% confidence level. The results of the analysis
resulted in physical activity having the greatest relationship compared to other variables
(p=0,000).
This means that the results of this relationship test show the closeness between the
relationship of physical activity with the risk of low bone mass density in respondents. This
can be seen from Table 2 which shows that a total of 47 people (90,4%) of respondents with
less active physical activity have low bone mass density. Although the closeness of the
relationship between physical activity and bone mass density is greater, the risk of family
income that has a <employee minimum wage is greater, causing respondents to experience
low bone mass density (PR=3,556), which is 53 people (85,5%).
The close relationship between variables using bivariate analysis has not shown the risk
of dominant factors associated with low bone mass density in respondents. Further analysis is
needed in order to find out which variable is most associated with low bone mass density in
respondents, namely multivathic logistic regression analysis.
Multivariate Analysis
The statistical analysis used is multiple logistic regression analysis. Variables that are
candidates for the multivariate model are independent variables with bivariate results
resulting in ps<0,25, then these variables directly enter the multivariate stage. For
independent variables whose bivariate results produce p>0,25 but substantially important,
these variables can be included in the multivariate model. The variables included in the
multivariate model can be seen in Table 3.
Table 3. Modeling the most dominant factors related to low bone mass density
Variables B SE Wald Sig Exp (B)
Protein intake 2,272 885 6,586 0,010 9,696
Father's Education -168 1,466 1,164 0,281 0,206
Level
Mother's Education -1,582 1,716 0,010 0,922 0,845
Level
Level of Family Income -2,256 1,717 1,727 0,189 9,549
Knowledge level 1, 354 998 4,797 0,032 6, 685
Physical activity 2,257 0,747 11,708 0,001 12,981
Table 3 shows that the variable calcium intake is the most dominant risk factor associated
with low bone mass density in adolescents with p=0,001, with Exp (B)=12,981 which means
that adolescents with physical activity less active risk of 12,981 times greater experience
osteopenia and can continue to become osteoporosis compared to adolescents with active
physical activity.
Discussion
Less physical activity can be reduced bone mass density. This occurs because physical
activity causes the formation of enzymes in bone, so enlargement/compaction of bones
(hypertrophy). For new bone formation to occur, continuous design is needed on the bone
through muscle training. Exercise regularly. With a frequency of 3-5 x/week not on
consecutive days with a time of 20-60 minutes and can properly increase low bone density
and reduce the risk of osteopenia. In addition, continuous activities and heavy loads may
quickly increase bone mass density, but must be adjusted to the load because the bone mass
density is not ocollegeimal compared to regular physical exercise and the appropriate load.
Certainly, it is supported by nutritional intake. such as protein, calcium, vitamin D which
meet the body's needs. With nutritional intake that matches the body's needs, the risk of
osteoporosis in old age can be minimized (7).
This is in line with this study which found that protein intake less than RDA is associated
with bone mass density. In multivariate analysis, Exp (B) 9,696, which means that protein
intake that is less than RDA causes respondents to experience low bone mass density.
Respondents whose protein intake is less than the RDA are 9,696 times more likely to
experience low bone mass density compared to respondents whose protein intake is
sufficient. Increased nutritional needs in adolescence are related to the accelerated growth
they experience. Bone mass density increases during puberty, its peak is reached at ages
above 10 to the beginning of 20 years (8). Bone is a complex network of cells and a matrix.
The bone matrix is formed by fibers and basic substances containing mineral salts. The mass
and thickness of the bones at any time always experience the dynamics of addition and
reduction through the process of remodeling (the bone matrix is absorbed and reshaped
(9,10). The process of forming and absorbing the bone, it is necessary to try to maintain bone
mass density from an early age, so as to avoid bone mass density such as osteopenia or
osteoporosis (9,11). In addition, osteoporosis is a systemic bone disease characterized by a
decrease in bone mass density and deterioration of bone microarchitecture, so bones become
brittle and break easily. Osteoporosis occurs when the process of bone erosion and bone
formation becomes unbalanced (12,13).
A high bone mass means strong and healthy bone, so it is not easy to get loose and
brittle. The cause or etiology comes from the risk factors that can be controlled and cannot be
controlled which is owned by an individual. Risk factors that can be controlled include lack
of activity or exercise. Previous studies have proven that physical exercise is carried out
regularly and with certain doses causing an increase in bone mass density, bone size and bone
shape (14,15,16). Statistical analysis showed that there was a significant relationship between
respondents whose physical activity was less active with low bone mass density (p<0,05) and
PR 1,506 which meant that respondents with less active physical activity had a risk of 1,506
times greater risk of experiencing low bone mass density compared to respondents whose
active physical activity. Sport is a repetitive physical activity and aims to maintain, improve
and express fitness. Several studies were conducted to determine the effect of physical
exercise on bones (17,18).
Exercise can play a role in the process of increasing bone mass density. High bone
density and mass are expected to be reached when the peak of bone mass, so that when the
process of decreasing bone remodeling will take a long time to reach the low point of bone
mass density which is at risk of osteoporosis. Therefore, regular and well-programmed
exercise in the age before 30 years is highly recommended in an effort to prevent early
osteoporosis. The volume of training is not only related to the duration of the exercise but
also includes aspects of distance or load per unit of time and aspects of the number of reps of
the exercise, so volume is the implication of the total quantity of training activity
performance or training phase. When referring to the training volume, the amount of time, the
number of training days, and the number of exercises must be specified (19,20).
Conclusion
Most of the bone mass density of respondents was low, amounting to 65 people (79,3%)
out of 82 total respondents. The most dominant risk factor for low bone mass density in these
respondents is due to the lack of active adolescents doing physical activity. With less active
physical activity, respondents had a greater risk of 12,981 times having osteopenia and could
continue to develop osteoporosis compared to respondents with active physical activity.
Acknowledgements
We thank all participants in this research.
Competing Interest
The authors declare that they have no competing interests.
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TUGAS
Oleh:
ATIKAH RAHAYU
NIM 20708261007
Atikah Rahayu
Correspondence:
Atikah Rahayu
Student of study program doctoral of sports science, Faculty of Sports Sciences,
Universitas Negeri Yogyakarta, Indonesia
Jl.Colombo Yogyakarta 55281, Indonesia
Tel/Fax: +62-81225331538
E-mail: atikahrahayu.2020@student.uny.ac.id
Abstract
Density of bone mass can be changed by physical activity, due to the formation of enzymes
in bone, resulting in enlargement/compaction of bones (hypertrophy). For new bone
formation to occur, continuous design is needed on the bone through muscle training. Low
bone mass density illustrates low bone quality. The study design used cross sectional design.
The subjects of the study were all teenagers in junior high schools selected along the
Martapura riverbank, Banjar Regency, South Borneo. Sampling by measuring physical
activity, level of knowledge, and protein intake as well as family characteristics such as
mother and father education, family income, and number of family members. The research
instrument used quantitative ultrasound bone densitometry to measure bone mass density,
Baecke questionnaire to measure physical activity, 24-hour food recall form to measure
protein intake and structured questionnaire to determine the characteristics of respondents
and families. The results showed a relationship between low bone mass density and physical
activity p=0,001, with Exp (B) =12,981. It can be concluded that less active physical activity
is at risk of causing low bone mass density.
Introduction
Low bone mass density is a description of the state of bone with low quality can be
identified after a period of perfect development. An early sign of low bone mass density is
low is osteopenia, while further osteoporosis. Osteoporosis is bone loss, especially in the
spine, upper arm and pelvis. The symtomatic of osteoporosis are difficult to detect, most are
only realized when there has been a swelling of the spine, cracks or broken bones, pinched
nerves. Some risks of osteopenia and osteoporosis are lack of protein intake in physical
activity. Lack of consumption of fish-sourced protein in adolescents will be related to bone
mass density, this is because teenagers often limit their consumption of food, and their
consumption patterns often violates the rules of nutrition (1).
These results are supported from the results of previous studies that the majority of
adolescents with low protein intake causes low bone mass density, which is 53,7%. When a
person reaches the peak of growth, the body's protein needs become stable. Protein in
adolescence is relatively high, because muscular, skeletal/skeletal acceleration and endocrine
development are greater than childhood and adulthood (2,3).
Bone mass density can be altered by physical activity. This occurs because physical
activity causes the formation of enzymes in bone, so enlargement/compaction of bones
(hypertrophy). For new bone formation to occur, continuous design is needed on the bone
through muscle training. Based on national data and data in South Kalimantan aged ≥10 years
included in the category of lack of physical activity. The less category is defined as
cumulative physical activity less than 150 minutes a week. The amount of age that lacks
physical activity is 33,5% (4). It is important to keep physical activity active so that bone
mass density is maintained (5,6).
Ethics Approval
This study was approved by the Ethics Committee faculty of Medical (ethic code 4/56).
Statistical Analysis
The data obtained were analyzed using univariate, bivariate, and multivariate. The results
of the univariate analysis are presented in the form of a frequency distribution table
(percentage) to find out the distribution of low bone mass density risk, bivariate analysis
using Chi-Square if not met followed by using the Fisher's Exact Test to find out the
relationship between risk factors and bone mass density and multivariate analysis using
logistic regression to find out the most dominant risk factor associated with low bone mass
density in adolescents.
.
Results
Univariate Analysis
Table 1 shows the distribution of variables according to categories that are likely related
to low bone mass density of respondents.
Table 1. Frequency distribution of respondent and family characteristics
Bone mass density categories Frequency (people) Percentage (%)
a. Low Bone mass
65 79,3
density/osteopenia/osteoporosis
b. Normal 17 20,7
Physical activity
a. Less active 51 62,2
b. Active 31 37,8
Father's Education Level
a. Not graduated from Junior High
62 74,6
School
b. High school - college 20 24,4
Mother's Education Level
a. Not graduated from Junior High
61 74,4
School
b. High school - college 21 25,6
Level of Family Income
a. < employee minimum wage 62 75,6
b. ≥ employee minimum wage 20 24,4
Number of Family Members
a. ≥ 5 people 54 65,9
b. < 5 people 28 34,1
Knowledge Level
a. Low 20 24,4
b. Good 62 75,6
Protein Intake
a. Inadequate 52 63,4
b. Adequate 30 35,6
Employment status of head of household
a. Does not work 10 12,2
b. Work 72 87,8
Source: Primary Data, 2019
Table 1 shows that the majority of respondents had osteopenia, 65 people (79,3%). Some
other potential variables have a relationship with the incidence of osteopenia in respondents,
namely physical activity, father's education level, mother's education level, family income,
number of family members, protein intake, level of knowledge, work status of parents. Table
1 shows that adolescents who have less active physical activity categories are more numerous
than adolescents with active physical activity that is equal to 51 people (62,2%), fathers and
mothers who have not completed primary education until junior high school are greater in
number each a total of 61 people (74,6%) and 62 people (74,4%). With the level of education
of parents low category resulted in incomes earned by parents/family also became inadequate
to meet the needs of family food consumption.
The results of this study indicate that the majority of family income is still below the
employee minimum wage of 60 people (75,6%). This employee minimum wage refers to the
employee minimum wage Regency of Banjar in the amount of Rp.2,248,000.00. In addition,
a factor that contributes to the incidence of osteopenia is the number of family members. The
results of this study found that the majority of respondents had a relatively large number of
family members (>5 people) namely 54 people (65,9%). It is likely that the relatively large
number of family members will affect the food distribution of family members.
The results of this study indicate that the level of knowledge of respondents still have
knowledge of less than 24,4%. It is potential that most of the protein intake is lacking due to
the low level of respondents' knowledge to meet their body's need for protein. The number of
respondents who have low protein intake is equal to 63,4%. The magnitude of the frequency
distribution between each of these variables has not been able to show the relationship
between the variable characteristics of respondents and families with low bone mass density,
so it needs bivariate analysis so that the relationship between the two variables (free and
bound) is known for their significance, in detail can be seen in Table 2.
Bivariate Analysis
Table 2. Relationship between respondent and family characteristics with Bone Mass Density
Bone Mass Density
Low Bone Mass Normal PR
Characteristics Category
Density (95% CI)
p
n % n %
Physical activity Less active 47 90,4 5 9,6 1,506 0,000*
Active 18 60,0 12 40,0 (1,110-2,044)
Father's Education Level Not graduated from 52 83,9 10 16,1 1,290 0,110
Junior High School- 13 65,0 17 35,0 (0,919-1,812)
Mother's Education Level college
52 85,2 9 14,8 3,556 0,032*
Not graduated from
Junior 13 61,9 8 38,1 (1,15-7,005)
Level of Family Income
High School- college 53 85,5 9 14,5 3,396 0, 024*
< employee minimum wage 12 60,0 8 40,0 (1,126-6,258)
Number of Family Members
> employee minimum wage 42 77,8 12 22,2 0,947 0,644
> 5 people 23 82,1 5 17,9 (0,757-1,185)
Protein intake
< 5 people 48 66,3 3 33,7 1,716 0,001*
inadequate 17 33,7 14 66,3 (1,238-2,380)
Knowledge Level
adequate 16 80,0 4 20,0 1,012 1,000
Employment status of head of Low 49 79,0 13 21,0 (0,785-1,305)
household Good 9 90,0 1 10,0 1,157 0,679
Does not work 56 77,8 16 22,2 (0,909-1,472)
Work
*p value (<0,05)
Table 2 shows that several variables show a relationship with bone mass density in
respondents. These variables are physical activity with p=0,000 and PR=1,506 (1,110-2,044),
mother's education level with p=0,032 and PR=3,556 (1,15-7,005), number of family
members with p=0,024 and PR=3,396 (1,126-6,258), protein intake with p=0,001. This
analysis uses the Che-Square test with a 95% confidence level. The results of the analysis
resulted in physical activity having the greatest relationship compared to other variables
(p=0,000).
This means that the results of this relationship test show the closeness between the
relationship of physical activity with the risk of low bone mass density in respondents. This
can be seen from Table 2 which shows that a total of 47 people (90,4%) of respondents with
less active physical activity have low bone mass density. Although the closeness of the
relationship between physical activity and bone mass density is greater, the risk of family
income that has a <employee minimum wage is greater, causing respondents to experience
low bone mass density (PR=3,556), which is 53 people (85,5%).
The close relationship between variables using bivariate analysis has not shown the risk
of dominant factors associated with low bone mass density in respondents. Further analysis is
needed in order to find out which variable is most associated with low bone mass density in
respondents, namely multivathic logistic regression analysis.
Multivariate Analysis
The statistical analysis used is multiple logistic regression analysis. Variables that are
candidates for the multivariate model are independent variables with bivariate results
resulting in ps<0,25, then these variables directly enter the multivariate stage. For
independent variables whose bivariate results produce p>0,25 but substantially important,
these variables can be included in the multivariate model. The variables included in the
multivariate model can be seen in Table 3.
Table 3. Modeling the most dominant factors related to low bone mass density
Variables B SE Wald Sig Exp (B)
Protein intake 2,272 885 6,586 0,010 9,696
Father's Education -168 1,466 1,164 0,281 0,206
Level
Mother's Education -1,582 1,716 0,010 0,922 0,845
Level
Level of Family Income -2,256 1,717 1,727 0,189 9,549
Knowledge level 1, 354 998 4,797 0,032 6, 685
Physical activity 2,257 0,747 11,708 0,001 12,981
Table 3 shows that the variable calcium intake is the most dominant risk factor associated
with low bone mass density in adolescents with p=0,001, with Exp (B)=12,981 which means
that adolescents with physical activity less active risk of 12,981 times greater experience
osteopenia and can continue to become osteoporosis compared to adolescents with active
physical activity.
Discussion
Less physical activity can be reduced bone mass density. This occurs because physical
activity causes the formation of enzymes in bone, so enlargement/compaction of bones
(hypertrophy). For new bone formation to occur, continuous design is needed on the bone
through muscle training. Exercise regularly. With a frequency of 3-5 x/week not on
consecutive days with a time of 20-60 minutes and can properly increase low bone density
and reduce the risk of osteopenia. In addition, continuous activities and heavy loads may
quickly increase bone mass density, but must be adjusted to the load because the bone mass
density is not ocollegeimal compared to regular physical exercise and the appropriate load.
Certainly, it is supported by nutritional intake. such as protein, calcium, vitamin D which
meet the body's needs. With nutritional intake that matches the body's needs, the risk of
osteoporosis in old age can be minimized (7).
This is in line with this study which found that protein intake less than RDA is associated
with bone mass density. In multivariate analysis, Exp (B) 9,696, which means that protein
intake that is less than RDA causes respondents to experience low bone mass density.
Respondents whose protein intake is less than the RDA are 9,696 times more likely to
experience low bone mass density compared to respondents whose protein intake is
sufficient. Increased nutritional needs in adolescence are related to the accelerated growth
they experience. Bone mass density increases during puberty, its peak is reached at ages
above 10 to the beginning of 20 years (8). Bone is a complex network of cells and a matrix.
The bone matrix is formed by fibers and basic substances containing mineral salts. The mass
and thickness of the bones at any time always experience the dynamics of addition and
reduction through the process of remodeling (the bone matrix is absorbed and reshaped
(9,10). The process of forming and absorbing the bone, it is necessary to try to maintain bone
mass density from an early age, so as to avoid bone mass density such as osteopenia or
osteoporosis (9,11). In addition, osteoporosis is a systemic bone disease characterized by a
decrease in bone mass density and deterioration of bone microarchitecture, so bones become
brittle and break easily. Osteoporosis occurs when the process of bone erosion and bone
formation becomes unbalanced (12,13).
A high bone mass means strong and healthy bone, so it is not easy to get loose and
brittle. The cause or etiology comes from the risk factors that can be controlled and cannot be
controlled which is owned by an individual. Risk factors that can be controlled include lack
of activity or exercise. Previous studies have proven that physical exercise is carried out
regularly and with certain doses causing an increase in bone mass density, bone size and bone
shape (14,15,16). Statistical analysis showed that there was a significant relationship between
respondents whose physical activity was less active with low bone mass density (p<0,05) and
PR 1,506 which meant that respondents with less active physical activity had a risk of 1,506
times greater risk of experiencing low bone mass density compared to respondents whose
active physical activity. Sport is a repetitive physical activity and aims to maintain, improve
and express fitness. Several studies were conducted to determine the effect of physical
exercise on bones (17,18).
Exercise can play a role in the process of increasing bone mass density. High bone
density and mass are expected to be reached when the peak of bone mass, so that when the
process of decreasing bone remodeling will take a long time to reach the low point of bone
mass density which is at risk of osteoporosis. Therefore, regular and well-programmed
exercise in the age before 30 years is highly recommended in an effort to prevent early
osteoporosis. The volume of training is not only related to the duration of the exercise but
also includes aspects of distance or load per unit of time and aspects of the number of reps of
the exercise, so volume is the implication of the total quantity of training activity
performance or training phase. When referring to the training volume, the amount of time, the
number of training days, and the number of exercises must be specified (19,20).
Conclusion
Most of the bone mass density of respondents was low, amounting to 65 people (79,3%)
out of 82 total respondents. The most dominant risk factor for low bone mass density in these
respondents is due to the lack of active adolescents doing physical activity. With less active
physical activity, respondents had a greater risk of 12,981 times having osteopenia and could
continue to develop osteoporosis compared to respondents with active physical activity.
Acknowledgements
We thank all participants in this research.
Competing Interest
The authors declare that they have no competing interests.
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20. Manske SL, Lorincz CR, Zernicke RF. Bone Health: Part 2, Physical Activity. Sports
Health. 2009;1(4): 341-346.
Jawaban 2
Dua Jurnal Dalam Negeri Dan 2 Jurnal Luar Negeri
Status Jurnal
Jurnal MEDIKORA merupakan jurnal nasional terindek sinta 3. Jurnal ini telah
TERAKREDITASI oleh Badan Akreditasi Jurnal Nasional (ARJUNA) yang Dikelola oleh
Kementerian Riset dan Teknologi. Badan Riset dan Inovasi Nasional Republik Indonesia
Peringkat III (Peringkat 3 Sinta 3) sejak tahun 2018 sampai dengan 2023 sesuai dengan Keputusan
Nomor 148 / M / KPT / 2020. MEDIKORA adalah jurnal ilmiah kesehatan olahraga terbitan
Program Studi Ilmu Olah Raga Fakultas Ilmu Keolahragaan Universitas Negeri Yogyakarta yang
memuat hasil kajian dan penelitian analisis kritis di bidang kesehatan olahraga, terapi jasmani,
kebugaran jasmani, terapi olahraga, manajemen olahraga, adaptif, psikologi olahraga, biomekanik
olahraga, dan sosiologi olahraga. Jurnal diterbitkan dua kali setahun (April dan Oktober).
JAWABAN 4: Petunjuk bagi Penulis
Jawaban 5
Nama Penulis Pertama1, Nama Penulis Kedua2*, Tanpa Gelar Akademis (11pt)1
1
Ilmu Keolahragaan, Fakultas Ilmu Keolahragaan, Universitas Negeri Yogyakarta, Jl. Colombo No. 1,
Karangmalang, Depok, Sleman, Daerah Istimewa Yogyakarta, Indonesia.
2
Program Studi, Fakultas, Universitas, Alamat Lengkap, Jalan, Kabupaten, Propinsi, Negara, (10pt).
penulis_pertama@uny.ac.id, penuliskedua@uny.ac.id, ditulis_miring_10pt@instansi.ac.id
Abstrak
Abstrak berbahasa Indonesia ditulis menggunakan Times New Roman 11, rata kanan kiri. Jarak
antarbaris 1 spasi. Abstrak berisi 150-250 kata dan hanya terdiri atas 1 paragraf, menunjukkan tujuan
dan lingkup penelitian/kajian, memberikan gambaran metode yang digunakan, merangkum temuan
penelitian, menyatakan kesimpulan utama penelitian.
Kata kunci : 1 kata, tidak lebih dari 5 kata, frase yang penting, spesifik, representatif.
Abstract
Abstract english version, written using Times New Roman 11, italic, justify. Abstract contains 150-250
words. Abstract contains research aim/purpose, method, and reseach results; written in 1 paragraph,
single space among rows, using past tense sentences.
Keywords: 1 word, no more than 5 words, important, specific, representative phrase.
(Jenis: e-book)
Bransford, J. D., Brown, A. L., & Cocking, R. R. (2005). How people learn: Brain, mind,
experience and school. from https://www.nap.edu/catalog/9853/how-people-learn-
brain-mind-experience-and-school-expanded-edition.
(Jenis: prosiding)
Retnowati, E. (2012, 24-27 November). Learning mathematics collaboratively or individually.
Paper presented at the The 2nd International Conference of STEM in Education, Beijing
Normal University, China. Retrieved from
http://stem2012.bnu.edu.cn/data/short%20paper/stem2012_88.pdf.
Jurnal MEDIKORA merupakan jurnal nasional terindek sinta 3. Jurnal ini telah
TERAKREDITASI oleh Badan Akreditasi Jurnal Nasional (ARJUNA) yang Dikelola oleh
Kementerian Riset dan Teknologi. Badan Riset dan Inovasi Nasional Republik Indonesia
Peringkat III (Peringkat 3 Sinta 3) sejak tahun 2018 sampai dengan 2023 sesuai dengan Keputusan
Nomor 148 / M / KPT / 2020. MEDIKORA adalah jurnal ilmiah kesehatan olahraga terbitan
Program Studi Ilmu Olah Raga Fakultas Ilmu Keolahragaan Universitas Negeri Yogyakarta yang
memuat hasil kajian dan penelitian analisis kritis di bidang kesehatan olahraga, terapi jasmani,
kebugaran jasmani, terapi olahraga, manajemen olahraga, adaptif, psikologi olahraga, biomekanik
olahraga, dan sosiologi olahraga. Jurnal diterbitkan dua kali setahun (April dan Oktober).
Medikora menerbitkan penelitian yang melaporkan praktik pendidikan dalam semua
konteks yang sesuai termasuk, namun tidak terbatas pada, pendidikan jasmani sekolah, olahraga
klub, dan program rekreasi aktif. Jurnal ini mempertimbangkan makalah yang membahas berbagai
kegiatan fisik, termasuk akuatik, tari, olahraga, senam, kegiatan luar ruangan dan petualangan,
meditasi dan seni bela diri dan olahraga.
Aturan pengiriman naskah yaitu Sebelum pengiriman,penulis harus memastikan bahwa
kertas Anda disiapkan menggunakan TEMPLATE Kertas MEDIKORA, telah dikoreksi dan
dipoles dengan hati-hati, dan sesuai dengan Panduan Penulis. Ketika Pengiriman Online, penulis
sudah punya Username/Password untuk Jurnal Inovasi Teknologi Pendidikan? BUKA LOGIN
butuh Nama Pengguna/Kata Sandi? BUKA PENDAFTARAN. Pendaftaran dan login diperlukan
untuk mengirimkan item secara online dan untuk memeriksa status pengiriman saat ini. Publikasi
Artikel: Rp. 500000.00. Jika makalah ini diterima untuk publikasi, Anda akan diminta untuk
membayar Biaya Publikasi Artikel untuk menutupi biaya publikasi. Adapun cara mengirim naskah
pada jurnal medikora: 1. Naskah dalam microsoft word harus dikirim ke editor dengan mengklik
tab Online Submission di Website kami. 2. Biodata singkat yang memuat nama lengkap, gelar
akademik, institusi, telepon, nomor handphone, dan lain-lain harus dicantumkan pada kolom data
pada saat mendaftar online pada pengajuan website.
Adapun struktur manuskrip memuat: 1). Judul. Judul harus jelas dan informatif, tidak
lebih dari 16 kata. 2).Nama penulis dan institusi. Nama penulis harus disertai dengan institusi
penulis dan alamat email, tanpa gelar akademis. Untuk makalah bersama, salah satu penulis harus
diberitahukan sebagai penulis terkait. 3). Abstrak, kata kunci, dan nomor klasifikasi MRBM.
Abstrak harus kurang dari 250 kata. Harap berikan abstrak dalam versi bahasa Inggris dan bahasa
Indonesia. Kata kuncinya harus terdiri dari 3 sampai 5 kata atau frase. Harap berikan setidaknya
satu nomor klasifikasi MEDIKORA yang sesuai dengan naskah Anda, yang tersedia di
https://journal.uny.ac.id/index.php/medikora. 4). Pendahuluan. Bagian ini menjelaskan latar
belakang penelitian, tinjauan terhadap penelitian-penelitian sebelumnya di daerah tersebut, dan
tujuan pembuatan naskah. Hal yang penting juga harus menunjukkan signifikansi dan kebaruan
penelitian. 5). Metode. Bagian ini menjelaskan alat analisis yang sesuai bersama dengan data dan
sumbernya. 6). Hasil dan Pembahasan. Bagian ini menjelaskan hasil penelitian. Ini harus disajikan
dengan jelas dan ringkas. Penulis harus mengeksplorasi kebaruan atau kontribusi karya untuk
pendidikan jasmani. 7). Kesimpulan. Bagian ini menyimpulkan dan memberikan implikasi
kebijakan, jika ada, dari studi tersebut. Kesimpulan harus dalam urutan yang sama dengan
kesimpulan yang dibahas dalam badan naskah. 8). Referensi. Bagian ini hanya mencantumkan
makalah, buku, atau jenis publikasi lain yang dirujuk dalam badan manuskrip.
Jawaban 7
a. Cara mengirim artikel
Bagaimana mengirim naskah 1). Naskah dalam microsoft word harus dikirim ke editor
dengan mengklik tab Online Submission di Website kami. 2). Biodata singkat yang
memuat nama lengkap, gelar akademik, institusi, telepon, nomor handphone, dan lain-lain
harus dicantumkan pada kolom data pada saat mendaftar online pada pengajuan website.
Keputusan terakhir. Dengan mempertimbangkan hasil dari proses peer review, keputusan
tentang penerimaan setiap naskah untuk publikasi akan diberitahukan kepada penulis
melalui sistem situs web dalam kesimpulan alternatif berikut:
a. Diterima tanpa revisi, atau
b. Diterima dengan revisi kecil, atau
c. Diterima dengan revisi besar, atau
d. Ditolak.
File pengiriman dalam format file dokumen OpenOffice, Microsoft Word, RTF, atau Word
Perfect. Jika tersedia, URL untuk referensi telah disediakan. Teksnya memiliki spasi
tunggal; menggunakan font 12 poin; menggunakan huruf miring, bukan menggarisbawahi
(kecuali dengan alamat URL); dan semua ilustrasi, gambar, dan tabel ditempatkan di dalam
teks pada titik yang sesuai, bukan di akhir. Teks tersebut mematuhi persyaratan gaya dan
bibliografi yang diuraikan dalam Panduan Penulis, yang dapat ditemukan di Tentang
Jurnal. Jika mengirimkan ke bagian jurnal yang ditinjau sejawat, petunjuk dalam blinded
review.
Oleh:
ATIKAH RAHAYU
NIM 20708261007
Atikah Rahayu
Correspondence:
Atikah Rahayu
Student of study program doctoral of sports science, Faculty of Sports Sciences,
Universitas Negeri Yogyakarta, Indonesia
Jl.Colombo Yogyakarta 55281, Indonesia
Tel/Fax: +62-81225331538
E-mail: atikahrahayu.2020@student.uny.ac.id
Abstract
Density of bone mass can be changed by physical activity, due to the formation of enzymes
in bone, resulting in enlargement/compaction of bones (hypertrophy). For new bone
formation to occur, continuous design is needed on the bone through muscle training. Low
bone mass density illustrates low bone quality. The study design used cross sectional design.
The subjects of the study were all teenagers in junior high schools selected along the
Martapura riverbank, Banjar Regency, South Borneo. Sampling by measuring physical
activity, level of knowledge, and protein intake as well as family characteristics such as
mother and father education, family income, and number of family members. The research
instrument used quantitative ultrasound bone densitometry to measure bone mass density,
Baecke questionnaire to measure physical activity, 24-hour food recall form to measure
protein intake and structured questionnaire to determine the characteristics of respondents
and families. The results showed a relationship between low bone mass density and physical
activity p=0,001, with Exp (B) =12,981. It can be concluded that less active physical activity
is at risk of causing low bone mass density.
Introduction
Low bone mass density is a description of the state of bone with low quality can be
identified after a period of perfect development. An early sign of low bone mass density is
low is osteopenia, while further osteoporosis. Osteoporosis is bone loss, especially in the
spine, upper arm and pelvis. The symtomatic of osteoporosis are difficult to detect, most are
only realized when there has been a swelling of the spine, cracks or broken bones, pinched
nerves. Some risks of osteopenia and osteoporosis are lack of protein intake in physical
activity. Lack of consumption of fish-sourced protein in adolescents will be related to bone
mass density, this is because teenagers often limit their consumption of food, and their
consumption patterns often violates the rules of nutrition (1).
These results are supported from the results of previous studies that the majority of
adolescents with low protein intake causes low bone mass density, which is 53,7%. When a
person reaches the peak of growth, the body's protein needs become stable. Protein in
adolescence is relatively high, because muscular, skeletal/skeletal acceleration and endocrine
development are greater than childhood and adulthood (2,3).
Bone mass density can be altered by physical activity. This occurs because physical
activity causes the formation of enzymes in bone, so enlargement/compaction of bones
(hypertrophy). For new bone formation to occur, continuous design is needed on the bone
through muscle training. Based on national data and data in South Kalimantan aged ≥10 years
included in the category of lack of physical activity. The less category is defined as
cumulative physical activity less than 150 minutes a week. The amount of age that lacks
physical activity is 33,5% (4). It is important to keep physical activity active so that bone
mass density is maintained (5,6).
Ethics Approval
This study was approved by the Ethics Committee faculty of Medical (ethic code 4/56).
Statistical Analysis
The data obtained were analyzed using univariate, bivariate, and multivariate. The results
of the univariate analysis are presented in the form of a frequency distribution table
(percentage) to find out the distribution of low bone mass density risk, bivariate analysis
using Chi-Square if not met followed by using the Fisher's Exact Test to find out the
relationship between risk factors and bone mass density and multivariate analysis using
logistic regression to find out the most dominant risk factor associated with low bone mass
density in adolescents.
.
Results
Univariate Analysis
Table 1 shows the distribution of variables according to categories that are likely related
to low bone mass density of respondents.
Table 1. Frequency distribution of respondent and family characteristics
Bone mass density categories Frequency (people) Percentage (%)
a. Low Bone mass
65 79,3
density/osteopenia/osteoporosis
b. Normal 17 20,7
Physical activity
a. Less active 51 62,2
b. Active 31 37,8
Father's Education Level
a. Not graduated from Junior High
62 74,6
School
b. High school - college 20 24,4
Mother's Education Level
a. Not graduated from Junior High
61 74,4
School
b. High school - college 21 25,6
Level of Family Income
a. < employee minimum wage 62 75,6
b. ≥ employee minimum wage 20 24,4
Number of Family Members
a. ≥ 5 people 54 65,9
b. < 5 people 28 34,1
Knowledge Level
a. Low 20 24,4
b. Good 62 75,6
Protein Intake
a. Inadequate 52 63,4
b. Adequate 30 35,6
Employment status of head of household
a. Does not work 10 12,2
b. Work 72 87,8
Source: Primary Data, 2019
Table 1 shows that the majority of respondents had osteopenia, 65 people (79,3%). Some
other potential variables have a relationship with the incidence of osteopenia in respondents,
namely physical activity, father's education level, mother's education level, family income,
number of family members, protein intake, level of knowledge, work status of parents. Table
1 shows that adolescents who have less active physical activity categories are more numerous
than adolescents with active physical activity that is equal to 51 people (62,2%), fathers and
mothers who have not completed primary education until junior high school are greater in
number each a total of 61 people (74,6%) and 62 people (74,4%). With the level of education
of parents low category resulted in incomes earned by parents/family also became inadequate
to meet the needs of family food consumption.
The results of this study indicate that the majority of family income is still below the
employee minimum wage of 60 people (75,6%). This employee minimum wage refers to the
employee minimum wage Regency of Banjar in the amount of Rp.2,248,000.00. In addition,
a factor that contributes to the incidence of osteopenia is the number of family members. The
results of this study found that the majority of respondents had a relatively large number of
family members (>5 people) namely 54 people (65,9%). It is likely that the relatively large
number of family members will affect the food distribution of family members.
The results of this study indicate that the level of knowledge of respondents still have
knowledge of less than 24,4%. It is potential that most of the protein intake is lacking due to
the low level of respondents' knowledge to meet their body's need for protein. The number of
respondents who have low protein intake is equal to 63,4%. The magnitude of the frequency
distribution between each of these variables has not been able to show the relationship
between the variable characteristics of respondents and families with low bone mass density,
so it needs bivariate analysis so that the relationship between the two variables (free and
bound) is known for their significance, in detail can be seen in Table 2.
Bivariate Analysis
Table 2. Relationship between respondent and family characteristics with Bone Mass Density
Bone Mass Density
Low Bone Mass Normal PR
Characteristics Category
Density (95% CI)
p
n % n %
Physical activity Less active 47 90,4 5 9,6 1,506 0,000*
Active 18 60,0 12 40,0 (1,110-2,044)
Father's Education Level Not graduated from 52 83,9 10 16,1 1,290 0,110
Junior High School- 13 65,0 17 35,0 (0,919-1,812)
Mother's Education Level college
52 85,2 9 14,8 3,556 0,032*
Not graduated from
Junior 13 61,9 8 38,1 (1,15-7,005)
Level of Family Income
High School- college 53 85,5 9 14,5 3,396 0, 024*
< employee minimum wage 12 60,0 8 40,0 (1,126-6,258)
Number of Family Members
> employee minimum wage 42 77,8 12 22,2 0,947 0,644
> 5 people 23 82,1 5 17,9 (0,757-1,185)
Protein intake
< 5 people 48 66,3 3 33,7 1,716 0,001*
inadequate 17 33,7 14 66,3 (1,238-2,380)
Knowledge Level
adequate 16 80,0 4 20,0 1,012 1,000
Employment status of head of Low 49 79,0 13 21,0 (0,785-1,305)
household Good 9 90,0 1 10,0 1,157 0,679
Does not work 56 77,8 16 22,2 (0,909-1,472)
Work
*p value (<0,05)
Table 2 shows that several variables show a relationship with bone mass density in
respondents. These variables are physical activity with p=0,000 and PR=1,506 (1,110-2,044),
mother's education level with p=0,032 and PR=3,556 (1,15-7,005), number of family
members with p=0,024 and PR=3,396 (1,126-6,258), protein intake with p=0,001. This
analysis uses the Che-Square test with a 95% confidence level. The results of the analysis
resulted in physical activity having the greatest relationship compared to other variables
(p=0,000).
This means that the results of this relationship test show the closeness between the
relationship of physical activity with the risk of low bone mass density in respondents. This
can be seen from Table 2 which shows that a total of 47 people (90,4%) of respondents with
less active physical activity have low bone mass density. Although the closeness of the
relationship between physical activity and bone mass density is greater, the risk of family
income that has a <employee minimum wage is greater, causing respondents to experience
low bone mass density (PR=3,556), which is 53 people (85,5%).
The close relationship between variables using bivariate analysis has not shown the risk
of dominant factors associated with low bone mass density in respondents. Further analysis is
needed in order to find out which variable is most associated with low bone mass density in
respondents, namely multivathic logistic regression analysis.
Multivariate Analysis
The statistical analysis used is multiple logistic regression analysis. Variables that are
candidates for the multivariate model are independent variables with bivariate results
resulting in ps<0,25, then these variables directly enter the multivariate stage. For
independent variables whose bivariate results produce p>0,25 but substantially important,
these variables can be included in the multivariate model. The variables included in the
multivariate model can be seen in Table 3.
Table 3. Modeling the most dominant factors related to low bone mass density
Variables B SE Wald Sig Exp (B)
Protein intake 2,272 885 6,586 0,010 9,696
Father's Education -168 1,466 1,164 0,281 0,206
Level
Mother's Education -1,582 1,716 0,010 0,922 0,845
Level
Level of Family Income -2,256 1,717 1,727 0,189 9,549
Knowledge level 1, 354 998 4,797 0,032 6, 685
Physical activity 2,257 0,747 11,708 0,001 12,981
Table 3 shows that the variable calcium intake is the most dominant risk factor associated
with low bone mass density in adolescents with p=0,001, with Exp (B)=12,981 which means
that adolescents with physical activity less active risk of 12,981 times greater experience
osteopenia and can continue to become osteoporosis compared to adolescents with active
physical activity.
Discussion
Less physical activity can be reduced bone mass density. This occurs because physical
activity causes the formation of enzymes in bone, so enlargement/compaction of bones
(hypertrophy). For new bone formation to occur, continuous design is needed on the bone
through muscle training. Exercise regularly. With a frequency of 3-5 x/week not on
consecutive days with a time of 20-60 minutes and can properly increase low bone density
and reduce the risk of osteopenia. In addition, continuous activities and heavy loads may
quickly increase bone mass density, but must be adjusted to the load because the bone mass
density is not ocollegeimal compared to regular physical exercise and the appropriate load.
Certainly, it is supported by nutritional intake. such as protein, calcium, vitamin D which
meet the body's needs. With nutritional intake that matches the body's needs, the risk of
osteoporosis in old age can be minimized (7).
This is in line with this study which found that protein intake less than RDA is associated
with bone mass density. In multivariate analysis, Exp (B) 9,696, which means that protein
intake that is less than RDA causes respondents to experience low bone mass density.
Respondents whose protein intake is less than the RDA are 9,696 times more likely to
experience low bone mass density compared to respondents whose protein intake is
sufficient. Increased nutritional needs in adolescence are related to the accelerated growth
they experience. Bone mass density increases during puberty, its peak is reached at ages
above 10 to the beginning of 20 years (8). Bone is a complex network of cells and a matrix.
The bone matrix is formed by fibers and basic substances containing mineral salts. The mass
and thickness of the bones at any time always experience the dynamics of addition and
reduction through the process of remodeling (the bone matrix is absorbed and reshaped
(9,10). The process of forming and absorbing the bone, it is necessary to try to maintain bone
mass density from an early age, so as to avoid bone mass density such as osteopenia or
osteoporosis (9,11). In addition, osteoporosis is a systemic bone disease characterized by a
decrease in bone mass density and deterioration of bone microarchitecture, so bones become
brittle and break easily. Osteoporosis occurs when the process of bone erosion and bone
formation becomes unbalanced (12,13).
A high bone mass means strong and healthy bone, so it is not easy to get loose and
brittle. The cause or etiology comes from the risk factors that can be controlled and cannot be
controlled which is owned by an individual. Risk factors that can be controlled include lack
of activity or exercise. Previous studies have proven that physical exercise is carried out
regularly and with certain doses causing an increase in bone mass density, bone size and bone
shape (14,15,16). Statistical analysis showed that there was a significant relationship between
respondents whose physical activity was less active with low bone mass density (p<0,05) and
PR 1,506 which meant that respondents with less active physical activity had a risk of 1,506
times greater risk of experiencing low bone mass density compared to respondents whose
active physical activity. Sport is a repetitive physical activity and aims to maintain, improve
and express fitness. Several studies were conducted to determine the effect of physical
exercise on bones (17,18).
Exercise can play a role in the process of increasing bone mass density. High bone
density and mass are expected to be reached when the peak of bone mass, so that when the
process of decreasing bone remodeling will take a long time to reach the low point of bone
mass density which is at risk of osteoporosis. Therefore, regular and well-programmed
exercise in the age before 30 years is highly recommended in an effort to prevent early
osteoporosis. The volume of training is not only related to the duration of the exercise but
also includes aspects of distance or load per unit of time and aspects of the number of reps of
the exercise, so volume is the implication of the total quantity of training activity
performance or training phase. When referring to the training volume, the amount of time, the
number of training days, and the number of exercises must be specified (19,20).
Conclusion
Most of the bone mass density of respondents was low, amounting to 65 people (79,3%)
out of 82 total respondents. The most dominant risk factor for low bone mass density in these
respondents is due to the lack of active adolescents doing physical activity. With less active
physical activity, respondents had a greater risk of 12,981 times having osteopenia and could
continue to develop osteoporosis compared to respondents with active physical activity.
Acknowledgements
We thank all participants in this research.
Competing Interest
The authors declare that they have no competing interests.
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Health. 2009;1(4): 341-346.
Jawaban 2
Dua Jurnal Dalam Negeri Dan 2 Jurnal Luar Negeri
Status Jurnal
Journal of Sport and Health Science (JSHS) adalah jurnal multidisiplin, internasional, dan
peer-review yang didedikasikan untuk kemajuan olahraga, olahraga, aktivitas fisik, dan ilmu
kesehatan. JSHS menerbitkan penelitian asli dan berdampak, ulasan topik, editorial, opini, dan
makalah. Impact Factor 2019: 5.200 © Clarivate Analytics Journal Citation Reports 2020. 5-Year
Impact Factor: 4.687, Source Normalized Impact per Paper (SNIP): 1.880, SCImago Journal Rank
(SJR): 1.136. Adapun Abstrak dan indeks: Science Citation Index, Social Sciences Citation Index,
PubMed/Medline, PubMed Central, Scopus, Embase, Cambridge Scientific Abstracts, Directory
of Open Access Journals (DOAJ), ProQuest, EBSCO SPORTDiscus, EBSCO, ehabilitation &
Sports Medicine Source, Hinari.
JAWABAN 4
Petunjuk Bagi Penulis
JOURNAL OF SPORT AND HEALTH SCIENCE
• Description p.1
• Impact Factor p.1
• Abstracting and Indexing p.2
• Editorial Board p.2
• Guide for Authors p.5
ISSN: 2095-2546
DESCRIPTION
.
The Journal of Sport and Health Science (JSHS) is a peer-reviewed, international, multidisciplinary
journal dedicated to the advancement of sport, exercise, physical activity, and health sciences. JSHS
publishes original and impactful research, topical reviews, editorials, opinion, and commentary papers
relating physical and mental health, injury and disease prevention, traditional Chinese exercise,
and human performance. Through a distinguished, carefully selected international editorial board,
JSHS has adopted the highest academic standards, impeccable integrity, and an efficient publication
platform.
Fields of particular interest to the journal include (but are not limited to):
• Sport and exercise medicine
• Injury prevention and clinical rehabilitation
• Sport and exercise physiology
• Public Health Promotion
• Physical activity epidemiology
• Biomechanics and motor behavior
• Sport and exercise biochemistry and nutrition
• Sport and exercise psychology
• Exercise and brain health
• Physical education
• Traditional Chinese sports, exercise and health
IMPACT FACTOR
.
EDITORIAL BOARD
.
Editors-in-Chief
Peijie Chen, Shanghai University of Sport, Shanghai, China
Sport medicine, Diagnosis and evaluation of exercise-induced immunosuppression, Sport and
medicine integrated rehabilitation, and Physical fitness evaluation and surveillance
Walter Herzog, University of Calgary, Calgary, Alberta, Canada
Muscle contraction mechanisms, Mechanical properties of muscles, growth, healing, and adaptation
of soft (ligament, tendon, muscle, and articular cartilage) and hard (bone) tissues
Deputy Editors-in-Chief
Barbara E. Ainsworth, Arizona State University, Tempe, Arizona, United States
Physical activity and public health with focus on the assessment of physical activity in populations,
the Evaluation of physical activity questionnaires, and Physical activity in women
Lijuan Mao, Shanghai Municipal Education Commission, Shanghai, China
Sports biochemistry, Exercise stress, Oxidation and antioxidant
Yu Liu, Shanghai University of Sport, Shanghai, China
Neuromotor control of human movement, Biomechanics of sports injury
Jian Wu, Shanghai University of Sport, Shanghai, China
Physical Education, Sport information and communication
Associate Editors
Ralph Beneke, University of Marburg, Marburg, Germany
Modeling and computer-simulated analysis of energetics, Regulation and kinetics of physiological
measurements, Cellular integrity and function with special attention to event, training, environmental
conditions, age, health and clinical intervention
Chetwyn C.H. Chan, The Hong Kong Polytechnic University, Hong Kong, China
Applied cognitive neuroscience, Attention and working memory, Cognitive ergonomics, Evidence
based practice and clinical program evaluation
Yu-Kai Chang, National Taiwan Normal University, Taipei, Taiwan, China
Sport and exercise psychology, Sport and exercise cognitive neuroscience
Ang Chen, University of North Carolina at Greensboro, Greensboro, North Carolina, United States
Pedagogical studies in kinesiology
Sulin Cheng, University of Jyväskylä, Jyväskylä, Finland
Anatomy, Public health, Nutrition, Physiology, Physical activity assessment
J. Larry Durstine, University of South Carolina, Columbia, South Carolina, United States
Lipid and lipoprotein metabolism, Exercise management for chronic diseases and disabilities physical
activity, Physical fitness and health, Cardiac rehabilitation
Zan Gao, University of Minnesota, Minneapolis, Minnesota, United States
Promoting health with emerging technology through population-based physical activity interventions
Fuzhong Li, Oregon Research Institute, Eugene, Oregon, United States
Postural control, Cognitive function, Balance training, and Falls prevention in older adults and people
with movement disorders
Li Li, Georgia Southern University, Statesboro, Georgia, United States
Gait and balance of patients with peripheral neuropathy, The dynamics and neuromuscular control of
human gait transition, Locomotion stability and variability with different age groups
INTRODUCTION
Aims and Scope
The Journal of Sport and Health Science (JSHS) is a peer-reviewed, international, multidisciplinary
journal dedicated to the advancement of sport, exercise, physical activity, and health sciences. JSHS
publishes original and impactful research, topical reviews, editorials, opinion, and commentary papers
relating physical and mental health, injury and disease prevention, traditional Chinese exercise,
and human performance. Through a distinguished, carefully selected international editorial board,
JSHS has adopted the highest academic standards, impeccable integrity, and an efficient publication
platform.
Fields of particular interest to JSHS include (but are not limited to): Sport and exercise medicine
Injury prevention and clinical rehabilitation Sport and exercise physiology Public health promotion
Physical activity epidemiology Biomechanics and motor behavior Sport and exercise biochemistry
and nutrition Sport and exercise psychology Exercise and brain health Physical education Traditional
Chinese sports, exercise and health
Types of Paper
Contributions falling into the following categories will be considered for publication: Research
highlight, Commentary, Opinion, Review, Original article,Case study, Letter to the editor
Please ensure that you select the appropriate article type from the list of options when making your
submission. Authors contributing to special topic/section/issue should ensure that they select the
special issue article type from this list.
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Research Highlights are by invitation only and present short updates on new progress in the field of
sport and health. They should be no more than 900 words.
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Commentary articles comment on articles that have been published in JSHS and other top journals
or hot topics. They should contain no more than 1000 words of text, 1 display item (figure or table)
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Opinion pieces cover a wide variety of topics that are of current interest in sport and health and
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A Case study should report on specific cases that are unique, exciting, and current to exercise and
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individual or a community depending on the nature of the study. We expect most case studies to
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This journal operates a single blind review process. All contributions are typically sent to a minimum of
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for the final decision regarding acceptance or rejection of articles. The Editor's decision is final. More
information on types of peer review.
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Please submit the names and institutional e-mail addresses of several potential referees. For more
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international comparable and standardized measures of PA. The Each subject was invited to participate in a face-to-face
long form of the IPAQ (31 items) was developed to capture interview on Day 0 (D0) and received all explanations about
information about domains of PA but has been considered too the study and its purpose from an interviewer. After giving
long and too complex to be used in surveillance studies, while consent, participants answered sociodemographic and anthro-
the short form (9 items) does not take into account the domains pometric questions, then completed the GPAQ and IPAQ-LF.
of PA.7,8 For PA surveillance, the measurement of PA domains Then, the interviewer gave the participant an accelerometer
is needed to understand the patterns of PA and to develop inter- and explained its use. Participants were asked to wear the
ventions. Thus, in order to provide an instrument that would accelerometer for 7 consecutive days. Eight days after the first
address the limits of these questionnaires, the Global Physical interview (D8), participants returned the accelerometer and
Activity Questionnaire (GPAQ) has been developed by the completed the GPAQ and IPAQ-LF a second time. They were
WHO, as part of the WHO STEPwise approach to survey also asked if they had changed their activity during the week
chronic disease risk factors. It is now recommended by the of the study as compared to a typical week.
WHO for national surveillance of PA.1 Since its development,
the GPAQ has been translated into and tested in many languages
2.2. Instruments
and is used in many countries.916 In France, the GPAQ has
been used to describe and analyse PA and sedentary time of the We used the French translation of the GPAQ (Version
general population.17 However, it has not been validated in the 2.0)21 to gather information on the time spent in moderate and
9. Endash should be
French language. Evidence for the validity and reliability of the vigorous PA and in sedentary behavior. At the WHO level, the
used when more than
French version of the GPAQ is needed because the results may GPAQ has been translated in French by a professional transla-
3 consecutive
country.18
be affected by the sociocultural specificities of thereferences were cited. tor, and back-translated by 2 independent technical experts.
Rigorous methodology is needed to examine the degree in The versions were then compared, and where discrepancies
which an instrument is affected by measurement error (reliabil- existed, these were discussed and a consensus was found. The
ity) and measures the construct it intends to measure (validity).19 GPAQ contains 16 items designed to assess the frequency and
Concurrent validity refers to the degree to which the GPAQ duration of PA in 3 domains: during work, transportation, and
measures what it purports to measure, and criterion validity is leisure time as well as time spent sitting during a typical week.
the degree to which the results of the questionnaire are an ade- It distinguishes PA duration by min/day and min/week for
quate reflection of a “gold standard”. Because of no satisfying each PA domain, which allows for calculating the energy
available gold standard measurement for PA behavior, objective expenditure scored in metabolic equivalent tasks (METs). One
measures such as accelerometers and pedometers are commonly MET corresponds to resting energy expenditure. According to
used. To appraise the concurrent validity of the GPAQ, a ques- duration and energy expenditure, PA level was classified as
tionnaire measuring the same construct and with similar structure low, moderate, and high.
is considered relevant. Even if the IPAQ-LF is more detailed The French IPAQ-LF was used to test the concurrent valid-
than the GPAQ, it is the most similar in its construct and its ity of the GPAQ. It contains 27 items designed to assess the
structure. For this reason, the IPAQ-LF has been considered rele- frequency and duration of PA in 4 domains: during work,
vant to examine the concurrent validity of the GPAQ. transportation, household activities, and leisure time, then
This study aimed to assess the testretest reliability as well time spent sitting.11.
22 The company information of
The IPAQ-LF scores PA in terms of
as criterion and concurrent validity of the French version of energy expenditure (MET), including
instrument intensity"product model,
(low, moderate, high,
company name, city, country" is required.
the GPAQ by comparison with the IPAQ-LF and use of an and sedentary), and duration (min/day, min/week).
accelerometer in a general adult population in France. The ActiGraph accelerometer, model GT3X+ (ActiGraph,
Pensacola, FL, USA), was used as the criterion measure. The
2. Methods device is worn at the waist and measures and records the
10. IRB and informed
changes in acceleration and deceleration movements in 3 axes
2.1. Patients and study design consent satement are
necessary for original (antero-posterior, superio-inferior, and medial side). Data for
A convenient sample was recruited
articles. from January 20, 2015 measuring acceleration and deceleration are stored in non-vola-
to April 20, 2015, from the Medicine Campus, University of tile flash memory and can be read by using ActiLife software.
Lorraine, Nancy (north-eastern France), by posting an adver- Accelerometer data were scored using ActiLife 6 Data Analysis
tisement on campus and by e-mailing students and staff. Par- Software (ActiGraph) to assess time spent at various PA inten-
ticipants had to be 18 years old, working or studying at the sity levels (moderate and vigorous in min/day). Freedson’s
Medicine Campus, able to read and understand French, and Adult VM3 (2011) cut-off points were used to determine several
willing to participate in the study. The study protocol was PA levels: light: 02690 counts per minute (cpm); moderate:
approved by the Legal representative of the French data pro- 26916166 cpm; vigorous: 61679642 cpm; and very vigor-
tection authority (Commission Nationale Informatique et Lib- ous: 96431 cpm. Minutes spent at each intensity level were
ertes) of the University of Lorraine, France. All participants averaged across valid days. Non-wear periods were identified as
were asked to read and sign a consent form. A ratio of 5 sub- 60 consecutive minutes with no movement data (0 counts).23
jects per item was used to determine the number of partici- All calculations were based on 60 s epochs; an epoch is a user-
pants to include.20 Because the GPAQ contained 16 items, a defined time-sampling interval used to filter the acceleration
minimum number of 80 participants was required. signal. In this study, we used 7-day PA questionnaires, so only
12. A running head (short title) under 6
words is necessary.
French version of the GPAQ 341
data with 10 h of wear time per day for 7 days were consid- 0.000.20; fair: 0.210.40; moderate: 0.410.60; substantial:
ered valid and included in the analysis.24,25 0.610.80; and almost perfect: 0.811.00. ICC and Spearman
Sociodemographic data such as age, sex, and education correlation <0.50 were considered as poor, 0.500.75 were
(high school or higher education) and socioprofessional status considered as moderate, and >0.75 were as good.29
(student or staff) were collected. Anthropometric data including
height (in m) and weight (in kg) were reported by each partici- 3. Results 14. KEY point to be noted: all the data
pant for calculating body mass index (BMI, kg/m2), then partic- presentation should be consistent throughout
3.1. Participant
the characteristics
article including the Abstract, text of the
ipants were classified by BMI level: underweight (BMI
Results, Tables and Figures.
<18.5 kg/m2), normal weight (18.524.9 kg/m2), overweight In total, 92 subjects participated in the study (age
25.029.9 kg/m2), and obese (30 kg/m2). All data (except 30.1 § 10.7 years, range 1958 years; 67 (72.8%) females);
accelerometer data directly transferred into ActiLife software) 56.5% were students, 95.6% had higher education, 9.8% had
were entered into an electronic case report form (CRF) created chronic disease, and 76.9% had normal BMI (Table 1). Over-
13. TheAssociation,
with Epidata 3.1 (The EpiData company information
Odense, of software
Denmark). all, 25% of participants declared having changed their activity
including "product model, company name, between the 2 visits, but the difference between the total PA
city, country" is required. means measured by the GPAQ was not statistically significant
2.3. Statistical analysis (p = 0.49).
Data analysis involved use of SAS Version 9.4 (SAS Inst.,
Cary, NC, USA). Qualitative variables were reported as rela- 3.2. Descriptive statistics for the GPAQ, IPAQ, and
tive frequency and quantitative variables as mean § SD or accelerometer
median. The Kolmogorov-Smirnov test was used to assess the All descriptive statistics for GPAQ, IPAQ, and accelerome-
normality of data distribution. For participants who declared ter are presented in Table 2.
changing their PA, paired Student’s t test was used to evaluate
the difference in total PA between the 2 visits. Because the 3.3. Testretest reliability
activity measured by the GPAQ includes work and household
The ICCs ranged from 0.37 to 0.94, with the highest ICC for
activities, it was compared to the sum of work and household
vigorous leisure PA. Only total vigorous and vigorous leisure
PA measured by the IPAQ-LF.
PA showed good reliability, whereas all other PA scores were
Testretest reliability was tested by the Kappa coefficient for
poor to moderate, with the lowest value for moderate leisure PA
categorical data and the intraclass correlation coefficient (ICC) for
(ICC = 0.37, 95%CI: 0.150.56). A good reliability for total sit-
quantitative data. Spearman correlation was also calculated for
ting time was also observed (ICC = 0.80, 95%CI: 0.690.87)
quantitative data to compare with previous studies.1114 Non
whereas it was moderate for total PA (ICC = 0.58, 95%CI:
parametric correlation coefficient was used because of non-Gauss-
0.400.72). For PA level, the Kappa coefficient showed moder-
ian distribution for most of PA-score. For one of the GPAQ’s ques-
ate to substantial correlation, varying from 0.50 to 0.62 for mod-
tion, one answer modality was overrepresented and the correlation
erate and low PA levels, respectively. For vigorous activity at
was not concordant with the observed agreement (when visualizing
work, the GPAQ showed an almost perfect reliability
the data, the agreement seems good but it was not observed when
(PABAK = 0.91). Except for total PA, with ICC = 0.58, 95%CI:
assessed with ICC and Spearman correlation). Thus the variable
0.400.72 and Spearman’s r = 0.82, 95%CI: 0.720.88, most
was converted into a discrete variable, and the prevalence-adjusted
Spearman values were similar to the ICC (Table 3).
and bias-adjusted Kappa (PABAK) was used to assess the agree-
ment.26 Concurrent validity was examined by comparing data for Table 1
the GPAQ and IPAQ-LF at D0 and D819 with the Spearman corre- Sociodemographic and anthropometric characteristics of participants (n = 92).
lation coefficient and its 95% confidence interval (CI) for quantita- Total sample (%)
tive data and the Phi coefficient for qualitative data. Criterion
Sex
validity was examined by comparing minutes of PA obtained with Male 25 (27.2)
the GPAQ to accelerometer-obtained data at D8 by the Spearman Female 67 (72.8)
correlation coefficient and its 95%CI. Socio-professional status
Both the concurrent and criterion validity of the GPAQ were Student 52 (56.5)
Staff 40 (43.5)
assessed by Bland-Altman plots to measure the agreement and
Education level
bias for total PA and sedentary time between questionnaire’s High school 4 (4.4)
answers and results from accelerometer.27 Correlation assesses Higher education 88 (95.6)
the degree to which 2 variables are related. However, a high Age (year)a 30.1 § 10.7
correlation does not necessary imply that there is good agree- BMI (kg/m2)a 22.6 § 3.5
BMI classes (kg/m2)a
ment between the 2 methods. Thus, Bland-Altman was used to
Underweight <18.5 3 (3.3)
quantify the agreement between 2 measurements by plotting Acceptable weight 18.524.9 71 (76.9)
the difference between the 2 measurements against the average Overweight 25.029.9 14 (15.4)
obtained with each of the 2 methods. Obese 30 4 (4.4)
Kappa and Phi coefficients were classified by the ratings a
Data are presented as mean § SD. 15. Notes and
suggested by Landis and Koch:28 poor: <0.00; slight: Abbreviation: BMI = body mass index. Abbreviations should be
reflected as footnote.
All the abbreviations
should be listed
alphabetically.
342 F. Riviere et al.
Table 2
Data for PA measured by GPAQ, IPAQ, and an accelerometer at Day 0 (D0) and Day 8 (D8) in 92 participants.
3.4. Concurrent validity (Table 4). The values at D0 and D8 seemed almost identical,
but important discrepancies were observed between vigorous
For both measurement times, we observed good correlations
work at D0 (r = 0.58, 95%CI: 0.430.70) and at D8 (r = 0.81,
between the GPAQ and IPAQ for vigorous activity during lei-
95%CI: 0.730.87). Overall, total PA showed moderate
sure, total vigorous activity, and sitting time (r = 0.760.89)
Table 4
Concurrent validity between the GPAQ and IPAQ-LF data at Day 0 (D0) and
Day 8 (D8) (n = 92).
Table 3
Testretest reliability of the GPAQ (n = 68). Variable D0 D8
Variables ICC Spearman’s Rho Kappa Spearman’s Phi Spearman’s Phi
(95%CI) (95%CI) coefficient Rho (95%CI) coefficient Rho (95%CI) coefficient
Total PA 0.58 (0.400.72) 0.82 (0.720.88) Total PA 0.66 (0.530.76) 0.67 ((0.540.77)
PA by domain PA by domain
Work Work
Vigorous 0.91(+) Vigorous 0.58 (0.430.70) 0.81 (0.730.87)
Moderate 0.48 (0.280.64) 0.52 (0.330.68) Moderate 0.56 (0.400.68) 0.61 (0.460.72)
Transport 0.67 (0.520.79) 0.69 (0.530.79) Transport 0.52 (0.350.65) 0.69 (0.570.79)
Leisure Leisure
Vigorous 0.94 (0.910.96) 0.89 (0.840.94) Vigorous 0.86 (0.790.90) 0.79 (0.700.85)
Moderate 0.37 (0.150.56) 0.53 (0.330.68) Moderate 0.46 (0.280.61) 0.53 (0.360.66)
Sitting time 0.80 (0.690.87) 0.78 (0.670.86) Sitting time 0.85 (0.780.90) 0.89 (0.840.93)
PA by intensity PA by intensity
Total vigorous 0.84 (0.760.90) 0.80 (0.700.88) Total vigorous 0.86 (0.790.90) 0.76 (0.660.84)
Total moderate 0.48 (0.280.65) 0.56 (0.380.71) Total moderate 0.41 (0.220.56) 0.58 (0.420.70)
PA level PA level
Low 0.62 Low 0.22 0.49
Moderate 0.50 Moderate 0.27 0.27
High 0.57 High 0.57 0.54
(+): Adjusted Kappa (PABAK). Abbreviations: GPAQ = Global Physical Activity Auestionnaire; IPAQ-LF =
Abbreviations: CI = confidence interval, GPAQ = Global Physical Activity International Physical Activity QuestionnaireLong Form; PA = physical
Questionnaire; ICC = intraclass correlation coefficient; PA = physical activity. activity.
20. Tips for Figure preparation:
1. version
French The preferred Figure format: TIFF or EPS;
of the GPAQ 343
4. Text with figures: use the same font as "Arial" for all figures
with the font size of 6-8 pt;
Fig. 1. Bland-Altman plots of the validity of the Global Physical Activity Questionnaire (GPAQ). A and C: Agreement of GPAQ with IPAQ for total PA and sitting
time at D0; B and D: Agreement of GPAQ with accelerometer for total PA and sitting time at D8. IPAQ = International Physical Activity Questionnaire; PA = physical
activity. 21. Figure legend should interpret the meaning of the information which was
given in all figures, so that readers can easily get the idea based on them.
correlation at both D0 (r = 0.66, 95%CI: 0.530.76) and D8 day reported with the GPAQ and derived from accelerometer
(r = 0.67, 95%CI: 0.540.77). Results of Bland-Altman analysis counts.
The significance Poor but
(*, #) symbols significant
in the correlations
figure should be describedforheresedentary
like time
(Fig. 1A, C) for the GPAQ and IPAQ demonstrated a mean "*p<0.05,
dif- compared < 0.01)group".
withpcontrol
(r = 0.42, and total vigorous PA (r = 0.38, p < 0.01)
ference of 637.2 § 1641.5 MET min/week. The limits of agree- were observed (Table 5).
ment for the 2 instruments were wide, with the difference Abbreviations should be arranged findings
Bland-Altman alphabeticallyis at the that
revealed end ofthe
figure legendunderre-
GPAQ
between 1004.3 MET min/week and 2580.1 MET min/week. ported total PA, with a mean difference between the GPAQ
For sedentary time, the mean difference of sedentary time Permission
was must andbe provided if the data
accelerometer figures
ofwere cited§or157.46
443.95 adaptedmin/week
from other(Fig. 1B,
publications.
¡15.5 § 79.2 min/day. Overall, the classification by level of PA D). Limits of agreement for the 2 instruments were wide, with
with the 2 questionnaires, at both times, was only poorly to the difference between 286.5 min/week and 601.3 min/week
moderately correlated, with a Phi coefficient ranged from 0.22 GPAQ underestimated sedentary time as compared with the
to 0.57 (Table 4). accelerometer, with a mean difference between the 2 instru-
22. Please cite figure or tables as "Fig.1"(Figs.
ments of 251.2 § 161.1 min/day. Limits of agreement for the 2
1-3) or "Table 1"(Tables 1 and 2), respectively.
3.5. Criterion validity instruments ranged from 90.1 min/day to 412.3 min/day.
Accelerometer data were considered valid for 87 of the 92
participants (5 participants did not wear an accelerometer for
4. Discussion
at least 10 h per day over 7 days). Criterion validity was
assessed by comparing total PA time spent in vigorous-inten- This study provides results, for the first time in a French
sity activity, or in moderate-intensity activity, or sitting per population, for the reliability and validity of the GPAQ.
344 F. Riviere et al.
Lorent Phialy: Responsible for the publication on dynamic 12. Cleland CL, Hunter RF, Kee F, Cupples ME, Sallis JF, Tully MA. Validity
screens of the Faculty of Medicine of Nancy, who participated of the Global Physical Activity Questionnaire (GPAQ) in assessing levels
in the development of the video message; and change in moderate-vigorous physical activity and sedentary behav-
iour. BMC Public Health 2014;14:1255. doi:10.1186/1471-2458-14-1255.
Elisabeth Schmitt: Responsible for the education office of 13. Herrmann SD, Heumann KJ, Der Ananian CA, Ainsworth BE. Validity
the Faculty of Medicine of Nancy, who participated in the dis- and reliability of the Global Physical Activity Questionnaire (GPAQ).
semination of the information about the study to students; Meas Phys Educ Exerc Sci 2013;17:221–35.
25. Authors'
All volunteers who participated contributions should be written
in this study. 14. Hoos T, Espinoza N, Marshall S, Arredondo EM. Validity of the Global
in the following format. Please note that Physical Activity Questionnaire (GPAQ) in adult Latinas. J Phys Act
each author's name can ONLY appear forHealth 2012;9:698–705.
Authors’ contributions once. 15. Soo K, Manan WWA, Suriati WW. The Bahasa Melayu version of the
Global Physical Activity Questionnaire reliability and validity study in
FZW participated in the design of the study, contributed to Malaysia. Asia Pac J Public Health 2015;27:NP184–93.
data collection and data reduction/analysis; AV, ES partici- 16. Trinh OT, Do Nguyen N, van der Ploeg HP, Dibley MJ, Bauman A.
Testretest repeatability and relative validity of the Global Physical
pated in the design of the study; FR participated in the design
Activity Questionnaire in a developing country context. J Phys Act Health
of the study and contributed to data collection; MLE contrib- 2009;6:(Suppl. 1):S46–53.
uted to data reduction/analysis; HE contributed to data analy- 17. Escalon H, Bossard C, Beck F, Bachelot-Narquin R. Barom etre sante
sis and interpretation of results. All authors contributed to the nutrition 2008. Saint-Denis: INPES; 2009.
manuscript writing. All authors have read and approved the 18. Arredondo EM, Mendelson T, Holub C, Espinoza N, Marshall S. Cultural
adaptation of physical activity self-report instruments. J Phys Act Health
final version of the manuscript, and agree
26. Competing with the
interests order isof
statement 2012;9:(Suppl. 1):S37–43.
presentation of the authors. neccessary for each article. 19. Terwee CB, Mokkink LB, van Poppel MN, Chinapaw MJ, van Mechelen
W, de Vet HC. Qualitative attributes and measurement properties of phys-
ical activity questionnaires. Sports Med 2010;40:525–37.
Competing interests 20. Anthoine E, Moret L, Regnault A, Sebille V, Hardouin J-B. Sample size
used to validate a scale: a review of publications on newly-developed
The authors declare that they have no competing interests. patient reported outcomes measures. Health Qual Life Outcomes
2014;12:176. doi:10.1186/s12955-014-0176-2.
21. World Health Organization. Global Physical Activity Questionnaire
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TUGAS
Oleh:
ATIKAH RAHAYU
NIM 20708261007
Atikah Rahayu
Correspondence:
Atikah Rahayu
Student of study program doctoral of sports science, Faculty of Sports Sciences,
Universitas Negeri Yogyakarta, Indonesia
Jl.Colombo Yogyakarta 55281, Indonesia
Tel/Fax: +62-81225331538
E-mail: atikahrahayu.2020@student.uny.ac.id
Abstract
Density of bone mass can be changed by physical activity, due to the formation of enzymes
in bone, resulting in enlargement/compaction of bones (hypertrophy). For new bone
formation to occur, continuous design is needed on the bone through muscle training. Low
bone mass density illustrates low bone quality. The study design used cross sectional design.
The subjects of the study were all teenagers in junior high schools selected along the
Martapura riverbank, Banjar Regency, South Borneo. Sampling by measuring physical
activity, level of knowledge, and protein intake as well as family characteristics such as
mother and father education, family income, and number of family members. The research
instrument used quantitative ultrasound bone densitometry to measure bone mass density,
Baecke questionnaire to measure physical activity, 24-hour food recall form to measure
protein intake and structured questionnaire to determine the characteristics of respondents
and families. The results showed a relationship between low bone mass density and physical
activity p=0,001, with Exp (B) =12,981. It can be concluded that less active physical activity
is at risk of causing low bone mass density.
Introduction
Low bone mass density is a description of the state of bone with low quality can be
identified after a period of perfect development. An early sign of low bone mass density is
low is osteopenia, while further osteoporosis. Osteoporosis is bone loss, especially in the
spine, upper arm and pelvis. The symtomatic of osteoporosis are difficult to detect, most are
only realized when there has been a swelling of the spine, cracks or broken bones, pinched
nerves. Some risks of osteopenia and osteoporosis are lack of protein intake in physical
activity. Lack of consumption of fish-sourced protein in adolescents will be related to bone
mass density, this is because teenagers often limit their consumption of food, and their
consumption patterns often violates the rules of nutrition (1).
These results are supported from the results of previous studies that the majority of
adolescents with low protein intake causes low bone mass density, which is 53,7%. When a
person reaches the peak of growth, the body's protein needs become stable. Protein in
adolescence is relatively high, because muscular, skeletal/skeletal acceleration and endocrine
development are greater than childhood and adulthood (2,3).
Bone mass density can be altered by physical activity. This occurs because physical
activity causes the formation of enzymes in bone, so enlargement/compaction of bones
(hypertrophy). For new bone formation to occur, continuous design is needed on the bone
through muscle training. Based on national data and data in South Kalimantan aged ≥10 years
included in the category of lack of physical activity. The less category is defined as
cumulative physical activity less than 150 minutes a week. The amount of age that lacks
physical activity is 33,5% (4). It is important to keep physical activity active so that bone
mass density is maintained (5,6).
Ethics Approval
This study was approved by the Ethics Committee faculty of Medical (ethic code 4/56).
Statistical Analysis
The data obtained were analyzed using univariate, bivariate, and multivariate. The results
of the univariate analysis are presented in the form of a frequency distribution table
(percentage) to find out the distribution of low bone mass density risk, bivariate analysis
using Chi-Square if not met followed by using the Fisher's Exact Test to find out the
relationship between risk factors and bone mass density and multivariate analysis using
logistic regression to find out the most dominant risk factor associated with low bone mass
density in adolescents.
.
Results
Univariate Analysis
Table 1 shows the distribution of variables according to categories that are likely related
to low bone mass density of respondents.
Table 1. Frequency distribution of respondent and family characteristics
Bone mass density categories Frequency (people) Percentage (%)
a. Low Bone mass
65 79,3
density/osteopenia/osteoporosis
b. Normal 17 20,7
Physical activity
a. Less active 51 62,2
b. Active 31 37,8
Father's Education Level
a. Not graduated from Junior High
62 74,6
School
b. High school - college 20 24,4
Mother's Education Level
a. Not graduated from Junior High
61 74,4
School
b. High school - college 21 25,6
Level of Family Income
a. < employee minimum wage 62 75,6
b. ≥ employee minimum wage 20 24,4
Number of Family Members
a. ≥ 5 people 54 65,9
b. < 5 people 28 34,1
Knowledge Level
a. Low 20 24,4
b. Good 62 75,6
Protein Intake
a. Inadequate 52 63,4
b. Adequate 30 35,6
Employment status of head of household
a. Does not work 10 12,2
b. Work 72 87,8
Source: Primary Data, 2019
Table 1 shows that the majority of respondents had osteopenia, 65 people (79,3%). Some
other potential variables have a relationship with the incidence of osteopenia in respondents,
namely physical activity, father's education level, mother's education level, family income,
number of family members, protein intake, level of knowledge, work status of parents. Table
1 shows that adolescents who have less active physical activity categories are more numerous
than adolescents with active physical activity that is equal to 51 people (62,2%), fathers and
mothers who have not completed primary education until junior high school are greater in
number each a total of 61 people (74,6%) and 62 people (74,4%). With the level of education
of parents low category resulted in incomes earned by parents/family also became inadequate
to meet the needs of family food consumption.
The results of this study indicate that the majority of family income is still below the
employee minimum wage of 60 people (75,6%). This employee minimum wage refers to the
employee minimum wage Regency of Banjar in the amount of Rp.2,248,000.00. In addition,
a factor that contributes to the incidence of osteopenia is the number of family members. The
results of this study found that the majority of respondents had a relatively large number of
family members (>5 people) namely 54 people (65,9%). It is likely that the relatively large
number of family members will affect the food distribution of family members.
The results of this study indicate that the level of knowledge of respondents still have
knowledge of less than 24,4%. It is potential that most of the protein intake is lacking due to
the low level of respondents' knowledge to meet their body's need for protein. The number of
respondents who have low protein intake is equal to 63,4%. The magnitude of the frequency
distribution between each of these variables has not been able to show the relationship
between the variable characteristics of respondents and families with low bone mass density,
so it needs bivariate analysis so that the relationship between the two variables (free and
bound) is known for their significance, in detail can be seen in Table 2.
Bivariate Analysis
Table 2. Relationship between respondent and family characteristics with Bone Mass Density
Bone Mass Density
Low Bone Mass Normal PR
Characteristics Category
Density (95% CI)
p
n % n %
Physical activity Less active 47 90,4 5 9,6 1,506 0,000*
Active 18 60,0 12 40,0 (1,110-2,044)
Father's Education Level Not graduated from 52 83,9 10 16,1 1,290 0,110
Junior High School- 13 65,0 17 35,0 (0,919-1,812)
Mother's Education Level college
52 85,2 9 14,8 3,556 0,032*
Not graduated from
Junior 13 61,9 8 38,1 (1,15-7,005)
Level of Family Income
High School- college 53 85,5 9 14,5 3,396 0, 024*
< employee minimum wage 12 60,0 8 40,0 (1,126-6,258)
Number of Family Members
> employee minimum wage 42 77,8 12 22,2 0,947 0,644
> 5 people 23 82,1 5 17,9 (0,757-1,185)
Protein intake
< 5 people 48 66,3 3 33,7 1,716 0,001*
inadequate 17 33,7 14 66,3 (1,238-2,380)
Knowledge Level
adequate 16 80,0 4 20,0 1,012 1,000
Employment status of head of Low 49 79,0 13 21,0 (0,785-1,305)
household Good 9 90,0 1 10,0 1,157 0,679
Does not work 56 77,8 16 22,2 (0,909-1,472)
Work
*p value (<0,05)
Table 2 shows that several variables show a relationship with bone mass density in
respondents. These variables are physical activity with p=0,000 and PR=1,506 (1,110-2,044),
mother's education level with p=0,032 and PR=3,556 (1,15-7,005), number of family
members with p=0,024 and PR=3,396 (1,126-6,258), protein intake with p=0,001. This
analysis uses the Che-Square test with a 95% confidence level. The results of the analysis
resulted in physical activity having the greatest relationship compared to other variables
(p=0,000).
This means that the results of this relationship test show the closeness between the
relationship of physical activity with the risk of low bone mass density in respondents. This
can be seen from Table 2 which shows that a total of 47 people (90,4%) of respondents with
less active physical activity have low bone mass density. Although the closeness of the
relationship between physical activity and bone mass density is greater, the risk of family
income that has a <employee minimum wage is greater, causing respondents to experience
low bone mass density (PR=3,556), which is 53 people (85,5%).
The close relationship between variables using bivariate analysis has not shown the risk
of dominant factors associated with low bone mass density in respondents. Further analysis is
needed in order to find out which variable is most associated with low bone mass density in
respondents, namely multivathic logistic regression analysis.
Multivariate Analysis
The statistical analysis used is multiple logistic regression analysis. Variables that are
candidates for the multivariate model are independent variables with bivariate results
resulting in ps<0,25, then these variables directly enter the multivariate stage. For
independent variables whose bivariate results produce p>0,25 but substantially important,
these variables can be included in the multivariate model. The variables included in the
multivariate model can be seen in Table 3.
Table 3. Modeling the most dominant factors related to low bone mass density
Variables B SE Wald Sig Exp (B)
Protein intake 2,272 885 6,586 0,010 9,696
Father's Education -168 1,466 1,164 0,281 0,206
Level
Mother's Education -1,582 1,716 0,010 0,922 0,845
Level
Level of Family Income -2,256 1,717 1,727 0,189 9,549
Knowledge level 1, 354 998 4,797 0,032 6, 685
Physical activity 2,257 0,747 11,708 0,001 12,981
Table 3 shows that the variable calcium intake is the most dominant risk factor associated
with low bone mass density in adolescents with p=0,001, with Exp (B)=12,981 which means
that adolescents with physical activity less active risk of 12,981 times greater experience
osteopenia and can continue to become osteoporosis compared to adolescents with active
physical activity.
Discussion
Less physical activity can be reduced bone mass density. This occurs because physical
activity causes the formation of enzymes in bone, so enlargement/compaction of bones
(hypertrophy). For new bone formation to occur, continuous design is needed on the bone
through muscle training. Exercise regularly. With a frequency of 3-5 x/week not on
consecutive days with a time of 20-60 minutes and can properly increase low bone density
and reduce the risk of osteopenia. In addition, continuous activities and heavy loads may
quickly increase bone mass density, but must be adjusted to the load because the bone mass
density is not ocollegeimal compared to regular physical exercise and the appropriate load.
Certainly, it is supported by nutritional intake. such as protein, calcium, vitamin D which
meet the body's needs. With nutritional intake that matches the body's needs, the risk of
osteoporosis in old age can be minimized (7).
This is in line with this study which found that protein intake less than RDA is associated
with bone mass density. In multivariate analysis, Exp (B) 9,696, which means that protein
intake that is less than RDA causes respondents to experience low bone mass density.
Respondents whose protein intake is less than the RDA are 9,696 times more likely to
experience low bone mass density compared to respondents whose protein intake is
sufficient. Increased nutritional needs in adolescence are related to the accelerated growth
they experience. Bone mass density increases during puberty, its peak is reached at ages
above 10 to the beginning of 20 years (8). Bone is a complex network of cells and a matrix.
The bone matrix is formed by fibers and basic substances containing mineral salts. The mass
and thickness of the bones at any time always experience the dynamics of addition and
reduction through the process of remodeling (the bone matrix is absorbed and reshaped
(9,10). The process of forming and absorbing the bone, it is necessary to try to maintain bone
mass density from an early age, so as to avoid bone mass density such as osteopenia or
osteoporosis (9,11). In addition, osteoporosis is a systemic bone disease characterized by a
decrease in bone mass density and deterioration of bone microarchitecture, so bones become
brittle and break easily. Osteoporosis occurs when the process of bone erosion and bone
formation becomes unbalanced (12,13).
A high bone mass means strong and healthy bone, so it is not easy to get loose and
brittle. The cause or etiology comes from the risk factors that can be controlled and cannot be
controlled which is owned by an individual. Risk factors that can be controlled include lack
of activity or exercise. Previous studies have proven that physical exercise is carried out
regularly and with certain doses causing an increase in bone mass density, bone size and bone
shape (14,15,16). Statistical analysis showed that there was a significant relationship between
respondents whose physical activity was less active with low bone mass density (p<0,05) and
PR 1,506 which meant that respondents with less active physical activity had a risk of 1,506
times greater risk of experiencing low bone mass density compared to respondents whose
active physical activity. Sport is a repetitive physical activity and aims to maintain, improve
and express fitness. Several studies were conducted to determine the effect of physical
exercise on bones (17,18).
Exercise can play a role in the process of increasing bone mass density. High bone
density and mass are expected to be reached when the peak of bone mass, so that when the
process of decreasing bone remodeling will take a long time to reach the low point of bone
mass density which is at risk of osteoporosis. Therefore, regular and well-programmed
exercise in the age before 30 years is highly recommended in an effort to prevent early
osteoporosis. The volume of training is not only related to the duration of the exercise but
also includes aspects of distance or load per unit of time and aspects of the number of reps of
the exercise, so volume is the implication of the total quantity of training activity
performance or training phase. When referring to the training volume, the amount of time, the
number of training days, and the number of exercises must be specified (19,20).
Conclusion
Most of the bone mass density of respondents was low, amounting to 65 people (79,3%)
out of 82 total respondents. The most dominant risk factor for low bone mass density in these
respondents is due to the lack of active adolescents doing physical activity. With less active
physical activity, respondents had a greater risk of 12,981 times having osteopenia and could
continue to develop osteoporosis compared to respondents with active physical activity.
Acknowledgements
We thank all participants in this research.
Competing Interest
The authors declare that they have no competing interests.
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Jawaban 2
Dua Jurnal Dalam Negeri Dan 2 Jurnal Luar Negeri
Status Jurnal
Journal of Preventive Medicine and Hygiene diterbitkan setiap tiga bulan dan mencakup
bidang epidemiologi dan kesehatan masyarakat. Jurnal menerbitkan makalah asli dan prosiding
Simposium dan / atau Konferensi yang harus diserahkan dalam bahasa Inggris dengan
pengecualian bahasa lain. Makalah diterima berdasarkan orisinalitas dan minat umum.
Pertimbangan etis akan diperhitungkan. JPMH adalah jurnal akses terbuka, peer-review yang
membahas makalah tentang epidemiologi dan pencegahan penyakit menular dan degeneratif dan
pemahaman tentang semua aspek kesehatan masyarakat.
JAWABAN 4
Petunjuk Bagi Penulis
Jawaban 5
The Journal of Preventive Medicine and Hygiene (JPMH) adalah jurnal internasional,
multidisiplin, akses terbuka, peer-review yang diterbitkan setiap tiga bulan dan mencakup bidang
Hygiene, Preventive Medicine, dan Kesehatan Masyarakat. Jurnal telah menerbitkan artikel asli,
review, editorial, surat dan prosiding simposium dan konferensi sejak 1960. Review sistematis dari
topik yang relevan dengan tujuan jurnal sangat disambut baik. Validitas ilmiah, kelayakan
metodologis, orisinalitas, dan kemajuan di bidang Higiene, Pengobatan Pencegahan, dan
Kesehatan Masyarakat adalah kriteria penerimaan utama. Untuk informasi lebih lanjut, silakan
periksa Kebijakan Bagian kami.
Dalam persiapan naskah, Semua manuskrip harus disimpan dalam Microsoft Word
(format file .doc dan .docx dapat diterima). Gunakan teks Times New Roman 12 poin, dengan
spasi baris ganda (teks harus rata). Gunakan huruf miring untuk penekanan, nama spesies
(misalnya N. meningitidis) dan kata non-Inggris (misalnya Raffreddore). Semua halaman dan baris
harus diberi nomor secara otomatis. Jangan membenarkan atau pun memenggal teks. Tidak ada
batasan panjang; namun, penulis diundang untuk menjadi faktual dan ringkas.
JPMH menerbitkan dalam bahasa Inggris Britania. Jika bahasa asli pengarang bukan bahasa
Inggris, kami sangat menyarankan pemeriksaan ulang oleh profesional yang berkualifikasi. Ini
dapat dilakukan oleh layanan pengeditan bahasa Inggris JPMH. Jenis makalah berikut
dipertimbangkan untuk publikasi di JPMH: Artikel asli, Artikel pendek, Ulasan naratif dan
sistematis, Editorial, dan Surat untuk Editor.
Sedangkan untuk organisasi naskah, Artikel dan review asli dan pendek harus disajikan dengan
urutan sebagai berikut:Judul Halaman, Abstrak, Teks utama dengan bagian-bagian berikut: a.
Pendahuluan, Metode, Hasil, Diskusi, kesimpulan untuk artikel asli dan singkat serta tinjauan
sistematis; b. Judul dan subjudul yang sesuai untuk ulasan naratif. Ucapan Terima Kasih, Konflik
kepentingan, Referensi, Judul gambar / legenda, dan Tabel. Adapun editorial dan Surat untuk
Editor harus ditulis sebagai satu bagian berkelanjutan; abstrak, tabel atau gambar tidak
diperbolehkan.
Teks tersebut memiliki spasi ganda; menggunakan font 12 poin; menggunakan huruf
miring, bukan menggarisbawahi (kecuali dengan alamat URL); dan semua ilustrasi, gambar, dan
tabel ditempatkan di dalam teks pada titik yang sesuai, bukan di akhir. Teks tersebut mematuhi
persyaratan gaya dan bibliografi yang diuraikan dalam Panduan Penulis, yang dapat ditemukan di
Tentang Jurnal. Jika mengirimkan ke bagian jurnal yang ditinjau sejawat, petunjuk dalam
Memastikan Peninjauan Buta telah diikuti.
Jawaban 7