KARYA TULIS AKHIR HUBUNGAN ANTARA INDEKS MASSA TUBUH (IMT) YANG MENINGKAT DENGAN KEJADIAN CARPAL TUNNEL SYNDROME (CTS) PADA PEKERJA INDUSTRI ROKOK
Oleh : SYARIFAH YASMIN HUDRINA 08020074
UNIVERSITAS MUHAMMADIYAH MALANG FAKULTAS KEDOKTERAN 2011
HASIL PENELITIAN
HUBUNGAN ANTARA INDEKS MASSA TUBUH (IMT) YANG MENINGKAT DENGAN KEJADIAN CARPAL TUNNEL SYNDROME (CTS) PADA PEKERJA INDUSTRI ROKOK
KARYA TULIS AKHIR Diajukan Kepada Universitas Muhammadiyah Malang untuk Memenuhi Salah Satu Persyaratan dalam Menyelesaikan Program Sarjana Fakultas Kedokteran
Oleh : SYARIFAH YASMIN HUDRINA 08020074
UNIVERSITAS MUHAMMADIYAH MALANG FAKULTAS KEDOKTERAN 2011
KATA PENGANTAR
Assalamu’alaikum Wr.Wb Puji syukur ke hadirat Tuhan Yang Maha Esa yang telah memberikan rahmat-Nya sehingga penulis dapa menyelesaikan karya tulis akhir yang berjudul Hubungan Antara Indeks Massa Tubuh ( IMT) Yang Meningkat Dengan Kejadian Carpal Tunnel Syndrome ( CTS ) Pada Pekerja Industri Pabrik Rokok, tepat pada waktunya. Karya tulis akhir ini disusun untuk memenuhi sebagian syarat guna memperoleh derajat sarjana kedokteran di Fakultas Kedokteran Universitas Universitas Muhammadiyah Malang. Dalam kesempatan ini penulis mengucapkan terimakasih kepada: 1. Dekan Fakultas Kedokteran dr. Irma Suswati, M.kes yang telah memberi kesempatan dan fasilitas dalam pelaksanaan penelitian. 2. Pembantu Dekan I dr.Meddy Setiawan Sp.PD, Pembantu Dekan II dr. Fathiyah Safithri, M.Kes dan Pembantu Dekan III dr. Iwan Sis, SpKJ yang telah memberikan kesempatan dan fasilitas dalam pelaksanaan penelitian 3. Prof. DR. Dr. Djoni Djunaedi,Sp.PD,KPTI, selaku dosen pembimbing I yang selalu memberi dorongan motivasi,bantuan dan kesedian waktunya
untuk selalu membimbing penulis,sehingga penulis dapat menyelesaikan tugas akhir ini dengan baik. 4. dr. Rahayu Sp.S, selaku dosen pembimbing II yang telah memberi bimbingan dengan baik dan penuh kesabaran dalam membantu penulis menyelesaikan karya tulis akhir ini dengan baik. 5. dr. Mohammad Bahrudin Sp.S, selaku dosen penguji yang telah memberikan petunjuk,saran dan kritik yang membangun saat ujian maupun diluar ujian demi kesempurnaan karya tulis akhir ini. Penulis sadar tugas akhir ini sangat jauh dari kesempurnaan. 6. Abi H. Sayyid Abdullah Alqadri dan Ummi Hj. Syarifah Anisah Alkaf tercinta yang telah bekerja keras demi ananda, terima kasih atas segala doa,kasih sayang,kesabaran dan segalanya yang telah diberikan kepada ananda. ”Jazakallah bil jannah” Semua itu tak akan pernah bisa terbalas semoga ALLAH SWT mengganti semuanya dengan syurga. 7. Terima Kasih kepada Pak Tato serta Staf pabrik rokok yang telah membantu dalam proses penelitian karya tulis akhir ini. 8. Staf TU FK UMM dan Staf Lab FK UMM terima kasih atas bantuannya selama ini kepada penulis 9. Sahabat-sahabatku angkatan FK UMM 2008 yang tak bisa disebutin satupersatu terima kasih atas bantuan serta doanya. 10. Semua pihak yang turut membantu dalam menyelesaikan TA ini dan juga mendoakan yang tidak bisa penulis sebutkan satu-persatu
Penulis Sadar bahwa karya tulis akhir ini pasti jauh dari kata sempurna,oleh karena itu penulis membuka diri untuk segala saran dan kritik yang bersifat membangun guna kesempurnaan dari karya tulis akhir ini. Akhir kata semoga karya tulis akhir ini dapat memberikan manfaat bagi penulis,pembaca, dan menjadi sumbangan yang berarti bagi perkembangan ilmu pengetahuan kedepan. Wassalamu’alaikum Wr.Wb
Malang. ..... Desember 2011
Penulis
ABSTRAK Yasmin,Syarifah . 2011. Hubungan antara antara Indeks Massa Tubuh (IMT) yang Meningkat Dengan Kejadian Carpal Tunnel Syndrome (CTS) Pada Pekerja Industri Rokok. Karya Tulis Akhir,Fakultas Kedokteran Universitas Muhammadiyah Malang. Pembimbing : (1) Djoni Djunaedi*/(2) Rahayu**//. Latar Belakang : Carpal Tunnel Syndrome (CTS) adalah kumpulan gejala akibat penekanan pada nervus medianus, ketika melalui terowongan carpal (Carpal Tunnel) di pergelangan tangan. Merupakan penyakit yang paling sering ditemukan pada wanita. Kondisi ini bisa diperparah dengan faktor pekerjaan yang dilakukan secara berulang-ulang,serta kondisi kesehatan, berat badan berlebih atau IMT ≥ 25 dapat meningkatkan resiko terjadinya CTS. Tujuan Penelitian : Untuk mengetahui hubungan antara indeks massa tubuh (IMT) yang meningkat dengan kejadian Carpal Tunnel Syndrome (CTS) pada pekerja Industri rokok. Metode Penelitian : Observasional analitik dengan pendekatan secara cross sectional, sampel 100 responden menggunakan uji Chi square dengan =0.05. Hasil penelitian : Menunjukan bahwa para pekerja wanita pada unit industri rokok dengan indeks massa tubuh (IMT) ≥ 25 ada sebanyak 50% ( rata-rata IMT 31,29) dan 50% pekerja lainnya mempunyai indeks massa tubuh (IMT) ≤ 25 ( IMT rata-rata 21,87 ). Kejadian Carpal Tunnel Syndrome (CTS) pada pekerja pabrik industri rokok mempunyai persentase 43 % dari 100 reponden dengan IMT ≥ 25 dan IMT ≤ 25. Kesimpulan : Ada hubungan antara indeks massa tubuh (IMT) yang meningkat dengan kejadian Carpal Tunnel Syndrome (CTS) pada pekerja pabrik Industri rokok. Kata Kunci: Indeks Massa Tubuh (IMT), Carpal Tunnel Syndrome (CTS), Pekerja Industri Rokok.
*/ Guru Besar Bagian Ilmu Penyakit Dalam Fakultas Kedokteran Muhammadiyah Malang. **/ Staf bagian Ilmu Penyakit Syaraf Fakultas Kedokteran Muhammadiyah Malang.
ABSTRACT
Yasmin,Syarifah.2011.The relationship between increased body mass indeks ( BMI) with the incidence of Carpal Tunnel Syndrome (CTS ) Cigarette Industry workers. Thesis,Medical Faculty,University of Muhammadiyah Malang . Advisers : (1) Djoni Djunaedi*/(2) Rahayu**/. Background : Carpal Tunnel Syndrome (CTS) is a collection of symptoms caused by pressure on the median nerve, when the carpal tunnel (Carpal Tunnel) on the wrist and as a disease that most often found in female. This condition can be aggravated by working’s factor that continually done, as well as in healthy condition of being overweight (BMI ≥ 25) that create risk of CTS. Objective : To determine the relationship betweenthe increasing Body Mass Index (BMI) and the incidence of CTS conducted the female cigarettes industry workers. Method : Observational analytical approach, cross sectional using 100 respondents of the Chi square test with = 0.05. Results : Reviewed that the female workers in cigarette industry which had a BMI ≥ 25 are 50% (of the average BMI 31.29 ) and the other 50% workers had a BMI ≤ 25 ( of the average BMI 21.87). The Incidence of Carpal Tunnel Syndrome (CTS) on the cigarette industry has a factory worker until the percentage reaches 43% of the 100 people workers showed a CTS with BMI ≥ 25 and BMI ≤ 25. Conclusion : There is a relationship between the increased body mass index (BMI) with the incidence of Carpal Tunnel Syndrome (CTS) on the female cigarette industry factory workers.
Key words: Body Mass Index (BMI), Carpal Tunnel Syndrome (CTS), Cigarette Industry Workers. */ Lecturer in Internal Medicine Department Medical Faculty University of Muhammadiyah Malang. **/ Lecturer in Neurological Department Medical Faculty University of Muhammadiyah Malang.
DAFTAR ISI
Halaman JUDUL ............................................................................................................. i LEMBAR PENGESAHAN ............................................................................. ii LEMBAR PENGUJIAN .................................................................................. iii KATA PENGANTAR ..................................................................................... iv ABSTRAK ....................................................................................................... vii ABSTRACT ....................................................................................................... viii DAFTAR ISI .................................................................................................... ix DAFTAR TABEL ............................................................................................ xiii DAFTAR GAMBAR ....................................................................................... xiv DAFTAR SINGKATAN ................................................................................. xv BAB I. PENDAHULUAN ............................................................................... 1 1.1 Latar Belakang................................................................................. 1 1.2 Rumusan Masalah............................................................................ 3 1.3 Tujuan Penelitian ............................................................................. 3 1.3.1 Tujuan Umum ........................................................................ 3 1.3.2 Tujuan Khusus ....................................................................... 3 1.4 Manfaat Penelitian ........................................................................... 3 1.5 Keterbatasan Penelitian ................................................................... 4 1.6 Ruang Lingkup Penelitian ............................................................... 4 1.6.1 Lingkup Keilmuan ................................................................. 4 1.6.2 Lingkup Sasaran ..................................................................... 4
BAB II. TINJAUAN PUSTAKA ..................................................................... 5 2.1 Obesitas ............................................................................................ 5 2.1.1 Definisi Obesitas..................................................................... 5 2.1.2 Epidemiologi ......................................................................... 5 2.1.3 Faktor yang mempengaruhi obesitas...................................... 5 2.1.4 Patogenesis Obesitas .............................................................. 6 2.1.5 Pengukuran Secara Antropometrik ........................................ 7 2.1.5.1 Metode pengukuran IMT ......................................... 7 2.1.5.2 IMT dan CTS ............................................................ 8 2.2 Nyeri ................................................................................................. 9 2.2.1 Definisi nyeri .......................................................................... 9 2.2.2 Mekanisme Nyeri .................................................................. 9 2.2.3 Klasifikasi Nyeri ................................................................... 10 2.3 Carpal Tunnel Syndrome ( CTS ) ..................................................... 12 2.3.1 Definisi CTS........................................................................... 12 2.3.2 Epidemologi ........................................................................... 12 2.3.3 Anatomi ................................................................................. 11 2.3.4 Patofisiologi CTS ................................................................... 15 2.3.5
Gejala klinis CTS................................................................. 17
2.3.6 Faktor resiko terjadinya CTS................................................ 17 2.3.7 Faktor yang mempengaruhi CTS ......................................... 18 2.3.8 Klasifikasi dan Diagnosa CTS ............................................. 19 2.3.8.1 Klasifikasi CTS .......................................................... 19 2.3.8.2 Diagnosa CTS ............................................................ 20
2.3.9 Pemeriksaan Klinis CTS ........................................................ 20 2.4 Terapi CTS ...................................................................................... 22 2.5 Ergonomi Pencegahan ..................................................................... 23 BAB III. KERANGKA KONSEPTUAL DAN HIPOTESIS .......................... 26 3.1 Kerangka Konseptual Penelitian....................................................... 26 3.2 Hipotesis ........................................................................................... 28 BAB VI. METODOLOGI PENELITIAN ....................................................... 29 4.1 Rancangan Penelitian ...................................................................... 29 4.2 Tempat Penelitian ............................................................................ 29 4.3 Populasi dan Sampel ........................................................................ 29 4.3.1 Populasi .................................................................................. 29 4.3.2 Teknik Pengambilan Sampel.................................................. 29 4.3.3 Karakteristik Sampel Penelitian ............................................. 30 4.3.3.1 Kriteria Inklusi ........................................................... 30 4.3.3.2 Kriteria Eksklusi........................................................ 30 4.4 Variabel Penelitian .......................................................................... 30 4.5 Definisi Operasional ........................................................................ 31 4.6 Metode Pengumpulan Data ............................................................. 31 4.6.1 Alat Pengumpul Data ............................................................. 31 4.6.2 Sumber Data ........................................................................... 32 4.6.2.1 Data Primer ................................................................ 32 4.6.2.2 Metode Pengumpulan Data ........................................ 32 4.7 Metode Pengolahan dan Analisi Data ............................................. 33 4.7.1 Metode Pengolahan ................................................................ 33
4.7.2 Analis Data ............................................................................ 33 4.7.3 Alur Penelitian ....................................................................... 34 BAB V HASIL PENELITIAN......................................................................... 35 5.1 Hasil Penelitian ................................................................................. 35 5.1.1 Deskripsi karakteristik responden ......................................... 35 5.12 Tabulasi silang ( crosstabs )..................................................... 38 5.1.3 Hubungan antara IMT yang meningkat dengan kejadian CTS pada pekerja industri rokok .......................................... 40 BAB VI. PEMBAHASAN ............................................................................... 42 6.1 Deskripsi Karakteristik Responden ........................................... 42 6.1.1 Usia,Lama Kerja,IMT serta CTS pada pekerja industri Rokok .............................................................................. 42 6.2 Hubungan IMT yang meningkat dengan kejadian CTS ........... 45 BAB VII. KESIMPULAN DAN SARAN ....................................................... 47 7.1 KESIMPULAN ......................................................................... 47 7.2 SARAN ...................................................................................... 47 DAFTAR PUSTAKA ...................................................................................... 49 LAMPIRAN ..................................................................................................... 53
DAFTAR TABEL
Tabel
Halaman
1.1 klasifikasi IMT kategori untuk Asia ......................................................... 8 5.1 Distribusi Frekuensi Usia Responden ...................................................... 35 5.2 Distribusi Frekuensi Lama Masa Kerja..................................................... 36 5.3 IMT para pekerja wanita pada unit industri rokok ................................... 37 5.5 Hasil Tes Tinnel dan Phalen .................................................................... 37 5.6 Kategori Carpal Tunnel Syndrome (CTS) ................................................ 37 5.7 Tabulasi silang antara Usia dengan IMT ................................................. 38 5.8 Tabulasi silang antara Usia dengan CTS ................................................. 39 5.9 Tabulasi silang antara Bagian Kerja dengan CTS.................................... 39 5.10 Tabulasi silang antara Lama Bekerja dengan CTS .................................. 39 5.11 Tabulasi Silang Hubungan Antara indeks IMT yang meningkat dengan kejadian CTS pada pekerja Industri rokok ........................................... 40
DAFTAR GAMBAR
Gambar
Halaman
1. Anatomy of Carpal Tunnel ........................................................................... 13 2. Anatomy of wirst joint .................................................................................. 15 3. Tes Phallen.................................................................................................. 21 4. Tes Tinnel ..................................................................................................... 21
DAFTAR SINGKATAN
CTS
=
Carpal Tunnel Syndrome
WHO
=
World Health Organization
IMT
=
Indeks Massa Tubuh
BMI
=
Body Mass Index
WPRO
=
Western Pasific Region of WHO
Riskerdas
=
Riset Kesehatan Dasar
MSDs
=
Musculoskeletal disorders
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