Authors (including presenting author) :
CHAN YYR (1), NG WY (1), WONG YSF (1), LAW KW (2), KAN WS (2), YUEN SY (3), LEUNG KC (1)
Affiliation :
(1) Department of Medicine & Rehabilitation, Tung Wah Eastern Hospital
(2) Department of Ophthalmology, Tung Wah Eastern Hospital
(3) Nursing Services Division, Tung Wah Eastern Hospital
Keyword 1: :
Buerger Allen Exercise
Keyword 2: :
Diabetes Mellitus
Keyword 3: :
Lower Limb Circulation
Keyword 4: :
Ankle Brachial Pressure Index
Introduction :
Diabetes Mellitus (DM) is a significant public health challenge in Hong Kong. Complications like peripheral vascular disease (PVD) and diabetic neuropathy significantly impair lower limb circulation, contributing to increased morbidity and healthcare costs. Enhancing peripheral circulation in patients with DM is crucial. Exercise like Buerger Allen Exercise (BAE) can improve lower limb circulation. This EBP project aims to evaluate the efficacy of BAE.
Objectives :
•Evaluate the efficacy of Buerger Allen Exercise (BAE) in enhancing lower limb circulation in Type II Diabetes Mellitus (T2DM) patients
•Increase in Ankle Brachial Index (ABI) of 10% over baseline measurements
•Increase lower limb sensation and decrease self-reported lower limb discomfort
•Improve in HbA1C level
Methodology :
The study employed a quantitative, prospective, one-group quasi-experimental design and recruited 30 outpatients. Participants performed BAE three times daily for 14 days, with support from diabetes nurses’ education and provided with educational materials, including an information leaflet and a QR code linking to a training video. Pre- and post-intervention assessments included ABI measurements to evaluate peripheral vascular status, Vibration Perception Threshold (VPT) tests to assess sensory function, as well as subjective evaluations of lower limbs discomfort and HbA1C levels.
Result & Outcome :
Although the study did not achieve statistically significant improvements in ABI values, there were trends toward improvement in post-intervention ABI measurements. 20% of participants showed improved ABI values, while 78% maintained consistent ABI values. When ABI values were categorized as normal or abnormal ranks, results approached significance (P = 0.059). There was a statistically significant reduction in VPT levels in the right leg (p = 0.003), indicating improved sensory function. Furthermore, longer duration of diabetes and older age were negatively correlated with post-ABI values (r = -0.491, p = 0.006), whereas higher education was protective (r = -0.364, p = 0.048). Patient-reported lower-limb discomfort indicated reduced claudication and rest pain, accompanied by high compliance with BAE. Moreover, six months after the intervention, HbA1c levels showed a statistically significant mean reduction of 0.35 (p < 0.001). BAE is a safe and effective intervention for improving lower-limb circulation and enhancing quality of life in diabetes. Exercise intervention is significant for improving patient outcomes and preventing diabetes-related complications. Integrating BAE into standard intervention for T2DM patients, along with tailored education should be explored. Public health initiatives should focus on promoting exercise, education, early detection, and empowering patients to take an active role in their self-care.
