APPLICATION OF PROGRESSIVE MUSCLE RELAXATION IN HYPERTENSIVE PATIENTS WITH INEFFECTIVE PERIPHERAL PERFUSION IN THE MAWAR WARD OF ARIFIN ACHMAD HOSPITAL, RIAU PROVINCE

Abstract

Hypertension is a global health issue characterized by systolic blood pressure >140 mmHg and/or diastolic blood pressure >90 mmHg. One of the complications of persistent elevated blood pressure is Ineffective Peripheral Perfusion, manifested by impaired circulation to the extremities, such as cold acral areas and delayed capillary refill. Data in Indonesia show that the prevalence of hypertension has reached 34.1%, while in Riau Province it increased from 22.8% in 2021 to 32.5% in 2022. Management of this problem requires comprehensive interventions, both pharmacological and non-pharmacological. This case study aims to apply Progressive Muscle Relaxation (PMR) therapy as a non-pharmacological intervention to address Ineffective Peripheral Perfusion in hypertensive patients. The method used is a case study with a nursing care approach and Evidence-Based Practice (EBP), conducted over five days in the Mawar Ward of Arifin Achmad Regional Hospital, Riau Province, on two patients. PMR was performed four times a week with a duration of 15 minutes per session, focusing on cycles of muscle contraction and relaxation. Data were collected through observation of blood pressure, peripheral pulse rate, skin color, and acral condition before and after the intervention. After five days of PMR implementation, the average reduction in systolic blood pressure in both patients was 15 mmHg and diastolic 10 mmHg. Additionally, improvements were observed in peripheral perfusion indicators: both patients’ acral areas became warm (improved), capillary refill time decreased from >3 seconds to <3 seconds, and peripheral pulses were palpated more strongly. Progressive muscle relaxation therapy proved effective in lowering blood pressure and improving symptoms of Ineffective Peripheral Perfusion in hypertensive patients. This intervention is recommended to be systematically integrated into the standard nursing care for hypertensive patients in the Mawar Ward of Arifin Achmad Regional Hospital.