EFFECTIVENESS RANGE OF MOTION THERAPY AND DIETARY

MANAGEMENT TRAINING TOWARD KNOWLEDGE AND ABILITY

OF CAREGIVER TO CARE FOR POST STROKE PATIENT

CHAPTER I

1.1 BACKGROUND OF THE STUDY

Today, stroke befits a grievous threat in health world field and in earnest concern to resolve

it. World Federation of Neurology (2017) has declared it too, through their conference

collaborated with World Stroke Organization which has promoted a slogan and topic “Stroke

is a brain attack. Prevent it and threat it”. Each two second somebody in the world predict will

have stroke disease and approximately 1 in 8 death incidents worldwide reasoned by stroke

(Stroke Association,2017). From those informations above we coincide that stroke is really

serious disease and threat for the world at this time.

World Health Organization (Pietrangelo et al, 2017) has update 10 diseases caused of death

globally and Ischemic Heart disease and stroke are the first disease has killed over 15 million

after the last 15 years and make them as a world’s biggest killers. Especially for stroke has

consumed 6,2 Million in 2015. The last update in 2000 is 5,7 Million, so it made the world

wide percent of death is 11,1 percent (Pietrangelo et al,2017)

According to Junaidi (in Rohmatul Laily,2016) In America has estimated around 500.000

new patients of stroke and 150.000 patients died cause of stroke and WHO (2010) explained

too, that countries in South East Asia region have 4,4 billion people have stroke. In Asia, a

country befits the most number of incidents is Indonesia (Wayunah and Saefulloh,2016).
 Riskesdas (2013) has published that the prevalence of stroke in Indonesia based on

diagnosis of health workforce is 7 per mi and 12,1 per mi is diagnosed as symptom. Area with

the highest prevalence of stroke in Indonesia is North Sulawesi (10,8%). Then followed by

Yogyakarta (10,3%), after that Bangka Belitung and DKI Jakarta have 9,7 percent.

The high of stroke prevalence in North Sulawesi caused by bad life style according to the

health minister of Indonesia, Nafsia Boih (JPNN,2014). Begin with unhealthy eating patterns

that manado’s citizen fond to eat fat meat like rat and dog meat, this statement has published

by Government Hospital Prof. Dr. R.D. Kandow (etcadm,2018). Consume more fat meat and

high cholesterol food with low or none fiber are made in productive ages or young generation.

So stroke today can strike not only to old ages but for the young age too who shall not control

their life style.

Beside eating pattern of life style, there are some causing too. According to Dourman

(2013, in Purwaningtiyas, 2014), he said that if someone rare to doing exercise or sport, less

of sleep cause work or anything caused many case for productivity patient with stroke. Than

Bhat, et.al research (2008, in Purwaningtiyas, 2014 said smoking is one of risk factor of stroke.

With high risk for woman than man, smoking shall elevate the tendency of red blood cells and

lower HDL (High Density Lipoprotein).

Health Department of Indonesia are attempting especially in North Sulawesi has prioritized

education and socialization about non communicable disease including stroke

(Issetiabudi,2016). For rehabilitation according to WHO standard, patient post stroke will get

therapy for motoric, speech impaired and cognitive function. Own goal for rehabilitation is to

reach patient independence then patient could interact in social and adapt mental. And the last

goal is they can do their daily activity without a help (Widyo,2014).

 For motoric therapy need physiotherapy to help patient recovery. It doesn’t take only just

a couple day but even month by month, depend on their condition. The physiotherapists make

sure cannot visit patient everyday and make sure it needs more cost to pay for if the patient

need home visitation/care. This