Range of Motion Therapy to Improve Physical Mobility in an Ischemic Stroke Patient: A Case Study Open Access

Authors

  • 1 Nur Fadlilah Faculty of Nursing and Midwifery, Universitas Nahdlatul Ulama Surabaya, Surabaya, East Java, Indonesia
  • 2 Yurike Septianingrum Faculty of Nursing and Midwifery, Universitas Nahdlatul Ulama Surabaya, Surabaya, East Java, Indonesia
  • 3 Lono Wijayanti Faculty of Nursing and Midwifery, Universitas Nahdlatul Ulama Surabaya, Surabaya, East Java, Indonesia
  • 4 Umdatus Soleha Faculty of Nursing and Midwifery, Universitas Nahdlatul Ulama Surabaya, Surabaya, East Java, Indonesia

https://doi.org/10.55018/ihc.v12.14 Published: 2025-12-21

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Abstract

Background: Stroke is a neurological disease caused by an occlusion or hypoperfusion in the cerebral blood vessels, leading to neurological deficits and resulting in disability or death. Objective: The purpose of this case study is to describe nursing care in addressing impaired physical mobility needs by implementing Range of Motion (ROM) exercises in stroke patients, from initial assessment to evaluation

Methods: This study adopted a descriptive single-case study design and was reported in accordance with the CARE (Case Report) guideline. The sampling frame consisted of one postoperative orthopedic patient who met predefined inclusion criteria, namely stable vital signs, the ability to communicate and cooperate with examination procedures, and no contraindication to range-of-motion (ROM) exercises. Data were collected through interviews, physical examination, structured observation, and review of clinical records. Functional status and motor impairment were assessed using the standardized muscle strength grading scale (Medical Research Council [MRC] scale, 0–5), along with clinical monitoring sheets to document changes in movement capacity. The intervention protocol consisted of prescribed ROM exercises—including passive-assisted and active movement techniques—administered twice daily over the observation period, with progression based on clinical tolerance and patient feedback.

Result: At baseline assessment, the patient demonstrated unilateral left-sided weakness, with muscle strength graded at 3/5 for both upper and lower extremities based on the Medical Research Council (MRC) scale, indicating movement against gravity but not resistance. After three consecutive days of prescribed ROM intervention, follow-up assessment showed improvement to 4/5 in both extremities, reflecting increased capability to move against moderate resistance. Measurements were conducted by the same trained clinician using the same standardized scale to enhance reliability, although potential subjective scoring bias inherent to manual muscle testing cannot be fully excluded.

Conclusion: There was an increase in muscle strength between before and after the intervention. It is expected that ROM therapy can be applied as an intervention to overcome physical mobility impairment in stroke patients.

Keywords:

Range of Motion, physical mobility impairment, Ischemic Stroke

References

Faridah, A. A., Istiqomah, I. N., Kurnianto, S., & Khovifah, N. (2022). The effectiveness of range of motion (ROM) on increasing muscle strength in stroke patients: A literature review. Nursing and Health Sciences Journal, 2(2), 137–142. https://doi.org/10.53713/nhs.v2i2.118
Ferry, & Nurani, D. R. (2022). Pengaruh latihan range of motion (ROM) terhadap peningkatan kekuatan otot pada pasien stroke non-hemoragik. Jurnal Keperawatan Bunda Delima, 4(1), 52–56.
Indonesian Nursing Diagnosis Association. (2018). Standar diagnosis keperawatan Indonesia (SDKI). Dewan Pengurus Pusat Persatuan Perawat Nasional Indonesia.
Li, W., Xiao, W. M., Chen, Y. K., Qu, J. F., Liu, Y. L., Fang, X. W., Weng, H. Y., & Luo, G. P. (2019). Anxiety in patients with acute ischemic stroke: Risk factors and effects on functional status. Frontiers in Psychiatry, 10, Article 257. https://doi.org/10.3389/fpsyt.2019.00257
Mahyuvi, T., & Nursalam, N. (2020). The effect of social cognitive theory–based psychoeducation on depression and blood pressure of ischemic stroke patients. Journal for Quality in Public Health, 4(1), 202–207. https://doi.org/10.30994/jqph.v4i1.140
Masliah, M., Muftadi, M., & Rahayu, A. N. (2022). Literature review: Pengaruh range of motion (ROM) terhadap kekuatan otot pasien stroke. Malahayati Nursing Journal, 5(2), 414–419. https://doi.org/10.33024/mnj.v5i2.5914
Powers, W. J., Rabinstein, A. A., Ackerson, T., Adeoye, O. M., Bambakidis, N. C., Becker, K., Biller, J., Brown, M., Demaerschalk, B. M., Hoh, B., Jauch, E. C., Kidwell, C. S., Leslie-Mazwi, T. M., Ovbiagele, B., Scott, P. A., Sheth, K. N., Southerland, A. M., Summers, D. V., & Tirschwell, D. L. (2018). Guidelines for the early management of patients with acute ischemic stroke. Stroke, 49(3), e46–e110. https://doi.org/10.1161/STR.0000000000000158
Prayoga, A., & Rasyid, Z. (2022). Determinants of ischemic stroke disease among inpatients at a public hospital in Riau Province. Journal of Community Health, 8(1), 52–58. https://doi.org/10.25311/keskom.vol8.iss1.640
Riskesdas. (2018). Riset kesehatan dasar. Badan Penelitian dan Pengembangan Kesehatan, Kementerian Kesehatan Republik Indonesia.
Setyawati, V. Y., & Retnaningsih, D. (2024). Penerapan range of motion pada pasien stroke dengan gangguan mobilitas fisik. Jurnal Manajemen Asuhan Keperawatan, 8(1), 18–24. https://doi.org/10.33655/mak.v8i1.179
Sitoresmi, H., Irwan, A. M., & Sjattar, E. L. (2020). Nursing intervention for patients with chronic renal failure undergoing hemodialysis: A systematic review. Jurnal Ilmiah Keperawatan.
Sitoresmi, H., Irwan, A. M., & Sjattar, E. L. (2020). Prevalence and impact of stroke-related disability in low- and middle-income countries: A narrative review. Journal of Neurological Nursing, 12(2), 85–92.
Susanti, S., & Bistara, D. N. (2019). Pengaruh range of motion (ROM) terhadap kekuatan otot pada pasien stroke. Jurnal Kesehatan Vokasional, 4(2), 112. https://doi.org/10.22146/jkesvo.44497
Sustika, A. M., Maisyaroh, A., Widianto, E. P., & Azizah, L. N. (2020). Effectiveness of range of motion to increase joint motion range in stroke patients. Proceedings of the 4th International Agronursing Conference. https://doi.org/10.1177/088307
Tarigan, N., Inayah, I., Irianto, G., Setiawan, A., & Chan, C. M. (2023). Studi komparatif metode discharge planning terhadap self-care klien stroke iskemik. Journal of Telenursing (JOTING), 5(2), 3578–3588. https://doi.org/10.31539/joting.v5i2.7850
Waruwahang, A. J., Afriyanti, L., Ruhdiyat, A., & Faizah, A. (2023). The effect of range of motion (ROM) exercises on stroke patients. Zona Keperawatan, 13(3), 17–25. https://doi.org/10.37776/zk.v13i1
Widya, A. R. (2023). Effectiveness of range of motion exercises on muscle strength improvement in ischemic stroke patients. Jurnal Keperawatan Klinis Indonesia, 7(1), 15–22.
Yuliasani, S. R., Silvitasari, I., & Sumardi. (2023). Penerapan range of motion cylindrical grip terhadap kekuatan otot ekstremitas atas pada pasien stroke non-hemoragik. Jurnal Ilmiah Ilmu Kesehatan, 1(3).

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Copyright (c) 2025 Nur Fadlilah, Yurike Septianingrum, Lono Wijayanti, Umdatus Soleha (Author)

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How to Cite

Fadlilah, N., Septianingrum, Y. ., Wijayanti, L. ., & Soleha, U. . (2025). Range of Motion Therapy to Improve Physical Mobility in an Ischemic Stroke Patient: A Case Study. International Journal of Health Concord, 1(2), 57-65. https://doi.org/10.55018/ihc.v12.14

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