Play-based interventions for reducing blood pressure among older adults with hypertension: A narrative literature review
DOI: https://doi.org/10.33024/minh.v9i4.3213
Ball-Throwing Blood Pressure Hypertension Older Adults Play Therapy Puzzle
Abstract
Background: Hypertension is a common health problem among older adults and requires both pharmacological and non-pharmacological management. Play-based activities may provide cognitive, psychological, social, and physical benefits, but their effects on blood pressure remain unclear.
Purpose: To summarize evidence on play-based interventions and their potential effects on blood pressure and related health outcomes among older adults.
Method: A narrative literature review was conducted using Google Scholar, PubMed, and ScienceDirect. Studies published between 2018 and 2026 were screened using predefined eligibility criteria. Thirteen articles were included and synthesized descriptively.
Results: The majority of respondents had adequate knowledge (69%), negative attitudes (56%), and good management (78%). Bivariate testing showed a significant relationship between knowledge and management of primary dysmenorrhea (p = 0.027) and attitudes and management of primary dysmenorrhea (p = 0.000). The review results showed that most studies used pre-experimental and quasi-experimental designs. The types of play therapy found were puzzle games and ball throwing. Of the 13 articles, eight discussed puzzle therapy, with seven demonstrating effective results in improving cognitive function and reducing stress, and two articles demonstrating reduced blood pressure. Meanwhile, five articles discussed ball-throwing therapy, with four articles demonstrating increased physical activity and reduced anxiety, and two articles demonstrating reduced blood pressure. The instruments used included the MMSE, HARS, a sphygmomanometer, and observation sheets.
Conclusion: Play-based interventions may support cognitive, psychological, and physical well-being among older adults. However, current evidence is insufficient to confirm their effectiveness in reducing blood pressure, particularly for intergenerational interventions involving preschool children.
Downloads
References
Assjidiq, A., Purnama, A., Ristinawati, R., & Putri, S, R. (2026). The Effect Of Fishing Ball Therapy And Puzzle Therapy On Cognitive Function In Elderly Patients With Dementia At Club Bugar Ideal, Bojonggede District, Bogor Regency In 2025. International Journal of Health, Engineering and Technology, 5(1), 288-300.
Burnier, M., & Egan, B. M. (2019). Adherence in hypertension: a review of prevalence, risk factors, impact, and management. Circulation research, 124(7), 1124-1140.
Daeli, N. E., Pranata, L., Ajul, K., & Sukistini, A. S. (2022). Pendampingan lansia dalam meningkatkan fungsi kognitif dengan bermain puzzle. JCES (Journal of Character Education Society), 5(2), 403–407.
Domènech‐Abella, J., Mundó, J., Switsers, L., Van Tilburg, T., Fernández, D., & Aznar‐Lou, I. (2021). Social network size, loneliness, physical functioning and depressive symptoms among older adults: Examining reciprocal associations in four waves of the Longitudinal Aging Study Amsterdam (LASA). International journal of geriatric psychiatry, 36(10), 1541-1549.
Dunphy, K., Baker, F. A., Dumaresq, E., Carroll-Haskins, K., Eickholt, J., Ercole, M., & Wosch, T. (2019). Creative arts interventions to address depression in older adults: A systematic review of outcomes, processes, and mechanisms. Frontiers in psychology, 9, 2655.
Grassi, G., & Drager, L. F. (2024). Sympathetic overactivity, hypertension and cardiovascular disease: state of the art. Current medical research and opinion, 40(sup1), 5-13.
Hatmanti, N. M., & Yunita, A. (2019). Senam lansia dan terapi puzzle terhadap demensia pada lansia. Jurnal Keperawatan Muhammadiyah, 4(1), 104-107.
Isnaini, N., & Komsin, N. K. (2020). Gambaran fungsi kognitif pada lansia dengan pemberian terapi puzzle. Jurnal Human Care, 5(4), 1060-1066.
Lito, P., Gaharpung, M. S., Wega, M. O., Reong, A. R., Kekang, M. S. P., Bara, M. R., Bluden, M. N. L., & Nggato, K. R. (2022). Terapi Aktifitas Kelompok Melatih Stimulus Motorik: Bermain Lempar Tangkap Bola di Kecamatan Lela Desa Du-Kabupaten Sikka. Jurnal Peduli Masyarakat, 4(3), 527-532.
Ministry of Health of the Republic of Indonesia. (2023). Hipertensi Disebut sebagai Silent Killer, Menkes Budi Imbau Rutin Cek Tekanan Darah. Accessed from: https://kemkes.go.id/eng/%20hipertensi-disebut-sebagai-silent-killer-menkes-budi-imbau-rutin-cek-tekanan-darah
Manolis, A. A., Manolis, T. A., & Manolis, A. S. (2023). Neurohumoral activation in heart failure. International Journal of Molecular Sciences, 24(20), 15472.
Permatasari, L. I., & Nurapipah, M. (2024). Pengaruh Pemberian Chromotherapy (Terapi Warna) dan Permainan Puzzle Jigsaw O’Clock terhadap Fungsi Kognitif Lansia. Jurnal Keperawatan, 16(3), 1003-1012.
Sijabat, F., Siregar, R., & Purba, S. D. (2023). Bermain puzzle dalam meningkatkan fungsi kognitif lansia. Jurnal Abdimas Mutiara, 4(2), 56-59.
Simanullang, D. R., Pranata, L., & Manurung, A. (2024). Penerapan terapi puzzle untuk meningkatkan fungsi kognitif pada lansia di Panti Werdha Palembang. Vitamin: Jurnal Ilmu Kesehatan Umum, 2(3), 255–265.
Smith, T. N. (2022). Counseling self-efficacy in family play therapy telemental health services throughout the Covid-19 pandemic: A mixed method approach.
Sukesih, S., Suwarto, T., & Susilosari, P. (2021). The effectiveness of stress ball therapy to reduce anxiety level in COVID-19 patients in Pati, Central Java. In The International Conference on Public Health Proceeding (Vol. 6, No. 01, pp. 1116-1123).
Thuamthai, P., Phuttaraksa, T., Saengboon, N., & Suwanpasu, S. (2024). The effect of isometric handgrip exercise on blood pressure in the elderly with hypertension level 1. Journal of the Police Nurses and Health Science, 16(2), 408–418.
Tiocosby, J. M., Akram, N. Z., & Sartika, A. (2025). The Effect of Brain Game Puzzle Intervention on Cognitive Function in Elderly Residents at the Karawang Social Rehabilitation Center for the Elderly. Jurnal Keperawatan Dan Fisioterapi (JKF), 8(1), 56-62.
Utami, P. A. S., Sulistiowati, N. M. D., & Karin, P. A. E. S. (2021). The effect of creative arts therapy on stress level and blood pressure of the elderly with hypertension. J. Sustain. Glob. South, 5(11).
Ungar, A., Latini, E., Rivasi, G., & Mossello, E. (2025). Renin-angiotensin system inhibition and risk of dementia in hypertensive patients. An old dilemma. Age and Ageing, 54(6), afaf140.
Vorwerg-Gall, S., Stamm, O., Perotti, L., & Müller-Werdan, U. (2024). Efficacy of a 6-week VR exergame for older adults with essential hypertension: a randomized controlled pilot trial. Virtual Reality, 29(1), 1.
Wahyuningsih, T., & Aryanti, D. (2024). Terapi Bermain Puzzle untuk Meningkatkan Fungsi Kognitif Lansia. Jurnal Penelitian Kesehatan" SUARA FORIKES"(Journal of Health Research" Forikes Voice"), 15(3), 377-380.
World Health Organization. (2025). Uncontrolled high blood pressure puts over a billion people at risk. Accessed from: https://www.who.int/news/item/23-09-2025-uncontrolled-high-blood-pressure-puts-over-a-billion-people-at-risk
Yang, C., Zhu, S., Hui, Z., & Mo, Y. (2023). Psychosocial factors associated with medication burden among community-dwelling older people with multimorbidity. BMC geriatrics, 23(1), 741.
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Syarifah Ayni Harahap, Yufitriana Amir, Siti Rahmalia Hairani Damanik
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
