TUGAS KEPERAWATAN KOMUNITAS II

ANALISIS ARTIKEL INNOVATIVE SENSOR TO STOP FALLS

oleh
Roby Aji Permana
NIM. 102310101005

PROGRAM STUDI ILMU KEPERAWATAN

UNIVERSITAS JEMBER
2012

Innovative Sensor to Stop Falls

By Lindsey Getz
Aging Well
Vol. 5 No. 5 P. 26
Recent data suggest that fall accidents are on the rise among the older
adult population. In fact, according to the Centers for Disease Control and
Prevention (CDC), each year one in three adults aged 65 and older experiences a
fall. Falls are now the leading cause of injury-related deaths among this
population and the most common cause of nonfatal injuries and hospital
admissions for trauma.
However, researchers at Virginia Tech and the University of Virginia are
looking to change these disturbing fall statistics. With a $1.2 million grant from
the National Science Foundations Smart Health and Wellbeing program, they are
creating a portable fall prediction monitoring system for the early detection of fall
risk that can provide diagnosis and treatment before a fall occurs.
With the aid of the grant, a device is in the development stages that could
be worn by older adults to measure potentially small declining changes in gait,
posture, and mobilityall major indicators that can help point to a future fall. The
sensor will function for several days between battery recharging, collecting longterm data during everyday wear, explains Thurmon Lockhart, PhD, an associate
professor in the Virginia Tech Grado department of industrial and systems
engineering and a researcher involved with the grant. An early prototype of the
sensor has already been built and tested under a previous National Science
Foundation-funded project.
In-clinic studies have used a wristwatch-sized node worn on both the
wrists and the ankles as well as the sacrum to collect data. The products
wearability is important, and researchers are contemplating incorporating these
sensors into a faux piece of jewelry. The final product will also develop a
monitoring system called ROOP-Alert (for Remote Observation Operating
Platform). Lockhart says it will bridge gait and posture analysis, body sensor

networks, low-power radio-frequency wireless communication, and gerontology.

Once the device has collected the necessary information, data-processing
algorithms will provide a mobility analysis and fall risk assessment for each
patient. Physicians will be able to determine which of their patients are at the
greatest risk of falling and then implement fall prevention measures.
While the research is still new, the long-term hope is that this portable
monitoring system will become widely available. With the technology, primary
care physicians or gerontologists could make fall risk assessment a routine part of
their patients care. Down the road, this technology could be used in a variety of
settings, says Karen Roberto, PhD, a professor of human development at Virginia
Tech and director of the Center for Gerontology and the Institute for Society,
Culture, and Environment, who is also involved in the research grant. The dream
is that it could be incorporated into a routine exam the way many other tests have
become standard preventive measures. Fall prevention would become routine.
A. Serious Silent Danger
While modern medicine puts a lot of focus on disease prevention and has
made many advances in that area, falls remain a huge problem, and the issue
requires more attention. Lockhart has been involved in several lines of research
regarding falls and has become passionate on the subject. In the US, as well as
other countries, we are approaching such a significant portion of the elderly
population experiencing falls that its on the verge of becoming a pandemic, says
Lockhart, who is also the director of the Virginia Tech Locomotion Research
Laboratory and has worked with dozens of companies invested in preventing falls,
including UPS. When we look at a fall accident, we look at it from various points
of view, including a number of characteristics, or change of characteristics,
affecting the outcome of the fall. So when people come into the lab, we measure
information such as their gait speed, strength, and reactive/recovery time. Then
we make them slip and fall and see what happens.
One of the bigger issues surrounding slips and falls is that elders often
dont mention them to others. The CDC estimates that of all the falls occurring

each year, fewer than one-half of those patients actually talk to their healthcare
providers about fall incidents. Its a hidden problem for a lot of people, Roberto
says. They may keep that information to themselves because they worry it would
signal a lack of independence; or maybe theyve just decided it wasnt a big deal.
But even if the person doesnt get hurt, that initial fall may be a sign that they
have a greater propensity to fall in the future, and that future fall could be much
more costly.
Roberto says there is also growing fear around falling. Many older adults
are aware of the statistics or have a friend who has fallen and they become afraid
as a result. That fear of fallingwhether youve actually fallen or notmay
cause people to limit their activities, Roberto says. In the long run, that can be
detrimental on emotional and physical levels.
B. Making Changes
While the new remote monitoring technology is still in its early phases,
there are other important intervention solutions that can be considered in the
meantime. There are prevention opportunities out there, such as strengthening
programs and balance programs, that can help the patient with their
musculoskeletal integrity, Lockhart says. Task has to be taught as well. For
instance, carrying a pillow, even though its very light, still changes your gait. The
patient can be taught safer ways to perform tasks, such as a better way to hold the
pillow.
But Lockhart says its not just about exercise and balance training, as
theres more to falls than the musculoskeletal system. Nutrition, the vestibular
system, vision, and personal habits all also influence fall accidents, he says. So
there has to be some risk assessment. We can test vision, and we can ask the
patient some important questions.
Roberto says physicians cant expect that patients will be forthcoming
about a fall. You have to ask the direct questions, she says. And its not just
about falling to the ground. Even a trip or slip can indicate some instability. Once
the physician knows there is some likelihood that this person could fall, then they

can talk about prescribing exercise and improving balance. Medications can also
come into play. If part of the exam reveals that a medication has side effects that
may lead to a greater likelihood of falls, then they can discuss what options there
might be in switching those medications or at least becoming more aware of those
side effects.
Lockhart says once a patient falls, the risk of falling again is very high. He
believes this new technology will help reduce that risk and may even help reduce
the risk of that initial fall. Lockhart says that result could be significant. I believe
we could really help some people, and that is the reason for this program: helping
save lives.

PEMBAHASAN
Kejadian jatuh tidak hanya sering dialami oleh anak yang baru belajar
berjalan, tetapi juga dialami oleh golongan lanjut usia (lansia). Banyak faktor
yang menyebabkan seorang lansia mengalami jatuh, baik faktor intrinsik maupun
ekstrinsik. Definisi jatuh adalah suatu kejadian yang dilaporkan penderita atau
saksi mata yang melihat kejadian yang menyebabkan sesorang mendadak
terbaring atau terduduk di lantai atau di tempat yang lebih rendah dengan atau
tanpa kehilangan kesadaran atau luka.
Jatuh menjadi salah satu insiden yang paling sering terjadi pada orang
lanjut usia (lansia) yang mengakibatkan trauma serius, seperti nyeri, kelumpuhan
bahkan kematian. Hal ini menimbulkan rasa takut dan hilangnya rasa percaya diri
sehingga mereka membatasi aktivitasnya sehari-hari yang menyebabkan
menurunnya mutu kehidupan pada lansia yang mengalaminya dan juga
berpengaruh pada anggota keluarganya.
Faktor penyebab jatuh pada lansia dapat dibagi dalam 2 golongan besar,
yaitu: Faktor Intrinsik dan Ekstrinsik. Faktor instrinsik dapat disebabkan oleh
proses penuaan dan berbagai penyakit seperti Stroke dan TIA yang
mengakibatkan kelemahan tubuh sesisi. Jatuh dapat disebabkan karena
berkurangnya stabilitas tubuh yang dibentuk oleh sistim sensorik yaitu
penglihatan, pendengaran, fungsi vestibuler dan proprioseptif, kemudian oleh
sistim saraf pusat yang akan memberikan respon motorik untuk mengantisipasi
input sensorik, berperan juga fungsi kognitif dari lansia, bila mengalami demensia
atau kepikunan risiko jatuh akan lebih besar. Selanjutnya sistem muskuloskeletal
juga

merupakan

faktor

yang

penting,

karena

gangguan

pada

sistim

muskuloskeletal akan mengakibatkan gangguan gaya berjalan (kelambanan gerak,

langkah yang pendek, penurunan irama dan pelebaran base support). Selain itu
perlambatan reaksi mengakibatkan seorang lansia terlambat mengantisipasi bila
terpeleset atau tersandung yang dapat mengakibatkan jatuh. Penyakit parkinson
yang mengakibatkan kekakuan alat gerak, maupun depresi yang menyebabkan

lansia tidak terlalu perhatian saat berjalan juga menjadi factor risiko penyebab
jatuh pada lansia. Gangguan penglihatan pun seperti misalnya katarak
meningkatkan risiko jatuh pada lansia. Gangguan sistem kardiovaskuler akan
menyebabkan syncope juga sering menyebabkan jatuh pada lansia. Selain itu
Faktor-faktor lingkungan pun dapat menyebabkan risiko jatuh meningkat, seperti,
alat-alat atau perlengkapan rumah tangga yang sudah tua atau tergeletak di bawah,
tempat tidur tidak stabil atau kamar mandi yang rendah dan tempat berpegangan
yang tidak kuat atau tidak mudah dipegang, lantai tidak datar, licin atau menurun,
karpet yang tidak dilem dengan baik, keset yang tebal/menekuk pinggirnya, dan
benda-benda alas lantai yang licin atau mudah tergeser, lantai licin atau basah,
penerangan yang tidak baik (kurang atau menyilaukan), alat bantu jalan yang
tidak tepat ukuran, berat, maupun cara penggunaannya.
Berdasarkan survey di AS didapatkan sekitar 30% lansia yang berumur
lebih dari 65 tahun jatuh setiap tahunnya, separuh dari angka tersebut mengalami
jatuh berulang. Jatuh dapat mengakibatkan fraktur kolum femoris, yang
menyebabkan lansia mengalami imobilisasi. Fraktur kolum femoris merupakan
fraktur yang berhubungan dengan proses menua dan osteoporosis.
Center for Desease Control (CDC) menyebutkan bahwa setiap tahunnya,
satu dari tiga orang yang berumur 65 tahun mengalami kejadian jatuh. Kejadian
jatuh menjadi penyebab utama dari trauma yang memiliki dampak pada kematian
dan menjadi penyebab trauma nonfatal yang memerlukan hospitalisasi. Dari
sinilah, para peneliti dari Virginia Tech dan University of Virginia menciptakan
alat portable untuk alat yang berfungsi sebagai pencegahan dini terhadap risiko
jatuh pada lansia.

http://www.agingwellmag.com/archive/091712p26.shtml