Increasing muscle strength through range-of-motion training in patients with Guillain-Barré syndrome at RSUP Sardjito General
Keywords:
guillain-barré syndrome, impaired physical mobility, range of motionAbstract
Background: Guillain Barre Syndrome is an autoimmune condition in the form of polyradiculoneuropathy,
characterized by progressive inflammation that affects the peripheral nervous system, Guillain Barre Syndrome
begins with damage to the peripheral nerves due to an autoimmune response that results in weakness in the limbs.
Therefore, effective nursing interventions are needed to increase the patient's muscle strength. Objective: This
study aims to provide nursing care to Child N with Susp Guillain Barre Syndrome in the West Aster ward of
RSUP (Central General Hospital) Dr. Sardjito. Method: This study applied a case study through the nursing care
process from the assessment stage, diagnosis, nursing planning, nursing implementation, and evaluation carried
out for three days from December 17-19, 2025. The data obtained from observation, interviews, physical
examinations, and medical records. The case report was performed using the MRC (Medical Research Council)
instrument scale to assess muscle strength. Results: After Range of Motion exercises showed an increase in the
patient's muscle strength. Conclusion: Range of Motion (ROM) exercises in patients with Guillain Barre
Syndrome showed an increase in muscle strength on the third day of implementation. Based on these findings, the
researchers concluded that the Range of Motion intervention provided positively contributed to improving the
patient's motor function and muscle strength.
References
American Physical Therapy Association. (2023). Physical Therapy Guide to Guillain-Barré Syndrome.
Retrieved from https://www.choosept.com/guide/physical-therapy-guide-guillain-barresyndrome.
Arsenault, N.S., Vincent, P.O., Shen, Y.B.H., Bastien, R., Sweeney, A., & Zhu, S. (2016). Influence of
exercise on patients with Guillain-Barré syndrome: A systematic review. In Physiotherapy
Canada (Vol. 68, Issue 4, pp. 367–376). University of Toronto Press Inc.
https://doi.org/10.3138/ptc.2015-58
Bellanti, R., & Rinaldi, S. (2024). Guillain-Barré syndrome: a comprehensive review. In European
Journal of Neurology (Vol. 31, Issue 8). John Wiley and Sons Inc.
https://doi.org/10.1111/ene.16365
Frates, F. de. (2023). Basic Concepts of Nursing. Satya Wacana Christian University.
Gawande, I., Akhuj, A., & Samal, S. (2024). Effectiveness of Physiotherapy Intervention in Guillain
Barre Syndrome: A Case Report. Cureus. https://doi.org/10.7759/cureus.52062
Indrayana, A., & Wahyudi, W. (2020). The Effect of Active Range of Motion (ROM) Exercises on
Increasing Joint Range of Motion in GBS Patients. Semarang Health Polytechnic Journal.
Ishwari Gawande, Aditi Akhuj, & Snehal Samal. (2024). Effectiveness of Physiotherapy Intervention
in Guillain Barre Syndrome: A Case Report. Cureus Part of Springer Nature.
Kiper, P., Chevrot, M., Godart, J., Cieślik, B., Kiper, A., Regazzetti, M., & Meroni, R. (2025a). Physical
Exercise in Guillain-Barré Syndrome: A Scoping Review. In Journal of Clinical Medicine (Vol.
, Issue 8). Multidisciplinary Digital Publishing Institute (MDPI).
https://doi.org/10.3390/jcm14082655
Proceedings International Conference on Nursing Relateded to Palliative Care
Vol. 1 (2025): 21 November 2025
(Nailul Izza, Kustiningsih – Increasing muscle strength through range-of-motion training....) 690
Kiper, P., Chevrot, M., Godart, J., Cieślik, B., Kiper, A., Regazzetti, M., & Meroni, R. (2025b). Physical
Exercise in Guillain-Barré Syndrome: A Scoping Review. In Journal of Clinical Medicine (Vol.
, Issue 8). Multidisciplinary Digital Publishing Institute (MDPI).
https://doi.org/10.3390/jcm14082655
Kiper, P., Chevrot, M., Godart, J., Cieślik, B., Kiper, A., Regazzetti, M., & Meroni, R. (2025c). Physical
Exercise in Guillain-Barré Syndrome: A Scoping Review. In Journal of Clinical Medicine (Vol.
, Issue 8). Multidisciplinary Digital Publishing Institute (MDPI).
https://doi.org/10.3390/jcm14082655
Kumar, G., Arora, L., & Arora, R. (2021). Effectiveness Of High and Low Intensity Rehabilitation
Programmer in Chronic Phase of Guillain Barre Syndrome Patients: A Randomized Control Trial.
European Journal of Physiotherapy and Rehabilitation Studies, 2 (1).
https://doi.org/10.46827/ejprs.v2i1.53
Leonhard, SE, Mandarakas, MR, Gondim, FAA, Bateman, K., Ferreira, MLB, Cornblath, DR, van
Doorn, PA, Dourado, ME, Hughes, RAC, Islam, B., Kusunoki, S., Pardo, CA, Reisin, R., Sejvar,
JJ, Shahrizaila, N., Soares, C., Umapathi, T., Wang, Y., Yiu, EM, … Jacobs, B. C. (2019).
Diagnosis and management of Guillain–Barré syndrome in ten steps. Nature Reviews Neurology,
(11), 671–683. https://doi.org/10.1038/s41582-019-0250-9
Lubis, AJ (2020). Nursing Evaluation as the Final Phase of the Nursing Process. Research Gate.
M. Bustan, & Dwi Purnama. (2023). Descriptive Study of Documentation of Mental Health Nursing
Care by Nurses at the Mental Hospital of Southeast Sulawesi Province. Kendari Nursing Journal.
Merdiyanti, D., Ayubbana, S., Hs, SS, Dharma, AK, & Metro, W. (2021). Application of Passive Range
of Motion (ROM) to Improve Muscle Strength of Non-Hemorrhagic Stroke Patients. Jurnal
Cendikia Muda, 1 (1).
MRC. (2020). Medical Research Council (MRC)ScaleforMuscleStrength_NeurologicalScales.
Nguyen, T. P., & Taylor, R. S. (2023). Guillain Barre Syndrome. National Library of Medicine.
https://www.ncbi.nlm.nih.gov/books/NBK532254/#:~:text=Guillain-Barré syndrome (GBS),
which can progress to paralysis.
Ong, K. L., & Van der Schaaf, M. (2020). Interprofessional collaboration in neurological rehabilitation:
A systematic review. Disability and Rehabilitation, 42(24), 3486–3497.
https://Doi.Org/10.1080/09638288.2019.1689176.
Permana, GP, & Laily, I. (2025). Physical Exercise Prescription Protocol for Muscle Strength Recovery
in GBS Patients.
Permana, GP, & Laily, I. (2025). Physical Exercise Intake Protocol for Muscle Strength Recovery in
Guillain-Barre Syndrome Patients: A Literature Review. Journal of Health Research, Poltekkes
Depkes Bandung, 17 (1), 197–213. https://doi.org/10.34011/juriskesbdg.v17i1.2725
Potter, P. A., & Perry, A. G. (2017). Fundamentals of Nursing, 9th ed.
Putri, A., Amalia, R., Nursing Professional Education Study Program, M., Nursing, Syiah Kuala
University, Banda Aceh, F., & Medical Surgical Nursing Science, B. (2024). Nursing Care at Mr.
T With Guillain Barre Syndrome: A Case Study.
Ramadhani, A., Astuti, I., Widiastuti, MG, & Purwanti, N. (2024). Methylcobalamin as a candidate for
chronic peripheral neuropathic pain therapy: review of molecular pharmacology action. In Korean
Journal of Pain (Vol. 37, Issue 4, pp. 299–309). Korean Pain Society.
https://doi.org/10.3344/kjp.24171
Ratu, M., Widhikarsa, P., & Purwanti, OS (2025). Application of Range of Motion Intervention to
Reduce Paraesthesia in Guillain Barre Syndrome: A Case Study. 6 (1).
Savsek, L., Stergar, T., Strojnik, V., Ihan, A., Koren, A., Spiclin, Z., & Jazbec, S.S. (2021). Impact of
aerobic exercise on clinical and magnetic resonance imaging biomarkers in persons with multiple
sclerosis: An exploratory randomized controlled trial. Journal of Rehabilitation Medicine, 53 (4).
https://doi.org/10.2340/16501977-2814
Shaffer, H.M. (2023). The Progression, Treatment, and Rehabilitation of Guillain Barré the
Progression, Treatment, and Rehabilitation of Guillain Barré Syndrome: Case Report Syndrome:
Case Report. https://commons.und.edu/pt-grad/766
Shah, N., Shrivastava, M., Kumar, S., & Nagi, R. S. (2022). Supervised, individualized exercise reduces
fatigue and improves strength and quality of life more than unsupervised home exercise in people
Proceedings International Conference on Nursing Relateded to Palliative Care
Vol. 1 (2025): 21 November 2025
(Nailul Izza, Kustiningsih – Increasing muscle strength through range-of-motion training....) 691
with chronic Guillain-Barré syndrome: a randomized trial. Journal of Physiotherapy, 68 (2), 123–
https://doi.org/10.1016/j.jphys.2022.03.007
Shang, P., Feng, J., Wu, W., & Zhang, H.L. (2021). Intensive Care and Treatment of Severe Guillain–
Barré Syndrome. In Frontiers in Pharmacology (Vol. 12). Frontiers Media SA
https://doi.org/10.3389/fphar.2021.608130
Sheriff, Y. (2019). Impacts of Exercise on Functional Ability of Recovering GBS Patients: An
Integrative Literature Review Patients: An Integrative Literature Review Running Head: Impacts
of Exercise on GBS Mobility & Recovery Impacts of Exercise on Functional Ability of Recovering
GBS Patients: An Integrative Literature Review Impacts of Exercise on GBS Mobility & Recovery
Impacts of Exercise on GBS Mobility and Recovery Background & Significance.
https://via.library.depaul.edu/nursing-colloquium
Smeltzer, S.C. et al. (2020). Brunner & Suddarth's Textbook of Medical-Surgical Nursing. 15th ed.
SDKI Working Group Team of the Indonesian National Nurses Association (2018). Indonesian Nursing
Diagnosis Standards (1st Edition). SDKI Working Group Team of the Indonesian National Nurses
Association (2018).
SIKI DPP PPNI Working Group Team. (2018). Indonesian Nursing Intervention Standards.
SLKI DPP PPNI Working Group Team. (2019). Indonesian Nursing Outcome Standards.
Titus, J., Sarmiento, B., & Crouse, R. (2024). Management of Severe Pain in a Case of Sensory GuillainBarre Syndrome. Cureus. https://doi.org/10.7759/cureus.64432
van Doorn PA, Van den Bergh PYK, Hadden RDM Avau B Rajabally, Y.A., Umapathi, T., … Willison,
H.J. (2023). European Academy of Neurology/Peripheral Nerve Society Guideline on diagnosis
and treatment of Guillain–Barré syndrome. In European Journal of Neurology (Vol. 30, Issue 12,
pp. 3646–3674). John Wiley and Sons Inc. https://doi.org/10.1111/ene.16073
Willison, H. J., Jacobs, B. C., & van Doorn, P. A. (2016). Guillain-Barré syndrome. In The Lancet (Vol.
, Issue 10045, pp. 717–727). Lancet Publishing Group. https://doi.org/10.1016/S0140-
(16)00339-1
