IMPLEMENTATION OF STRETCHING EXERCISE WITH

ERGONOMIC BASED HEALTH EDUCATION APPROACH

, idp_sucana@yahoo.com

, handari_adiputra@unud.ac.id

,

which has been developed on area agriculture in Province Bali. M majority farmer orange in

Bali come from Bangli Regency, Buleleng Regency, and Gianyar Regency (Alitawan &

Sutrisna, 2017) . One of the largest local citrus producers is in Bayung Gede Village,

Kintamani District, Bangli Regency (Aluhariandu et al ., 2016) .

an area of 10.24 km, this village is located about 55 km from the Denpasar sea and about 35

km north of Bangli. There are 2 routes to reach Bayung Gede Village, either from Payangan -

Kintamani or Bangli - Kintamani. The environmental status of Bangli district (2015) states

that the basic physical condition of the area based on topography, geology, Bayung Gede

village is at an altitude of about 800-900 M above sea level which causes Bayung Gede

Village to have cool air with the highest peak point being the Writing Peak. Regional

conditions vary between sub-districts and are generally in plain (0-2%), sloping (2-15%),

wavy (15-30%), steep (30-40%) and very steep (>40%) conditions.). Relatively flat

al ., 2016) . Based on preliminary studies in field , agricultural activities carried out farmer

Citrus fruits in Bayung Gede Village such as hoeing, spraying pesticides, and cleaning weeds

are routine jobs, while pruning oranges, fertilizing and picking oranges are seasonal jobs.

From the results of direct interviews with some citrus farmers, the physical activity or task

they do is quite heavy. Hoeing, cleaning and transporting weeds with a less ergonomic

posture and farmers usually bring grass that has been cleaned by carrying or carrying by hand

manually has a high risk. The type of activity of citrus farmers that poses a high risk to health

is when hoeing, spraying pesticides and cleaning weeds, the attitude of farmers who always

bend over and work for a long time will cause musculoskeletal complaints and work fatigue.

lifting machine. The placement of water reservoirs that are far away and the unavailability of

automatic faucets make farmers have to draw when spraying, causing an increase in the

workload of citrus farmers in addition to carrying the spray machine for a long time. Farming

is one of the jobs that uses a lot of muscle power and has a high risk of experiencing

musculoskeletal complaints and work fatigue, farmers can be said to be workers who have a

high risk of muscle injury caused by doing work still manually so that many workers' body

movements are still carried out in the wrong position and attitude and are not in accordance

with the limits of body functions (Utami et al . , 2017) .

average, they complained of moderate fatigue and musculoskeletal complaints with a score of

et al . , 2016) . While research in Nigeria, on average, complains about the lower waist about

72% due to repetitive work, excessive use of energy, static working position, poor working

position, mechanical stress, vibration and temperature extreme in the place work (Faujiyah,

2020) .

Minahasa district has the largest prevalence, namely moderate fatigue as many as 53 people

(62.3%), fatigue caused by workload and long working time > 8 hours of work in a day, then

the work environment , as well as monotonous work for a long time will trigger work fatigue

(Wurarah et al. , 2020) . Farmer activities that are monotonous, long work intensity, mental,

positions, take breaks between work hours, avoid long working hours to reduce occupational

diseases, implement prevention strategies such as reducing injuries and overwork.

Agricultural activities will also result in farmers experiencing stress, muscle tension and

work-related musculoskeletal disorders that result in several diseases and disabilities (Ghosh

et al. , 2018) .

of farmers about good and correct work attitudes (Lestari, 2010) . Knowledge of farmers in carrying

out farming activities is also very influential on the activities carried out at work and the work risks

caused such as occupational health, work safety, work-related injuries, and work-related fatigue

(Murtiningrum & Silamat, 2019) . The work of citrus farmers with a heavy workload and the use

believed to reduce musculoskeletal complaints and fatigue. Giving stretching exercises is

able to overcome musculoskeletal complaints, increase morale, increase blood circulation,

improve physical function, and increase muscle flexibility so that it will reduce muscle injury

and will certainly reduce musculoskeletal complaints and fatigue (Syafrianto, KH, & Zulfa,

2019) .

stretching exercise and work modification on musculoskeletal complaints and fatigue. In

previous studies, by modifying work without doing stretching exercises , there were no

significant changes in musculoskeletal complaints and fatigue . While giving regular

stretching exercises, it turns out that stretching exercises are effective in reducing

data before farmers work in Period 1 and Period 2 (p> 0.05). This means that there is no

effect of the previous condition in Period 1 that affects changes in the dependent variable. In

addition, the washing out period is sufficient to give the effect of returning to the initial

condition as in the condition before the farmer worked in Period 1. Thus, the intervention

effect occurs purely because of the treatment.

In this study, the research subjects were given an intervention in the form of

implementing stretching exercises and health promotion programs as an ergonomics-based

health education approach. Giving stretching exercises or stretching at work was carried out

for 15 minutes on the sidelines of the break at 13.00 WITA 3 times a week for 3 week.

Meanwhile, the health promotion program is given in the first and last weeks. To determine

the effect of the treatment effect on reducing musculoskeletal complaints and fatigue, a paired

t-test was performed. The results of the analysis can be seen in Table 5.

Table 5. Test of Treatment Effects Using the t-paired . test

In this study, it can also be seen in Table 6. test the effect of additional treatment on

musculoskeletal complaints which as an additional test to determine the long-term effect of

giving the intervention by measuring musculoskeletal complaints on the last day of the third

2 by 29.53%. This shows that the intervention provided can improve the health of workers as

seen from the decrease in musculoskeletal complaints of citrus farmers. In Period 1, many

farmers experienced musculoskeletal complaints in the category of pain in the left shoulder,

as many as 8 people (61.54%), right shoulder as many as 4 people (30.77%). In the left upper

arm in the pain category as many as 10 people (61.54%), the right upper arm in the pain

category as many as 11 people (84.62%), then in the waist with pain category (84.62%), and

complaints on the left knee as many as 10 people (76.92%) and right knee as many as 8

people (61.54%). While in Period 2 musculoskeletal complaints after the intervention, there

was a decrease in musculoskeletal complaints in the shoulders by 23.08%, in the upper arms

by 15.38%, then in the waist by 7.69%, and in the knees by 15.38%.

to be blocked so that the oxygen supply to the muscles is not enough. This situation causes

the accumulation of lactic acid deposits and body heat which in turn causes fatigue in the

skeletal muscles which is felt as a form of muscle pain in workers and triggers

musculoskeletal complaints.

work that the average musculoskeletal complaints in Period 1 was 58.70±9,096 while the

average musculoskeletal complaints in Period 2 was 42.41±4,090 . This indicates a decrease

of 29.53%. The decrease is caused because when given active stretching, the muscles can

recover and can build the substances needed for the muscles, in this case the lactic acid left

over from muscle metabolism is recycled and converted into carbon dioxide (CO2), water

relaxation contractions. So by doing stretching or stretching exercises will reduce

musculoskeletal complaints.

decreasing musculoskeletal complaints that occurred because of the intervention that has

been given in the form of workplace stretching exercise or stretching on the sidelines of

working hours. The intervention or stretching exercises provided have the effect of relaxing

muscles and joints and improving blood circulation around them, thereby reducing muscle

pain and decreasing musculoskeletal complaints (Syafrianto et al., 2019) . This is also in

accordance with research (Smith et al., 2019) that by doing exercise or exercise can trigger

the release of endorphins from the pituitary and hypothalamus which in turn activates

respond to a decrease in musculoskeletal complaints which is a mechanism for reducing pain

when doing exercise or exercise .

decreasing musculoskeletal complaints that occurred because of the intervention that has

been given in the form of workplace stretching exercise or stretching on the sidelines of

working hours. The intervention or stretching exercises provided have the effect of relaxing

muscles and joints and improving blood circulation around them, thereby reducing muscle

pain and decreasing musculoskeletal complaints (Syafrianto et al., 2019). This is also in

accordance with research (Smith et al., 2019) that by doing exercise or exercise can trigger

felt in musculoskeletal complaints, during exercise the human body will naturally produce

endogenous opioids. So that when someone does exercise or exercise in the short term, it will

respond to a decrease in musculoskeletal complaints which is a mechanism for reducing pain

when doing exercise or exercise.

stretching exercises on reducing musculoskeletal complaints because stretching exercises

lead to adaptations in both the cardiovascular and musculoskeletal systems that support

increased capacity and overall sports performance. Local adaptations in skeletal muscle, such

as increased mitochondrial biogenesis and capillary density, aid the body's ability to transport

and use oxygen to generate energy and therefore delay the onset of muscle fatigue during

causes skeletal muscle hypertrophy. Muscle hypertrophy can be defined as an increase in

muscle mass due to an increase in the content of contractile proteins and connective tissue.

Muscle hypertrophy can occur due to stimuli such as resistance and stretching exercises for a

long time. So that by doing resistance training and stretching or stretching exercises can

provide muscle endurance when done for a long time, when the exercise has reached 6-7

weeks it will show hypertrophy or a more significant increase in muscle mass so that it will

trigger muscle endurance and increase strength. muscle. In addition, endurance and muscle

strength that occurs when doing stretching exercises are also supported by agonist muscle

activation, neuron stimulation, motor unit synchronization, antagonistic muscle activation,

which are proven to be the main contributors in doing exercises to increase muscle endurance

of time, namely with a bent standing posture causes farmers to become tired quickly due to

less ergonomic work (Rasna et al., 2015) .

form of stretching exercises can reduce work fatigue by 26.97%. WSE ( workplace stretching

exercise ) uses the principle of stretching movements in the neck muscle group to the leg

muscle group. In muscles that experience spasm, there will be shortening of muscle fibers

because the myofilaments overlap each other. At the time of stretching with holding for a few

seconds in an elongated muscle position, the muscle fiber structure, especially the

sarcomeres, will stretch because the overlapping myofilaments will decrease and

Figure 2. Health Promotion Program as an Ergonomics-Based Health Education

Approach

farmers to provide education that working ergonomically according to their abilities is very

important to improve the health of farmers. In this study, it was found that there was a

decrease in musculoskeletal complaints and work fatigue caused by the intervention. Health

Promotion Program or health promotion in the workplace, one of the ergonomics-based

health education approach strategies that can be done to increase work productivity. By

promoting health to farmers, it will maintain balance and physical, mental, social elements

and will increase health knowledge related to habits related to good physical condition,