THE APPLICATION OF A COMBINATION OF SLOW STROKE BACK MASSAGE (SSBM) AND RUBBER BALL GRIP EXERCISES TO INCREASE MUSCLE STRENGTH IN PATIENTS WITH NON-HEMORRHAGIC STROKE AT SOFIFI GENERAL HOSPITAL

Enggar Ardiani Tagap; Amrih Widiati

doi:10.63922/ijeter.v4i03.4505

Enggar Ardiani Tagap Karya Husada University
Amrih Widiati Karya Husada University

DOI: https://doi.org/10.63922/ijeter.v4i03.4505

Keywords: Hand Grip Exercise, Muscle Strength, Non-Hemorrhagic Stroke, Rehabilitation, Slow Stroke Back Massage

Abstract

Non-hemorrhagic stroke often causes muscle weakness, which impacts mobility limitations and reduces patient independence. This study aims to describe the application of a combination of Slow Stroke Back Massage (SSBM) and rubber ball grip exercises to increase muscle strength in non-hemorrhagic stroke patients at Sofifi General Hospital. The study used a descriptive design with a case study approach. The study population was non-hemorrhagic stroke patients treated in the Crysan Ward of Sofifi General Hospital, with a sample of one patient selected using a purposive sampling technique. The research instruments included a nursing assessment format, observation sheets, medical records, vital sign measurements, and Manual Muscle Testing (MMT). Data were collected through interviews, observations, physical examinations, and documentation, then analyzed descriptively by comparing conditions before and after the intervention. The results showed an increase in right upper extremity muscle strength from an MMT value of 3/5 to 4/5 after three days of intervention. Patients also experienced increased mobilization ability, decreased blood pressure, and increased comfort. In conclusion, the combination of SSBM and rubber ball grip exercises has the potential to increase muscle strength and support the rehabilitation process of non-hemorrhagic stroke patients.

References

Amila, A., Sembiring, E., & Rifami, E. (2022). Characteristics of stroke in young patients. JINTAN: Journal of Nursing Science, 2(2), 151–159.
Creswell, J. W., & Poth, C. N. (2024). Qualitative inquiry and research design: Choosing among five approaches (5th ed.). Sage Publications.
Emzir. (2023). Qualitative research methodology: Data analysis (Revised edition). Rajawali Pers.
Febrywati, H., et al. (2025). Application of rehabilitation exercises in non-hemorrhagic stroke patients. Indonesian Nursing Journal.
Feigin, VL, Stark, BA, Johnson, CO, Roth, GA, Bisignano, C., Abady, GG, Abbasifard, M., Abbasi-Kangevari, M., Abd-Allah, F., Abdelalim, A., & GBD 2019 Stroke Collaborators. (2021). Global, regional, and national burden of stroke and its risk factors, 1990–2019: A systematic analysis for the Global Burden of Disease Study 2019. The Lancet Neurology, 20(10), 795–820.https://doi.org/10.1016/S1474-4422(21)00252-0
Hangkiho, F., & Lumingkewas, M. (2026). Nursing care with ball grip exercise techniques to increase upper extremity muscle strength. Manado Scientific Health Journal, 5(1), 15–25.
Jamaludin, M., Mahmudah, RA, & Budi, I. (2021). The effectiveness of slow stroke back massage therapy on increasing physical mobility in post stroke patients: Literature review. In International Conference on Health and Science (Vol. 1, No. 1, pp. 405–411).
Ministry of Health of the Republic of Indonesia. (2024). Indonesia's health profile 2024. Ministry of Health of the Republic of Indonesia.
Marhamah, M., & Rahani, R. (2023). The effect of slow stroke back massage on the physiological condition of hypertensive patients. Indonesian Nursing Journal.
Rahmasari, D., & Purwaningsih, P. (2023). Effectiveness of rubber ball grip exercises on increasing muscle strength in non-hemorrhagic stroke patients. Journal of Medical-Surgical Nursing.
Rahmawati, I., Dewi, R., Pertami, SB, & Pasaribu, E. (2021). Hand exercise using a rubber ball increases grip strength in patients with non-haemorrhagic stroke. The Malaysian Journal of Nursing, 12(3), 32–36.https://doi.org/10.31674/mjn.2021.v12i03.005
Sartika, S., Putri, NK, Wenny, BP, Wijaya, NE, & Saifudin, IMMY (2023). Implementation of slow stroke back massage to reduce anxiety in patients with hemorrhagic stroke: A case study. SMART Nursing Journal, 10(2), 69–75.
Sudaryono. (2023). Quantitative, qualitative, and mixed method research methodology (Latest edition). Rajawali Pers.
Sugiyono. (2022). Quantitative, qualitative, and R&D research methods (2nd Edition). Alfabeta.
Utami, DNWS (2026). Application of rubber ball grip therapy as an effort to improve grip muscles in patients with non-hemorrhagic CVA infarction in the Edelweiss B Ward of Karsa Husada Batu Regional Hospital. Journal of Contemporary Nursing Research, 6(1), 35–46.