The effectiveness of discharge planning and range of motion (ROM) training in increasing muscle strength of nonhemorrhagic stroke patients

Mohamat Iskandar


Background: Non-hemorrhagic stroke patients experience hemiparesis, an improper handling results in joint contractures. Discharge planning combined with a range of motion (ROM) training given to patients and their families are expected to improve muscle strength in patients after returning from the hospital. Aims: This study is to identify the effectiveness of discharge planning in increasing muscle strength.

Methods: This is a quasi-experimental study with a pre-posttest design. A total of 34 respondents were selected by cluster random sampling technique, from RAA Soewondo Pati General Hospital of Pati, Central Java, Indonesia. The respondents were divided equally into two groups; an intervention group (N = 17) was given a discharge planning program together with stroke information and range of motion (ROM) training while the control group (N = 17) received a standard discharge planning available in the hospital. Further, Muscle Rating Scale (MRS) was employed to assess the muscle strength on the 2nd, 7th, and 14th day after discharge planning presented to the nonhemorrhagic stroke patients. Results: This present study clearly acknowledges the standard discharge planning program available in the hospital improve the muscle strength of the upper and lower extremity in the nonhemorrhagic stroke patients just 2nd day after the care (pretest), and the significant improvement was observed until the day 14. Moreover, combining the care with ROM training at the intervention group faster the recovery and the muscle strength improved significantly at the 7th day and continue increase at the day 14. Looking to the muscle strength since the 2nd day to the day 14, respectively the muscle strength of upper and lower limb at the control group improved at the point of 0.588 and 0.882, while at the group received the ROM training reached the value of 1.472 and 1.412.

Conclusions: The ROM training combined to the current discharge planning program will faster the muscle strength recovery of the nonhemorrhagic stroke patients. This research provide insight how family plays important role to the success in monitoring the rehabilitation and recovery progress. 

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Patricia Gonce Morton DF, Carolyn M Hudak, Barbara M Gallo. Keperawatan Kritis 2011. In: Pendekatan Asuhan Holistik [Internet]. Jakarta: Penerbit Buku Kedokteran EGC.

Misbach J, Harmani k. Stroke Mengancam usia produktif:; 2017 [cited 2017 25 November].

Westerlind E, Persson HC, Sunnerhagen KS. Return to Work after a Stroke in Working Age Persons; A Six-Year Follow Up. Plos One. 2017;12(1):e0169759-e.

RI KK. Riset Kesehatan Dasar (Riskesda). Jakarta: Badan Penelitian dan Pengembangan Kesehatan; 2013.

Kelly-Hayes M, Beiser A, Kase CS, Scaramucci A, D’Agostino RB, Wolf PA. The influence of gender and age on disability following ischemic stroke: the Framingham study. Journal of Stroke and Cerebrovascular Diseases.12(3):119-26.

Dobkin BH. Rehabilitation after Stroke. New England Journal of Medicine. 2015;352(16):1677-84.

Harsono ED. Kapita Selekta Neurologi. Yogyakarta: Gadjah Mada University Press; 2009.

Almborg A-H. Perceived participation in discharge planning and health related quality of life after stroke: Hälsohögskolan; 2008.

Tseng CN, Chen CCH, Wu SC, Lin LC. Effects of a range- of- motion exercise programme. Journal of Advanced Nursing. 2007;57(2):181-91.

Mawarti H. F. Pengaruh latihan rom (range of motion) pasif terhadap peningkatan kekuatan otot pada pasien stroke dengan hemiparase [Rom exercise influence (range of motion) passive to increase muscle strength in stroke patients with hemiparase]. Journal Eduhealth. 2012;2(2).

Mackenzie A, Perry L, Lockhart E, Cottee M, Cloud G, Mann H. Family carers of stroke survivors: needs, knowledge, satisfaction and competence in caring. Disability and Rehabilitation. 2007;29(2):111-21.

Sudirman H, Yuliyanti C, Sari AI, editors. Effectiveness of ‘fast’stroke campaign for fast stroke recognition and response: a systematic review. Proceedings of the International Conference on Applied Science and Health; 2018.

Hankey GJ. Stroke. The Lancet. 2017;389(10069):641- 54.

Smeltzer&Bare, Brunner&Suddart. Buku Ajar Keperawatan Medikal Bedah. Jakarta: EGC; 2008.

Potter AP, Perry, A. Fundamental of Nursing. 4, editor. Missouri: Mosby-Year Book, Ink; 2009.

Pemila U, Sitorus R, Hastono SP. Penurunan Risiko Kambuh dan Lama Rawat Pada Klien Stroke Iskemik Melalui Rencana Pemulangan Terstruktur. Jurnal Keperawatan Indonesia. 2010;13(3):187-94.

Rhestifujiayani E, Huriani E, Muharriza M. Comparison of Muscle Strength in Stroke Patients between The Given and Not Given Range of Motion Exercise. 2015. 2015;5(2):13.

Hartono W, Darmawan ES, editors. Stroke care: Stroke unit versus non stroke unit. Proceedings of the International Conference on Applied Science and Health; 2018.


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