Effects of Buerger Exercise Combined Health‐Promoting Program on Peripheral Neurovasculopathy Among Community Residents at High Risk for Diabetic Foot Ulceration

Abstract

Peripheral neuropathy and vasculopathy are important risk factors for diabetic foot ulceration (DFU). Buerger exercises for patients with arterial occlusive disease have previously been noted; however, current evidence to support this intervention is limited. We established a standardized procedure for Buerger exercises combined with a health-promoting program and investigated its effectiveness in reducing peripheral neurovasculopathy among rural Taiwanese residents with type 2 diabetes who were at high risk of developing DFU. A one group quasi-experimental pretest-posttest design was used. The Buerger exercise protocol composed of a three-step posture change with 9 minutes for each cycle. The health-promoting program composed of six dimensions of healthy habits. Outcome measurements 1 year after the beginning of the intervention included the ankle brachial pressure index (ABI), the Michigan neuropathy screening instrument (MNSI), blood pressure, frequency of self-reported leg discomfort, and a type 2 Diabetes Health Promoting Score. Thirty-one of 66 (47%) subjects completed this study. Buerger exercises combined with the health-promoting program significantly improved (a) the ABI in the legs, (b) health-promoting behaviors, (c) MNSI values, and (d) leg discomfort symptoms. This study supports the use of Buerger exercises combined with the health-promoting program to improve symptoms of peripheral neuropathy and peripheral circulation in patients with type 2 diabetes.