<![CDATA[Background & Objectives : Prolonged immobilization following laparotomy under general anesthesia poses serious risks including muscle weakness, deep vein thrombosis, atelectasis, and extended hospital stays. To describe the implementation of ROM exercise to improve early mobilization in post-laparotomy patients under general anesthesia. Methods: A descriptive qualitative case study involving two post-laparotomy patients under general anesthesia at the surgical ward of RSUD Daerah Kota Magelang (October-November 2025). ROM exercise was implemented for two consecutive days, initiated within 24 hours postoperatively. Mobility level was assessed using the Johns Hopkins Highest Level of Mobility (JH-HLM) scale (0-8), twice daily. Results: The first patient (post exploratory laparotomy due to appendix perforation with peritonitis) showed a JH-HLM improvement from score 1 to score 5 (walking in room) within two days. The second patient (post laparotomy due to ovarian cyst with torsion) improved from score 1 to score 6 (walking in hallway) despite initial barriers of postoperative nausea and vomiting (PONV) and anxiety. Both patients demonstrated reduced pain NRS scores, and no complications were observed during implementation. Conclusions: ROM exercise initiated within the first 24 hours after laparotomy under general anesthesia is proven effective and safe in promoting early mobilization. An integrated approach encompassing pain management, PONV treatment, and psychological support is essential to optimize implementation outcomes.]]>
