Allen exercise buerger combinations and SPA against brachial index ankle in DM type II patients outreach in poly disease in RSUD Dr. R. Goeteng Taroenadibrata Purbalingga
Corresponding Author(s) : Dwi Agus Yulianto
ydwiagus@ymail.com
International Journal of Allied Medical Sciences and Clinical Research,
Vol. 8 No. 2 (2020): 2020 Volume 8- Issue -2
Abstract
Background
Uncontrolled blood sugar levels in diabetes mellitus can cause vascular complications. The peripheral vascular disease causes a decrease in blood flow to the lower extremity which is characterized by a decrease in the ankle-brachial index (ABI).
Objectives
This study aims to determine the effect of the combination of Allen exercise Buerger and SPA on the ankle-brachial index value in type II DM patients.
Research methods
This study used a quasi-experimental design with a non-equivalent pre-test post-test design with a control group with a sample of 38 diabetics with purposive sampling, divided into 2 treatment and control groups. Respondents in the treatment group were given intervention Buerger Allen exercise and SPA 6 times 2 times every week for 3 weeks. ABI measurements were performed 4 times.
Result
Data from the measurement of ABI values are in the form of ratios. Tested statistically by the Friedman test with the Wilcoxon test. Based on statistical tests obtained p-value brachial ankle index 0,000 (p<0.05). This shows that there is a significant effect of statistically significant changes in the value of the ankle-brachial index after the intervention in the control group. Wilcoxon results for each comparison are less than 0.05 (p <0.05). It can be concluded that differences are found in all measurements.
Conclusion
There is an increase in the ABI after being given a combination of allen exercise and spa buerger action duration 2 times per week for a period of 3 weeks.
Keywords
Ankle-brachial index
Buerger Allen Exercise
SPA
Type II diabetes mellitus
1.
Dwi Agus Yulianto. Allen exercise buerger combinations and SPA against brachial index ankle in DM type II patients outreach in poly disease in RSUD Dr. R. Goeteng Taroenadibrata Purbalingga. Int. J. of Allied Med. Sci. and Clin. Res. [Internet]. 2020 Aug. 15 [cited 2025 Sep. 21];8(2):351-8. Available from: https://ijamscr.com/ijamscr/article/view/872
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References
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[1]. Supriyadi Sri Nabawiyati NM, Novita KS. The Effect of Buerger Allen Exercise on Ankle Brachiale Index and Blood Sugar Levels when Type 2 Diabetes Mellitus sufferers in the Nganjuk District Health Center. repositoryumyacid. 2017 MKep UMY
[2]. Yunita S. Treatment of Diabetes Wounds. Yogyakarta: Graha Science; 2015
[3]. Tabatabaei-Malazy O, Fakhrzadeh H, Sharifi F, Mirarefin M, Arzaghi SM, Badamchizadeh Z, et al. Effects of metabolic control on oxidative stress, subclinical atherosclerosis and peripheral artery disease in diabetes patients. Journal of Diabetes & Metabolic Disorders. 14(1), 2015, 84.
[4]. Thakur P, Sharma K. A Study to Assess the Effectiveness of Buerger Allen Exercise in Improving the Peripheral Circulation among Patients with Diabetes Mellitus Admitted in Sharda Hospital, Greater Noida. International Journal of Nursing Education. 11(2), 2019.
[5]. Li X, Hirokawa M, Inoue Y, Sugano N, Qian S, Iwai T. Effects of acupressure on lower limb blood flow for the treatment of peripheral arterial occlusive diseases. Surgery Today. 37(2), 2007, 103-8
[6]. Black JMH, JH Surgical Medical Nursing: Clinical Management for the expected results. Jakarta: Salemba Medika; 2014.
[7]. Kohlman-Trigoboff D. Management of lower extremity peripheral arterial disease: interpreting the latest guidelines for nurse practitioners. The Journal for Nurse Practitioners. 9(10), 2013, 653-60.
[8]. Sari A, Sofiani Y. Effectiveness Comparison of Buerger Allen Exercise and Foot Gymnastics against ABI Values in Type II DM Patients. Journal of Telenursing (Joting). 1(1), 2019, 1-16
[9]. Sari A, Sofiani Y. Efektifitas Perbandingan Buerger Allen Exercise dan Senam Kaki terhadap Nilai ABI pada Penderita DM Tipe II. Journal of Telenursing (Joting). 1(1), 2019, 1-16.
[10]. Indriyani P, Supriyatno H, Santoso A. Effect of physical exercise; aerobic exercise on reducing blood sugar levels in patients with type 2 diabetes in the Bukateja Purbalingga health center. Nurse Media Journal of Nursing. 1(2), 2010.
[11]. Fitri Y, Mulyani NS, Fitrianingsih E, Suryana S. The Effect of Giving Physical Activity (Aerobic Exercise) on Blood Pressure, BMI and RLPP in Obese Women. Actions: Aceh Nutrition Journal. 1(2), 2016, 105-10.
[12]. Aalaa M, Malazy OT, Sanjari M, Peimani M, Mohajeri-Tehrani M. Nurses' role in diabetes foot prevention and care; a review. Journal of Diabetes & Metabolic Disorders. 11(1), 2012, 24
[13]. Chang CF, Chang CC, Hwang, SL, & Chen, MY Effects of burger exercise combined health promoting programs on peripheral neurovascular stimulation among community residents at high risk for diabetic foot ulceration. Worddviews on Evidence-Based Nursing. 12(3), 2015, 145-53
[14]. Aruna S, Thenmozhi P. Effectiveness of allen buerger exercise in preventing peripheral arterial disease among people with type ii diabetes mellitus. International Journal of Pharma and Bio Sciences. 6(2), 2015, 966-70
[15]. Suyanto S. The Influence Of Spa Therapy And Diabetic Foot Exercise On Diabetic Peripheral Neuropathy Patients. Nurscope: Journal of Nursing Scientific Research and Thought. 3(2), 2017, 29-37.
[16]. Hoekstra SP, Bishop NC, Faulkner SH, Bailey SJ, Leicht CA. Acute and chronic effects of hot water immersion on inflammation and metabolism in sedentary, overweight adults. Journal of Applied Physiology. 125(12), 2018, 2008-18
[17]. Chang CF, Chang CC, MY Chen. Effect of Buerger's exercises on improving peripheral circulation: A systematic review. Open journal of nursing. 5(02), 2015, 120.
[18]. Pebrianti S. Buerger allen exercise and ankle brachial index (abi) in patients with diabetic foot ulcers in RSU DR. Slamet Garut. Indonesian Journal of Nursing Sciences and Practice. 1(1), 2018.
[19]. Yahya N. Healthy Living with Diabetes. Solo: PT Tiga Serangkai Pustaka Mandiri; 2018
[20]. Taharuddin T. Effectiveness of the Implementation of a Structured Discharge Planning Conservation Model against Changes in Wound Degrees and Blood Glucose Levels in Diabetic Ulcer Patients. Care: Scientific Journal of Health Sciences. 5(3), 2017, 403-17.
[21]. Anani S. Relationship between Diabetes Control Behavior and Blood Glucose Levels in Diabetes Mellitus Outpatients (Case Study in Arjawinangun District Hospital Cirebon District). Journal of Public Health, Diponegoro University. 1(2), 2012, 18753.
[22]. Affiani R, Astuti P. Effectiveness of diabetic foot spa on peripheral blood circulation in patients with type 2 diabetes mellitus in the working area of the Wonokromo Health Center in Surabaya. Journal of Health Sciences. 10(1), 2017.
[23]. Guanopatin Freire SK. Ejercicios de buerguer allen en pacientes de 40 a 70 años que present venas varicosas grado 1 y 2 que acuden al centro eco-laser de varices y úlceras e Instituto de Trombosis Benalcázar en la ciudad de Latacunga: Universidad Técnica de Ambato-Facultad de Ciencias He Salud-Carrera de.; 2015
[24]. Djafar RH, Nur BM, Azzam R. Effectiveness of Diabetic Foot Spa on Ankle Brachial Index Values in Type II Diabetes Mellitus Patients. Silampari Nursing Journal. 3(1), 2019, 312-21.
[25]. Suandika M. The effect of warm foot baths on increasing peripheral blood circulation is seen from the value of the ankle brachial index (ABI) in patients with diabetes mellitus in Purwojati village, Purwojati sub-district. Medisains. 14(1), 2016.
References
[1]. Supriyadi Sri Nabawiyati NM, Novita KS. The Effect of Buerger Allen Exercise on Ankle Brachiale Index and Blood Sugar Levels when Type 2 Diabetes Mellitus sufferers in the Nganjuk District Health Center. repositoryumyacid. 2017 MKep UMY
[2]. Yunita S. Treatment of Diabetes Wounds. Yogyakarta: Graha Science; 2015
[3]. Tabatabaei-Malazy O, Fakhrzadeh H, Sharifi F, Mirarefin M, Arzaghi SM, Badamchizadeh Z, et al. Effects of metabolic control on oxidative stress, subclinical atherosclerosis and peripheral artery disease in diabetes patients. Journal of Diabetes & Metabolic Disorders. 14(1), 2015, 84.
[4]. Thakur P, Sharma K. A Study to Assess the Effectiveness of Buerger Allen Exercise in Improving the Peripheral Circulation among Patients with Diabetes Mellitus Admitted in Sharda Hospital, Greater Noida. International Journal of Nursing Education. 11(2), 2019.
[5]. Li X, Hirokawa M, Inoue Y, Sugano N, Qian S, Iwai T. Effects of acupressure on lower limb blood flow for the treatment of peripheral arterial occlusive diseases. Surgery Today. 37(2), 2007, 103-8
[6]. Black JMH, JH Surgical Medical Nursing: Clinical Management for the expected results. Jakarta: Salemba Medika; 2014.
[7]. Kohlman-Trigoboff D. Management of lower extremity peripheral arterial disease: interpreting the latest guidelines for nurse practitioners. The Journal for Nurse Practitioners. 9(10), 2013, 653-60.
[8]. Sari A, Sofiani Y. Effectiveness Comparison of Buerger Allen Exercise and Foot Gymnastics against ABI Values in Type II DM Patients. Journal of Telenursing (Joting). 1(1), 2019, 1-16
[9]. Sari A, Sofiani Y. Efektifitas Perbandingan Buerger Allen Exercise dan Senam Kaki terhadap Nilai ABI pada Penderita DM Tipe II. Journal of Telenursing (Joting). 1(1), 2019, 1-16.
[10]. Indriyani P, Supriyatno H, Santoso A. Effect of physical exercise; aerobic exercise on reducing blood sugar levels in patients with type 2 diabetes in the Bukateja Purbalingga health center. Nurse Media Journal of Nursing. 1(2), 2010.
[11]. Fitri Y, Mulyani NS, Fitrianingsih E, Suryana S. The Effect of Giving Physical Activity (Aerobic Exercise) on Blood Pressure, BMI and RLPP in Obese Women. Actions: Aceh Nutrition Journal. 1(2), 2016, 105-10.
[12]. Aalaa M, Malazy OT, Sanjari M, Peimani M, Mohajeri-Tehrani M. Nurses' role in diabetes foot prevention and care; a review. Journal of Diabetes & Metabolic Disorders. 11(1), 2012, 24
[13]. Chang CF, Chang CC, Hwang, SL, & Chen, MY Effects of burger exercise combined health promoting programs on peripheral neurovascular stimulation among community residents at high risk for diabetic foot ulceration. Worddviews on Evidence-Based Nursing. 12(3), 2015, 145-53
[14]. Aruna S, Thenmozhi P. Effectiveness of allen buerger exercise in preventing peripheral arterial disease among people with type ii diabetes mellitus. International Journal of Pharma and Bio Sciences. 6(2), 2015, 966-70
[15]. Suyanto S. The Influence Of Spa Therapy And Diabetic Foot Exercise On Diabetic Peripheral Neuropathy Patients. Nurscope: Journal of Nursing Scientific Research and Thought. 3(2), 2017, 29-37.
[16]. Hoekstra SP, Bishop NC, Faulkner SH, Bailey SJ, Leicht CA. Acute and chronic effects of hot water immersion on inflammation and metabolism in sedentary, overweight adults. Journal of Applied Physiology. 125(12), 2018, 2008-18
[17]. Chang CF, Chang CC, MY Chen. Effect of Buerger's exercises on improving peripheral circulation: A systematic review. Open journal of nursing. 5(02), 2015, 120.
[18]. Pebrianti S. Buerger allen exercise and ankle brachial index (abi) in patients with diabetic foot ulcers in RSU DR. Slamet Garut. Indonesian Journal of Nursing Sciences and Practice. 1(1), 2018.
[19]. Yahya N. Healthy Living with Diabetes. Solo: PT Tiga Serangkai Pustaka Mandiri; 2018
[20]. Taharuddin T. Effectiveness of the Implementation of a Structured Discharge Planning Conservation Model against Changes in Wound Degrees and Blood Glucose Levels in Diabetic Ulcer Patients. Care: Scientific Journal of Health Sciences. 5(3), 2017, 403-17.
[21]. Anani S. Relationship between Diabetes Control Behavior and Blood Glucose Levels in Diabetes Mellitus Outpatients (Case Study in Arjawinangun District Hospital Cirebon District). Journal of Public Health, Diponegoro University. 1(2), 2012, 18753.
[22]. Affiani R, Astuti P. Effectiveness of diabetic foot spa on peripheral blood circulation in patients with type 2 diabetes mellitus in the working area of the Wonokromo Health Center in Surabaya. Journal of Health Sciences. 10(1), 2017.
[23]. Guanopatin Freire SK. Ejercicios de buerguer allen en pacientes de 40 a 70 años que present venas varicosas grado 1 y 2 que acuden al centro eco-laser de varices y úlceras e Instituto de Trombosis Benalcázar en la ciudad de Latacunga: Universidad Técnica de Ambato-Facultad de Ciencias He Salud-Carrera de.; 2015
[24]. Djafar RH, Nur BM, Azzam R. Effectiveness of Diabetic Foot Spa on Ankle Brachial Index Values in Type II Diabetes Mellitus Patients. Silampari Nursing Journal. 3(1), 2019, 312-21.
[25]. Suandika M. The effect of warm foot baths on increasing peripheral blood circulation is seen from the value of the ankle brachial index (ABI) in patients with diabetes mellitus in Purwojati village, Purwojati sub-district. Medisains. 14(1), 2016.
[2]. Yunita S. Treatment of Diabetes Wounds. Yogyakarta: Graha Science; 2015
[3]. Tabatabaei-Malazy O, Fakhrzadeh H, Sharifi F, Mirarefin M, Arzaghi SM, Badamchizadeh Z, et al. Effects of metabolic control on oxidative stress, subclinical atherosclerosis and peripheral artery disease in diabetes patients. Journal of Diabetes & Metabolic Disorders. 14(1), 2015, 84.
[4]. Thakur P, Sharma K. A Study to Assess the Effectiveness of Buerger Allen Exercise in Improving the Peripheral Circulation among Patients with Diabetes Mellitus Admitted in Sharda Hospital, Greater Noida. International Journal of Nursing Education. 11(2), 2019.
[5]. Li X, Hirokawa M, Inoue Y, Sugano N, Qian S, Iwai T. Effects of acupressure on lower limb blood flow for the treatment of peripheral arterial occlusive diseases. Surgery Today. 37(2), 2007, 103-8
[6]. Black JMH, JH Surgical Medical Nursing: Clinical Management for the expected results. Jakarta: Salemba Medika; 2014.
[7]. Kohlman-Trigoboff D. Management of lower extremity peripheral arterial disease: interpreting the latest guidelines for nurse practitioners. The Journal for Nurse Practitioners. 9(10), 2013, 653-60.
[8]. Sari A, Sofiani Y. Effectiveness Comparison of Buerger Allen Exercise and Foot Gymnastics against ABI Values in Type II DM Patients. Journal of Telenursing (Joting). 1(1), 2019, 1-16
[9]. Sari A, Sofiani Y. Efektifitas Perbandingan Buerger Allen Exercise dan Senam Kaki terhadap Nilai ABI pada Penderita DM Tipe II. Journal of Telenursing (Joting). 1(1), 2019, 1-16.
[10]. Indriyani P, Supriyatno H, Santoso A. Effect of physical exercise; aerobic exercise on reducing blood sugar levels in patients with type 2 diabetes in the Bukateja Purbalingga health center. Nurse Media Journal of Nursing. 1(2), 2010.
[11]. Fitri Y, Mulyani NS, Fitrianingsih E, Suryana S. The Effect of Giving Physical Activity (Aerobic Exercise) on Blood Pressure, BMI and RLPP in Obese Women. Actions: Aceh Nutrition Journal. 1(2), 2016, 105-10.
[12]. Aalaa M, Malazy OT, Sanjari M, Peimani M, Mohajeri-Tehrani M. Nurses' role in diabetes foot prevention and care; a review. Journal of Diabetes & Metabolic Disorders. 11(1), 2012, 24
[13]. Chang CF, Chang CC, Hwang, SL, & Chen, MY Effects of burger exercise combined health promoting programs on peripheral neurovascular stimulation among community residents at high risk for diabetic foot ulceration. Worddviews on Evidence-Based Nursing. 12(3), 2015, 145-53
[14]. Aruna S, Thenmozhi P. Effectiveness of allen buerger exercise in preventing peripheral arterial disease among people with type ii diabetes mellitus. International Journal of Pharma and Bio Sciences. 6(2), 2015, 966-70
[15]. Suyanto S. The Influence Of Spa Therapy And Diabetic Foot Exercise On Diabetic Peripheral Neuropathy Patients. Nurscope: Journal of Nursing Scientific Research and Thought. 3(2), 2017, 29-37.
[16]. Hoekstra SP, Bishop NC, Faulkner SH, Bailey SJ, Leicht CA. Acute and chronic effects of hot water immersion on inflammation and metabolism in sedentary, overweight adults. Journal of Applied Physiology. 125(12), 2018, 2008-18
[17]. Chang CF, Chang CC, MY Chen. Effect of Buerger's exercises on improving peripheral circulation: A systematic review. Open journal of nursing. 5(02), 2015, 120.
[18]. Pebrianti S. Buerger allen exercise and ankle brachial index (abi) in patients with diabetic foot ulcers in RSU DR. Slamet Garut. Indonesian Journal of Nursing Sciences and Practice. 1(1), 2018.
[19]. Yahya N. Healthy Living with Diabetes. Solo: PT Tiga Serangkai Pustaka Mandiri; 2018
[20]. Taharuddin T. Effectiveness of the Implementation of a Structured Discharge Planning Conservation Model against Changes in Wound Degrees and Blood Glucose Levels in Diabetic Ulcer Patients. Care: Scientific Journal of Health Sciences. 5(3), 2017, 403-17.
[21]. Anani S. Relationship between Diabetes Control Behavior and Blood Glucose Levels in Diabetes Mellitus Outpatients (Case Study in Arjawinangun District Hospital Cirebon District). Journal of Public Health, Diponegoro University. 1(2), 2012, 18753.
[22]. Affiani R, Astuti P. Effectiveness of diabetic foot spa on peripheral blood circulation in patients with type 2 diabetes mellitus in the working area of the Wonokromo Health Center in Surabaya. Journal of Health Sciences. 10(1), 2017.
[23]. Guanopatin Freire SK. Ejercicios de buerguer allen en pacientes de 40 a 70 años que present venas varicosas grado 1 y 2 que acuden al centro eco-laser de varices y úlceras e Instituto de Trombosis Benalcázar en la ciudad de Latacunga: Universidad Técnica de Ambato-Facultad de Ciencias He Salud-Carrera de.; 2015
[24]. Djafar RH, Nur BM, Azzam R. Effectiveness of Diabetic Foot Spa on Ankle Brachial Index Values in Type II Diabetes Mellitus Patients. Silampari Nursing Journal. 3(1), 2019, 312-21.
[25]. Suandika M. The effect of warm foot baths on increasing peripheral blood circulation is seen from the value of the ankle brachial index (ABI) in patients with diabetes mellitus in Purwojati village, Purwojati sub-district. Medisains. 14(1), 2016.