Management of Physiotherapy in Case Diabetes Mellitus Type 2 With Methods

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MANAGEMENT OF PHYSIOTHERAPY IN CASE
DIABETES MELLITUS TYPE 2 WITH METHODS
BODY WEIGHT TRAINING AND
DIABETES EXERCISE
SCIENTIFIC PAPERS
Arranged by :
SEFHIA LESTARI
201951015
DIII PHYSIOTHERAPY STUDY PROGRAM
BAITURRAHIM HIGH SCHOOL OF HEALTH SCIENCES
JAMBI 2022
MANAGEMENT OF PHYSIOTHERAPY IN CASE
DIABETES MELLITUS TYPE 2 WITH METHODS
BODY WEIGHT TRAINING AND
DIABETES EXERCISE
SCIENTIFIC PAPERS
To Fulfill the Requirements for Achieving an Associate Degree

In the Diiii Physiotherapy Study Program
Arranged by :
SEFHIA LESTARI
201951015
DIII PHYSIOTHERAPY STUDY PROGRAM
BAITURRAHIM HIGH SCHOOL OF HEALTH SCIENCES
JAMBI 2022
ii
APPROVAL PAGE
Scientific Writing with the Title
MANAGEMENT OF PHYSIOTHERAPY IN CASE OF DIABETES

MELITUS TYPE 2 WITH BODY WEIGHT METHOD
DIABETES TRAINING AND EXERCISE
Arranged by:
SEFHIA LESTARI
19 51 015
Has Been Tested In Front Of The Board Of Examiners
Scientific and declared to have passed and
Eligible, on:
Day :
Date :
Examiner Board
1. Wanti Hasmar, S.Ftr., M.Or Chairperson of the Session
2. Ucu Suherman, S.Pd., Ftr Secretary
3. Main Examiner
iii
ENDORSEMENT PAGE
Scientific Writing with the title:
Arranged by:
SEFHIA LESTARI
2019 51 015
Has been tested on June 2022 and declared passed with the composition of
the test team
Chairperson of the Session : Wanti Hasmar, S.Ftr., M.Or

Secretary : Ucu Suherman, S.Pd., Ftr
Examiner :
agree
Advisor I Advisor II
Wanti Hasmar, S.Ftr., M.Or Ucu Suherman, S.Pd., Ftr

NPP. 63719 Date : NPP. 34013
Date :
Knowing
Head of STIKBA Head of DIII Physiotherapy Study Program
Dr. Filius Chandra, SE., MM Adi Saputra Junaidi, S.Fis., M.Fis

NPP.03404 Date : NPP. 33013
Date :
iv
STATEMENT LETTER
The undersigned below :
Name : SEFHIA LESTARI
NPM : 2019 51 015
Study Program : DIII Physiotherapy
Stating that the Scientific Writing with the title "
Physiotherapy Management With the "Body Weight Training And " Method
Diabetes Gymnastics in the Case of Type 2 Diabetes Mellitus” is the result of the work
Write scientifically yourself and do not plagiarize, according to the rules
applies at the Baiturrahim Jambi School of Health Sciences.
Thus this statement I make in truth. If
in the future what I say is not true, then I am willing

receive sanctions for this action.
Jambi, May 28, 2022
SEFHIA LESTARI
NPM. 201951012
v
WORD OF DEPOSIT
I dedicate this scientific paper:

1. Thanks to ALLAH SWT for His blessings and guidance
the author can complete this scientific paper, and don't forget us
Say sholawat and greetings to our lord the prophet Muhammad
SAW.
2. Thanks also to my parents papa Wasito (late) and mama

Asnawati, my respect, thank you once again I say to both
my parents for all the love and love and support that you guys
give it to me, hopefully this initial achievement can be a little
proud and make papa and mama smile, especially to
my dear mother thank you for raising me, sorry if it's long
this is only difficult that I give to you, through this scientific paper I
will prove I can compete with other friends,
Mama you have become a successful mother because you have been to school
we reached the level of education, I love you.

3. Thank you to all the big family, especially Sri Rahayu's sister and
Amel who always prays and gives encouragement to everyone
step.
4. To the loved ones, fia alvareza, thank you for your constant support
be the best support to always be an encouragement to achieve the target,
I love you guys.
5. To the supervisor I Wanti Hasmar, S.Fis, M.Or and to the supervisor
II Ucu Suherman, S.Pd, Ftr who always divides his time for
guide, direct, and motivate the writing of the work
Scientific writing can run smoothly and finish as it should.
6. To all DIII Physiotherapy lecturers, thank you for the knowledge that has been given
you convey and be my provision for the future.

7. Thanks to my comrades in arms, Cemey, Adel, Taca, Dila, Dina,
dhea, supok, uci, sis jum, sis mei, sis and the dormitory personnel who
vi
has supported and encouraged me to immediately complete the above kti

our solidarity, tears, jokes and laughter for these 3 years that will
I miss you, thank you to friends of FT 19, for your solidarity
and solidarity during this time. Always go forward and compact FT 19, graduation
together yes.
8. To all parties involved in helping.
9. STIKBA IS THE BEST
viii
MOTTO
"Live life in this world without letting the world live in you,
because when the boat is on the water, it is able to sail perfectly,
but when water got into it, the boat sank."
(Ali bin Abi Talib)
“Health is the greatest gift, contentment is the greatest wealth,
loyalty is the best relationship.”
(Buddha)
“Keep smiling, because life is a beautiful thing and
there is much to be grateful for.”
(Marilyn Monroe)
“Success and happiness lies in yourself. Stay happy, and
your happiness and you will form a strong character

against adversity."
(Helen Keller)
"If there are difficulties in your path to the future, keep walking forward don't"
stop. That every time, will surely pass. After trouble,
there will surely be infinite happiness.”
(SL)
viii
FOREWORD
All praise and gratitude I always pray to Allah SWT

God Almighty who has given His grace and guidance
so that in writing this scientific paper, I do not experience any problems
which means that until the completion of this Scientific Writing entitled
“Management of Physiotherapy in Cases of Type 2 Diabetes Mellitus with
Method of Body Weight Training and Diabetes Gymnastics”
In making this scientific paper, the author gets guidance

as well as many instructions from many parties so that researchers can complete
this scientific paper. Furthermore, through this paper, the researcher would like to say:
thanks to:
1. Mr. Dr. Filius Chandra, SE, MM as Head of the College of Science

Health of Baiturrahim Jambi
2. Mr. Ariyanto, SKM, M.Kes, as vice chairman I of the College of Sciences

3. Mrs. Gustina, M.Keb, as Vice Chair II of the College of Sciences

4. Mr. Adi Saputra Junaidi, S.Fis., M.Fis as Head of the DIII Study Program
Physiotherapy Baiturrahim High School of Health Jambi
5. Mr. Putra Hadi, Sst.Ft, M.Or., AIFO As the first supervisor who
willing to provide input and suggestions for the improvement of the paper
Scientific
6. Mr. Ucu Suherman, S.pd, Ftr as Advisor II who is willing

provide input and suggestions for the improvement of Scientific Writing
7. All Lecturers and Staff of the DIII Physiotherapy Study Program at the College of Sciences
8. Both of my parents who always support me are good

It's in the form of moral support and material support
ix
9. Comrades in arms who have provided good motivation in the form of

sharing, opinions, motivation and other things in order to make
Scientific papers
10. Other related parties who also helped me in
the making of this Scientific Writing
The author realizes that this research report is still far from
perfect, therefore the author expects suggestions and input from
all parties. Hopefully this article can be useful for development
Knowledge.
Jambi, 03 June 2022
Writer
x
TABLE OF CONTENTS
Page
FRONT COVER PAGE............................................................... .......................... i
TITLE PAGE ................................................ ................................................. ii
APPROVAL PAGE .......................................................... ............................ iii
ENDORSEMENT PAGE................................................ ............................... iv
STATEMENT LETTER ................................................ ................................................ v
WORDS OF DEPOSIT................................................................................. .................................. vi
MOTTO ................................................................. ................................................................. ...........viii
FOREWORD................................................ .......................................... ix
TABLE OF CONTENTS................................................ ................................................................. ....... xi
LIST OF GRAPHICS................................................................................ ............................................ xvi
APPENDIX LIST ................................................ ................................................ xvii
CURRICULUM VITAE ............................................... ......................... xviii
ABSTRACT ................................................. ................................................................. .......xix
ABSTRACT................................................................. ................................................................. ...... xx
CHAPTER I INTRODUCTION............................................... ............................................... 1
1.1. Background................................................ ........................................ 1
1.2 Problem Formulation ............................................................... .................................. 4
1.3 Purpose of Writing ............................................................... ................................................ 4
1.4 Benefits of Writing ............................................................... ................................ 5
CHAPTER II LITERATURE REVIEW............................................... ................................ 6
2.1 Case Description............................................................... ........................................ 6
2.1.1 Definition of Diabetes Mellitus................................................................. .................. 6
2.1.2 Classification of Diabetes Mellitus................................................................. .............. 6
xi
2.1.3 Etiology of Diabetes Mellitus................................................................. .................. 7
2.1.4 Risk Factors for Diabetes Mellitus.......................................................... ......... 8
2.1.5 Pathophysiology of Diabetes Mellitus ............................................... ........ 10
2.1.6 Diagnosing Diabetes Mellitus................................................................. .............. 10
2.1.7 Complications of Diabetes Mellitus ............................................... .......... 11
2.2 Objects Discussed............................................................... ................................ 13
2.2.1 Muscle Weakness in the Lower Limb................................................. 13
2.2.2 Examination of muscle strength ............................................................... ............ 15
2.2.3 Functional Abilities................................................................. ................. 16
2.2.4 High Blood Sugar.......................................................... ................................ 17
2.3 Description of Physiotherapy Problems.......................................................... ......... 18
2.3.1 Impairments ............................................................... .................................. 19
2.3.2 Functional Limitations .......................................................... ........................ 19
2.3.3 Disability ............................................................... ............................................... 19
2.4 Physiotherapy Intervention Technology................................................................. .............. 19
2.4.1 Body Weight Training.......................................................... ........................ 19
2.4.2 Diabetes Gymnastics ............................................... ............................... 20
2.5 Schematic Framework for Thinking............................................................... ........................ 24
CHAPTER III PHYSIOTHERAPY PROCESS ............................................... ......................... 25
3.1 Physiotherapy Assessment ............................................................... ............................ 25
3.1.1 General History ............................................................... .............................. 25
3.1.2 Hospital Medical Data................................................................. ........... 25
3.2 ASPECT OF PHYSIOTHERAPY : ............................................... ................................ 26
3.2.1 Auto History ............................................... ................................ 26
3.2.2 Physical Examination.......................................................... ................................ 28
xii
3.2.4 Cognitive, Intrapersonal, and Interpersonal Examination ............ 30
3.2.5 Functional Abilities and Activity Environment................. 30
3.2.6 Specific Inspection.............................................................. ...................... 31
3.3 Problems of Physiotherapy ............................................................... ......................... 34
3.4 Physiotherapy Program/Plan................................................................ .................. 35
3.5 Prognosis ................................................................ ............................................... 36
3.6 Management of Physiotherapy ............................................................... .................. 36
3.6.1 Day: Saturday,Date: 23 May 2022 ................................................. 36
3.6.1.1 Body Weight Training ............................................... ........ 36
3.6.1.2 Diabetes Gymnastics (Aerobic).......................................... .... 37
3.7 Evaluation................................................................................ ................................................. 39
3.8 Final Evaluation Results .......................................................... .............................. 42
CHAPTER IV RESULTS AND DISCUSSION .......................................... ............... 43
4.1 Results................................................................. ................................................................. ..... 43
4.2 Discussion .......................................................... ................................................. 45
4.2.1 Diabetic Neuropathy ............................................... ......................... 45
4.2.2 Limb Muscle Strength ............................................... ................... 47
4.2.3 Functional Ability Limitation ............................................... 49
4.2.4 Blood Sugar Level............................................................... ............................ 51
CHAPTER V CLOSING............................................................... ................................................ 54
5.1 Conclusion................................................................................ ............................................... 54
5.2 Suggestions ................................................................ ................................................................. .... 54
BIBLIOGRAPHY................................................ .......................................... 56
ATTACHMENT................................................. ................................................................. ...... 61
xiii
LIST OF FIGURES
Figure 2. 1 Squat................................................................. ................................................................. .............. 20
Figure 2. 2 Warm-up movement ............................................... ............................................... 22
Figure 2. 3 Core movements................................................................. ................................................................. .... 22
Figure 2. 4 Cooling................................................................ ................................................................. ... 23
Figure 3. 1 Squat.......................................................... ................................................................. .............. 37
Figure 3. 2 Heating................................................................ ................................................................. ..... 38
Figure 3. 3 Core movements................................................................. ................................................................. .... 38
Figure 3. 4 Cooling.......................................................... ................................................................. ... 39
xiv
LIST OF TABLES
Table 2. 1 Michigan Neuropathy Screening Instrument (MNSI)................................................ 14
Table 2. 2 Values of Muscle Strength ................................................................ ............................................... 16
Table 2. 3 Functional Ability Check................................................................. .................. 17
Table 2. 4 Criteria for Results of Measurement of Blood Glucose Figures................................................................ ... 18
Table 3. 1 Results of Active Motion Examination .......................................... ................................ 29
Table 3. 2 Results of Passive Motion Examination.......................................... .............................. 29
Table 3. 3 Results of Isometric Motion Examination.......................................... ......................... 29
Table 3. 4 Neuropathy Examination ............................................... ............................................... 31
Table 3. 5 Examination of Limb Muscle Strength ............................................... .................. 32
Table 3. 6 Examination of ADL................................................................. ................................................ 33
Table 3. 7 ADL Examination................................................................. ................................................ 34
Table 3. 8Scores of Diabetic Neuropathy Examination .......................................... .................. 40
Table 3. 9 Manual Muscle Testing (MMT) Limb Muscle Strength Score ............... 41
Table 3. 10 Functional Ability Scores (Jette Scale)................................................. ............ 41
Table 3. 11 Blood Sugar Score (Easy Touch Gcu))................................................................ ......................... 42
Table 4. 1 Results of the Evaluation of Diabetic Neuropathy............................................... .... 44
Table 4. 2 Results of Evaluation of Leg Muscle Strength............................................... ................... 45
Table 4. 3 Results of Evaluation of Functional Ability .......................................... ................45
Table 4. 4 Results of Evaluation of Blood Sugar Levels ............................................... ................................ 45
xv
LIST OF GRAPHICS
Graph 4. 1 Diabetic Neuropathy ............................................... ................................................ 46
Figure 4. 2 Increase in the Strength of the Limb Muscles.......................................... ............... 48
Graph 4. 3 Improvement of Functional Capabilities ............................................... ................. 50
Graph 4. 4 Decrease in Blood Sugar Levels.......................................... ............................... 51
xvi
APPENDIX LIST
Appendix 1 Informed Consent Sheet................................................................ ................... 62
Appendix 2 Documentation............................................................... ................................................ 63
xvii
CURRICULUM VITAE
1. Personal Data
Name : Sefhia Lestary

Gender : Woman
Age : 20 years
Place and date of birth : Jambi, September 21, 2001
Tall : 155cm
Religion : Islam
Marital status : Not married yet
Nationality : Indonesia
Address : Land Mendal
2. Educational History
a. Kindergarten Hope Mother
b. SD N 120/ IV Jambi
c. SMP N 7 MJ
d. SMA N 10 Jambi City
e. Baiturrahim Jambi School of Health Sciences
1. Field Practice History

a. Jambi Provincial Hospital
b. Villa Gading Physiotherapy Clinic
xviii
Baiturrahim Jambi School of Health Sciences

DIII Physiotherapy Study Program
KTI, June 2022

(SEFHIA LESTRY, 2022, 83 PAGES)

Wanti Hasmar, S.Ftr., M.Or and Ucu Suherman, S.pd., Ftr
ABSTRACT
Background Type 2 DM is diabetes caused by:
the failure of the body to utilize insulin so that it leads to
weight gain and decreased physical activity, which can affect

the level of a person's body strength, especially in the leg muscle strength and
high blood sugar.

Objective : To find out the management of physiotherapy in improving
leg muscle strength and lowering blood sugar levels with the body . method
weight training and diabetes exercise.
Result : After doing physiotherapy using body weight

Diabetes training and gymnastics with a dose of 3-5 times a week is obtained
The result is an increase in leg muscle strength and a decrease in sugar levels
blood.
Conclusion :Body Weight Training and Diabetes Gymnastics can improve

leg muscle strength and lower blood sugar levels.
Keywords: Type 2 Diabetes Mellitus, Body Weight Training and Gymnastics

Diabetes
*) Supervisor : 1
*)) Supervisor : 2
xx
Baiturrahim Jambi College of Health Sciences

DIII Physiotherapy Study Program
KTI, June 2022

MELLITUS TYPE 2 WITH BODY WEIGH TRAINING
AND DIABETES GYMNASTICS
(SEFHIA LESTARI, 2022, 83 PAGES)

Wanti Hasmar, S.Ftr., M.Or *) and Ucu Suherman, S.pd., Ftr. *))
ABSTRACT
Background: Type 2 diabetes mellitus is diabetes caused by the body's failure to
utilize insulin so that it leads to weight gain and decreased physical activity,
which can affect a person's body strength level, especially in leg muscle strength
and high blood sugar levels.
Objective: To determine the management of physiotherapy in increasing leg
muscle strength and lowering blood sugar levels with method body weight
training and diabetes gymnastics.
Results: After doing physiotherapy using body weight training and diabetes
gymnastics with a dose of 3-5 times a week, the results showed an increase in leg
muscle strength and a decrease in blood sugar levels.
Conclusion: Body Weight Training and Diabetes Gymnastics can increase leg
muscle strength and reduce blood sugar levels.
Keywords: Diabetes Mellitus Type 2, Body Weight Training and Diabetes

Gymnastics
*) Advisors : 1
*)) Advisors : 2
xx
PIG
PRELIMINARY
1.1. Background
The variety of people's lives at this time is experiencing a lot
changes, both made by adolescents and adults.
Fast food and packaged food are the most common types of food
much liked, Eating a variety of foods that contain sugar will
cause various diseases, one of which is diabetes mellitus. For
maintain blood sugar levels, meal schedules and meal portions must be balanced.
Increasing the portion of food can cause complications of Diabetes

Melitus(Susilowati & Waskita, 2019)
Diabetes mellitus is a disease caused by
damage to the pancreas resulting in an increase in blood sugar or
insulin intensity which is a health problem because
declining quality of human life (Isnaini & Ratnasari, 2018)
Classification Diabetes Mellitus is divided into two types. DM type 1
is diabetes as indicated by insulin that is below
normal line. In addition, type 2 diabetes is diabetes caused by
failure of the body to use insulin, which leads to an increase in
weight and decreased physical activity (Salasa, Rahman, & Andiani, 2019)
According to An-Nur 2020, the risk factors for type 2 DM are divided into:
two, namely risk factors that cannot be changed and risk factors that can be changed
changed with a healthy living system. Non-modifiable risk factors

namely family history and age. And the risk factors that can be changed are:
weight, lack of physical activity, cholesterol, smoking habits,
high blood pressure and stress.
According to (Isnaini & Ratnasari, 2018) Someone who has a history of
Families who suffer from diabetes mellitus will have a greater chance
have the potential to suffer from type 2 diabetes mellitus due to inheritance compared to
someone who has no family history of diabetes mellitus
1
type 2. The family in question is mother, father, and siblings.

Based on the opinion above, the researchers concluded that the incidence of diabetes
mellitus type 2 is closely related to a person's congenital history of

have type 2 diabetes mellitus.
Research conducted by (Yosmar, Almasdy, & Rahma, 2018)
states that someone who is overweight
greatly affect the occurrence of diabetes mellitus because this
is often associated with the development of insulin resistance which can
absorption of glucose into fat and muscle cells, causing
an increase in blood sugar levels in the body.
DM as a global problem continues to increase in prevalence from
year after year both International and in Indonesia. Based on data
International Diabetes Federation (IDF) global DM prevalence in

2019 is estimated at 9.3% (463 million people), rising to 10.2% (578 million) in
in 2030 and 10.9% (700 million) in 2045 (IDF, 2019). In the year of
In 2015, Indonesia was ranked 7th as a country with
people with diabetes mellitus in the world, and is expected to rise to rank 6
in 2040 (Nurdin, 2021)
The problems of physiotherapy in the case of Type 2 Diabetes Mellitus part
impairment , namely a decrease in leg muscle strength and the presence of

increase in blood glucose. Part of the functional limitation is the presence of
limitation of movement in the leg muscles, such as difficulty in
goes a long way. There is a disability problem in the patient in this case, namely the patient
experience limitations in performing daily activities.

Physiotherapy is a medical science that deals with movement
and body functions. Physiotherapist is a term for someone who
carry out the profession. According to the Decree of the Minister of Health
Republic of Indonesia No. 778 of 2008 concerning Service Guidelines
Physiotherapy in Health Facilities, physiotherapy is a health service
aimed at individuals and or groups in an effort to
develop, maintain, and restore movement and function throughout
life cycle using physical modalities, physical agents, mechanical,

movement, and communication (Kemenkes RI, 2008 in Rahmadani, 2017).
With the complaints caused by the condition of

Patients with Type 2 Diabetes Mellitus, then physiotherapy can help to
overcome the problems of Type 2 Diabetes Mellitus by using
methods in the form of body weight training and diabetes gymnastics to improve
leg muscle strength and lowers blood sugar.
Weight training is one of the right alternatives for weight loss
helps increase muscle strength. Exercising with weight training
(weight training) is an exercise that is carried out in a structured way
using weights as a tool to increase the strength of muscle function,
to achieve goals such as improving physical condition, preventing
injury, or for health purposes (Nasrulloh et al. 2018).
Weight training with one's own body weight is heavier than weight training
using tools, due to focus on using body weight
counting the entire body strength (Usman & Argantos, 2020).
used in body weight training is squats. Every training
performed with 4-6 sets, repetitions 6-10 times, recovery 2-5 minutes 3 times in
a week according to (Afif & Nasrulloh, 2016)
Blood sugar content can be determined using a tool
portable easy touch GCU for patients aged 17 to
63 years (zulkarnain, et al. 2018). To lower blood sugar levels in
people with type 2 diabetes mellitus is aerobic exercise such as gymnastics. Gymnastics
Diabetes is a physical exercise designed according to age and

physical ability which is part of the recovery of diabetes mellitus.
Diabetes mellitus exercise is done regularly for 30-60 minutes
as much as 3-5 times a week regular physical exercise can

lowering blood glucose levels (Yusran Haskas & Nurbaya, 2019)
Diabetes exercise can lower blood sugar levels at the same time
doing physical activity then there will be an increase in usage
glucose by muscles, so insulin receptors are more available and more
active to lower blood sugar. Diabetes exercise can improve

circulation so that it can increase the number of receptors on the wall
cells where insulin is produced. The effect of exercise on changes in levels
blood sugar, namely in active muscles that increase blood sugar levels
contraction so that insulin resistance is reduced and insulin sensitivity
increased (Sanjaya et al, 2016 in Rahmatia, 2021)
Doing regular exercise can improve blood flow,
can increase calorie burning and improve insulin action on
body that accumulates so that it can avoid obesity. Type of sport
It is recommended that you do aerobic exercise. Glucose burning
can occur throughout the body and can keep the body
by doing aerobic exercise (Evangeline, 2018)
Based on the description of the problem described above, the writer
want to know more about the benefits of giving Body Weight
Diabetes Training and Gymnastics in this case so that the author
take the title "MANAGEMENT OF PHYSIOTHERAPY IN CASE"
DIABETES MELLITUS TYPE 2 WITH BODY WEIGHT MODALITY
DIABETES TRAINING AND EXERCISE”
1.2 Problem Formulation
1.2.1 How the effect of Body Weight Training can increase

leg muscle strength in Type 2 Diabetes Mellitus patients ?
1.2.2 How Diabetes Exercise can lower blood sugar levels
blood in patients with Type 2 Diabetes Mellitus?
1.3 Writing Objectives

Based on the problem formulation described above, then
This research has several objectives to achieve, namely:
1.3.1. General purpose
Adding knowledge and to know

physiotherapy management in cases of Type 2 Diabetes Mellitus
1.3.2. Special purpose
1. To find out the effect of Body Weight Training, you can
increase leg muscle strength in Diabetes Mellitus patients
Type 2.
2. To find out the effect of Diabetes Gymnastics can reduce
blood sugar in patients with Type 2 Diabetes Mellitus.
1.4 Benefits of Writing
The author hopes that this scientific paper is useful for:
1.4.1. For Writers
This scientific paper can add insight, knowledge
knowledge, can identify problems and experiences so that
can add to the author's understanding in the management of physiotherapy
in patients with type 2 diabetes mellitus .
1.4.2. For Physiotherapy
Can provide knowledge and skills in the health sector
especially in dealing with cases of type 2 diabetes mellitus
using body weight training and diabetes exercise methods .
1.4.3. For Educational Institutions
This scientific paper can provide benefits to the institution
educational institutions in the field of physiotherapy to further develop
knowledge about cases of diabetes mellitus type 2 agar
can be handled optimally and appropriately and make it easier for candidates
physiotherapy to find out more about diabetes cases
mellitus type 2.
1.4.4. For Society
The results of this study can provide insight into cases
Type 2 diabetes mellitus and provide knowledge about the role of
Physiotherapy in dealing with cases of type 2 diabetes mellitus
The public is aware of efforts to prevent type 2 diabetes mellitus.

CHAPTER II
LITERATURE REVIEW
2.1 Case Description

2.1.1 Definition of Diabetes Mellitus
DM is a metabolic health disorder characterized by
the occurrence of hyperglycemia as a result of impaired production of
insulin, or because of impaired insulin action, or because of both
both (Ahmad, 2017). DM is part of a chronic disease
what happens when there is a level of glucose / sugar in the blood
increase because the pancreas can not produce or can not
secrete enough insulin or the body can't
use insulin in an effective way (Wibowo, 2021). Diabetes
mellitus occurs due to damage to the function of the pancreas so that
imbalance of glucose levels in the blood. According to
(Rumahorbo, 2015 in Salindeho, Anggelin, 2016) Diabetes mellitus
is a metabolic disorder characterized by a deficiency
insulin or reduced biologic activity of insulin or both
with a prevalence that continues to increase every year.

2.1.2 Classification of Diabetes Mellitus
Diabetes mellitus can be classified according to its type in
several types, including the following: (Hanugrah Ardya C,
2018)
a. DM Type 1
Type 1 diabetes is diabetes caused by the breakdown of
autoimmune cells, leading to insulin deficiency.
As a result, the pancreas is not sufficient or can not produce
insulin, so that sugar in the blood accumulates because it does not
can move into cells in the body (Hanugrah Ardya C,
2018).
b. DM Type 2
6
Type 2 DM is diabetes that occurs as a result of loss of

B cell insulin secretion or the amount in insulin production has decreased
so that it cannot function properly. as a result

glucose in the blood has increased (Hanugrah Ardya
C, 2018).
c. Gestational DM
Gestational diabetes is diabetes that occurs when a woman is

pregnant. This type of gestational diabetes can be diagnosed in the first trimester
third during pregnancy. This happens because the resistance to

insulin caused by some hormone formation in
pregnant women (Primal, 2021).
d. Special Type DM
Specific type DM is a specific type of diabetes mellitus
because the cause is from other comorbidities that
can cause disruption of production or work systems
of insulin. For example, monogenic diabetes syndrome, pancreatitis,
adrenal gland disorders, use of glucocorticoid drugs, drugs
antihypertensives, anticholesterol drugs, malnutrition, and infections (eg
HIV/AIDS) (Primal, 2021).

2.1.3 Etiology of Diabetes Mellitus
DM is a health disorder that occurs as a result of
damage to a small part or all of the cells of the islets
Langerhans which has a function to produce hormones
insulin, resulting in insulin deficiency.
Causes of insulin resistance in clients with type 2 DM
can not be clearly identified, but the lifestyle is lacking
be a risk factor that can play a role in the occurrence of
resistant to insulin. Insulin resistance occurs when cells are unable to
to stimulate glucose uptake in peripheral tissues and
when its ability has decreased in inhibiting the production of sugar/
glucose in the liver, resulting in insulin deficiency.
In addition, DM can also occur as a result of impaired function
insulin to get glucose into cells. (Skyler & Ricordi,
2011)
2.1.4 Risk Factors for Diabetes Mellitus
Type 2 DM risk factors according to (LeMone, 2015 in Sari,
2019). inside is as follows:

a. heredity
Hereditary history from parents to children has
two to four times increased risk of developing DM or
Approximately 50% of people with type 2 diabetes have parents with
DM history. If any of his family members have
history of DM, the descendants of these family members are more
at risk for developing DM. While identical twins are at risk
by 25% - 50%, while siblings are at 6% risk
(LeMone, 2015 in Sari, 2019).
b. Dietary habit
Consuming too much food can trigger
the onset of DM. The number of calorie levels that exceed the body's needs
and which is not proportional to the amount of insulin produced
the right way, it can increase the amount of glucose in the blood
blood. This of course will increase the risk of experiencing
DM. High blood glucose levels or hyperglycemia will
effect on the function of blood platelets which will increase
clotting in the blood. So it will be at risk of experiencing
damage to the walls of peripheral arteries, resulting in blood circulation
on the periphery, especially in the lower extremities will be disturbed
(Kohlman-Trigoboff & D, 2019).
c. Obesity
Obesity (overweight) is identified as having body weight
(BW) more than or equal to 20% of ideal body weight.
Obesity is closely related to resistance to insulin action

due to the abundance of fat tissue, body tissue, and muscle. Fat
that accumulate in the body can hinder the work of
insulin, as a result sugar cannot be circulated to the cells in the body
the body so that sugar becomes accumulated in the vessels
blood. This can impede peripheral blood circulation.
This makes the peripheral blood circulation not smooth
(Sari, 2019).
d. Lack of exercise/physical activity
Lack of exercise or physical activity has more risk
high affected by DM, because with exercise glucose in the blood
can be burned and converted into energy. So that the cells
in the body becomes more sensitive to the action of insulin and can
improve circulation in the blood (Almaini, A., & Heriyanto,
2019).
e. Age
Ages over 40 years are at risk of developing DM, because people
lazy to do activities, reduced muscle mass, and weight
body goes up. However, currently the incidence of type 2 DM is
increased in adolescents and even in children. This matter
because many children are obese (Almaini, A., &
Heriyanto, 2019).
f. Metabolic syndrome
Metabolic syndrome is a collection of symptoms
associated with type 2 diabetes. BP > 140/90 mmHg,
Blood triglycerides > 150 mg/dl, HDL cholesterol < 40 mg/dl, BMI >
30 due to central obesity, male waist circumference > 102 cm, and
women's waist circumference > 88 cm. Metabolic syndrome can occur
due to lack of physical activity and poor food intake
excess, causing diabetes, hypertension, obesity, etc
(Sari, 2019).
10
2.1.5 Pathophysiology of Diabetes Mellitus
DM is a collection of symptoms of a chronic disease that

indicated by the presence of hyperglycemia as a result of the breakdown of
production of insulin, or impaired insulin performance, or

both of which cause inhibition of metabolism
carbohydrates, proteins, and fats (Adrianti, 2017). Glucose by
normally required for the needs of cells and tissues. Glucose in
production in the liver from food stored in the form of glycogen
with the help of insulin. The hormone insulin is produced in the
pancreas by the cells of the islets of langerhans and then will be entered
into the blood in small amounts and will increase
when consuming food (Adrianti, 2017).
In type 2 diabetes, it is closely related to insulin resistance and
impaired insulin secretion. Insulin resistance causes a decrease in
tissue sensitivity to insulin (Sari, 2019). To overcome
insulin resistance, insulin levels must be secreted higher in order to
blood glucose remains within normal limits. However, if cell
is damaged or can't increase the need
insulin results in a deficiency of the hormone insulin,
This results in an increase in the amount of sugar in the blood
(Adrianti, 2017).
Increased amount of sugar in the blood that lasts
can inhibit the activity of Endothelium Nitric Oxide Synthetase
(e-NOS) and can increase reactive oxygen species (ROS)
in the endothelium. An increase in ROS will result in a decrease in
on nitric oxide (NO). Decreased NO will have an impact on
damage to the vascular endothelium (Thiruvoipati, 2015).
2.1.6 Diagnosing Diabetes Mellitus
Diagnostic tests aim to diagnose diabetes
mellitus, while the laboratory examination aims to
evaluate the effectiveness of diabetes management. There are three
11
The recommended diagnostic test criteria include:

is as follows:
a. Symptoms of hyperglycemia such as (polyuria, polydipsia, and weight gain)
decreased body weight) and plasma glucose levels when (plasma

glucose, PG) > 200 mg/dl.
b. Fasting plasma glucose (FPG) >
126 mg/dl. Fasting means that the body does not get
calorie intake for more than equal to 8 hours.
c. The oral glucose tolerance test (OGTT) should be performed with a load
75 g of anhydrous glucose dissolved in water.

(Aljehani, 2020)
The diagnosis of impaired fasting glucose (IFG) was made after
FPG examination showed results of 100-125 mg/dl. Normal FPG
that is 100 mg/dl. Diagnosis of DM after doing FPG examination
showed results > 126 mg/dl. Meanwhile, if to enforce
diagnosis of impaired glucose tolerance (IGT), i.e. with
OGTT control obtained with plasma glucose 2 hours
after load with results between 140-199 mg/dl. PG 2 hours normal
is < 140 mg/dl. Diagnosis of DM after OGTT examination if
200 mg/dl (Aljehani ,2020).
2.1.7 Complications of Diabetes Mellitus

DM complications according to Ernawati in (Sari, 2019) can be:
acute and chronic complications, including:
as follows:
a. Acute complications
1) Hypoglycemia
Hypoglycemia is the amount of glucose in the blood below
50-60 mg/dl or blood glucose level < 80 mg
accompanied by clinical signs. Hypoglycemia can occur due to:
administration of uncontrolled insulin therapy or
excess (Sari, 2019).
12
2) Diabetic ketoacidosis (DKA)
DKA occurs due to absolute or relative insulin deficiency
characterized by the presence of a triad of hyperglycemia,
acidosis and ketosis with decompensation
metabolic disorder (Sari, 2019).
3) HHNK syndrome (non .hyperosmolar hyperglycemic coma)
ketotic) HHNK syndrome occurs because the amount of production
little or less insulin, causing
prevention of fat breakdown but cannot prevent
hyperglycemia (Sari, 2019).
b. Chronic Complications (Sari, 2019)
1) Microvascular Complications
Diabetic retinopathy is damage to the retinal nerve in the eye
caused by chronic hyperglycemia. So that it can
lead to blindness in the patient.
2) Diabetic nephropathy is a disorder of the nerves in the kidneys
which can lead to kidney failure in the patient.
3) Diabetic neuropathy is damage to the peripheral nerves that
can cause disturbances to the body's organs, especially
sensory disturbance.
c. Macrovascular Complications (Sari, 2019).
1) Coronary artery disease is a disorder of the heart and blood vessels
blood vessels that can affect heart function and
can be a cause of coronary heart disease.
2) Cerebrovascular disease, which is blockage of blood vessels

cerebral atherosclerotic effects.
3) Peripheral vascular disease, namely disorders of the vasculature
Peripheral is characterized by a decrease in peripheral pulse

and intermittent claudication.
13
2.2 Objects Discussed
2.2.1 Muscle Weakness in the Lower Limb
Muscular strength is the ability to withstand loads or
an object that will continue to decline with age and will
aggravated if you have a history of DM and risk factors for DM
(Lopez otin C et al, 2013 in Aulia, 2021)). muscle strength
is an important determinant of healthy aging aging can
result in impaired body function, limited mobility,
aggravating treatment costs and causing negative effects on
well-being and quality of life (Lee MR et al, 2018 in Aulia,
2021)
Muscle strength is influenced by various factors such as age, gender,
gender, race, and nutritional intake and certain chronic conditions, such as
hypertension, diabetes, obesity, dyslipidemia, and other diseases.
Muscle strength affected by diabetes complications, gender,
nutritional status, medical history, ethnicity, duration of hospitalization, lack of
insulin signaling, fat infiltration in muscle, hyperglycemia,
dysglycemia, and hyperinsulinemia (Kalyani RR, et al, 2014 in
Aulia, 2021)).
Muscle weakness, decreased muscle mass, and changes in muscle fibers
glycemic-related framework in diabetes, may be due to
peripheral neuropathy and reduced vascular supply. Study
previously found that exercise can cause
increase in muscle mass (Sigal et al., 2018 in Zulkifli, 2021)
Examination with Michigan Neuropathy Screening Instrument
(MNSI) can be used to determine the symptoms of neuropathy
in patients with diabetes mellitus, the MNSI is a questionnaire that
consists of 15 questions about the symptoms of diabetes experienced
and 5 physical examinations on both legs. Examination assessment
The physical MNSI consists of 0 (no response/wrong response), 0.5 (no response)
14
little response) and 1 (good response), if the score is more than 2 then
the patient has DPN (Fadli, 2021).
Table 2. 1 Michigan Neuropathy Screening Instrument (MNSI)
Question Yes No Score
1. Are your feet numb?
2. Do you feel pain like

burning in the leg
3. Are your feet less sensitive?

to touch
4. Do you have muscle cramps in your stomach?
foot
5. Have you ever felt stabbed-

stab in the leg
6. Does the skin feel sore if

touched by cloth
7. When you take a bath, do you
use cold water more

first then warm water
8. Have you ever had an injury?
open to the feet
9. Did the doctor ever tell
you that you have neuropathy
diabetic
10.Do you feel tired every day
11.Do you feel bad

at night
12. Do your feet hurt when you walk
13. Are you able to feel

your feet when
15
walk
14. Is the skin on your feet dry
until it breaks
15. Have you ever experienced
amputation
Total
Source: (Novelia, Mayasari Usman, & Adi Pamungkas, 2021)
Information :
This question consists of 2 types of questions, namely 13 questions
positive (1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 14, 15) and 2 questions
negative (7 and 13). Interpretation of the results of this instrument, namely the patient
is said to be neuropathic if it has a score of 7.
2.2.2 Examination of muscle strength
Examination of muscle strength is done by manual method
muscle testing (MMT), this method is carried out to determine the value of
of each muscle with an interpretation of 0 to 5, examination
MMT is performed on the muscles of the lower extremities which include the hip, knee,
and ankles. From the results of the examination obtained a value for muscle
the hip, knee and ankle regions are 4/5 which means the muscles can
against light prisoners (Fadli, 2021).

16
Table 2. 2 Value of Muscle Strength
No Value Information
1 0 Muscle contraction not detectable by palpation
There is muscle contraction and no movement

2 1
joints
Muscle contraction and movement

3 2
joint not full ROM
Muscle contraction, joint movement

4 3
full ROM and able to fight gravity

5 4 full ROM, able to fight gravity and resistance
minimum

6 5 full ROM, able to defy gravity and able to
against maximum resistance
Source: (Wasilah, Rohimah, & Su'udi, 2019)
2.2.3 Functional Abilities

Functional ability is the ability to perform
daily activities. Someone who is able to do activities
everyday life independently is someone who has
good functional ability and able to carry out activities
physically more than people who have
dependency. By doing physical activity, you can
improve body balance, muscle strength and strengthen
joints so that it can help a person to avoid risk
fall (STIKES AISYIYAH, 2015 in Paramitha, 2017).
17
Table 2. 3 Functional Ability Examination

No Activity Criteria Score
1. Stand up from position Painful

sit Difficulty
Dependency
2. Walk 15 meters Painful
Difficulty
Dependency
3. Go up the stairs 3 steps Painful
Difficulty
Dependency
Source: (Kurniasari, 2010)
Information :
Pain Assessment Difficulty Assessment Evaluation
Score 1: No Score 1: Easy Dependency

Painful Score 2: Somewhat Grade 1: No Help
Score 2: Pain Easy Score 2: Need Help
Light Score 3: No Grade 3:Need Help
Grade 3: Pain Easy Others

Currently Score 4: A bit difficult Grade 4: Need Help
Grade 4: Pain Value 5: Can't Others and

Heavy To do Tool
Value 5: Can't
To do
2.2.4 High Blood Sugar

Diabetes mellitus is a chronic condition characterized by
increase in blood glucose concentration, caused by
relative or absolute deficiency of the hormone insulin. When sugar
blood is not controlled properly, it can cause
18
various complications, both acute complications and complications
chronic. Diabetic neuropathy is the most common chronic complication
often found in DM patients (Almaini, A., & Heriyanto,
2019).
Most patients with Type 2 DM have at least one
complications, and cardiovascular complications are the causes of
major cause of morbidity and mortality in DM patients. This complication can
prevented or slowed down by controlling sugar levels
blood. Controlling blood sugar levels in DM patients can
performed both non-pharmacologically and pharmacologically. By
non-pharmacological, blood sugar control can be done by
doing physical activity or sports (Almaini, A., & Heriyanto,
2019).
Table 2. 4 Criteria for Measurement of Blood Glucose Numbers
Criteria Measurement results

Normal 8 hour fasting blood glucose: 70-99 mg/dL
Blood glucose 2 hours after eating: less than 140 mg/dL
• HbA1c: less than 5.7%

Pre-diabetes • 8-hour fasting blood glucose: 100-125 mg/dL
Blood glucose 2 hours after consuming 75 g glucose:
140-199 mg/dL
• HbA1c: 5.7% - 6.4%
Diabetes 8-hour fasting blood glucose: more than 126 mg/dL (result
of 2 consecutive tests)
Glucose 2 hours after eating: more than 200
mg/dL
• Blood glucose test intermittently: more than 200
mg/dL
HbAIc: more than 6.5%
Source: (Komalasari, 2021)
2.3 Description of Physiotherapy Problems
To find out the problems that arise in peripheral neuropathy then:
about the clinical picture can be used as a basis in explaining this problem.
19
2.3.1 Impairment
Impairment is a disorder related to the function or structure of the body
contained in the patient. Impairment that occurs in this patient

namely: the presence of pain in the hips as well as cramps and tingling in the
ankle, resulting in muscle weakness in the lower leg.

2.3.2 Functional Limitations
Functional limitation is the limitation of the activity that occurs

on the patient. From inspection it was found that the patient
have difficulty in activities related to
ambulation from sitting to standing, standing too long, going up and down stairs,
walk quite a distance.

2.3.3 Disability
Disability is an inability related to
social, religious and work activities that occur
on the patient. From the examination, it was found that the patient was disturbed
in activities that require standing and walking, so that when

the patient will move places must always hold on because
The patient had decreased muscle strength in the lower limbs.
2.4 Physiotherapy Intervention Technology
2.4.1 Body Weight Training

Weight training is one of the right alternatives for weight loss
helps increase muscle strength. Exercising with practice
Weight training is an exercise that is done regularly
structured, can use the load as a tool to increase
strength of muscle function, to achieve goals such as improving
physical condition, preventing injury, or for health purposes
(Nasrulloh & Wicaksono, 2020). Weight training with body weight
itself is somewhat heavier than using a tool, because
focus on using body weight including all strength
body (Novelia et al., 2021). Method used on body
20
weight training is squats. Every exercise is given
with 4-6 sets, reps 6-10 times, recovery 2-5 minutes 3 times in
a week according to (Bompa et al, 2015 in Afif & Nasrulloh, 2016)
Body weight training will be good for lowering blood sugar
because when doing body weight training it will train the muscles
framework, for which weight training is the most effective and
the shortest way to burn blood sugar. Then when our muscles
damaged that's where muscles need glucose, and muscle tissue is
the main target tissue for insulin action (Yang, D, 2019).
Figure 2. 1 Squat
2.4.2 Diabetes Exercise
The function of DM exercise is to increase insulin sensitivity in muscles
muscle and liver which can cause a decrease in the dose of drugs
oral hypoglycemia or insulin the person needs. Also,
lipid profiles also tend to be improved. More specifically, the rate
HDL cholesterol which is very helpful to increase and maybe
reduction of triglycerides, thereby reducing the risk of atherosclerosis.
It is suspected that lack of exercise could be a contributing factor
have a direct risk of developing insulin resistance
in type 2 diabetes, and the ability to remain physically active during
Life is a means for protection and prevention
disease (Yani & Bachtiar, 2021).

21
Diabetes gymnastics can also help people with diabetes

control glucose levels in the blood so that the quality of life
DM patients can increase because the patient's blood glucose
controlled (Y. Haskas, 2019). Diabetes gymnastics is included in the category
aerobics. Aerobic exercise with moderate intensity can

lowers Body Mass Index (BMI) and total cholesterol levels
in women who are obese (Samosir, 2018). Aerobics
also has an influence on flexibility and cardiopulmonary endurance.
Diabetes gymnastics is done twice a week, which
carried out in a guided manner with a duration of 45-60 minutes. Before
and after exercise, blood pressure was checked.
Check blood sugar levels when done once a month.
The results of this examination have not been analyzed analytically, how much
the benefits of diabetes exercise on blood sugar levels (Yani &

Bachtiar, 2021).
Diabetic gymnastics that is done daily on a regular basis can
improve fat profile, lose weight and maintain
fitness. In addition, it will increase insulin sensitivity so that
will lower blood glucose. Recommended diabetes exercise
including aerobic. Use of glucose in active muscles
in that case it will increase, but is not accompanied by
increase in insulin. This is due to the increase in
insulin receptor sensitivity in muscles during exercise (Yusran Haskas,
2019).
Diabetes gymnastics is a physical exercise designed according to
age and physical status that are part of diabetes treatment
mellitus. Diabetes mellitus exercise is done regularly for 30-60
minutes 3-5 times a week. Research by Allen, et al., in

(Yusran Haskas, 2019) suggests that regular exercise
and consistently can reduce insulin requirements by 30-50%
and lowers blood glucose levels. Indriati's research results
22
(1990) in (Yusran Haskas, 2019), said that in

patients with diabetes mellitus type 1 and 2 the influence of physical exercise
with a decrease in blood glucose levels as evidenced by a decrease in

average blood glucose levels of 60% (Salindeho, Anggelin, 2016).
So it is necessary to carry out diabetes exercise training for
diabetics.
Figure 2. 2 Warm-up movement
Source: (William, 2006 in Permadi, 2021)
Figure 2. 3 Core movement

23
Figure 2. 4 Cooling

24
2.5 Schematic Framework
Type 2 Diabetes Mellitus
Muscle Weakness In High blood sugar

Lower Limb
1. Bodyweight Training
2. Diabetes Exercise
Evaluation
Michigan Neuropathy Screening Instrument (MNSI)

Manual Muscle Testing(MMT)
ADL (Jette Scale)
Easy Touch Gcu

CHAPTER III
PHYSIOTHERAPY PROCESS
3.1 Physiotherapy Assessment
The problem-solving process that physiotherapists must deal with in
Type 2 Diabetes Mellitus condition physiotherapy assessment, goals and plans
physiotherapy, implementation of physiotherapy, and evaluation of the results of therapy.
3.1.1 General History
History is an examination carried out by asking questions
answer to the patient to obtain as much information as possible
regarding the patient's condition. In the history, information is obtained
important for making a diagnosis. In this condition, history taking
This is done by auto-anamnesis, which is a question and answer obtained directly
directly to the patient. The data obtained from auto
history on 23 May 2022 includes:

1. Name : Mrs. M
2. Age : 29 years
3. Gender: Female
4. Religion : Islam
5. Work : IRT
6. Address : Mendalo Land, Fisheries
7. No Reg :-
8. Place of care : Home
3.1.2 Hospital Medical Data

A. Medical Diagnosis: Diabetes Mellitus Type 2
B. Clinical Notes
Medical: NSAIDs (Mefenamic Acid, Ibuprofen)
C. General Therapy (General Treatment): -
25
26
D. Physiotherapy Referral From Doctor :-
3.2 ASPECTS OF PHYSIOTHERAPY:
Date : Monday 23 May 2022
3.2.1 Auto History
This history was carried out to find out more about

patient's health condition. From the specific history, the results include:
a. Main complaint
The patient complains of difficulty moving from a sitting position to a sitting position
standing due to weakness in the lower limbs due to

diabetes.
b. Complaint Location
c. History of Present Disease

About approximately two months ago when the patient did
homework is pulling the grass in the yard, the patient sits in the
special low chair for pulling grass for about 5 minutes the patient sits
then change position to standing the patient feels tingling

and cramps in the ankle so that when you stand you feel weakness
on the lower leg. Factors that aggravate the patient's condition are:
27
when the patient sits for too long then changes position to standing,
then the patient's pain subsides when resting lying down and sleeping.
When the patient feels pain, usually the patient only takes medicine
NSAIDs such as mefenamic acid and ibuprofen.
d. Past medical history
The patient does not have the same disease
e. History of co-morbidities
Hypertension (+), Heart (-), Cholesterol (-)
f. Personal History
The patient is a housewife where everyday
spending time doing homework doing
maximum activity.
g. Family History:
No family has the same disease
h. System History:
a) Head and Neck:
Complaints of dizziness and neck stiffness
b) Cardiovascular:
No complaints
c) Respiration:
Complaints when breathing feels heavy
d) Gastrointestinal:
smooth and controlled
e) Urogenital:
Frequent urination at night
f) Musculoskeletal:
Decreased lower leg muscles
g) Nervorum:
There is a feeling of cramping and tingling in the ankle

28
3.2.2 Physical Examination

1. Vital Signs:
a) Blood Pressure: 140/80 mmHg
b) Pulse: 72x/minute
c) Breathing: 22 x/minute
d) Temperature : 36 oC
e) Height: 155 cm
f) Weight: 66 kg
2. Inspection:
a. Static : The general condition of the patient is good
b. Dynamic : When moving the patient looks difficult and heavy
to step
3. Palpation:
a. Normal body temperature
b. No signs of inflammation
c. No edema
4. Percussion:
No crepitus
5. Auscultation:
Are not done
6. Basic Motion Check
Movement test examination is a method of examination by means of
perform the movement, basic movement examination consists of examination of
active, passive and resistance movement.

29
a. Active motion:
Table 3. 1 Results of Active Motion Examination
No. Region Movement Painful ROM

1. Hip Flexion + full
Extension + full
2. Ankle Dorso flexion - full
plantar flexion - full
Ever - full
Inversion - full
b. Passive motion
Table 3. 2 Passive Motion Examination Results
No. Region Movement Painful ROM Endfeel

1. Hip Flexion + full Soft end feel
Extension + full Soft end feel
2. Ankle Dorso flexion - full Elastic endfeel
plantar flexion - full Elastic endfeel
Ever - full Elastic endfeel
Inversion - full Elastic endfeel
c. Isometric Motion Against Resistance
Table 3. 3 Results of Isometric Motion Examination
No. Region Movement Able/Not MMT

1. Hip Flexion Capable 3
Extension Capable 3
2. Ankle Dorso flexion Capable 4
plantar flexion Capable 4
Ever Capable 4
Inversion Capable 4
30
3.2.4 Cognitive, Intrapersonal and Interpersonal Examination

1. Cognitive: Patients are able to communicate well
2. Intrapersonal: Patients have enthusiasm and motivation to recover
3. Interpersonal : The patient is able to follow the instructions given by
patient
3.2.5 Functional Abilities and Activity Environment

Functional ability is a person's ability to perform
basic and functional activities of daily living. Whereas
The activity environment is the state of the surrounding environment that is related to
with the patient's condition.
1. Basic functional ability

At rest the patient's general condition looks good but when moving
The patient's lower limbs show a delay in movement due to the presence of
cramping and tingling in the ankle when sitting for too long
to stand.
2. Functional activities
The patient feels weakness in the lower limbs
tingling and cramping in the ankle so that there is a limitation of
sitting position for too long standing.
3. Activity environment
The patient's work environment supports the patient's recovery, because
the environment of the patient's daily activities at home as a housewife
can work and function optimally.
31
3.2.6 Specific Examination

1. Neuropathy Examination with Michigan Neuropathy Screening
Instruments (MNSI)
Table 3. 4 Neuropathy Examination
Questions Yes No Score

1. Are your feet numb 2. Do ÿ 1
you feel a burning pain in your 0_
feet 3. Are your feet less
sensitive to touch 4. Do you have 0_
muscle cramps in your legs 5.
Have you ever felt a tingling ÿ 1
sensation in your feet 6. Do you
feel the skin on your feet? pain ÿ 1
when touched by cloth
0_
7. When you take a bath, do you 0_

use cold water first then warm
water 8. Have you ever had
open sores on your feet 9. Has 0_
your doctor ever told you that
you have diabetic neuropathy 0_
10. Do you feel tired every time? ÿ 1

day
11. Do you feel unwell at night 12. ÿ 1
Do your feet hurt when you
walk 13. Can you feel your feet ÿ 1
when you walk 14. Have the
skin on your feet dry and cracked ÿ 1
15. Have you ever had an
amputation?
ÿ 1
0_
Total 8
Information :
32
This question consists of 2 types of questions, namely 13 positive questions
(1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 14, 15) and 2 negative questions (7 and
13). Interpretation of the results of this instrument, namely the patient is said to be neuropathic
if it has a score of 7.
2. Testing Lower Limb Muscle Strength With Manual Muscle Testing
(MMT)
Table 3. 5 Examination of Limb Muscle Strength
No. Region Movement Score

1. Hip Flexion 3
Extension 3
2. Ankle Dorso Flex 4
Plantar Flexion 4
Inversion 4
Ever 4
Information :
No Value Information
1 0 Muscle contractions not detectable by palpation
2 1 There is muscle contraction and no joint movement
Muscle contraction and joint movement

3 2
not full ROM
There is muscle contraction, full joint movement

4 3
ROM and able to defy gravity

5 4
ROM, able to resist gravity and minimal resistance

6 5 ROM, able to defy gravity and able to resist
maximum resistance
33
3. Examination of Functional Ability Limitations with the Jette Scale

Table 3. 6 Examination of ADL
No. Activity Criteria Score

1. Stand up from Painful 3
a sitting position Difficulty 4
Dependency 1
2. Walk 15 Painful 3
meters Difficulty 3
Dependency 1
3. Go up the stairs 3 Painful 3

steps Difficulty 3
Dependency 2
Information :
Pain Assessment Difficulty Assessment Evaluation
Score 1: No Score 1: Easy Dependency
Painful Score 2: Somewhat Grade 1: No Help
Score 2: Pain Easy Score 2: Need Help
Light Score 3: No Grade 3:Need Help
Grade 3: Pain Easy Others
Currently Score 4: A bit difficult Grade 4: Need Help
Grade 4: Pain Value 5: Can't Others and

Heavy To do Tool
Value 5: Can't
To do
34
4. Blood sugar check with Easy Touch Gcu

Table 3. 7 Examination of ADL
Inspection Score
When blood sugar 167
(GDS)
Fasting Blood Sugar 130
(GDP)
Blood sugar 2 hours after 156
eating (GDPP)
Information :
1. Current blood sugar 2. Fasting blood sugar 3. Blood sugar 2 hours
(GDS) (GDP) a. Normal after eating (GDPP) a.
a.Normal level: level Normal level :110 –
<200 mg/dL :80 –125 mg/dL 180 mg/dL
b.Best level :<200 mg/dL b. Best rate b. Best rate :110 –
:80 – 110 mg/dL 145 mg/dL
3.3 Problems of Physiotherapy
From the various examinations that have been carried out above, it can be concluded that:
concluded that the problems that arise include:
1. Impairments:
a. Decreased lower leg muscle strength
b. High blood sugar
2. Functional limitations:
a. Impaired ambulation from sitting to standing
b. Disturbance of doing work as a housewife
3. Disability:
Patients experience limitations in social activities in the environment
the house is like recitation and gotong royong.

35
3.4 Physiotherapy Program/Plan

1. Purpose:
a. Short-term :
a) Increase leg muscle strength
b) Lowering blood sugar levels
b. Long-term :
a) Continuing short term
b) Restore the ability of functional activities
2. Intervention Action
a) Alternative technology:
1) Body Weight Training
2) Diabetes Exercise
b) Selected Technology:
Body Weight Training : - Aims to train muscle strength
Diabetes Exercise : - Aims to lower levels
blood sugar
- Can lose weight

- To maintain fitness
b. Education:
a) Patients are advised to repeat the exercise (Body weight training and
diabetes exercise) at home
b) Patients are advised to set a healthy diet with
reduce fast food and go on a diet
c) Doing physical activity with regular exercise
d) Doing breathing exercises in order to reduce the feeling of heaviness when
take a breath
e) Performing cervical stretching exercises aimed at reducing
dizziness and stiffness in the neck
36
3. Evaluation Plan
a. Measuring neuropathy with Michigan Neuropathy Screening
Instruments (MNSI)
b. Measurement of muscle strength (Manual Muscle Testing)
d. Measurement of functional ability (Jette Scale)
e. Blood sugar measurement (Easy Touch Gcu)
3.5 Prognosis
Quo ad Vitam : Bonam
Quo ad sanam : Bonam
Quo ad functionalam : Bonam
Quo ad cosmeticam : Bonam
3.6 Management of Physiotherapy
After analyzing the data and knowing the problem, then the
The next step is therapy. For cases of Diabetes Mellitus
Type 2 with the methods given are Body Weight Training and Gymnastics
Diabetes.
3.6.1 Day: Saturday,Date: 23 May 2022
3.6.1.1 Body Weight Training
a. Patient preparation: The patient is asked to stand upright with his feet
shoulder width apart. Then bend your knees
and push the buttocks down like the position
want to sit down then count for 8 seconds
with 4-6 sets, reps 6-10 times recovery 2-5
minutes 3 times a week.
b. Therapist preparation: The therapist is by the patient's side to
accompany and see the patient's squat exercise

37
correct and correct so that it can be implemented

maximally.
Figure 3. 1 Squat
3.6.1.2 Diabetes Exercise (Aerobic)

a. Patient preparation: Patients were asked to use
sportswear, the patient must really
in good health then do
preheating movement 10-15

minute.
b. Therapist preparation: The therapist must provide movement

preheat for 10-15
minutes, then the therapist prepares the music
for gymnastics.
c. Governance : Then do exercise for 30-60 minutes
3-5 times a week

38
Figure 3. 2 Heating
Figure 3. 3 Core movements

39
Figure 3. 4 Cooling
3.7 Evaluation
Evaluation aims to determine the level of success in

administration of therapy, therefore evaluation is needed so that physiotherapy can
compare and find out the changes before and after therapy.
40
a. Neuropathy examination with Michigan Neuropathy Screening Instrument

(MNSI)
Table 3. 8 Diabetic Neuropathy Examination Score
Questions Yes No T1 T5
1. Are your feet numb 2. Do 1 0
you feel a burning pain in your 0_ 0
sensitive to touch 4. Do you have 0_ 0
Have you ever felt a tingling ÿ 1 1
feel the skin on your feet? pain ÿ 1 0
0_ 0
7. When you take a bath, do you 0_ 0

open sores on your feet 9. Has 0_ 0
you have diabetic neuropathy 0_ 0
10. Do you feel tired every time? ÿ 1 0

day
11. Do you feel unwell at night 12. ÿ 1 0
walk 13. Can you feel your feet ÿ 1 0
skin on your feet dry and cracked ÿ 1 1
amputation?
ÿ 1 1
0_ 0
Total 8 3
After the action for 5x therapy, the patient gets results

decrease in diabetic neuropathy. With T1-T5 results from a score of 8 to 3.
41
b. Muscle Strength (Manual Muscle Testing)
Table 3. 9 Manual Muscle Testing Leg Muscle Strength Score
(MMT)
No. Region 1. Movement T1 T2 T3 T4 T5

Hip Flexion 3 3 3 4 4
Extension 3 3 3 4 4
2. Ankle Dorso Flex 4 4 4 5 5
Plantar Flexion 4 4 4 5 5
Inversion 4 44 4 5 5
Ever 4 4 5 5
an increase in leg muscle strength. With results T1-T5 hip region
flexion from 3 to 4 and extension from 3 to 4. Ankle dorso region flexes from 4
5th, plantar flexion from 4 to 5, inversion from 4 to 5 and eversion from 4 to 5.
c. Functional Abilities (Jette Scale)
Table 3. 10 Functional Ability Scores (Jette Scale)
No. Activity Criteria T1 T2 T3 T4 T5

1. Stand up from a sitting Painful 3 3 3 2 2
position Difficulty 4 4 3 3 2
Dependency 1 1 1 1 1
2. Walk 15 Painful 3 3 3 3 2
meters Difficulty 3 3 3 2 2
3. Go up the stairs 3 Painful 3 3 3 2 2

steps Difficulty 3 3 3 2 2
an increase in functional ability. With results T1-T5 standing
from sitting position pain from 3 to 2, difficulty from 4 to 2 and

42
dependence from 1 to 1. Walking 15 meters pain from 3 to 2, difficulty
from 3 to 2 and dependence from 1 to 1. Climbing stairs 3 steps pain from 3
to 2, difficulty from 3 to 2 and dependency from 2 to 1.
d. Blood Sugar Level (Easy Touch Gcu)
Table 3. 11 Blood Sugar Score (Easy Touch Gcu))
Inspection T1 T2 T3 T4 T5
When blood sugar 167 165 162 158 142
(GDS)
Fasting Blood Sugar 130 125 122 120 115
(GDP)
Blood sugar 2 hours after 156 142 130 127 124
eating (GDPP)
After the action for 5x therapy the patient gets
results in a decrease in blood sugar. With the results of T1-T5 blood sugar when
(GDS) from 167 mg/dL to 142 mg/dL, fasting blood sugar (GDP) from 130 mg/dL
to 115 mg/dL and blood sugar 2 hours after eating (GDPP) 148 mg/dL to 124
mg/dL.
3.8 Final Evaluation Results
After the patient on behalf of Mrs. M who is 29 years old gets
therapy as much as 5x, get the results:
a. Decreased diabetic neuropathy
b. An increase in leg muscle strength
c. There is an increase in functional ability
d. There is a decrease in blood sugar levels

CHAPTER IV
RESULTS AND DISCUSSION
4.1 Results
This case study discusses the effect of Body Weight Training and
Diabetes gymnastics given to patients with diabetes mellitus conditions
Type 2. The problem that often arises is a decrease in muscle strength in the
limbs and high blood sugar levels such as difficulty ambulation of
sitting to standing, going up and down stairs and walking too far. Action taken
physiotherapy with five times starting from T1: Monday, 23 May
2022, Q2: Wednesday, May 25, 2022, T3: Friday, May 27 2022, Q4: Monday, May 30, 2022,
and June 1, 2022 in a patient named Mrs. M who is 29 years old with
body weight training method and diabetes exercise. As for the objectives to be
achieve is to increase muscle strength in the legs and reduce levels of
blood sugar.
43
44
Table 4. 1 Evaluation Results of Diabetic Neuropathy Examination
Questions Yes No T1 T5
1. Are your feet numb 2. Do 1 0
you feel a burning pain in your 0_ 0
sensitive to touch 4. Do you have 0_ 0
Have you ever felt a tingling ÿ 1 1
feel the skin on your feet? pain ÿ 1 0
0_ 0
7. When you take a bath, do you 0_ 0

open sores on your feet 9. Has 0_ 0
you have diabetic neuropathy 0_ 0
10. Do you feel tired every time? ÿ 1 0

day
11. Do you feel unwell at night 12. ÿ 1 0
walk 13. Can you feel your feet ÿ 1 0
skin on your feet dry and cracked ÿ 1 1
amputation?
ÿ 1 1
0_ 0
Total 8 3
45
Table 4. 2 Results of Evaluation of Leg Muscle Strength
No. Region 1. Hip Movement T1 T2 T3 T4 T5

Flexion 3 3 3 4 4
Extension 3 3 3 4 4
2. Ankle Dorso Flex 4 4 4 5 5
Plantar Flexion 4 4 4 5 5
Inversion 4 4 4 5 5
Ever 4 4 4 5 5
Table 4. 3 Results of Evaluation of Functional Ability
No. Activity Criteria T1 T2 T3 T4 T5

1. Stand up from Painful 3 3 3 2 2
a sitting position Difficulty 4 4 3 3 2
2. Walk 15 Painful 3 3 3 3 2
meters Difficulty 3 3 3 2 2
3. Go up the stairs 3 Painful 3 3 3 2 2

steps Difficulty 3 3 3 2 2
Table 4. 4 Results of Evaluation of Blood Sugar Levels
Inspection T1 T2 T3 T4 T5
When blood sugar 167 165 162 158 142
(GDS)
Fasting Blood Sugar (GDP) 130 125 122 120 115
Blood sugar 2 hours after 148 meals 136 130 127 124
(GDPP)
4.2 Discussion
4.2.1 Diabetic Neuropathy
Examination of diabetic neuropathy using Michigan
Neuropathy Screening Instrument (MNSI). Decreased rate of diabetic neuropathy

46
from the initial evaluation (T1) to the final evaluation (T5) whose results can be seen
in the following graph:
1.2
Numb feet
Pain like burning in the leg
1
Feet are less sensitive to
touch
Leg muscle cramps
Skin feels sore when touched by

0.8 cloth
The skin feels sore when touched by the cloth
Take a shower using cold water

first then hot water
0.6 Open wound on leg
Doctor's diagnosis of diabetic

neuropathy
Feeling tired every day

0.4
Feeling not good at night
Feet hurt when walking
Able to feel the footstep

0.2
Dry and cracked skin on feet
Have you ever had an amputation?
0
T1 T5
Graph 4. 1 Diabetic Neuropathy

47
Based on graph 4.1, it can be seen that there is a decrease in neuropathy

diabetic. Reduction of diabetic neuropathy was carried out for five times of therapy
with the provision of Body Weight Training exercises can be seen

development of the patient is a decrease in diabetic neuropathy which
performed with the Michigan Neuropathy Screening (MNSI). Day therapy
the first with a value of 8 and on the fifth day of therapy decreased
be a value of 3.
This is because of the effect of Diabetes Gymnastics by doing sports
regularly can control and lower blood sugar levels, so that
with regular exercise can improve fat profile,
lose weight and maintain fitness. Besides it will
increase insulin sensitivity so that it will lower glucose
blood so as to reduce problems that occur in the nerves
edge is diabetic neuropathy.
4.2.2 Limb Muscle Strength

Measurement of muscle gain can be seen using
Manual Muscle Testing. Muscle gain from initial evaluation (T1) to
final evaluation (T5) whose results can be seen in the following graph:
48
Flexion
4
Extension
3 Dorso Flex
Plantar Flexion
2
Inversion
Ever
1
0
T1 T2 T3 T4 T5
Graph 4. 2 Increasing the Strength of the Limbs
Based on graph 4.2, it can be seen that there is an increase in strength
leg muscles which was carried out for five times of therapy by giving
Body Weight Training as measured by Manual Muscle Testing. On
flexion and extension of hip therapy on the first day to the third day with a value of
3, the fourth and fifth day of therapy increased to a value of 4.

In plantar flexion, dorsi flexion, inversion and eversion of the ankle daily therapy
the first to the fourth day with a value of 4 and therapy on the fifth day
increased to a value of 5.
This is due to the training effect of Body Weight Training in

increase muscle strength. The Body Weight Training method focuses on
weight support is with squats. By exercising

done in a structured way can increase the strength of muscle function, so that
able to achieve goals such as improving physical condition, preventing

injury, and for health purposes.
49
4.2.3 Functional Ability Limitation

Measurement of functional ability can be seen with
using the Jette scale. Improved functional ability of
initial evaluation (T1) to final evaluation (T5) whose results can be seen
in the following graph:
Stand up from a sitting position
4.5
3.5
2.5 Painful
2 Difficulty
1.5
Dependency
1
0.5
0
T1 T2 T3 T4 T5
Walk 15 meters
3.5
2.5
2 Painful
1.5 Difficulty
1 Dependency
0.5
0
T1 T2 T3 T4 T5
50
Go up the stairs 3 steps
3.5
2.5
2 Painful
1.5 Difficulty
1 Dependency
0.5
0
T1 T2 T3 T4 T5
Graph 4. 3 Functional Abilities Improvement
Based on graph 4.3, it can be seen that there is an increase in ability

functional limitation carried out for five times therapy with
giving Diabetes Gymnastics as measured by the Jette Scale. When
standing sitting position standing for pain therapy the first to the third day
with a value of 4, therapy four and five increased to 2,
for the first and second therapy difficulties with a value of 4, the third therapy and
fourth with a value of 3, the fifth therapy has increased

to 2 and for dependence on the first to fifth therapy no
there is a problem with a value of 1. When walking 15 meters for pain
the first therapy until the fourth day with a value of 3, the fifth therapy
increased to 2, for the first therapy difficulty until
the third therapy with a value of 3, the fourth and fifth therapy experienced
increase to 2 and for dependence on first therapy to
five there is no problem with the value 1. When climbing stairs 3 steps
for the first treatment pain until the fourth day with a value of 3, therapy
the fifth has increased to 2, for the first therapy difficulty
until the fourth day with a value of 3, the fifth therapy increased
51
to 2 and for first and second therapy dependence with
value of 2, for the third and fifth therapy increased to 1.
This is because of the effect of Diabetes Gymnastics in increasing
functional ability. Methods of Diabetes Gymnastics Regular exercise can
is a factor that has a direct risk for development
insulin resistance in type 2 diabetes, and poor physical ability
staying active throughout life is a means of protection
and prevention of disease so as to increase the ability
functional.
4.2.4 Blood Sugar Level
Blood sugar levels can be checked using the
Easy Touch GCU. Decreased blood sugar from the initial evaluation (T1) to
final evaluation (T5) whose results can be seen in the following graph:
180
160
140
120 Current blood sugar (GDS)
100
Fasting blood sugar (GPP)
80
60
Blood sugar 2 hours after
40 eat (GDPP)
20
0
T1 T2 T3 T4 T5
Graph 4. 4 Decrease in Blood Sugar Levels
Based on graph 4.4, it can be seen that there is a decrease in sugar levels
blood which was carried out for five times of therapy with the administration of Body
Weight Training and Diabetes Gymnastics as measured by Easy Touch Gcu.
On blood sugar when (GDS) the first therapy with a value of 167 mg/dL
52
and the fifth therapy decreased to 142 mg/dL. On sugar

fasting blood (GDP) the first therapy with a value of 130 mg/dL and the second therapy
five decreased to 115 mg/dL. On blood sugar 2 hours

after meals (GDPP) first therapy 156 mg/dL and fifth therapy
decreased to 124 mg/dL.
This is because of the training effect of Body Weight Training and Gymnastics
Diabetes in lowering blood sugar levels. Body Weight Method

Diabetes Training and Gymnastics is good for lowering blood sugar because
When doing body weight training and diabetes exercise, it will
train skeletal muscles, which is a combination of gymnastics and exercise
load is the most effective and shortest thing to burn
blood sugar. Then when our muscles are damaged that's where the muscles need
glucose, and muscle tissue is the main target tissue for insulin action
thus lowering blood sugar levels.
Mechanism of Body Weight Training and Diabetes Gymnastics in

increase leg muscle strength and lower blood sugar levels.
1). Body Weight Training
Body weight training will be good for increasing muscle strength
limbs and lower blood sugar because, when doing body weight
training, the body will withstand the burden of the overall body weight and muscles
in the body will contract so that it can train the skeletal muscles that can
increase leg muscle strength, as well as the most effective and the shortest for
burn blood sugar.
2). Diabetes Exercise
Diabetic exercise that is done daily on a regular basis can

improve fat profile, lose weight and maintain fitness.
In addition, it will increase insulin sensitivity so that it will reduce blood sugar levels
blood glucose. The recommended diabetes exercise is aerobic.
53
The use of glucose in active muscles in this case will increase,

but not accompanied by an increase in insulin. This is because
by increased sensitivity of insulin receptors in muscles during exercise.
CHAPTER V
CLOSING
5.1 Conclusion
The patient named Mrs. M with the age of 29 years with a diagnosis of Diabetes
Type 2 mellitus with complaints of weakness in the lower limbs and levels of
high blood sugar.
Physiotherapy was carried out five times, starting on
May 23, 2022 using the Body Weight Training method and
Diabetes gymnastics, as well as providing education, have resulted in changes in the direction of
good, where there is an increase in leg muscle strength and a decrease in
blood sugar. From these results it can be concluded that the provision of technology
methods such as body weight training and mirror exercise diabetes can overcome
problems in Type 2 Diabetes Mellitus Cases.
5.2 Suggestions
1. For Writers
It is hoped that it can add insight and knowledge
depth and experience regarding cases of Type 2 Diabetes Mellitus
so that it can increase understanding in dealing with Diabetes cases
Mellitus Type 2.
2. Share science and technology
To enrich knowledge in the health sector, in particular
in dealing with cases of Type 2 Diabetes Mellitus using Body
Weight Training and Diabetes Gymnastics for Type 2 Diabetes Mellitus cases
and physiotherapy management techniques.
3. For Physiotherapy
Can help make it easier for prospective physiotherapists and find out
in depth about the case of Type 2 Diabetes Mellitus.
54
55
4. For Institutions
It is hoped that health institutions in the field of physiotherapy will
can further develop knowledge about cases of Diabetes
Type 2 mellitus can be handled optimally and appropriately. And can
make it easier for prospective physiotherapists to know deeply about
cases of Type 2 Diabetes Mellitus.
5. For the Community
Given the prognosis in this case can be good, it should be
people who have family members with cases of Diabetes Mellitus
Type 2 to immediately get health services and physiotherapy
as soon as possible so that optimal healing will be achieved.
6. For Hospitals
It is hoped that it can provide physiotherapy problematic techniques to students
planning information and descriptions on hospitals in dealing with
problems that arise in Type 2 Diabetes Mellitus.

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61
ATTACHMENT
62
Appendix 1 Informed Consent Lembar

WILLING TO BE A RESPONDENTS
(INFORMED CONSENT SHEET)

I, the undersigned below:
Name : Mela
Age : 29 years
Address : Mendalo Darat, Puri Arza Housing
Work : Housewife
After getting a fairly clear explanation, I hereby declare

WILLING to be the subject of KTI writing by:
Name : Sefhia Lestary
NPM : 2019 51 012
By title : “Physiotherapy Management in Cases of Type 2 Diabetes Mellitus”

With the Method of Body Weight Training and Diabetes Gymnastics.
With this statement, I make it true and without any coercion from any party.
The One Who Gives Explanation Jambi, 23 April 2022

That state
(Sefhia Lestari) (Mela)

63
Appendix 2 Documentation
1. Body Weight Training (Squats)
Squat exercise body weight training method

2. Diabetes Exercise
Warm Up Movement
64
Core movement
Cooling Movement
65
3. Checking Blood Sugar Levels
Check blood sugar level
Sugar test results Check up result
current blood (GDS) satisfied blood sugar (GPP)
Figure 3.12 Sugar inspection results
blood 2 hours after eating (GDPP)


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MANAGEMENT OF PHYSIOTHERAPY IN CASE

DIABETES MELLITUS TYPE 2 WITH METHODS

BODY WEIGHT TRAINING AND

DIII PHYSIOTHERAPY STUDY PROGRAM

BAITURRAHIM HIGH SCHOOL OF HEALTH SCIENCES

MANAGEMENT OF PHYSIOTHERAPY IN CASE

DIABETES MELLITUS TYPE 2 WITH METHODS

BODY WEIGHT TRAINING AND

To Fulfill the Requirements for Achieving an Associate Degree

DIII PHYSIOTHERAPY STUDY PROGRAM

BAITURRAHIM HIGH SCHOOL OF HEALTH SCIENCES

Scientific Writing with the Title

MANAGEMENT OF PHYSIOTHERAPY IN CASE OF DIABETES

Has Been Tested In Front Of The Board Of Examiners

Scientific and declared to have passed and

1. Wanti Hasmar, S.Ftr., M.Or Chairperson of the Session

2. Ucu Suherman, S.Pd., Ftr Secretary

Scientific Writing with the title:

MANAGEMENT OF PHYSIOTHERAPY IN CASE OF DIABETES

MELITUS TYPE 2 WITH BODY WEIGHT METHOD

DIABETES TRAINING AND EXERCISE

Chairperson of the Session : Wanti Hasmar, S.Ftr., M.Or

Wanti Hasmar, S.Ftr., M.Or Ucu Suherman, S.Pd., Ftr

Dr. Filius Chandra, SE., MM Adi Saputra Junaidi, S.Fis., M.Fis

The undersigned below :

Name : SEFHIA LESTARI

NPM : 2019 51 015

Study Program : DIII Physiotherapy

Stating that the Scientific Writing with the title "

Write scientifically yourself and do not plagiarize, according to the rules

applies at the Baiturrahim Jambi School of Health Sciences.

Thus this statement I make in truth. If

in the future what I say is not true, then I am willing

Jambi, May 28, 2022

I dedicate this scientific paper:

2. Thanks also to my parents papa Wasito (late) and mama

we reached the level of education, I love you.

you convey and be my provision for the future.

has supported and encouraged me to immediately complete the above kti

because when the boat is on the water, it is able to sail perfectly,

but when water got into it, the boat sank."

(Ali bin Abi Talib)

“Health is the greatest gift, contentment is the greatest wealth,

loyalty is the best relationship.”

“Keep smiling, because life is a beautiful thing and

there is much to be grateful for.”

“Success and happiness lies in yourself. Stay happy, and

your happiness and you will form a strong character

stop. That every time, will surely pass. After trouble,

there will surely be infinite happiness.”

All praise and gratitude I always pray to Allah SWT

In making this scientific paper, the author gets guidance

1. Mr. Dr. Filius Chandra, SE, MM as Head of the College of Science

2. Mr. Ariyanto, SKM, M.Kes, as vice chairman I of the College of Sciences

3. Mrs. Gustina, M.Keb, as Vice Chair II of the College of Sciences

6. Mr. Ucu Suherman, S.pd, Ftr as Advisor II who is willing

8. Both of my parents who always support me are good

9. Comrades in arms who have provided good motivation in the form of

Jambi, 03 June 2022

FRONT COVER PAGE............................................................... .......................... i

TITLE PAGE ................................................ ................................................. ii