EFFECT OF SPRING GRIP ACTIVE ASSISTIVE ROM EXERCISE ON UPPER EXTREMITIES MUSCLE STRENGHTH IN ISCHEMIC STROKE PATIENTS.
EFFECT OF SPRING GRIP ACTIVE ASSISTIVE ROM EXERCISE ON UPPER
EXTREMITIES MUSCLE STRENGHTH IN ISCHEMIC STROKE PATIENTS
Prapti, N.K.G., Armini, N.K.S., Azis, A.
ABSTRACT.
Stroke is the second leading cause of death in the world after heart disease, it also the number one cause
of disability in both the developed and developing countries. Approximately 85% of stroke patients
admitted to hospital with problems at their upper limb. The physical impairments of stroke such as a
muscle weakness, pain, and spasticity was leading to a declinement of the ability to use the strokeaffected upper limb in daily activities. Therefore upper extremity needs to be trained, One form of its
training by using the spring grip device. Gripping exercises using spring grip device are performed
actively and assisted. This study aims to find out the effect of ROM active assisted spring grip exercise
toward the strength of upper extremity muscle in ischemic stroke patients at IRNA D Sanglah Hospital.
This is a pre test - post test design study with a control group. This study held for 6 days with treatment
twice daily. The 30 respondents were taken as a subjects in this study that consists of 15 patients of the
treatment group and 15 patients as a control group . The results of an statistical paired t-test obtained p
value = 0.000 (< 0.05). So it can be concluded that there is an effect of ROM active assisted spring grip
exercise to the changes of muscle strength between pre and post ROM active assisted spring grip exercise
at IRNA D Sanglah Hospital . Based on the above results suggested to the hospital to consider apply
ROM active assisted spring grip exercise in ischemic stroke patients.
Key words: Stroke, ROM and Spring Grip Exercise
Background and Significant of the Problem
Stroke is the number two cause of death in the world after heart disease, and is the
number one cause of disability in both developed countries and in developing countries (America
Heart Association [AHA], 2010). According to Health Research (2008), the stroke becomes first
cause of death rank in Indonesia in 2011. Based on the profile of Bali provincial health
department in 2010, patients with cerebral infarction were hospitalized in Bali amounted to 968
people. While data from Center General Hospital (RSUP) Sanglah the period January to June
2013 states that in a month, stroke patients who are hospitalized have an average number of 37
people. Based on preliminary studies that have been conducted on July 1, 2013, the number of
stroke patients who are hospitalized in Inpatient D (IRNA D) Sanglah approximately in a month
period from April to June 2013 a number of 32 people with the average amount of suffering an
ischemic stroke as much as 24 people per month, in the age range 30 to 80 years.
Stroke becomes a major problem of movement disorders and body function in adults
(Irfan, 2010:69). About 85% of stroke patients who are hospitalized have muscle weakness, pain,
and spasticity so that impact on decrease in the ability to indulge. Decrease in ability impacts on
the loss of muscle strength, decrease in range of motion and fine motor skills (Eng & Harris,
2009).
Recovery of upper extremity muscle strength and returns of joint flexibility require
rehabilitation as soon as possible after the patient's condition is considered stable (Waluyo,
2009:106). Rehabilitation can be given to patients is the exercises of motion range or Range of
Motion (ROM). Allotment of training is preferred on specific skills that are meaningful to
patients with stroke (Smeltzer & Bare, 2002:399, Susilawathi, 2013:56), such as; grasping,
holding, and lifting objects (Irfan, 2010:203, Mehrholz, 2012: 75). Irfan (2010) and Mehrholz
(2012) state that one of the forms of specific exercise that can improve upper extremity muscle
strength and can restore hand function is to use the tool of spring grip by way of gripped.
Based on the results of preliminary studies that were conducted in Sanglah Hospital,
ROM passive rehabilitation has been done by the therapist once a day in the morning, but not
optimal due to limitation of personnel therapist. Nurse who is in charge in the area of stroke has
a major role to train the patient due to 24 hours near the patient. Based on the above presentation,
researcher is interested in knowing the effect of spring grip exercise active assistive to the upper
extremity muscle strength in stroke ischemic patients in Sanglah Hospital.
RESEARCH METHODS
This study is quasy-exsperimental research with pretest-posttest design with control group.
Collecting data in this study is conducted on patients with stroke ischemic who experience weakness in
the upper extremities. Measurements of muscle strength in patients with stroke ischemic are conducted
before and after given intervention by using Handgrip dynamometer. The sample in this study consisted
of 15 people who are given ROM exercises according to the procedure in the hospital and added to the
Spring grip active assistive exercise that is conducted twice a day and 15 others as a control group get
only ROM exercises according to the procedure in Sanglah Hospital. The analysis that is used in this
study is a parametric test.
RESEARCH RESULT
Characteristics of Respondents
In this research, the characteristics of respondents are categorized by sex, age, and history of
stroke that can be described as follows:
Tabel 1 the characteristics of respondents
Intervention
Characteristics
Control
Total
P Value
f
%
f
%
f
%
Male
12
80,0
10
66,7
22
73,3
Female
3
20,0
5
33,3
8
26,7
EXTREMITIES MUSCLE STRENGHTH IN ISCHEMIC STROKE PATIENTS
Prapti, N.K.G., Armini, N.K.S., Azis, A.
ABSTRACT.
Stroke is the second leading cause of death in the world after heart disease, it also the number one cause
of disability in both the developed and developing countries. Approximately 85% of stroke patients
admitted to hospital with problems at their upper limb. The physical impairments of stroke such as a
muscle weakness, pain, and spasticity was leading to a declinement of the ability to use the strokeaffected upper limb in daily activities. Therefore upper extremity needs to be trained, One form of its
training by using the spring grip device. Gripping exercises using spring grip device are performed
actively and assisted. This study aims to find out the effect of ROM active assisted spring grip exercise
toward the strength of upper extremity muscle in ischemic stroke patients at IRNA D Sanglah Hospital.
This is a pre test - post test design study with a control group. This study held for 6 days with treatment
twice daily. The 30 respondents were taken as a subjects in this study that consists of 15 patients of the
treatment group and 15 patients as a control group . The results of an statistical paired t-test obtained p
value = 0.000 (< 0.05). So it can be concluded that there is an effect of ROM active assisted spring grip
exercise to the changes of muscle strength between pre and post ROM active assisted spring grip exercise
at IRNA D Sanglah Hospital . Based on the above results suggested to the hospital to consider apply
ROM active assisted spring grip exercise in ischemic stroke patients.
Key words: Stroke, ROM and Spring Grip Exercise
Background and Significant of the Problem
Stroke is the number two cause of death in the world after heart disease, and is the
number one cause of disability in both developed countries and in developing countries (America
Heart Association [AHA], 2010). According to Health Research (2008), the stroke becomes first
cause of death rank in Indonesia in 2011. Based on the profile of Bali provincial health
department in 2010, patients with cerebral infarction were hospitalized in Bali amounted to 968
people. While data from Center General Hospital (RSUP) Sanglah the period January to June
2013 states that in a month, stroke patients who are hospitalized have an average number of 37
people. Based on preliminary studies that have been conducted on July 1, 2013, the number of
stroke patients who are hospitalized in Inpatient D (IRNA D) Sanglah approximately in a month
period from April to June 2013 a number of 32 people with the average amount of suffering an
ischemic stroke as much as 24 people per month, in the age range 30 to 80 years.
Stroke becomes a major problem of movement disorders and body function in adults
(Irfan, 2010:69). About 85% of stroke patients who are hospitalized have muscle weakness, pain,
and spasticity so that impact on decrease in the ability to indulge. Decrease in ability impacts on
the loss of muscle strength, decrease in range of motion and fine motor skills (Eng & Harris,
2009).
Recovery of upper extremity muscle strength and returns of joint flexibility require
rehabilitation as soon as possible after the patient's condition is considered stable (Waluyo,
2009:106). Rehabilitation can be given to patients is the exercises of motion range or Range of
Motion (ROM). Allotment of training is preferred on specific skills that are meaningful to
patients with stroke (Smeltzer & Bare, 2002:399, Susilawathi, 2013:56), such as; grasping,
holding, and lifting objects (Irfan, 2010:203, Mehrholz, 2012: 75). Irfan (2010) and Mehrholz
(2012) state that one of the forms of specific exercise that can improve upper extremity muscle
strength and can restore hand function is to use the tool of spring grip by way of gripped.
Based on the results of preliminary studies that were conducted in Sanglah Hospital,
ROM passive rehabilitation has been done by the therapist once a day in the morning, but not
optimal due to limitation of personnel therapist. Nurse who is in charge in the area of stroke has
a major role to train the patient due to 24 hours near the patient. Based on the above presentation,
researcher is interested in knowing the effect of spring grip exercise active assistive to the upper
extremity muscle strength in stroke ischemic patients in Sanglah Hospital.
RESEARCH METHODS
This study is quasy-exsperimental research with pretest-posttest design with control group.
Collecting data in this study is conducted on patients with stroke ischemic who experience weakness in
the upper extremities. Measurements of muscle strength in patients with stroke ischemic are conducted
before and after given intervention by using Handgrip dynamometer. The sample in this study consisted
of 15 people who are given ROM exercises according to the procedure in the hospital and added to the
Spring grip active assistive exercise that is conducted twice a day and 15 others as a control group get
only ROM exercises according to the procedure in Sanglah Hospital. The analysis that is used in this
study is a parametric test.
RESEARCH RESULT
Characteristics of Respondents
In this research, the characteristics of respondents are categorized by sex, age, and history of
stroke that can be described as follows:
Tabel 1 the characteristics of respondents
Intervention
Characteristics
Control
Total
P Value
f
%
f
%
f
%
Male
12
80,0
10
66,7
22
73,3
Female
3
20,0
5
33,3
8
26,7