Range of Motion Exercise to Reduce the Fall Risk in Older Adult with Hypertension at the Tresna Werdha Social Care Service Center, Jember: A Case Report

Abstract

Falls are a major health concern among older adults, particularly those with chronic conditions such as hypertension that affect balance, muscle strength, and postural stability. This case report describes the nursing management of an older adult with hypertension and high fall risk who received range of motion (ROM) exercise as a non-pharmacological intervention. The patient was a 76-year-old woman residing at the Tresna Werdha Social Care Facility in Jember, presenting with instability during standing and walking and a history of near-fall episodes. Initial assessment showed a high fall risk, with a Timed Up and Go Test (TUGT) time of approximately 71 seconds and a Morse Fall Scale score of 55. ROM exercises were performed in an active manner on the upper and lower extremities once daily for approximately 15–30 minutes over six consecutive days. Evaluation was conducted by measuring the Timed Up and Go Test (TUGT), Morse Fall Scale (MFS), blood pressure, and the client’s subjective responses before and after the intervention. The results showed a gradual reduction in TUGT duration over the intervention period, indicating improvement in mobility and movement coordination, although the TUGT values remained within the high fall risk category. The MFS score remained in the high-risk category, which may be influenced by the client’s baseline condition and the relatively short duration of the intervention. Blood pressure measurements demonstrated a decreasing trend, although they had not yet reached normal levels. Subjectively, the client reported increased confidence and improved stability when standing and walking. In conclusion, Range of Motion exercises demonstrated positive early effects on improving mobility and stability in older adults with hypertension. However, continuous and long-term implementation is required to achieve a significant reduction in fall risk categories.