i

KARYA TULIS AKHIR

HUBUNGAN TINGGI HAK SEPATU DAN LAMA BERDIRI TERHADAP

KEJADIAN HALLUX VALGUS PADA KARYAWATI MATAHARI

DEPARTMENT STORE MALANG TOWN SQUARE

Oleh:

SALMA RASYIDAH

201510330311117

UNIVERSITAS MUHAMMADIYAH MALANG

FAKULTAS KEDOKTERAN

2019

ii

HASIL PENELITIAN

HUBUNGAN TINGGI HAK SEPATU DAN LAMA BERDIRI TERHADAP

KEJADIAN HALLUX VALGUS PADA KARYAWATI MATAHARI

DEPARTMENT STORE MALANG TOWN SQUARE

KARYA TULIS AKHIR

Diajukan kepada

Universitas Muhammadiyah Malang

untuk Memenuhi Salah Satu Persyaratan

dalam Menyelesaikan Program Sarjana

Fakultas Kedokteran

Oleh:

Salma Rasyidah

201510330311117

UNIVERSITAS MUHAMMADIYAH MALANG

FAKULTAS KEDOKTERAN

2019

iii

iv

v

LEMBAR PENGUJIAN

vi

KATA PENGANTAR

Puji syukur penulis panjatkan kehadirat Allah SWT karena atas berkat dan

rahmat-Nya, penulis telah berhasil menyelesaikan karya tulis akhir yang berjudul

“Hubungan Tinggi Hak Sepatu dan Lama Berdiri Terhadap Kejadian Hallux

Valgus Pada Karyawati Matahari Department Store Malang Town Square”.

Penulisan penelitian ini dilakukan dalam rangka memenuhi salah satu syarat untuk

mencapai gelar Sarjana Kedokteran Jurusan Pendidikan Dokter pada Fakultas

Kedokteran Universitas Muhammadiyah Malang.

Penulis menyadari bahwa penyusunan karya tulis akhir ini jauh dari

sempurna. Tanpa bantuan dan dorongan dari berbagai pihak, sangatlah tidak

mudah menjalani masa perkuliahan hingga pada penyusunan karya tulis akhir

ini.

Akhir kata penulis berharap adanya saran dan kritik yang membangun dan

semoga penelitian ini dapat menambah wawasan serta bermanfaat bagi semua

pihak.

Malang, Juni 2019

Penulis

xi

DAFTAR ISI

Halaman

HALAMAN JUDUL………………………………………………………………i

LEMBAR PENGESAHAN………………………………………………………iii

PERNYATAAN ORISINALITAS……………………………………………….iv

LEMBAR PENGUJIAN…………………………………………………………..v

KATA PENGANTAR…………………………………………………………....vi

LEMBAR PERSEMBAHAN……………………………………………………vii

ABSTRAK………………………………………………………………………..ix

ABSTRACT…. …………………………………………………………………......x

DAFTAR ISI ………………………………………………………………….....xi

DAFTAR TABEL ................................................................................................. xv

DAFTAR GAMBAR ........................................................................................... xvi

DAFTAR SINGKATAN..................................................................................... xvii

DAFTAR LAMPIRAN ...................................................................................... xviii

BAB 1 PENDAHULUAN ...................................................................................... 1

1.1 Latar Belakang ...................................................................................... 1

1.2 Rumusan Masalah ................................................................................. 4

1.3 Tujuan Penelitian................................................................................... 4

1.3.1 Tujuan Umum .............................................................................. 4

1.3.2 Tujuan Khusus.............................................................................. 4

1.4 Manfaat Penelitian................................................................................. 4

1.4.1 Manfaat Akademik ....................................................................... 4

1.4.2 Manfaat Klinis .............................................................................. 4

1.4.3 Manfaat bagi Masyarakat ............................................................. 5

BAB 2 TINJAUAN PUSTAKA ............................................................................. 6

2.1 Hallux Valgus ........................................................................................ 6

xii

2.1.1 Anatomi Telapak Kaki ................................................................. 6

2.1.2 Definisi ......................................................................................... 8

2.1.3 Epidemiologi ................................................................................ 9

2.1.4 Faktor-Faktor yang Memengaruhi ............................................. 10

2.2 Sepatu Hak Tinggi ............................................................................... 13

2.2.1 Definisi ....................................................................................... 13

2.2.2 Jenis ............................................................................................ 14

2.2.3 Dampak Terhadap Kesehatan ..................................................... 16

2.3 Lama Berdiri ....................................................................................... 17

BAB 3 KERANGKA KONSEP DAN HIPOTESIS ............................................. 18

3.1 Kerangka Konsep ................................................................................ 18

3.2 Hipotesis Penelitian ............................................................................. 19

BAB 4 METODE PENELITIAN .......................................................................... 20

4.1 Jenis Penelitian .................................................................................... 20

4.2 Lokasi dan Waktu penelitian ............................................................... 20

4.3 Populasi dan Sampel ........................................................................... 20

4.3.1 Populasi ...................................................................................... 20

4.3.2 Sampel ........................................................................................ 20

4.3.3 Besar Sampel .............................................................................. 20

4.3.4 Teknik Pengambilan Sampel ...................................................... 21

4.3.5 Karakteristik Sampel Penelitian ................................................. 21

4.3.5.1 Kriteria Inklusi ............................................................... 21

4.3.5.2 Kriteria Eksklusi ............................................................. 21

4.3.6 Variabel Penelitian ..................................................................... 21

4.3.6.1 Variabel Bebas ............................................................... 21

4.3.6.2 Variabel Tergantung ....................................................... 22

xiii

4.3.7 Definisi Operasional ................................................................... 22

4.4 Alat dan Bahan Penelitian ................................................................... 23

4.5 Alur Penelitian..................................................................................... 23

4.6 Prosedur Penelitian .............................................................................. 24

4.7 Analisis Data ....................................................................................... 25

4.8 Jadwal Penelitian ................................................................................. 25

BAB 5 HASIL PENELITIAN DAN ANALISIS DATA ..................................... 26

5.1 Hasil Penelitian ................................................................................... 26

5.1.1 Deskripsi Karakteristik Sampel .................................................. 26

5.1.1.1 Distribusi Sampel berdasarkan Usia .............................. 26

5.1.1.2 Distribusi Sampel berdasarkan Masa Kerja ................... 27

5.1.1.3 Distribusi Sampel berdasarkan IMT .............................. 27

5.1.1.4 Distribusi Sampel berdasarkan Riwayat HV Keluarga .. 27

5.1.1.5 Distribusi Sampel berdasarkan Tinggi Hak Sepatu........ 28

5.1.1.6 Distribusi Sampel berdasarkan Lama Berdiri ................ 28

5.2 Tabulasi Silang antara Usia dan Skor HV ........................................... 29

5.3 Tabulasi Silang antara Masa Kerja dan Skor HV ............................... 29

5.4 Tabulasi Silang antara IMT dan Skor HV ........................................... 30

5.5 Tabulasi Silang antara Riwayat HV Keluarga dan Skor HV .............. 31

5.6 Tabulasi Silang antara Tinggi Hak Sepatu dan Skor HV .................... 31

5.7 Tabulasi Silang antara Lama Berdiri dan Skor HV............................. 32

5.8 Analisis Data ....................................................................................... 33

5.8.1 Hasil Output Uji Chi-Square variabel Tinggi Hak Sepatu ......... 33

5.8.2 Hasil Output Uji Mann-Whitney variabel Tinggi Hak Sepatu ... 33

5.8.3 Hasil Output Uji Regresi Logistik variabel Tinggi Hak Sepatu..34

5.8.4 Hasil Output Uji Chi-Square variabel Lama Berdiri ................. 36

xiv

BAB 6 PEMBAHASAN ....................................................................................... 37

6.1 Distribusi Kejadian HV berdasarkan Karakteristik Sampel

Penelitian……………………………………………………………..37

6.1.1 Distribusi Kejadian HV berdasarkan Usia ................................. 37

6.1.2 Distribusi Kejadian HV berdasarkan Masa Kerja ...................... 38

6.1.3 Distribusi Kejadian HV berdasarkan IMT.. ............................... 39

6.1.4 Distribusi Kejadian HV berdasarkan Riwayat HV Keluarga ..... 39

6.1.5 Distribusi Kejadian HV berdasarkan Tinggi Hak Sepatu .......... 40

6.1.6 Distribusi Kejadian HV berdasarkan Lama Berdiri ................... 40

6.2 Analisis Data……………………………………………...………….41

6.3 Keterbatasan Penelitian…………………………………...………….44

BAB 7 SIMPULAN DAN SARAN ...................................................................... 46

7.1 Simpulan…...……………………………………………...………….46

7.2 Saran………………….…………………………………...………….46

7.1.1 Bagi Peneliti Lain ....................................................................... 47

7.1.2 Bagi Masyarakat ......................................................................... 47

DAFTAR PUSTAKA ........................................................................................... 48

LAMPIRAN .......................................................................................................... 52

xv

DAFTAR TABEL

Halaman

Tabel 4.1 Definisi operasional variabel................................................................. 22

Tabel 4.2 Jadwal penelitian ................................................................................... 25

Tabel 5.1 Distribusi Sampel berdasarkan Usia ..................................................... 26

Tabel 5.2 Distribusi Sampel berdasarkan Masa Kerja .......................................... 27

Tabel 5.3 Distribusi Sampel berdasarkan IMT ..................................................... 27

Tabel 5.4 Distribusi Sampel berdasarkan Riwayat HV Keluarga ......................... 27

Tabel 5.5 Distribusi Sampel berdasarkan Tinggi Hak Sepatu .............................. 28

Tabel 5.6 Distribusi Sampel berdasarkan Lama Berdiri ....................................... 28

Tabel 5.7 Tabulasi Silang antara Usia dan Skor HV............................................. 29

Tabel 5.8 Tabulasi Silang antara Masa Kerja dan Skor HV ................................. 29

Tabel 5.9 Tabulasi Silang antara IMT dan Skor HV............................................. 30

Tabel 5.10 Tabulasi Silang antara Riwayat HV Keluarga dan Skor HV .............. 31

Tabel 5.11 Tabulasi Silang antara Tinggi Hak Sepatu dan Skor HV .................... 31

Tabel 5.12 Tabulasi Silang antara Lama Berdiri dan Skor HV ............................ 32

Tabel 5.13 Hasil Output Chi-Square Test variabel Tinggi Hak Sepatu ................ 33

Tabel 5.14 Hasil Output Mann-Whitney U Test Ranks ......................................... 33

Tabel 5.15 Hasil Output Mann-Whitney U Test Statistics .................................... 34

Tabel 5.16 Hasil Output uji Regresi Logistik Model Summary ............................ 34

Tabel 5.17 Hasil Output uji Regresi Logistik Variables in the Equation ............. 35

Tabel 5.18 Hasil Output Chi-Square Test variabel Lama Berdiri ......................... 36

xvi

DAFTAR GAMBAR

Halaman

Gambar 2.1 Zona pada kaki dan tulang pada tiap zona .......................................... 6

Gambar 2.2 Penampang superior (A) dan inferior (B) anatomi kaki ...................... 7

Gambar 2.3 Persendian pada telapak kaki .............................................................. 8

Gambar 2.4 Hallux valgus ....................................................................................... 8

Gambar 2.5 Hammer toe (A) dan Claw toe (B) ...................................................... 9

Gambar 2.6 Perbandingan bentuk kaki normal (kiri) dan pes planus (kanan) ...... 12

Gambar 2.7 Pump heels ........................................................................................ 14

Gambar 2.8 Stiletto heels dan Kitten heels ............................................................ 15

Gambar 2.9 Platform heels.................................................................................... 15

Gambar 2.10 Wedge heels ..................................................................................... 16

Gambar 3.1 Kerangka konsep ............................................................................... 18

Gambar 4.1 Alur penelitian ................................................................................... 24

xvii

DAFTAR SINGKATAN

HV : Hallux Valgus

IMT : Indeks Massa Tubuh

LBP : Low Back Pain

MTP : Metatarsophalangeal

xviii

DAFTAR LAMPIRAN

Lampiran Halaman

1 Persetujuan Setelah Penjelasan (Informed Consent) 52

2 Kuesioner Penelitian 55

3 Keterangan Layak Etik 57

4 Dokumentasi Penelitian 58

5 Hasil Analisis Data 59

6 Kartu Konsultasi Tugas Akhir 61

7 Surat Keterangan Hasil Deteksi Plagiasi 62

48

DAFTAR PUSTAKA

Asplund CA, Best TM, 2013, Achilles Tendon Disorders, BMJ2013;346:f1262

pp. 1-7 [online], (Diunduh tanggal 20 Oktober 2018), Tersedia dari:

https://doi.org/10.1136/bmj.f1262

Atik A, Ozyurek S, 2014, Flexible Flatfoot, North Clin Istanbul 2014 Volume 1

No 1 pp. 57-64 [online], (Diunduh tanggal 20 Oktober 2018), Tersedia

dari: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5175026/pdf/NCI-

1-57.pdf

Bahrizal AR, Meiyanti, 2017, Association between heel-height and low back pain

in sales promotion girls, JKKI 2017 Volume 8 No 3 pp. 198-204 [online],

(Diunduh tanggal 4 Desember 2018), Tersedia dari:

https://doi.org/10.20885/JKKI.Vol8.Iss3.art9

Barnish M, Morgan HM, Barnish J, 2018, The 2016 HIGh Heels: Health effects

And psychosexual BenefITS (HIGH HABITS) study: systematic review of

reviews and additional primary studies, BMC Public Health (2018)

Volume 18 No 37 pp.1-13 [online], (Diunduh tanggal 18 Juni 2018),

Tersedia dari: https://doi.org/10.1186/s12889-017-4573-4

Blakley K, Kepple A, 2013, Women’s High Heel Discomfort Analysis and

Prototype Solution [online], (Diunduh tanggal 20 Oktober 2018), Tersedia

dari: http://digitalcommons.calpoly.edu/imesp/127

Broega AC, Righetto M, Ribiero R, 2017, Female High Heel Shoes: A Study of

Comfort [online], (Diunduh tanggal 18 Juni 2018), Tersedia dari:

https://doi.org/10.1088/1757-899X/254/23/232001

Borchgrevink GE, Viset AT, Witsø E et al., 2015, Does the use of high-heeled

shoes lead to fore-foot pathology? A controlled cohort study comprising

197 women. Foot and Ankle Surgery, Volume 22, Issue 4, pp. 239-243

[online], (Diunduh tanggal 20 Juni 2018), Tersedia dari:

https://doi.org/10.1016/j.fas.2015.10.004

Cronin NJ, 2014, The Effects of High Heeled Shoes on Female Gait: A Review, J

Electromyogr Kinesiol 2014 Apr Volume 24 No 2 pp. 258-263 [online],

(Diunduh tanggal 4 Juni 2018), Tersedia dari:

https://doi.org/10.1016/j.jelekin.2014.01.004

Doty JF, Coughlin MJ, 2013, Hallux Valgus and Hypermobility of the First Ray:

Facts and Fiction, International Orthopedics (SICOT) (2013) Volume 37

pp. 1655-1660 [online], (Diunduh tanggal 20 Oktober 2018), Tersedia

dari: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3764306/

Dufour AB, Casey VA, Golightly YM et al., 2014, Characteristics Associated

With Hallux Valgus in a Population-Based Foot Study of Older Adults,

49

Arthritis Care & Research Volume 66, No 12, December 2014, pp. 1880–

1886 [online], (Diunduh tanggal 28 Agustus 2018), Tersedia dari:

https://onlinelibrary.wiley.com/doi/abs/10.1002/acr.22391

Durrant B, Chockalingam N, 2009, Functional Hallux Limitus, Journal of the

American Podiatric Medical Association Volume 99 No 3 pp. 236-243

[online], (Diunduh tanggal 20 Oktober 2018), Tersedia dari:

https://www.researchgate.net/publication/24433088_Functional_Hallux_L

imitus

Ekwere EO, Usman YM, Danladi A, 2016, Prevalence of hallux valgus among

medical students of the University of Jos, Ann Bioanthropol 2016 Volume

4 Issue 1 pp. 30-33 [online], (Diunduh tanggal 20 Oktober 2018), Tersedia

dari: http://www.bioanthrojournal.org/temp/AnnBioanthropol4130-

865077_001425.pdf

Fraissler L, Konrads C, Hoberg M et al., 2016, Treatment of hallux valgus

deformity, EFORT Open Rev 2016 Volume 1 pp. 295-302 [online],

(Diunduh tanggal 19 Juni 2018), Tersedia dari:

https://doi.org/10.1302/2058-5241.1.000005

Maarouf MA, 2015, The Impact of Wearing High Heels on Women's Health and

Attractiveness: A Field Study, J. Basic. Appl. Sci. Res., Volume 5 No 8 pp.

54-61 [online], (Diunduh tanggal 18 Juni 2018), Tersedia dari:

https://www.textroad.com/pdf/JBASR/J.%20Basic.%20Appl.%20Sci.%20

Res.,%205(8)54-61,%202015.pdf

Meijsen P, Knibbe HJ, 2007, Prolonged Standing in the OR: A Dutch Research

Study, AORN Journal September 2007 Volume 86 No 3 pp. 399-414

[online], (Diunduh tanggal 21 Oktober 2018), Tersedia dari:

https://doi.org/ 10.1016/j.aorn.2007.08.007

Menz HB, Roddy E, Thomas E et al., 2011, Impact of Hallux Valgus Severity on

General and Foot-Specific Health-Related Quality of Life, Arthritis Care

& Research Volume 63 No 3 March 2011 pp. 396-404 [online], (Diunduh

tanggal 4 Juni 2018), Tersedia dari:

https://onlinelibrary.wiley.com/doi/full/10.1002/acr.20396

Menz HB, Fotoohabadi MR, dan Wee E, 2010, Validity of self-assessment of

hallux valgus using the Manchester scale, BMC Musculoskeletal

Disorders 2010, Volume 11, No 215 pp. 1-6 [online], (Diunduh tanggal 15

Januari 2019), Tersedia dari: http://www.biomedcentral.com/1471-

2474/11/215

Moore KL, Dalley AF, Agur AMR, 2014, Clinically Oriented Anatomy 7th

Edition, Baltimore, MD: Lippincott William Wilkins, pp. 522-524, 667-

668

50

Nguyen US, Hillstrom HJ, Li W et al., 2010, Factors associated with hallux

valgus in a population-based study of older women and men: the

MOBILIZE Boston Study, Osteoarthritis and Cartilage (2010) Volume 18

pp. 41-46 [online], (Diunduh tanggal 18 Juni 2018), Tersedia dari:

https://doi.org/ 10.1016/j.joca.2009.07.008

Nix SE, Smith MD, Vicenzino BT, 2010, Prevalence of hallux valgus in the

general population: a systematic review and metaanalysis, Journal of Foot

and Ankle Research 2010 Volume 3 No 21 [online], (Diunduh tanggal 19

Juni 2018), Tersedia dari: http://www.jfootankleres.com/content/3/1/21

Nix SE, Vicenzino BT, Collins NJ et al., 2012, Characteristics of Foot Structure

and Footwear Associated with Hallux Valgus: A Systematic Review.

Osteoarthritis and Cartilage 20 (2012) pp. 1059-1074 [online], (Diunduh

tanggal 20 Oktober 2018), Tersedia dari:

https://www.oarsijournal.com/article/S1063-4584(12)00862-X/fulltext

Okudo H, Juman S, Ueda A et al., 2014, Factors Related to Prevalence of Hallux

Valgus in Female University Students: A Cross-Sectional Study, J

Epidemiol 2014 Volume 24 No 3 pp. 200-208 [online], (Diunduh tanggal

20 Oktober 2018), Tersedia dari:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4000767/pdf/je-24-200

Perera AM, Mason L, Stephens MM, 2011, The Pathogenesis of Hallux Valgus

[online], (Diunduh tanggal 5 Juni 2018), Tersedia dari:

http://upload.orthobullets.com/journalclub/free_pdf/21915581_1650.full_

Perera%20Pathogensis%200911.pdf

Pratiwi GA, Winaya IMN, Primayanti DAI, 2018, Hubungan Antara Berdiri Lama

Terhadap Terjadinya Kejadian Hallux Valgus Pada Pramuniaga, Majalah

Fisioterapi Indonesia, Volume 6, No 2, Mei 2018, pp. 11-14 [online],

(Diunduh tanggal 28 Agustus 2018), Tersedia dari: https://ojs.unud.ac.id

Rahayu A dan Wulan AJ, 2016, Risiko Pemakaian Sepatu Hak Tinggi Bagi

Kesehatan Tungkai Bawah, Majority, Volume 5, No 3, September 2016,

pp. 22-27 [online], (Diunduh tanggal 18 Oktober 2018), Tersedia dari:

https://juke.kedokteran.unila.ac.id/index.php/majority/article/view/1031

Samad SA, Shelke RD, 2016, Health Effect of Prolonged Standing at Work & Its

Control Measures: A Review, International Journal of Engineering

Research and General Science Volume 4 Issue 2 March-April 2016 pp.

527-529 [online], (Diunduh tanggal 21 Oktober 2018), Tersedia dari:

https://www.researchgate.net/publication/312377091_Health_Effect_of_Pr

olonged_Standing_at_Work_Its_Control_Measures_A_Review

Silva AM, de Siqueira GR, da Silva GA, 2013, Implications of high-heeled shoes

on body posture of adolescents, Rev Paul Pediatr 2013 Volume 31 No 2

pp. 265-271 [online], (Diunduh tanggal 21 Oktober 2018), Tersedia dari:

https://www.ncbi.nlm.nih.gov/m/pubmed/23828066/

51

Snell RS, 2006, Anatomi Klinik untuk Mahasiswa Kedokteran Edisi 6, Jakarta:

EGC, pp. 636-638

Soemarko DS, Rahmasari F, Kamal AF, et al., 2019, Hallux valgus among sales

promotion women wearing high heels in a department store, Journal of

Orthopaedic Surgery Volume 27 No 1 pp. 1–6 [online], (Diunduh tanggal

7 Mei 2019), Tersedia dari:

https://journals.sagepub.com/doi/full/10.1177/2309499019828456

Talu B, Koca TT, Bayramlar K et al., 2016, Evaluation of the Pain and Foot

Functions in Women with Hallux Valgus Deformities, J Clin Exp Invest

2016 Volume 7 No 2 pp. 144-149 [online], (Diunduh tanggal 4 Juni 2018),

Tersedia dari: https://doi.org/10.5799/ahinjs.01.2016.02.0587

Waters TR, Dick RB, 2015, Evidence of Health Risks Associated with Prolonged

Standing at Work and Intervention Effectiveness, Rehabil Nurs. 2015

Volume 40 No 3 pp. 148–165 [online], (Diunduh tanggal 4 Desember

2018), Tersedia dari: https://doi.org/10.1002/rnj.166

WHO, 2018, Body Mass Index [online], (Diunduh tanggal 18 Juni 2018), Tersedia

dari: www.euro.who.int/ en/health-topics/disease-prevention/nutrition/a-

healthy-lifestyle/body-mass-index-bmi

Younus SM, Ali T, Memon WA et al., 2014, High heel shoes; Outcome of

Wearing In Young Generation: A Cross Sectional Study, Professional Med

J 2014 Volume 21 No 4 pp. 798-803 [online], (Diunduh tanggal 18 Juni

2018), Tersedia dari: www.theprofesional.com/article/vol-21-no-04/prof-

2399.pdf

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