EFFECTIVENESS OF BUERGER-ALLEN EXERCISES IN IMPROVING LOWER EXTREMITY PERFUSION AMONG PATIENTS WITH TYPE-2 DIABETES MELLITUS: A RANDOMIZED CONTROLLED TRIAL IN PUNJAB, INDIA

Abstract

Background: Type-2 diabetes mellitus (T2DM) is a progressive metabolic disorder frequently complicated by peripheral arterial disease (PAD), microvascular dysfunction, and diabetic foot, resulting in significant morbidity and healthcare costs. While pharmacological management of diabetes has been extensively studied, there is limited evidence on non-pharmacologic, nurse-led interventions that can improve lower limb perfusion.

Objective: To evaluate the effectiveness of Buerger-Allen exercises in improving lower extremity perfusion among hospitalized T2DM patients in Punjab, India.

Methods: A randomized controlled trial was conducted among 60 T2DM patients with ankle-brachial index (ABI) <1. Participants were randomly assigned to an intervention group (n=30), who performed Buerger-Allen exercises three times daily for three consecutive days, or a control group (n=30), who received standard diabetic care. Outcomes included ABI measurement and a clinical perfusion checklist (capillary refill time, peripheral pulses, skin color, temperature, and edema). Patient satisfaction was also assessed. Statistical analysis was performed using SPSS v21; significance was set at p < 0.05.

Results: The intervention group showed significantly higher mean ABI improvement (1.20 ± 0.25) compared to controls (0.94 ± 0.21; t=4.0, p<0.05). Clinical perfusion parameters also improved, including reduced capillary refill times, enhanced peripheral pulses, and normalized skin temperature. Patient satisfaction was high, with most expressing willingness to continue exercises post-discharge.

Conclusion: Buerger-Allen exercises are an effective, low-cost, and practical nursing intervention to enhance peripheral circulation in T2DM patients. When integrated into routine care, these exercises may prevent progression of diabetic foot complications.