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Stroke is a neurological condition caused by disruption of blood flow to the brain due to blockage or rupture of blood vessels, leading to nerve cell death. WHO (2022) recorded more than 12 million new stroke cases annually, with a prevalence in Brebes Regency reaching 27.83 per mil. The high incidence of stroke accompanied by physical mobility impairment and the family's lack of knowledge about its management highlights the importance of comprehensive family nursing care. This study aims to apply a complete nursing care process including assessment, diagnosis, intervention, implementation, and evaluation to the family of Mr. K with a stroke case. The method used is descriptive with a case study approach through family nursing care. Assessment findings revealed that the patient had experienced stroke for approximately 7 years with a history of hypertension, weakness of the right extremities, decreased muscle strength, blood pressure of 160/90 mmHg, and the family did not understand how to care for stroke at home. Two nursing diagnoses were established: ineffective health maintenance in the family and impaired physical mobility. Interventions included health education about stroke, Range of Motion (ROM) exercises, and rubber ball grip therapy involving the family as caregivers. After 2 days of implementation, both nursing diagnoses were resolved: ineffective health maintenance in the family was resolved and impaired physical mobility was resolved.

Aerobic capacity, commonly measured by maximal oxygen uptake (VO₂max), is a key indicator of physical fitness and athletic performance, particularly in endurance sports. Recent attention has focused on the role of respiratory muscle function in supporting exercise performance, as respiratory muscle fatigue during high-intensity or prolonged activity may reduce ventilatory efficiency and exercise tolerance. This literature review aims to examine current evidence regarding the effects of Respiratory Muscle Training (RMT), including Inspiratory Muscle Training (IMT), on aerobic capacity in athletes. Relevant studies were identified through electronic databases such as PubMed, Scopus, and Google Scholar using keywords related to respiratory muscle training, VO₂max, and athletes. The reviewed studies generally reported improvements in inspiratory muscle strength, reduced respiratory muscle fatigue, and enhanced ventilatory efficiency following RMT interventions. These physiological adaptations may contribute to better exercise tolerance and overall athletic performance. However, evidence regarding direct improvements in VO₂max remains inconsistent across studies. The findings suggest that RMT can be used as a complementary strategy alongside conventional training programs to support aerobic performance. In addition, improved respiratory muscle function may provide benefits in health promotion and rehabilitation by reducing dyspnea and increasing exercise tolerance. Further well-designed studies are needed to clarify the extent of RMT’s contribution to improving VO₂max in athletic populations.

Aerobic capacity, commonly measured by maximal oxygen uptake (VO₂max), is a key indicator of physical fitness and athletic performance, particularly in endurance sports. Recent attention has focused on the role of respiratory muscle function in supporting exercise performance, as respiratory muscle fatigue during high-intensity or prolonged activity may reduce ventilatory efficiency and exercise tolerance. This literature review aims to examine current evidence regarding the effects of Respiratory Muscle Training (RMT), including Inspiratory Muscle Training (IMT), on aerobic capacity in athletes. Relevant studies were identified through electronic databases such as PubMed, Scopus, and Google Scholar using keywords related to respiratory muscle training, VO₂max, and athletes. The reviewed studies generally reported improvements in inspiratory muscle strength, reduced respiratory muscle fatigue, and enhanced ventilatory efficiency following RMT interventions. These physiological adaptations may contribute to better exercise tolerance and overall athletic performance. However, evidence regarding direct improvements in VO₂max remains inconsistent across studies. The findings suggest that RMT can be used as a complementary strategy alongside conventional training programs to support aerobic performance. In addition, improved respiratory muscle function may provide benefits in health promotion and rehabilitation by reducing dyspnea and increasing exercise tolerance. Further well-designed studies are needed to clarify the extent of RMT’s contribution to improving VO₂max in athletic populations.

Background: Stroke is a neurological dysfunction caused by impaired blood circulation to the brain. Stroke can cause disability for survivors, one of which is impaired physical mobility due to weakness in the extremities and decreased muscle strength that can hinder the fulfillment of daily life activities. Range of Motion (ROM) and rubber ball grasping are one of the non-pharmacological ways in providing nursing care to ischemic stroke patients according to evidence-based practice (EBP). Purpose: This study aims to explain the process of providing nursing care with Range of Motion (ROM) interventions and rubber ball grasping for the problem of impaired physical mobility in stroke patients in Mina 1 room of RSUDZA. Method: case study with one patient as the subject with impaired physical mobility. Results: what was obtained during 6 days of intervention was an increase in the patient's muscle strength before and after the intervention, which was initially 1, increased to 4. Conclusion: Physical mobility impairment was resolved because the patient's muscle strength increased much better. Suggestion: It is hoped that Dr. Zainoel Abidin Banda Aceh can continue to improve nursing care for stroke patients so that the care provided is more effective and can apply Range of Motion (ROM) and rubber ball grasping as non-pharmacological methods.

Background: Stroke is a neurological dysfunction caused by impaired blood circulation to the brain. Stroke can cause disability for survivors, one of which is impaired physical mobility due to weakness in the extremities and decreased muscle strength that can hinder the fulfillment of daily life activities. Range of Motion (ROM) and rubber ball grasping are one of the non-pharmacological ways in providing nursing care to ischemic stroke patients according to evidence-based practice (EBP). Purpose: This study aims to explain the process of providing nursing care with Range of Motion (ROM) interventions and rubber ball grasping for the problem of impaired physical mobility in stroke patients in Mina 1 room of RSUDZA. Method: case study with one patient as the subject with impaired physical mobility. Results: what was obtained during 6 days of intervention was an increase in the patient's muscle strength before and after the intervention, which was initially 1, increased to 4. Conclusion: Physical mobility impairment was resolved because the patient's muscle strength increased much better. Suggestion: It is hoped that Dr. Zainoel Abidin Banda Aceh can continue to improve nursing care for stroke patients so that the care provided is more effective and can apply Range of Motion (ROM) and rubber ball grasping as non-pharmacological methods.

Fractures are one of the most common musculoskeletal disorders caused by trauma, repetitive stress, or pathological factors. Supracondylar femur fracture is a type of femur fracture occurring at the distal 12 cm of the femur, and Open Reduction and Internal Fixation (ORIF) is the primary surgical intervention. Post-operative ORIF patients commonly experience impaired physical mobility and impaired skin integrity. This study aimed to provide comprehensive nursing care to a patient post-ORIF for right supracondylar femur fracture in the Mawar 2 Ward of RSUD dr. Soeselo, Tegal Regency. A descriptive method with a nursing process approach was used, employing interview, observation, documentation study, and literature study. Nursing assessments conducted on February 8, 2026 revealed that the patient (Ny. S, female, 68 years) experienced pain at the surgical site with a scale of 7, inability to move both lower extremities (muscle strength score 2), and a post-operative wound approximately 10 cm in length with redness and edema. Two nursing diagnoses were established: impaired physical mobility related to neuromuscular disorders and impaired structural bone integrity, and impaired skin/tissue integrity related to invasive procedure effects. Nursing interventions included mobilization support, pain management, wound care, and collaborative administration of medical therapy. After two days of nursing implementation, both diagnoses were partially resolved. Discharge planning focused on gradual mobilization, independent wound care, and high-protein and high-calorie diet to accelerate recovery.

Intracerebral hemorrhage (ICH) is the most common type of hemorrhhagic stroke and a leading cause of death and disability in Indonesia. The prevalence of stroke in Indonesia reached 0.83% in 2023, with ICH cases at RSUD dr. Soeselo, Tegal Regency recording 203 cases in 2024 and increasing significantly to 304 cases in 2025. This study aims to describe comprehensive nursing care for a patient with Intracerebral Hemorrhage. The method used was descriptive narrative through a nursing process approach. Nursing assessment of Ny. S (73 years old) revealed subjective data including headache, nausea and vomiting, and weakness in the left hand and foot, while objective data showed blood pressure 180/80 mmHg, MAP 113.3 mmHg, muscle strength of left extremities 2/2, and CT scan results showing a hyperdense lesion (volume 17.17 cc) with perifocal edema in the right thalamus and right corona, partially filling the ventricular system. Four nursing diagnoses were established: decreased intracranial adaptive capacity related to cerebral edema, impaired physical mobility related to decreased muscle strength, knowledge deficit related to lack of information exposure, and risk of falls. Nursing interventions included intracranial pressure management, mobilization support, health education, and fall prevention. After three days of nursing implementation, three nursing diagnoses were resolved, while impaired physical mobility was partially resolved, resulting in discharge planning recommendations including ROM exercises, gradual mobilization, and family involvement in patient care.

Physical mobility is highly influenced by the integrity of the musculoskeletal and neuromuscular systems, which play a fundamental role in facilitating body movement. Impairment in these systems, such as muscle weakness, limited joint range of motion, pain, or injury, may lead to decreased physical movement and functional limitations. This case study aimed to describe the implementation of joint strengthening exercise techniques in a patient with impaired physical mobility at RSUD Bayu Asih Purwakarta. Joint strengthening exercise techniques, as a nursing intervention, may improve joint flexibility and enhance physical mobility. This study employed a case study design using a comprehensive nursing care approach. Assessment findings revealed decreased extremity movement, reduced muscle strength, and limited joint range of motion. The nursing diagnosis established was impaired physical mobility. Nursing interventions were implemented through joint strengthening exercise techniques over three days in two sessions. Evaluation findings demonstrated partial improvement in extremity movement, muscle strength, and joint range of motion. The implementation of joint strengthening exercise techniques contributed to improved patient mobility; however, the problem of impaired physical mobility was not fully resolved, as the outcome indicators remained at scores of three to four, below the expected target score of five.

This case report examines the effectiveness of a combined pulmonary rehabilitation and musculoskeletal physiotherapy program for a 26-year-old male post-pulmonary tuberculosis patient with lumbar tuberculous spondylitis. The patient, who had completed anti-tuberculosis treatment, presented with low back pain, shortness of breath, fatigue, and limited mobility. Spirometry indicated severe restrictive ventilatory impairment (FVC 1.28 L, 32% of predicted), and lower extremity muscle strength was reduced (MMT 2-3/5). The patient used a TLSO brace and walking aid. Over a three-week physiotherapy program, the patient participated in breathing exercises, spinal mobilization, muscle strengthening, functional exercises, and education on brace use. Evaluation occurred at the first, second, and third weeks. After treatment, pain intensity decreased from VAS 6 to VAS 3, FVC improved to 1.72 L, chest expansion increased, muscle strength improved to MMT 4/5, and performance on the Five-Times Sit-to-Stand Test showed progress. The Functional Independence Measure (FIM) score increased from 98 to 115, reflecting improved functional independence. These findings suggest that the combination of pulmonary and musculoskeletal physiotherapy effectively improved respiratory function, muscle strength, and the patient’s overall functional capacity.

Post section caesarea (SC) and method of operative female sterilization (MOW) are surgical procedures that may cause various problems, such as pain, limited mobility, decreased muscle strength, and risk of postoperative complications. Physiotherapy management through exercise therapy is an important intervention to accelerate the recovery process. Objective this study aimed to determine the effectiveness of exercise therapy in improving the functional condition of patients post SC and MOW in Annisa Ward 32 A at PKU Muhammadiyah Karanganyar Hospital. Method: used was a case report on a 33-year-old female patient following SC and MOW procedures. The physiotherapy interventions included deep breathing exercises, active range of motion exercises of the extremities, light abdominal muscle contractions, gradual early mobilization, as well as breast massage and oxytocin stimulation. The results showed a reduction in pain from a scale of 4–5 to 2–3 based on the Numeric Rating Scale (NRS), improvement in mobility such as independent position changes, and increased activity tolerance, including sitting and walking with minimal assistance. In addition, the patient showed increased confidence in performing daily functional activities. Conclusion: exercise therapy has a positive effect on improving mobility, reducing pain, and accelerating functional recovery in post SC and MOW patients. Therefore, exercise therapy is recommended as an essential component of postoperative physiotherapy management to improve patients' quality of life.

The increasing elderly population presents challenges in healthcare services, particularly related to decreased mobility and independence in daily activities. Physiotherapy plays a crucial role in maintaining and improving the mobility function of older adults through appropriate evaluation and intervention approaches. One simple, valid, and reliable measurement tool for assessing functional mobility is the Timed Up and Go Test (TUG). This study aims to examine the role of physiotherapy in increasing independence in older adults through functional mobility assessment using the TUG. The method used was a descriptive-analytical study with a cross-sectional approach in a group of older adults. Measurements were conducted using the TUG to assess mobility, balance, and fall risk. The assessment results were then used as the basis for planning physiotherapy interventions, which included muscle strength training, balance training, and functional exercises. The results showed that older adults with better TUG scores had higher levels of independence in daily activities. Targeted physiotherapy interventions based on TUG results have proven effective in improving mobility and reducing fall risk. Therefore, using the TUG as an initial assessment tool is crucial in determining appropriate rehabilitation strategies. In conclusion, physiotherapy plays a significant role in increasing the independence of older adults through an approach based on functional mobility assessment using the TUG. Routine implementation of this assessment is expected to support optimal quality of life for older adults.

Background: Carpal Tunnel Syndrome (CTS) is a condition caused by compression of the median nerve at the wrist, resulting in pain, paresthesia, and decreased hand function. This condition is commonly experienced by individuals who perform repetitive wrist activities. Objective: To determine the effectiveness of a combination of neural mobilization exercises and electrotherapy modalities in improving hand function, increasing muscle strength, and reducing pain in a patient with Carpal Tunnel Syndrome. Methods: This study used a case report design involving a 57-year-old female patient (Mrs. Q) who presented with pain and sensory disturbances in the right hand. The intervention was administered for four weeks and consisted of ultrasound therapy, Transcutaneous Electrical Nerve Stimulation (TENS), grip strengthening exercises, and nerve gliding exercises. Outcome measures included pain intensity assessed using the Numeric Rating Scale (NRS), muscle strength evaluated using Manual Muscle Testing (MMT), and functional ability measured using the Wrist Hand Disability Index (WHDI). Results: The evaluation showed a reduction in pain intensity, with resting pain at 0/10, tenderness at 4/10, and movement pain at 4/10. Muscle strength improved from grade 3 to grade 4 based on MMT. Functional ability also improved, as indicated by a 20% reduction in the WHDI score. The combination of these interventions proved effective as a conservative management approach for Carpal Tunnel Syndrome. Conclusion: The administration of ultrasound, TENS, grip strengthening exercises, and nerve gliding exercises over four therapy sessions in Mrs. Q resulted in decreased pain, increased muscle strength, and improved hand functional ability.

Background: Knee osteoarthritis is a degenerative joint disease that often occurs in the geriatric population and causes pain, limited movement, and decreased function. In advanced conditions, management is carried out with Total Knee Replacement (TKR). However, post-surgery patients still experience functional limitations so that physiotherapy intervention is needed. Objective: To determine the effectiveness of static bicycle and quadriceps strengthening exercises on pain, range of motion, muscle strength, functional mobility, and quality of life in post-TKR patients. Methods: This study used a case study design in one patient with post-TKR dextra et causa bilateral knee osteoarthritis. The intervention was given for 3 weeks with a frequency of 2 times per week. Evaluation was carried out using the Numeric Rating Scale (NRS), goniometer, Manual Muscle Testing (MMT), Timed Up and Go Test (TUG), and the Knee Osteoarthritis Outcome Score (KOOS). Results: Results showed a decrease in motion pain from NRS 6 to 4 and stationary pain from 3 to 2. Knee range of motion increased from 75° to 90° of flexion and from -5° to 0° of extension. Muscle strength increased from MMT 3 to 4 in the quadriceps muscle. Functional mobility also improved, with TUG time decreasing from 22 seconds to 18 seconds. However, the KOOS score remained relatively unchanged at 38.84. Conclusion: Static bicycle and quadriceps strengthening exercises were effective in reducing pain, increasing ROM, muscle strength, and functional mobility in post-TKR patients. However, the improvement in quality of life as measured by the KOOS was not significant, requiring a longer rehabilitation period.

Frozen  shoulder or adhesive capsulitis is a chronic condition that causes pain and limited movement in the shoulder joint. Intervention in the early phase (freezing stage) is crucial to prevent more severe functional disabilities, especially in the elderly population. This case study was conducted on a 60-year-old female patient with complaints of pain and stiffness in the right shoulder for one month. Clinical assessment was conducted using the Numeric Rating Scale (NRS) for pain, Manual Muscle Testing (MMT) for muscle strength, goniometry for joint range of motion, and the Shoulder Pain and Disability Index (SPADI) for functional ability. The therapy program was administered in three intervention sessions. After undergoing three therapy sessions, there was a significant reduction in pain intensity, where movement pain decreased from a score of 7 to 5 and pressure pain from 5 to 2. Muscle strength improved from a value of 3 to 4 on the MMT scale. Additionally, the total SPADI score decreased from 66.1% to 50%, indicating an improvement in the patient's functional capacity in daily activities. The multimodal physiotherapy approach has proven effective in reducing pain, increasing muscle strength, and improving shoulder function in elderly patients with early-stage frozen  shoulder. The combination of electro-physical modalities and manual therapy provides more comprehensive clinical outcomes compared to single interventions.

Stroke is a leading cause of disability that requires long-term rehabilitation. Herbal-based therapies, such as Shengmai San, may complement conventional medical treatments in aiding post-stroke recovery. This quasi-experimental study involved 10 post-stroke patients who received Shengmai San therapy for four weeks, with one session per week. Key parameters measured included blood pressure, muscle strength, motor function, sensory complaints (e.g., tingling, numbness), sleep quality, and Traditional Chinese Medicine diagnostic findings (pulse and tongue). The results showed clinical improvements across all patients, including stabilized blood pressure, enhanced muscle strength and mobility, reduced sensory complaints, better sleep quality, and increased physical stamina. Pulse and tongue diagnostics suggested improved Qi and Xue circulation. No significant side effects were reported. The study concludes that Shengmai San is a promising adjunct therapy for post-stroke rehabilitation, especially for patients with Qi deficiency and impaired blood circulation. However, the study suggests that Shengmai San should not replace conventional treatments but be used as a complementary therapy to support recovery.

Childbirth is a series of natural processes that trigger various changes in the mother's body so that she can deliver her baby through the birth canal. Perineal stiffness can actually be anticipated and prevented early in pregnancy, one way is through physical exercises such as pregnancy yoga. Pregnancy yoga has many benefits, especially in alleviating complaints during pregnancy, reducing anxiety, improving sleep quality, and preparing the physical condition before childbirth by strengthening and increasing the elasticity of the pelvic floor muscles, so that the birth process becomes easier. This study aims to analyze the effect of prenatal gentle yoga on the incidence of perineal tears in mothers who will give birth in the work area of ​​the Tiley Health Center on Morotai Island. This study used a quasi-experimental method with a posttest control design. The sample used in the study consisted of mothers giving birth who met certain inclusion criteria, with a total of 36 pregnant women. The instruments used in this study were the Kegel Exercise SOP observation sheet and the assessment of the level of perineal tears. Data were analyzed using the Mann-Whitney statistical test. The results showed a distribution of respondents regarding Kegel exercises: 18 respondents (50%) performed Kegel exercises and 18 respondents (50%) did not. The highest rates of perineal rupture were grade I and grade II, with 13 respondents (36.1%) each. The resulting p-value was 0.0001 (p < 0.05), indicating a significant effect of Kegel exercises on the rate of perineal rupture in primiparous women.

Stroke is a serious neurological disorder. A stroke is an acute attack that can cause death or disability, both physically and mentally. Muscle weakness is one of the most common clinical signs experienced by stroke patients. One way to prevent permanent disability in stroke patients is to train muscle strength through acupressure therapy. This study aims to analyze the application of nursing care through acupressure therapy in improving muscle strength in stroke patients. The method used is a case study using a descriptive one-group research method with a pre-test-post-test design on three stroke patients with an intervention of 7 consecutive days with a frequency of 2 times a day for a duration of 12 minutes. The results showed that respondent I's muscle strength before therapy was on a scale of 3 and post-therapy was on a scale of 4, respondent II's pre-therapy was on a scale of 1 and post-therapy was on a scale of 1, and respondent III's pre-therapy was on a scale of 3 and post-therapy was on a scale of 4. It was concluded that acupressure therapy is effective as an additional therapy in nursing practice to help improve muscle strength in stroke patients.

Non-hemorrhagic cerebrovascular disease (CVD) results from blood flow obstruction in the brain due to thrombus or embolus formation, often leading to balance disorders that affect standing and walking. This loss of motor function increases the risk of falls and fractures, which are major complications. Additionally, reduced physical activity can lead to depression. Active exercise has been shown to improve motor function in CVD patients, with nurses playing a key role in supporting these exercises. One effective intervention is the bridging exercise (BE), used for lumbopelvic stabilization, which enhances muscle strength and coordination. BE is particularly beneficial for improving balance in post-CVD patients with hemiplegia. This case study examines the effects of evidence-based bridging exercise (EBP) on balance in three hospitalized non-hemorrhagic CVD patients. Over eight 15-minute sessions, balance was assessed using the Berg Balance Scale (BBS). All patients showed significant balance improvement, with an average BBS score increase of 40 points. These results highlight the effectiveness of non-pharmacological bridging exercises in enhancing balance in CVD patients and recommend BE as a routine therapy to continue at home after discharge.

Ankle sprain is one of the most common musculoskeletal injuries in sports activities and often results in pain, limited range of motion, muscle weakness, and decreased functional ability. Appropriate physiotherapy management is essential to accelerate recovery and restore ankle function. This study aims to analyze the effectiveness of combining electrotherapy modalities and exercise therapy in the rehabilitation of bilateral grade II ankle sprain caused by sports injury. The research used a case study approach with physiotherapy interventions conducted through several treatment sessions. The interventions consisted of electrotherapy modalities combined with therapeutic exercises designed to reduce pain, improve joint mobility, and increase muscle strength and functional stability of the ankle. Clinical evaluation was carried out through observation of pain levels, range of motion, and functional ability during the therapy period. The findings indicated a gradual improvement in the patient’s condition, including decreased pain, increased ankle range of motion, improved muscle strength, and better functional performance during daily activities. These results suggest that the integration of electrotherapy and exercise therapy can provide a comprehensive rehabilitation approach for ankle sprain injuries. The combined intervention not only supports pain reduction but also enhances joint stability and functional recovery, enabling patients to return safely to their physical activities and reducing the risk of recurrent injury.

The elderly often experience a decline in physical function that can interfere with the ability to carry out daily activities. This condition is more common in the elderly who have had a stroke, which is always accompanied by a decrease in muscle strength. Inactivity of the joint over a long period of time can lead to contracture. One of the nursing interventions that can be done to prevent this condition while increasing muscle strength is  passive Range of Motion (ROM) exercises. The purpose of this case study is to apply nursing measures to the elderly with a decrease in muscle strength that is already research-based. This scientific paper uses a case study design  with passive ROM training interventions. The number of respondents in this study was three patients. The intervention was carried out for three days on each respondent, with a frequency of twice a day for 20 minutes in the Stroke Nursing Room of Charitas Hospital Palembang. The results of the application showed an increase in muscle strength based on Manual Muscle Testing (MMT) scores in all respondents. Mr. P experienced an increase in the muscle strength of the left hand and leg from 2 to 4, Mrs. L from 2 to 3 in the right hand and foot, and Mr. A from 0 to 4 in the right hand and foot. This application is expected to add information about the use of passive ROM in stroke seniors who have decreased muscle strength.