Ronal Surya Aditya
Associate Degree in Nursing Program, Faculty of Nursing, University of Jember, Pasuruan, Indonesia

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STRETCHING EXERCISE THERAPY AS A NON-PHARMACOLOGICAL NURSING INTERVENTION FOR ACTIVITY INTOLERANCE IN HYPERTENSIVE PATIENTS: A CASE STUDY FROM A RURAL AGRICULTURAL COMMUNITY IN INDONESIA Fatmala Fathul Huda; Bagus Dwi Cahyono; Evy Aristawati; Nurul Huda; Apriana Rahmawati; Ronal Surya Aditya
Spectra Clinical Case Reports Journal Vol. 1 No. 1 (2025): December 2025
Publisher : Department of Nursing, Faculty of Medicine, Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/sccrj.v1i1.2

Abstract

Activity intolerance, characterized by fatigue, dyspnea, and reduced exercise capacity, is a common nursing diagnosis among patients with hypertension, particularly in rural farmers whose livelihoods require sustained physical labor. In resource limited settings such as Indonesia’s agricultural communities, non pharmacological nursing interventions play a critical role in managing functional impairment associated with uncontrolled hypertension. This case study describes the successful implementation of Stretching Exercise Therapy as a nurse led, home based intervention for Mr. S, a 67 year old farmer with hypertension from Pasuruan, East Java, who presented with activity intolerance manifested by dizziness, leg cramps, and exertional dyspnea. During a three day intervention period, the patient received supervised static stretching sessions lasting 5 to 10 minutes, administered twice daily and targeting major muscle groups. Vital signs and subjective symptoms were monitored before and after each intervention session. Following the intervention, Mr. S demonstrated marked clinical improvement. Blood pressure decreased from 160 over 103 mmHg to 137 over 84 mmHg, heart rate declined from 115 to 84 beats per minute, and all reported subjective symptoms resolved. The patient reported restored energy, improved mobility, and increased confidence in performing daily activities, including light farming tasks. The intervention was safe, cost free, and easily adopted by both the patient and his family. Although this evidence is derived from a single case, the findings suggest that Stretching Exercise Therapy may represent a feasible and low intensity strategy for nurses to address activity intolerance in rural populations with hypertension. Further studies with larger samples and longer follow up periods are needed to confirm efficacy and sustainability.
ALLEVIATING ACUTE PAIN TO RESTORE FUNCTION: A NURSING-LED GINGER OIL INTERVENTION FOR A FARMER WITH RHEUMATOID ARTHRITIS Fitriah Effendy; Bagus Dwi Cahyono; Evy Aristawati; Nurul Huda; Apriana Rahmawati; Ronal Surya Aditya
Spectra Clinical Case Reports Journal Vol. 1 No. 1 (2025): December 2025
Publisher : Department of Nursing, Faculty of Medicine, Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/sccrj.v1i1.3

Abstract

Rheumatoid arthritis is a chronic autoimmune disease causing persistent joint inflammation, pain, stiffness, and progressive functional decline, particularly exacerbated among farmers by repetitive non-ergonomic labor. This case involved a 74-year-old male farmer from Pasuruan Regency, Indonesia, who presented with severe functional limitations. Assessment revealed throbbing joint pain rated 7 out of 10 on the Numeric Rating Scale, prolonged morning stiffness, fatigue with minimal exertion, slow and assisted gait, and dependence on family for ambulation and self-care. The priority of nursing diagnosis was Acute Pain related to inflammatory joint process and mechanical stress, per the Standar Diagnosis Keperawatan Indonesia, as uncontrolled pain was the primary barrier to physical function; activity intolerance was identified as a secondary diagnosis. The purpose of this case report was to evaluate the effectiveness of a nursing-led, non-pharmacological intervention topical ginger (Zingiber officinale) extract oil combined with massage in reducing acute pain and thereby improving functional capacity in a rural rheumatoid arthritis patient with limited access to pharmacotherapy. The intervention plan consisted of twice-daily application of ginger oil to knees and ankles with 10-minute gentle massage over three consecutive days, integrated with health education on activity pacing and light stretching. Following the intervention, pain intensity decreased to 3/10, ambulation improved from assisted to independent, and the patient resumed light farming and self-care tasks without frequent rest. No adverse effects occurred. These outcomes suggest that targeted pain management using locally available ginger oil may rapidly enhance activity tolerance in resource-limited settings. Further research is warranted to confirm efficacy and safety in larger cohorts.