THE IMPACT OF TERA GYMNASTICS ON THE REDUCTION OF HYPERTENSION IN THE ELDERLY

Aging process in the journey of human life is a natural thing. Problems that commonly occur in the elderly related to physical health are susceptible to various diseases, due to reduced body resistance in dealing with outside influences. About 30% of the elderly have hypertension. Hypertension is a silent killer that must be watched out for. One strategy that is cost effective in an effort to control hypertension is to do therapy. The purpose of this study was to determine the Effectiveness of Tera Exercise on Lowering Blood Pressure in the Elderly with Hypertension at PSTW Sabai Nan Aluih Sicincin. This study used a Quasi-Experimental design with One Group PreTest – Posttest Design. The population in this study were elderly people with hypertension in PSTW with a sample of 14 people. The sample selection used a purposive sampling technique. The research was conducted in July-August 2022. Data analysis used the Independent T-Test statistical test. The results showed that there was a

Hypertension is a condition in which the increase in systolic blood pressure is higher than 140 mmHg and diastolic is higher than 90 mmHg after two measurements in an interval of 5 minutes in a state of adequate rest or calm (Eriyanti et al., 2016). Based on Basic Health Research data in 2018, the prevalence of hypertension in the elderly in Indonesia has increased in the population of 64 years and over by 55.2%. Meanwhile, the prevalence of hypertension in West Sumatra was 25.6% with a total of 176,169 cases detected through blood pressure measurements.
Judging from several articles found, it turns out that the prevention of hypertension is not only in the form of pharmacology that can be done, but also non-pharmacology. Pharmacological treatment using diuretic drugs, while non-pharmacology is in the form of complementary therapy. Complementary therapies that can be done are herbal therapy and relaxation therapy. Relaxation therapies that can be given such as laughter therapy, music therapy and progressive relaxationJudging from several articles found, it turns out that the prevention of hypertension is not only in the form of pharmacology that can be done, but also non-pharmacology. Pharmacological treatment using diuretic drugs, while non-pharmacology is in the form of complementary therapy. Complementary therapies that can be done are herbal therapy and relaxation therapy. Relaxation therapies that can be given such as laughter therapy, music therapy and progressive relaxation (Tulak, 2017).
However, from some of these therapies, the provision of physical activity therapy such as gymnastics still needs to be done. Gymnastics is a sport or physical activity that can be done to maintain heart and circulatory health. Sports can maintain muscle and joint flexibility and stimulate the heart to supply oxygen to meet the needs of the whole body. Tera gymnastics is one of the physical and mental activities that combines body movements using breathing techniques and rhythms through concentration of the mind which is carried out regularly, harmoniously, correctly, and continuously (Senja & Prasetyo, 2021).
Tera gymnastics is a breathing exercise combined with movement. This gymnastics is taken from Tai Chi Gymnastics which originated in China. The word Tera itself comes from the word therapy which means exercise that functions as therapy. Tera gymnastics has many benefits, one of which is from every movement, namely stretching movements that aim to stretch muscles before doing gymnastic movements, joint movements that move all joints that have benefits for physical and mental health. While The Impact of Tera Gymnastics on the Reduction of Hypertension in the Elderly Syntax Health Sains: Vol. 4, No. 1 January 2023 59 the last one is a breathing movement that adapts from Tai Chi Gymnastics, therefore the movements / moves of Tera Indonesia Gymnastics are gentle and relaxed. Therefore, it is not surprising that Tera Gymnastics can be followed by all layers of both children, adults and the elderly. (Rofika & Yuniastuti, 2018). Based on several studies, it was found that tera gymnastics can be useful for the elderly. This is in accordance with the research conducted by (Ekasari, Riasmini, & Hartini, 2019) entitled the effectiveness of tera gymnastics and heart-healthy gymnastics against blood pressure in the elderly with hypertension in Sinomwidodo Village, Tambakromo District, Pati Regency, said that by measuring using a mercury sphygmomanometer that there was a significant difference in the average systolic blood pressure before and after being given tera gymnastics, which used an experimental quasy method with a non-equivalet control group design. Further strengthened by research conducted by Sufendi (HARIANTO, n.d.) entitled The Effect of Tera Gymnastics on the Blood Pressure of Hypertensive Elderly, said the average value of systolic blood pressure before gymnastics was 172 mmHg and after gymnastics 169 mmHg. The average value of diastolic blood pressure before gymnastics is 89 mmHg and after gymnastics is 84 mmHg, where using the quasy method pre-post test experiments this research was conducted in Kalik Village, Tambelang District, Jombang Regency.
Based on data obtained by researchers from the Tresna Werdha Social Institution (PSTW) Sabai Nan Aluih Sicincin on March 16, 2022, there were 110 elderly people consisting of 64 men and 46 women consisting of 13 guesthouses. From the results of interviews and blood pressure measurements in 32 elderly people, data was obtained that out of the 32 elderly people, as many as 28 elderly people suffered from hypertension.

METODE PENELITIAN
The type of research used in this study is quasi-experimental with a one group pretest posttest design approach. Held at PSTW Sabai Nan Aluih Sicincin, in July-August 2022 (Notoatmodjo, 2012). The population of this study was all elderly people suffering from hypertension as many as 28 people. The sample was calculated using a sampling quota of 14 people. Selected to glorify the purposive sampling technique. Data analysis using the Indepent T-Test.

HASIL DAN PEMBAHASAN A. Characteristics of Respondents
The frequency distribution based on characteristics can be seen in Based on table 1, it was obtained from 14 respondents more than half (57.1%) respondents aged 60-69 years, respondents were more male than 10 people (71.4%). Based on table 2, it was found that the decrease in systolic blood pressure before and after tera gymnastics with the mean was 17.500 and the diastolic blood pressure before and after with a mean of 13.929. Based on the results of the statistical test, p value = 0.000 (p˂0.05) was obtained, so Ha was accepted. So there is an effectiveness of giving tera gymnastics against blood pressure in elderly people with hypertension at the Tresna Werdha Sabai Nan Aluih Sicincin Social Institution.

B. Hasi Bivariate Test
The results of this study are almost the same as the research conducted by Uswatul (Khasanah & Nurjanah, 2020) in the Lipi Complex RW 010 Rawapanjang Bojong Gede Bogor, a decrease in systolic blood pressure was obtained before and after tera gymnastics with a mean of 13,333 and a p value = 0.000 and diastolic blood pressure before and after tera gymnastics with a mean of 6.667 and a p value = 0.001. Strengthened by research conducted by Pratiwi (2021) at PSTW Nirwana Puri Samarinda, it was found that the decrease in systolic blood pressure before 125.71 and after 116.67 tera gymnastics was carried out and the p value = 0.000. In line with research by Ana Rofika (2018) in Sinomwido Village, Tambakromo District, Pati Regency, there was a decrease in blood pressure before and after tera gymnastics with a p value of 0.006.
Hypertension is an increase in blood pressure where the systolic pressure value is more than 140 mmHg and the diastolic pressure is more than 90 mmHg The Impact of Tera Gymnastics on the Reduction of Hypertension in the Elderly Syntax Health Sains: Vol. 4, No. 1 January 2023 61 (Pratiwi & Muflihatin, 2021). Hypertension is the main risk factor for death in the world. Hypertension is greatly influenced by the way and habits of a person who is often referred to as the killer disease because people with hypertension do not know if they have hypertension (Hasnawati, 2021). A person suffering from hypertension is caused by several factors, namely age, gender, obesity, smoking, stress, prevention of hypertension not only in the form of pharmacology that can be done, but also non-pharmacology. In nonpharmacology, namely in the form of providing physical activity therapy such as gymnastics, it is still necessary to do (Black & Hawks, 2014). Gymnastics is a sport or physical activity that can be done to maintain heart and circulatory health. Exercise can maintain muscle and joint flexibility and stimulate the heart to supply oxygen to meet the needs of the whole body. Doing tera gymnastics for people with hypertension can lower blood pressure.
Tera gymnastics is one of the physical and mental activities that combines body movements using breathing techniques and rhythms through concentration of the mind which is carried out regularly, harmoniously, correctly, and continuously (Ns Mohamad Roni Alfaqih & Ns Mei Fitria Kurniati, n.d.). Tera Gymnastics has many benefits, one of which is from every movement, namely stretching movements that aim to stretch muscles before doing gymnastic movements, joint movements that move all joints that have benefits for physical and mental health While the last one is a breathing movement that adapts from Tai Chi Gymnastics, therefore the movements / moves of Tera Indonesia Gymnastics are gentle and relaxed. Therefore, it is not surprising that Tera Gymnastics can be followed by all layers of both children, adults and the elderly. (Sugiyono, 2013).
Tera gymnastics can lower blood pressure because this gymnastics can stimulate a decrease in physical activity of the sympathetic nervous system and an increase in parasympathetic nerves which affects the decrease in the hormones adrenaline, norepinephrine and catecholamines as well as vasodilation (dilation of blood vessels) which results in the flow of oxygen throughout the body, especially the brain part smoothly so that it can lower blood pressure.
When a person performs this exercise, there will be a process where the mechanism of HPA (Hypothalamus Pituitary Adrenal) by the pineal gland to secrete serotonym and melatonin, then stimuli from the hypothalamus will be passed on to the anterior pituitary to form beta endorphins and ankephalin which can cause a person to be relaxed and happy (Triyanto, 2014) KESIMPULAN Tera Gymnastics Therapy for the elderly at PSTW Sabai Nan Aluih Sicincin has proven effective in reducing hypertension in the elderly. It is expected that the nursing home staff will routinely do this therapy for the elderly in the PSTW.