Implementation of Combined Slow Stroke Back Massage and Slow Deep Breathing Exercise in a Patient with Ischemic Stroke and Hypertension: A Case Report

Q: What is the clinical evidence from this study?

Study design: Case Report. Population: Ischemic stroke and hypertension (n=1). Intervention: Combined Slow Stroke Back Massage (SSBM) and Slow Deep Breathing Exercise (SDBE) vs. Pre-intervention baseline. Primary outcome: Systolic blood pressure (mmHg).

Q: What does this research mean for the field?

The combination of Slow Stroke Back Massage and Slow Deep Breathing Exercise is associated with transient reductions in systolic blood pressure and pulse rate in an acute ischemic stroke patient with hypertension. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Audryan Putra Santoso; I Wayan Sudarta; Asung Joko Sulistyo

doi:10.67307/ijmahs.v1i1.122

July 14, 2026Immortalis Journal of Medical and Allied Health SciencesOpen Access

Implementation of Combined Slow Stroke Back Massage and Slow Deep Breathing Exercise in a Patient with Ischemic Stroke and Hypertension: A Case Report

View Full Paper

Ask AI

Bookmark

Share

Key result

Combined back massage and deep breathing reduces systolic blood pressure by ~8 mmHg in ischemic stroke.

n=1

Why the study?

Evidence regarding the combined application of Slow Stroke Back Massage and Slow Deep Breathing Exercise for blood pressure management in acute ischemic stroke settings remains limited.

Does combined Slow Stroke Back Massage and Slow Deep Breathing Exercise reduce blood pressure in a patient with acute ischemic stroke and hypertension?

Key Points

Describe the implementation and observe blood pressure changes following combined Slow Stroke Back Massage and Slow Deep Breathing Exercise in a patient with ischemic stroke and hypertension.
Single-patient case study conducted in the Emergency Department of Bethesda Hospital Yogyakarta.
One patient (N=1) with acute ischemic stroke and elevated blood pressure received the combined non-pharmacological nursing intervention.
Vital signs were recorded prior to intervention (07:46 WIB) and at three post-intervention intervals spaced 15 minutes apart (08:30, 08:45, and 09:00 WIB).
Pre-intervention vital signs showed a blood pressure of 195/106 mmHg, a mean arterial pressure of 136 mmHg, and a pulse rate of 107 x/m.
Post-intervention blood pressure fluctuated at 207/100 mmHg (pulse 102 x/m) and 206/108 mmHg (pulse 106 x/m), before decreasing to 187/103 mmHg (pulse 100 x/m) at the final assessment.
Respiratory rate (20 x/m), body temperature (36.1°C to 36.6°C), and oxygen saturation (97% to 99%) remained relatively stable throughout the observation period.

Study Design

Type

Case Report (n=1)

Blinding

Open-label

Multicenter

No

Structured PICO

Does combined Slow Stroke Back Massage and Slow Deep Breathing Exercise reduce blood pressure in a patient with acute ischemic stroke and hypertension?

P

Population

1 cooperative male patient with ischemic stroke and blood pressure > 140/90 mmHg in the Emergency Department of Bethesda Hospital Yogyakarta, observed over 74 minutes.

I

Intervention

Combined Slow Stroke Back Massage (gentle, slow, rhythmic, and repetitive bilateral stroking movements from the sacral region to the cervical area along the spinal column for approximately 3–10 minutes) and Slow Deep Breathing Exercise (controlled slow and deep respiration at fewer than 10 breaths per minute with a prolonged exhalation phase).

O

Outcome

Changes in blood pressure (systolic and diastolic blood pressure) measured via calibrated sphygmomanometer before the intervention (at 07:46 WIB) and at three post-intervention observations at 15-minute intervals (08:30, 08:45, and 09:00 WIB).surrogate

Main Result

Absolute Event Rate: 187% vs 195%

In a single patient with acute ischemic stroke and hypertension, combined Slow Stroke Back Massage and Slow Deep Breathing Exercise was followed by initial blood pressure fluctuations and a subsequent modest reduction in blood pressure and heart rate, requiring controlled trials to establish clinical efficacy.

Limitations

Single-case design involving only one patient
Short observation period
Lack of a control group
Confounding factors such as straining during urination, hospitalization anxiety, and family emotional support
Single-case design (involved only one patient)
Lack of a controlled design
Blood pressure changes may have been influenced by confounding factors including prolonged straining during urination, psychological stress/anxiety, emotional support from family, disease progression, and concurrent medical management

Ask about this paper

Answers are grounded in this paper and cite their sources.

Implication

Modest BP reduction in one acute stroke case does not support practice change; leaves open efficacy pending randomized trials.

Abstract

Ischemic stroke is commonly associated with hypertension, which may contribute to impaired cerebral perfusion and increased risk of complications. Non-pharmacological nursing interventions based on relaxation techniques may provide complementary support for blood pressure management, however, evidence regarding the combined application of Slow Stroke Back Massage and Slow Deep Breathing Exercise in acute stroke settings remains limited. This case study aimed to describe the implementation and observed changes in blood pressure following the application of combined Slow Stroke Back Massage and Slow Deep Breathing Exercise in a patient with ischemic stroke and hypertension. A case study was conducted in the Emergency Department of Bethesda Hospital Yogyakarta. One patient with ischemic stroke and elevated blood pressure received the combined intervention, and changes in vital signs were monitored before and after the intervention. Before the intervention, the patient's blood pressure was 195/106 mmHg with a mean arterial pressure of 136 mmHg. Post-intervention observations showed fluctuations in blood pressure, with measurements of 207/100 mmHg, 206/108 mmHg, and 187/103 mmHg, respectively. The final assessment demonstrated a reduction in systolic blood pressure accompanied by a decrease in pulse rate, while other vital signs remained stable. The application of combined Slow Stroke Back Massage and Slow Deep Breathing Exercise was accompanied by observed changes in blood pressure in this patient with ischemic stroke and hypertension. Further studies with larger samples and controlled designs are required to evaluate its clinical effectiveness.

Discussion

No takes yet. Share an insight, caveat, or question.

Cite This Study

Santoso et al. (2026) conducted a case report in Ischemic stroke and hypertension (n=1). Combined Slow Stroke Back Massage (SSBM) and Slow Deep Breathing Exercise (SDBE) vs. Pre-intervention baseline was evaluated on Systolic blood pressure (mmHg). Combined Slow Stroke Back Massage and Slow Deep Breathing Exercise reduced blood pressure from 195/106 mmHg pre-intervention to 187/103 mmHg at final assessment in a patient with ischemic stroke.

synapsesocial.com/papers/6af0dba03c845ca7837ced8a https://doi.org/10.67307/ijmahs.v1i1.122

View Full Paper

Ask AI

Bookmark

Share

Implementation of Combined Slow Stroke Back Massage and Slow Deep Breathing Exercise in a Patient with Ischemic Stroke and Hypertension: A Case Report

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Implementation of Combined Slow Stroke Back Massage and Slow Deep Breathing Exercise in a Patient with Ischemic Stroke and Hypertension: A Case Report

Key Points

Study Design

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Keep reading

Keep reading