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During gravidity, back pain is a significant issue, especially due to changes in posture along with increasing physical load in the third trimester. Muscle relaxation and stretching exercises for pregnant women can help reduce back pain, one of which is the butterfly exercise. That study aims until determine the impact to the butterfly activity on gravidity in their third trimester at TPMB Amilia Intarti Klampisrejo, Pasuruan Regency. A quantitative method was used with a quasi-experimental approach employing a one-group pre-test also post-test design. The study involved 32 third-trimester gravidity as respondents. Data were collected using purposive sampling, before-and-after measurements, and assessed with the Numeric Rating Scale (NRS). The intervention be carried out over a period of four weeks. The findings show that the butterfly pregnancy exercise effectively reduces back pain in third-trimester gravid. Therefore, the butterfly exercise can serve as an alternative method to help alleviate back pain and enhance comfort during pregnancy.  

Musculoskeletal Disorders (MSDs) complaints in muscles, joints, and soft tissues can be caused by poor posture, repetitive movements, and excessive physical load. In the wet cake-making industry, workers often sit or stand for long periods, bend, and perform monotonous hand movements, which increases the risk of MSDs. The impact includes decreased work comfort, productivity, and quality of life. This study aims to assess the ergonomic risk level in wet cake-making workers and identify the relationship between work activities and MSD complaints. The method used is descriptive quantitative research with a cross-sectional design, involving 45 workers at Kue X Silaberanti. Ergonomic risk was assessed using the REBA method, while MSD complaints were measured using the Nordic Body Map questionnaire. The results show that in the mixing process, 58.8% of workers experienced a very high risk of MSDs. In the molding and baking processes, 52.9% and 68.8% of workers, respectively, were at high risk. The most frequent complaints were pain in the back, neck, shoulders, arms, and wrists due to poor posture and repetitive movements. To reduce the risk of MSDs, workers need to improve their posture, use ergonomic aids, rotate tasks, and undergo training in safe working techniques.

Low back pain is a common complaint among pregnant women in the second and third trimesters due to biomechanical and hormonal changes. Non-pharmacological interventions like prenatal exercise are believed to be effective, though evidence from controlled trials is limited. This study aimed to evaluate the effectiveness of prenatal exercise in reducing low back pain intensity. A quasi-experimental pretest–posttest control group design was used with 30 pregnant women (15 in the intervention group, 15 in the control group), selected by purposive sampling. The inclusion criteria were gestational age of 20–36 weeks, no medical contraindications, and willingness to participate. The intervention group performed prenatal exercises twice a week for 8 weeks (45 minutes per session), while the control group received health education without physical exercise. Pain intensity was measured using the Visual Analogue Scale (VAS). Data analysis was conducted using paired t-test, independent t-test/Mann–Whitney, and ANCOVA to control for age, parity, and BMI. Both groups had homogeneous baseline characteristics (p > 0.05). The intervention group’s pain score decreased from 6.9 ± 1.1 to 3.6 ± 1.0 (Δ = -3.3; p < 0.001), while the control group’s pain score decreased from 6.8 ± 1.2 to 6.3 ± 1.1 (Δ = -0.5; p = 0.09). The difference in pain reduction between groups was significant (p < 0.001). ANCOVA confirmed that prenatal exercise was significantly effective after adjusting for confounders (β = -2.8; p < 0.001). Prenatal exercise is an effective, safe, and affordable intervention for reducing low back pain in pregnant women.

Background: Oral health is an important indicator of overall health, well-being, and quality of life. According to the WHO, oral health is a state of freedom from various diseases and conditions, including dental and oral diseases that limit an individual's ability to bite, chew, smile, speak, and psychosocial well-being. Therefore, it is necessary to maintain oral hygiene as an effort to improve oral health. Case report: A 45-year-old man came to Soelastri General Hospital complaining of a large cavity in his upper left tooth. The tooth had been painful for about a year and had not undergone any treatment.Extraoral examination revealed a symmetrical face. Clinical examination of the maxillary left first premolar revealed a large cavity on the distoocclusal surface with pulpal depth.  Discussion: Perforations can be treated through cavity access; the prognosis depends on the elimination and prevention of infection in the perforation area and the choice of material. The success of perforation closure management is influenced by several factors, including the timing of perforation closure, the choice of material used, the location of the perforation, and adequate perforation closure. Conclusion: Case of maxillary left premolar with diagnosis of pulp necrosis which experienced lateral perforation and the area was closed using MTA, then root canal treatment.  

Overview: Back pain during pregnancy is a common problem experienced by approximately 50–70% of pregnant women. Back pain during pregnancy is caused by an imbalance between the muscle activity in the lumbar region. Several maternal factors are known to play a role in the onset of back pain during pregnancy, including maternal age, body mass index (BMI), number of pregnancies (gravida), and physical activity. Research Method: This is a quantitative analytical study with a cross-sectional approach. The sample size was 33 pregnant women in their third trimester. The sampling technique used purposive sampling, and data analysis used the Chi-square test. Research Results: There was a relationship between BMI and back pain (p-value: 0.015), and there was no relationship between maternal age (p-value: 0.715), gravida (p-value: 0.442), and physical activity (p-value: 0.156) and back pain in pregnant women in their third trimester. Conclusion: There was a significant relationship between BMI and back pain in pregnant women in their third trimester, and there was no significant relationship between maternal age, gravida, and physical activity and back pain in pregnant women in their third trimester.

The rapid development of the digital era has led to a major shift in the modern workplace, with over 1.5 billion people spending more than six hours daily in front of computer screens. This working condition poses significant occupational health risks, including Musculoskeletal Disorders (MSDs) such as Low Back Pain (LBP) and neck strain, with a global prevalence of 60-80%. Furthermore, prolonged screen exposure and high workload contribute to mental health issues like chronic stress and digital fatigue. This community service aimed to increase awareness among PT. XYZ employees regarding the importance of integrated ergonomics to achieve optimal productivity. The method used was an informative sharing session through a presentation and discussion. The material emphasized a three-pronged intervention approach: physical ergonomics (workstation adjustment), technology-based interventions (wearable devices, break reminder apps, and electromagnetic radiation prevention), and mental well-being integration (mindfulness and relaxation techniques). The results showed a significant increase in participant understanding of the health risks and the practical steps to implement integrated ergonomic solutions. It was found that combining technology-based reminders and mindfulness exercises can reduce health complaints by up to 40% better than physical interventions alone. The implication of this service is the recommendation for PT. XYZ to adopt an integrated ergonomic policy that addresses physical, technological, and mental aspects to create a healthier, safer, and more productive work environment for its employees.

Low back pain is a discomforting condition that can cause various disorders and potentially disrupt a person's quality of life, such as causing decreased work productivity. Therefore, it is important for the community, especially farmers in Bulakrejo Hamlet, Ngawi Regency. To improve understanding of low back pain, efforts are needed to expand farmers' knowledge regarding this condition, including its definition, prevention, and treatment in Bulakrejo Hamlet. The method applied was providing physiotherapy education through health promotion about low back pain using leaflets as a medium for information delivery. A question and answer session was also conducted to measure the level of understanding of farmers in Bulakrejo Hamlet and provide exercises that can address problems of weakness, stiffness, limitations and pain in the back muscles. The activity ran smoothly and the material was easily understood by farmers in Bulakrejo Hamlet. Evaluation results showed an increase in farmers' knowledge, from 40% to 90%. The extension activity proved effective in increasing farmers' understanding of low back pain cases.

Work activities in workshops often require static and repetitive body positions, such as bending over, lifting heavy loads, or reaching into narrow areas of vehicles. These habits can gradually cause muscle tension and lead to neck and lower back pain. Given the high risk, physiotherapy counseling on occupational safety and health (OSH) and ergonomics was conducted to provide practical understanding to B-Garage, Batu City workshop workers. The counseling was delivered interactively through material presentations, direct discussions, and demonstrations of stretching exercises that can be easily applied in daily activities. The results of the activity showed a very significant increase in knowledge; participants who initially did not understand the principles of ergonomics and musculoskeletal pain prevention were able to identify work risks and practice stretching exercises correctly after the education session. This change was clearly evident from the post-test results, which showed a significant overall improvement compared to the pre-test. These findings indicate that physical therapy education not only enhances knowledge but also promotes behavioral changes toward safer, more comfortable, and more productive work patterns.

In order to guarantee the best possible maternal health and fetal growth throughout pregnancy, complementary services for expectant mothers are required. These services include nutrition, mental health, and supplementary medical treatment. According to data, 70% of pregnant women have low back discomfort. According to a different poll, eight out of ten third-trimester pregnant women report having back pain. Doing Childpose (Balasana) exercises is one more way to lessen this problem. This study sought to ascertain if Childpose (Balasana) exercises were beneficial in lowering low back pain complaints among pregnant women in their third trimester at the South Bolango City Health Center. This study employed a quasi-experimental pretest-posttest approach with a sample of 34 pregnant women in the third trimester. There were twenty participants in the study's sample. Childpose or balasana exercises are beneficial in relieving back discomfort in third trimester pregnant women at the South Bolango Health Center, according to the data, which indicated a P-value of 0.000 <0.05.

Background: Indonesia, as an agrarian country, has a large workforce engaged in physically demanding activities that increase the risk of myofascial pain. The prevalence of myofascial pain syndrome (MPS) in the upper trapezius muscle in Indonesia reaches 40% annually, with a higher rate in women. This condition often causes complaints in the neck, shoulders, and lower back, leading to a decline in quality of life. Various management strategies exist, but many are less effective in the long term and carry potential side effects. Lidocaine, as a local anesthetic, offers an alternative therapy due to its simple procedure, affordable cost, rapid effect, and good safety profile; therefore, its effectiveness in managing myofascial pain needs to be evaluated. Methods: This study was an observational research with a prospective cohort design conducted at PKU Muhammadiyah Gamping Hospital. Patients with myofascial pain who received lidocaine injections were followed for 4 weeks, and pain intensity was measured using the Numeric Rating Scale (NRS) to assess the relationship between lidocaine administration and pain reduction. Results: The study showed that lidocaine injection was effective in significantly reducing myofascial pain. The Wilcoxon Signed Rank Test produced negative Z values with p = 0.000 (<0.05) for all comparisons from pretest to the fourth week. The Friedman test also indicated significant differences between weeks (χ² = 9.731; p = 0.021), with optimal pain reduction observed in the second week. Although lidocaine provided significant analgesic effects, its effectiveness tended to decrease in subsequent weeks, indicating a short-term effect that should be combined with other interventions for sustained outcomes. Conclusion: Lidocaine injection proved effective in reducing pain among patients with myofascial pain syndrome, with the most optimal reduction occurring in the second week after therapy. The dominant factors influencing the outcomes were the relatively short duration of lidocaine’s action and individual variability in response. This implies that lidocaine can be used as an effective initial therapy, but should be combined with other interventions such as physiotherapy or activity modification to achieve more stable and sustainable pain management.

Musculoskeletal disorders (MSDs) represent a prevalent health issue among clinical medical students, with global studies reporting incidence rates of 73% in India and 81.9% in Saudi Arabia. Pain is most frequently reported in the neck, lower back, and shoulder areas. However, similar data from Indonesia, particularly Papua, remains limited. This study aims to identify the prevalence and risk factors of MSDs among clinical medical students at the Faculty of Medicine, Cenderawasih University. The research employed a cross-sectional design with a sample of 78 clinical students selected through purposive sampling. Data collection utilized the Standardized Nordic Musculoskeletal Questionnaire (NMQ) to measure prevalence and the Nordic Body Map to localize pain. Data analysis used Chi-Square test to evaluate the relationship between risk factors (such as Body Mass Index/BMI and physical activity) and musculoskeletal complaints. Results showed the majority of respondents were female (74.4%) and aged ≥25 years (51.3%). Most respondents experienced pain at the "moderate pain" level (57.7%), with the most frequently reported pain areas being the back, waist, calves, knees, shoulders, and wrists. There was a statistically significant relationship between BMI and pain complaints (p=0.035), but no significant relationship was found between physical exercise and musculoskeletal complaints (p=0.129). This study concludes that BMI is a risk factor for MSDs in the studied population. Evidence-based recommendations are needed to reduce MSD risk and improve students' quality of life during clinical education.

Hyperkeratotic hand dermatitis (HHD) is a chronic hand eczema subtype marked by thick hyperkeratotic plaques, painful fissures, and minimal erythema or vesiculation.It is diagnostically challenging due to overlap with palmoplantar psoriasis and keratoderma and is strongly linked to repeated irritant exposure in wet work. A 60-year-old male taro leaf farmer presented with itching and burning on the palms and backs of both hands, spreading to the forearms for 2–3 weeks. Examination revealed papules, hyperpigmented plaques, erythematous macules, irregular scaling, and about 1 cm palmar fissures on both hands. The working diagnosis was chronic hyperkeratotic hand dermatitis. Initial treatment included oral cetirizine, topical betamethasone valerate, and Vaseline gel, plus education on using long rubber gloves at work. HHD results from skin barrier dysfunction and keratinocyte hyperproliferation caused by repeated irritant exposure. In this case, exposure to taro leaves and prolonged rubber glove use likely maintained irritation and occlusion. Differential diagnoses include palmoplantar psoriasis, contact dermatitis, and tinea manuum. Management involves potent corticosteroids, antihistamines, occlusive emollients, and occupational modifications such as replacing gloves and limiting occlusion time. Identifying occupational factors in HHD is essential. Effective management requires combined topical therapy, symptom control, and strict workplace modifications, along with patient education and allergy screening if needed.

A safe and healthy environment is crucial to minimizing accidents and occupational diseases, and this is where Occupational Health and Safety (OHS) comes in. Workers in the informal sector, such as online drivers, are more likely to experience musculoskeletal problems, especially low back pain (LBP), because they frequently lack proper occupational protection and health services. LBP is a complaint of lower back pain that can be brought on by extended periods of static sitting, bad posture, and personal characteristics like body mass index, smoking, and length of service. The purpose of this program is to educate online drivers in Malang City, East Java, and help them avoid LBP. The risk of LBP can be decreased in part by promoting physical activity and education. One recommended intervention is the William Flexion Exercise (WFE), an exercise aimed at improving posture, increasing muscle strength and flexibility, and reducing lower back pain. Implementing WFE education and training for online car drivers is anticipated to strengthen OHS awareness and reduce the incidence of LBP among informal sector workers.

Introduction: Pregnancy is a natural process that every woman experiences. During pregnancy, pregnant women experience many changes, both physiological and psychological. These changes can cause various symptoms in each pregnant woman. Some common complaints during pregnancy include nausea and vomiting, back pain, edema, and shortness of breath. Method: This activity was conducted through counseling aimed at explaining the condition and understanding it to pregnant women. This activity used leaflets and live demonstrations so that participants could perform exercises correctly. Conclusion: After conducting counseling on the role of physiotherapy in pregnancy problems at the integrated health posts (Posyandu) for pregnant women in Sempulang Village, Janju Village, and Keluang Lolo Village, it can be concluded that education is important regarding understanding good exercises to do during pregnancy, such as child pose, cat and camel exercise or yoga for pregnant women, and breathing exercises. This is useful for reducing and preventing symptoms during pregnancy by always paying attention to signs of when to stop the exercise.

Prenatal exercise plays a vital role in maintaining the physical and mental well-being of pregnant women. This activity helps reduce common discomforts such as back pain, enhances stamina, and strengthens pelvic muscles in preparation for childbirth. However, knowledge among pregnant women regarding safe and effective exercises remains limited. The lack of structured information often leads to uncertainty and discourages participation in physical activities during pregnancy. This condition highlights the need for well-directed and comprehensive physiotherapy education. This community service program was conducted in Building B of the Kedungkandang Community Health Center and involved 15 participants. A holistic approach was employed, combining interactive counseling to convey the theoretical benefits and safety of exercise, group discussions to share experiences, and practical demonstrations. The exercises demonstrated were carefully selected to be simple, safe, and easy to perform independently at home, ensuring continuity beyond the educational sessions. The results indicated a significant improvement in participants’ knowledge, as evidenced by the comparison between pre-test and post-test scores. This improvement reflects the growing awareness among pregnant women of the importance of maintaining fitness through structured and safe physical activity. Continuous education through a community physiotherapy approach is necessary to ensure consistent implementation of prenatal exercise and to support long-term behavioral changes toward better maternal health.

Background: Obesity has become a global epidemic, with substantial implications for musculoskeletal health, particularly in weight-bearing joints like the knee and ankle. Aim: To determine the prevalence of obesity with respect to age and gender and to assess its effect on the knee and ankle joints among adults in Ekpoma, Edo State. Materials and Methods: A descriptive cross-sectional study involving 60 obese adults was conducted using a structured, validated questionnaire. Ethical approval and informed consent were obtained. Results: Respondents were predominantly aged 40–45 years (35%) and female (80%). 65% reported pain in the knee and/or ankle joints; 56.7% reported joint stiffness or reduced range of motion. Conclusion: Obesity significantly affects the knee and ankle joints, contributing to pain, stiffness, and a reduced range of motion. These results reinforce the need for targeted public health interventions aimed at obesity prevention and management, particularly in populations at risk of joint-related complications.

Back discomfort is a common musculoskeletal complaint among pregnant women, particularly in the third trimester, caused by biomechanical and physiological changes during pregnancy. This condition can interfere with daily activities, reduce sleep quality, and decrease overall comfort. Pharmacological treatments during pregnancy are limited due to safety concerns, making non-pharmacological therapies essential in primary healthcare. One alternative is the use of warm ginger compresses, which combine the benefits of heat therapy with the anti-inflammatory properties of ginger. This study aimed to examine the effect of warm ginger compresses on reducing back pain intensity in third-trimester pregnant women at the Jailolo Community Health Centre. The research used a pre-experimental one-group pretest–posttest design. The sample consisted of 16 pregnant women selected through purposive sampling. Pain intensity was measured using the Numeric Rating Scale (NRS) before and after the intervention. The treatment involved applying warm ginger compresses to the lower back following a standardized procedure. Data analysis was conducted using univariate and bivariate methods with the Wilcoxon signed-rank test. The results showed a significant reduction in back pain intensity after the intervention (p < 0.05). These findings indicate that warm ginger compresses are an effective, safe, and simple non-pharmacological method for reducing back pain in third-trimester pregnant women.

Low Back Pain (LBP) is often caused by spondylolisthesis, which causes pain, limited mobility, and disability. Conservative physiotherapy is the primary option to reduce symptoms and improve function. This study aims to evaluate the effectiveness of multimodal physiotherapy interventions in patients with LBP and spondylolisthesis. A case report study was conducted on a 59-year-old female patient diagnosed with LBP and spondylolisthesis. The patient underwent three physiotherapy intervention sessions: Infrared (IR), Short-Wave Diathermy (SWD), Transcutaneous Electrical Nerve Stimulation (TENS), William Flexion Exercise, Core Stability, and Strengthening. Evaluation was performed using the Numeric Rating Scale (NRS) for pain, a goniometer for joint range of motion (LGS), Manual Muscle Testing (MMT) for muscle strength, and the Oswestry Disability Index (ODI) for function. The results of the therapy showed a significant reduction in pain, namely silent pain from a score of 5 to 1 and pain on movement from a score of 6 to 3. Lumbar ROM increased with flexion from 70 degrees to 85 degrees. Lumbar muscle strength also improved, flexors from a score of 4 to 5 and extensors from a score of 3 to 5. ODI decreased from 55.5% (severe disability category) to 12% (minimal disability category). Multimodal physiotherapy interventions have been proven effective in reducing pain, improving LGS, muscle strength, and function in patients with LBP et causa spondylolisthesis.

Background: Knee osteoarthritis is one of the most common degenerative conditions in older adults, often causing pain and limited range of motion (ROM), which negatively affects quality of life. Physiotherapy management plays an important role in reducing pain, improving flexibility, and maintaining joint function. Objective: This study aims to evaluate the effectiveness of physiotherapy interventions in reducing pain and improving ROM in elderly patients with knee osteoarthritis. Method: A case study was conducted on a 63-year-old patient at Dr. Soedjono Level II Hospital, Magelang, who underwent three therapy sessions consisting of Infrared (IR), Transcutaneous Electrical Nerve Stimulation (TENS), Proprioceptive Neuromuscular Facilitation (PNF) with the hold-relax technique, and static cycling. Assessments were carried out using the Numeric Rating Scale (NRS), Likert Gait Scale (LGS), and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Results: The findings showed a significant reduction in pain on palpation (from 4/10 to 1/10), improvement in knee flexion ROM (from 110° to 135°), and functional enhancement indicated by a decrease in WOMAC scores from 39.58% to 27.08%. Conclusion: These results suggest that structured physiotherapy interventions provide therapeutic benefits in reducing pain, improving joint flexibility, and enhancing functional ability in elderly patients with knee osteoarthritis.

Back pain is a common complaint among pregnant women, especially in the third trimester, caused by hormonal changes, uterine enlargement, and poor postural balance. If untreated, this pain can disrupt sleep quality and daily activities. The pelvic tilt technique, a non-pharmacological intervention, strengthens abdominal and pelvic muscles, maintains posture, and relieves back pain. This study examined the effect of the pelvic tilt technique on back pain intensity in third-trimester pregnant women at Karangdoro Public Health Center. The study used a quasi-experimental design with a one-group pretest–posttest approach. The population consisted of all third-trimester pregnant women with physiological back pain (without comorbid conditions or a history of premature rupture of membranes). Using a total sampling technique, 34 respondents were included. The intervention was conducted for seven consecutive days. Data collection employed observation sheets and the Numeric Rating Scale (NRS). Data analysis used the Wilcoxon test because the normality test yielded p < 0.05. Statistical results showed p = 0.000 (< 0.05), indicating that the pelvic tilt technique significantly reduced back pain intensity. These findings suggest that pelvic tilt exercises can serve as a safe, simple, and effective non-pharmacological alternative therapy to alleviate bapain in third-trimester pregnant women.