Prophetic Prayer as a Physical Exercise to Obtain Bone and Joint Health

. Osteoarthritis and osteoporosis are two conditions that come to people as they getting older. These conditions are types of degenerative diseases. Osteoarthritis is not the same as osteoporosis. To prevent their prevalence, education to increase the knowledge of the community about the conditions is necessary. Education is essential to prevent complications of the diseases. One of the recent trends is boarding courses for the senior community called as Pesantren Lansia . This Pesantren Lansia gives the members religious knowledge and practices. As a Muslim, praying five times a day is a routine which can also be considered as a physical exercise, including an exercise for some joints and muscles. This type of exercise has the benefits for a healthy body. This research was completed through the education and practice courses for seniors who joined Pesantren Lansia . Prophetic prayer was learned and practised during the course. Participants also completed a pre-test and post-test examination. This community service is a joint program between Universitas Muhammadiyah Yogyakarta and a charity foundation called Yayasan Amal Abadi Indonesia (YAAI). The course was held on January 22 nd , 2023 in Krajan, Ngemplak, Sleman. Following the course, the participants had better knowledge of osteoarthritis and osteoporosis. Participants had better knowledge of prophetic prayer practice, too. Participants could perform better prayer and understood the correlation between prophetic prayer and prevention of osteoarthritis and osteoporosis complication. Education and practising under guidance are needed to improve the knowledge of osteoarthritis and osteoporosis among senior participants. The five-time prayer is correlated to the health of bone and joint.


Introduction
Osteoarthritis and osteoporosis are two conditions of degenerative bone and joint disease, most commonly experienced by aged people.Osteoarthritis is typically the result of wear, tear, and progressive loss of articular cartilage.Meanwhile, osteoporosis is a decrease and progressive loss of bone mass caused by aging [1], [6].
Osteoarthritis mostly affects the knee with several signs and symptoms, pain or aching, stiffness, decreased range of motion or flexibility, and swelling.The symptoms vary from mild, moderate to severe.The severity of osteoarthritis is also classified into four grades.Grade 1 is for mild signs and symptoms, and the most severe one is classified into grade 4 [6], [7].
Osteoarthritis, or later abbreviated as OA, affects about 3.3 to 3.6% of the population globally.It causes moderate to severe disability in 43 million people, making it the 11 th most debilitating disease worldwide.In the United States, it is estimated that 80% of the population over 65 years old has radiographic evidence of OA although only 60% of this subset has symptoms.This is because radiographic OA is at least twice as common as symptomatic OA.OA affects over 32.5 million US adults, both male and female, at the same percentage.The risk factors of OA are: 1. Joint injury or overuse such as knee bending and repetitive stress on a joint.It can damage a joint and increase the risk of OA in that joint.2. Age.The risk of developing OA increases with age.3. Gender.Women are more likely to develop OA than men especially after the age of 50. 4. Obesity.Extra weight stresses joints, particularly weight-bearing joints like the hips and knees.This stress increases the risk of OA in that joint.Obesity may also have metabolic effects that increase the risk of OA. 5. Genetics.People who have family members with OA are more likely to develop OA.People who have hand OA are more likely to develop knee OA. 6. Race.Some Asian populations have a lower risk for OA [6], [7].7. Osteoarthritis is diagnosed through a comprehensive review of symptoms, physical examination and X-rays.The treatment goals for OA are to minimize both pain and functional loss.Comprehensive management of the disease involves both non-pharmacologic and pharmacologic therapies.Typically, the former can manage patients with mild symptoms, while more advanced diseases need a combination of both [7], [8].
On the other hand, osteoporosis is a metabolic bone disease that, on a cellular level, results from osteoclastic bone resorption not compensated by osteoblastic bone formation.This causes bones to become fragile, thus increasing the risk of fractures.Although osteoporosis can occur at any ages and in both genders, it typically is an age-related disease that more frequently affects women than men.Osteoporosis has no signs and symptoms until several complications happen [2], [9].
Osteoporosis therapy aims to reduce fracture risk and bone loss, prevent disability, and control pain.Prevention strategies include fall reduction, correcting impaired vision or hearing, reducing fall risk-inducing drugs (FRIDs), establishing muscle training, balance training, quitting cigarette smoking and alcohol intake, and adequate intake of vitamin D, protein, and calcium [9].

Treatment
Physical exercise is one of the main factors in treating osteoporosis and osteoarthritis.Medicine alone will not give a good result.With physical exercise, joint stiffness is prevented.With exercise, muscle weakness and decreased bone mass will reduce [3], [6].Some misunderstandings and lack of knowledge about osteoporosis and osteoarthritis are the obstacles to good treatment [7].
Prophetic prayer, joint and body movement during Muslim prayer five times a day is a routine activity considered as an exercise.Also, some studies have been published to show the effect of Muslim prayer [2], [9], [10].

Purpose
Understanding of osteoarthritis dan osteoporosis by the community, especially in aged people, is still not good enough to support the treatment for osteoarthritis dan osteoporosis.There are some misunderstandings in the community that osteoporosis is responsible for every complaint in the joints of the body.The traditional bone setter also takes place to treat osteoarthritis with a surprising technique of bone setter because they always say the joint is displaced and needs fixation.

Methodology
This program collaborates with Yayasan Amal Abadi Indonesia (YAAI) foundation.The course was held on January 22 nd , 2023 in Krajan, Ngemplak, Sleman.The program was a part of Pesantren Lansia, a short course of three-day boarding program.The syllabus was particular for the elderly community up to 55 years old.Spiritual matter, entrepreneurship, and health are the contents of the course.
A pretest was held to obtain information on the understanding of the disease, both osteoarthritis and osteoporosis.Lectures with power-point slides shown on LCD monitor were done to transfer knowledge.The participants were ordered to practice the prophetic prayer, especially when bending time called as Rukuk and Sujud.Complete stretching must be concerned for good results.Furthermore, a post-test was held to examine the progress.
40 participants joined the program, ranging from 55-year-old up to 70-year-old senior citizens.All participants were male.The program started with a spiritual learning about Islam.The prophetic prayer program was held in two parts; class lecture and practical course.
Most of the participants did not know the base from which hadith exactly the prayer movements of five-time prayer.Lecture and practical session were held to practise all movements like how the prophet taught Muslims to pray.Previously, most participants' knowledge was from practical teaching in the local mosque.One-by-one practise under guidance was carried out until all participants understood and were able to practise correctly by themselves.Various backgrounds of the participants will provide a better picture of the community itself.Test distribution is normal.

Results
Correlation study was conducted using paired T Test.The result before and after the study is significantly different.The post-test result is better than the pre-test.

Discussion
Senior community has a very limited knowledge of osteoarthritis and osteoporosis conditions.Community also misleads the correct definition of the two conditions.All complaints in knee are always known as uric acid abnormality.Based on this misleading of knowledge, preventive and curative program can make a false route of treatment.After such an improvement of understanding of the conditions, especially in senior community, promotive program can lead to a better result.In some occasions, it is hard to make physical exercise as a routine activity.Five-time daily prayer for Muslims is a mandatory activity.According to some literatures, all movements in prayer as narrated in hadith from the Prophet give a beneficial health impact.Senior community can perform five-time prayer as a physiotherapy for their joints, which feels a lot different from going to a clinic for some treatments.

Conclusion
The knowledge and understanding of the participants increased after learning in the course of Pesantren Lansia and practising the theories achieved from the lecture.Interactive methods, both lecture and practice under supervision, gave a better result in understanding osteoarthritis and osteoporosis.Lecture and practice of prophetic prayer after interactive program led to improvement of the prayer quality in terms of its physical movements.Participants understood and realized their condition as elderly persons with some limitations.They also had better spirits to pray five times a day as it benefits their bodies.