Key result
Passive leg ROM with elevation improves ankle-brachial index by ~0.11 and reduces edema in CHF.
Why the study?
Valvular heart disease can lead to blood flow disturbances and CHF, which has a high incidence in Indonesia. This case study aimed to determine the effectiveness of passive lower-extremity ROM exercises combined with 30° leg elevation on peripheral perfusion in a patient with CHF.
Does passive range of motion exercises for the lower extremities combined with 30° leg elevation improve peripheral perfusion and Ankle-Brachial Index in a patient with congestive heart failure?
Case Report (n=1)
No
Does passive range of motion exercises for the lower extremities combined with 30° leg elevation improve peripheral perfusion and Ankle-Brachial Index in a patient with congestive heart failure?
In a single patient with congestive heart failure and impaired peripheral perfusion, three days of daily passive lower extremity range of motion exercises combined with 30° leg elevation normalized Ankle-Brachial Index values and reduced peripheral edema from grade 3 to grade 2.
Hypothesis-generating for perfusion gains in CHF; leaves open need for controlled trials before any practice consideration.
Background & Objective: The high incidence of CHF is inseparable from various etiological factors, one of which is valvular heart disease. Valvular heart disease, whether in the form of stenosis or regurgitation, can lead to disturbances in blood flow and a chronic increase in cardiac workload. In Indonesia, valvular heart disease remains a significant problem, particularly rheumatic heart disease, which is commonly found among individuals in the productive age group. One of the interventions that can be provided is passive ROM (Range of Motion) exercises on the lower extremities combined with 30° leg elevation. This final scientific paper aims to determine the effectiveness of passive ROM exercises on the lower extremities combined with 30° leg elevation in patients with CHF. Method: A case study was conducted using a nursing care approach that included assessment, determination of nursing diagnoses, planning, implementation, and evaluation for a patient with CHF (Mrs. M) who was treated in the ICCU of Jakarta Islamic Hospital Cempaka Putih. The intervention of passive ROM (Range of Motion) exercises on the lower extremities combined with 30° leg elevation was administered once daily for three consecutive days to monitor the patient’s peripheral circulation using the Ankle Brachial Index (ABI) as an indicator. Result: The passive ROM intervention administered over three days resulted in improvements in ABI values, increased peripheral pulses, shortened capillary refill time (CRT), warm extremities, reduced muscle weakness, and decreased peripheral edema. Conclusion: Passive ROM exercises of the lower extremities combined with 30° leg elevation are effective nursing interventions for improving ABI values, peripheral pulses, capillary refill time (CRT), extremity warmth, muscle weakness, and peripheral edema in patients with CHF. Consistent application of passive ROM interventions to the lower extremities can support the rehabilitation process.
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Ibrahim et al. (2026) conducted a case report in Congestive Heart Failure (CHF) with ineffective peripheral perfusion due to valvular heart disease (mitral stenosis and tricuspid regurgitation) (n=1). Passive Range of Motion (ROM) exercises on the lower extremities combined with 30° leg elevation was evaluated on Ankle-Brachial Index (ABI) of the right lower extremity. Passive lower-extremity ROM with 30° leg elevation for 3 days increased right ABI from 0.92 to 1.03, left ABI from 0.96 to 1.01, and reduced edema from grade 3 to 2 in a CHF patient.
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