The The Effect of Buerger Allen Exercise on Peripheral Tissue Perfusion in Patients with Type 2 Diabetes Mellitus: A Literature Review
DOI:
https://doi.org/10.33755/jkk.v12i1.945Keywords:
Ankle Brachial Index, Buerger Allen Exercise, Peripheral Perfusion, Type 2 Diabetes MellitusAbstract
Background: Type 2 diabetes mellitus is a chronic metabolic disorder characterized by persistent hyperglycemia due to impaired insulin secretion and/or insulin resistance. One of the most common long-term complications is impaired peripheral tissue perfusion of the lower extremities, which can progress to diabetic foot ulcers and significantly increase the risk of amputation. Consequently, identifying effective and accessible non-pharmacological interventions to improve peripheral circulation is crucial.
Objective: This literature review aimed to evaluate the effectiveness of Buerger Allen Exercise (BAE) in improving peripheral tissue perfusion among patients with type 2 diabetes mellitus.
Methods: A literature review was conducted using Google Scholar, PubMed, ScienceDirect, ProQuest, and Elsevier databases. Articles published between 2016 and 2024 were identified using the keywords “Buerger Allen Exercise,” “BAE,” “Type 2 Diabetes Mellitus,” “Peripheral Perfusion,” and “Ankle Brachial Index,” combined with Boolean operators “AND” and “OR.” Inclusion criteria comprised intervention studies published in English or Indonesian that reported outcomes related to peripheral perfusion.
Results: Ten studies met the inclusion criteria. Overall, BAE was associated with significant improvements in peripheral perfusion, evidenced by increased Ankle Brachial Index values, improved capillary refill time, enhanced skin temperature and color, strengthened peripheral pulses, and reduced lower extremity pain. Several studies also reported greater benefits when BAE was combined with adjunctive interventions such as vitamin C supplementation, foot spa therapy, or music therapy.
Conclusion: Buerger Allen Exercise is a low-cost, feasible, and evidence-supported non-pharmacological intervention that effectively enhances peripheral tissue perfusion in patients with type 2 diabetes mellitus and may help prevent vascular complications and improve patient well-being.
References
1. PERKENI. Pedoman pengelolaan dan pencegahan diabetes melitus tipe 2 di Indonesia. Perkumpulan Endokrinologi Indonesia. 2021;
2. Nadrati, B., & Supriatna D. Buerger Allen exercise and Ankle Brachial Index (ABI) in patients with diabetes mellitus. Jakarta: Penerbit NEM; 2021.
3. Efendi M, Hartini S, Lestari T. Hubungan neuropati perifer dengan risiko ulkus diabetikum pada pasien diabetes melitus tipe 2. Jurnal Keperawatan dan Kesehatan Masyarakat. 2020;9(2):100–8.
4. (WHO) WHO. Global Report on Diabetes. World Health Organization. 2021.
5. (IDF) IDF. IDF Diabetes Atlas (10 ed.). Brussels: International Diabetes Federation; 2021.
6. Riskesdas. Laporan hasil riset kesehatan dasar tahun 2018. Badan Penelitian dan Pengembangan Kesehatan, Kementerian Kesehatan Republik Indonesia; 2018.
7. Setiyorini, E., & Wulandari NA. Hubungan Status Nutrisi dengan Kualitas Hidup pada Lansia Penderita Diabetes Mellitus Tipe 2 yang Berobat di Poli Penyakit Dalam RSD Mardi Waluyo Blitar. Jurnal Ners dan Kebidanan (Journal of Ners and Midwifery). 2017;4(2):125–33.
8. Smeltzer, S. C., Bare, B. G., Hinkle, J. L., & Cheever KH. runner & Suddarth’s textbook of medical-surgical nursing (12th ed.). Lippincott Williams & Wilkins; 2010.
9. Rosyid FN, Hudiawati D, Kristinawati B. Peningkatan pengetahuan dan upaya pencegahan diabetes melitus melalui pendidikan kesehatan. J-ADIMAS (Jurnal Pengabdian Kepada Masyarakat). 2019;7 (2):91–4.
10. Puspasari S, Hardiani I. The Effectiveness of Audio-Visual-Based Education on Type 2 Diabetes Mellitus in Enhancing Self-Awareness Among Adolescents at Risk: A Quasi-Experimental Study. Jurnal Keperawatan Komprehensif (Comprehensive Nursing Journal). 2025;11(1):133–40.
11. Dewi R, Rahayu N, Sanjaya W, Arsyi DN, Budhiana J. The Effect of Health Education on Diet Compliance Among Patients with Diabetes Mellitus in the Sukaraja Public Health Center’s Work Area in Sukabumi Regency. Jurnal Keperawatan Komprehensif (Comprehensive Nursing Journal). 2022;8(Special Edition).
12. Radhika J, Poomalai G, Nalini SJ, Revathi R. Efektifitas latihan Buerger allen exercise terhadap perfusiekstremitas bawah dan gejala neuropati perifer pada pasien diabetes melitus. Iranian Journal of Nursing and Midwifery Research. 2020;25(4):291–5.
13. Chang CC, Chen MY, Shen JH, Lin Y Bin, Hsu WW, Lin BS. A quantitative real-time assessment of Buerger exercise on dorsal foot peripheral skin circulation in patients with diabetes foot. Medicine (United States). 2016;95(46):1–5.
14. Jannaim J, Dharmajaya R, Asrizal A. Pengaruh Buerger Allen Exercise Terhadap Sirkulasi Ektremitas Bawah Pada Pasien Luka Kaki Diabetik. Jurnal Keperawatan Indonesia. 2018;21(2):101–8.
15. Wahyuni, N. T., Herlina, L., Abdurakhman, R. N., Hidayat, A., & Supriyadi C. Implementation of Buerger Allen Exercise in patients with DM type II to improve lower extremity circulation. World Journal of Advanced Research and Reviews. 2022;14(1):573–9.
16. Shirley Prakash, Porkodi Arjunan, Gladys, Dhanya K Chandran. Effect of Buerger Allen Exercise on Lower Limb Tissue Perfusion among Patients with Type 2 Diabetes Mellitus. Indian Journal of Public Health Research & Development. 2022;13(2):144–50.
17. Adel Ebada El Sayed R, Nabil Abd Elsalam S, Mohamed Elmetwaly R. Effect of Buerger-Allen exercise on lower extremities perfusion among patients with type 2 diabetes mellitus. Egyptian Journal of Health Care. 2021;12(2):555–72.
18. Rushdy I, Fahim EM, Heggy EH. Impact of buerger-allen exercises on foot perfusion and pain level for diabetic patients risk with peripheral arterial disease. Assiut Scientific Nursing Journal. 2021;9(24.0):170–81.
19. Permatasari ED, Rakhman A, Widodo YP, Setyaningrum I, Hidayat F. IMPACT OF BUERGER ALLEN EXERCISE ON ANKLE BRACHIAL INDEX IN TYPE II DIABETES MELLITUS PATIENTS. Jurnal Keperawatan. 2025;10(1):1–7.
20. Jannaim J, Dharmajaya R, Asrizal A. Pengaruh buerger allen exercise terhadap sirkulasi ektremitas bawah pada pasien luka kaki diabetik. Jurnal Keperawatan Indonesia. 2018;21(2):101–8.
21. Bhuvaneshwari S, Tamilselvi S. A study to assess the effectiveness of Buerger Allen exercise on lower extremity perfusion among patients with type 2 diabetes mellitus in Saveetha Medical College and Hospital in Chennai. International Journal for Advance Research and Development. 2018;3(9):15–20.
22. Digal PE. Effect of Buerger Allen exercise on lower extremity perfusion among patients with diabetes mellitus. Randomized clinical trial. Nurs J India. 2019;110(5):221–5.
