Impact of Buerger-Allen Exercises on Peripheral Circulation in Hospitalized Patients with Type 2 Diabetes Mellitus: A Controlled Pretest–Posttest Study

Abstract

Background: This study investigated the effectiveness of Buerger-Allen exercises on lower extremity perfusion in hospitalized patients with type 2 diabetes mellitus, addressing the increased risk of peripheral arterial disease in this population. Materials and Methods: A true experimental, pretest-posttest repeated measures design with a control group (n=10 per group) was employed. Twenty patients were randomized, with the experimental group performing Buerger-Allen exercises three times daily for 15 days. Lower extremity perfusion was assessed at pretest and three post-tests (days 5, 10, 15) using a self-developed scale. Data were analyzed using repeated measures ANOVA and paired 't' tests. Results: At pretest, no significant difference in perfusion was observed between groups for either leg (Right Leg: F=0.802, p=0.440; Left Leg: F=0.802, p=0.440). Repeated measures ANOVA revealed significant main effects for Group (F=36.424, p=0.0001*) and Assessment (F=187.284, p=0.0001*), alongside a crucial significant interaction effect between Assessment and Group​​ (F=291.21, p=0.0001*), indicating differential changes over time between groups for both legs. For the experimental group, significant progressive improvements in perfusion scores were observed from pretest to all post-tests for both right (e.g., Pretest vs. Post Test 3: Mean Difference=9.30, t=10.391, p=0.0001*) and left legs (e.g., Pretest vs. Post Test 3: Mean Difference=9.30, t=10.391, p=0.0001*). In contrast, the control group showed no significant changes in perfusion scores across any time points for either leg (all p > 0.05). Post-hoc tests confirmed significant between-group differences at all post-test time points for both legs (e.g., Post-test III: Mean Difference=8.900, p=0.0001*). Conclusion: Buerger-Allen exercises significantly improved lower extremity perfusion in patients with type 2 diabetes mellitus, with the experimental group demonstrating substantial and progressive improvements compared to the control group for both right and left legs. While promising, the small sample size (n=20) necessitates cautious interpretation and calls for further research with larger cohorts.