Skip to main content Skip to main navigation menu Skip to site footer

Diabetic ulcers prevention in the elderly for improving blood circulation of lower extremities with combination foot exercise therapy and electrophysical therapy



Abstract

Background: Diabetic foot ulcer is one of the complications of diabetes. The intervention for diabetic foot examination is the Ankle Brachial Index (ABI). Decreased ABI scores indicate decreased peripheral blood circulation in the extremities. An increase in ABI can be done by combining foot exercise therapy with electrophysical therapy. This study aims to analyze ABI scores in patients with type II diabetes performing a foot exercise combined with electrophysical therapy.

Method: The research design is quasi-experimental, with a pretest-posttest comparison group used. The sampling method used was purposive sampling. A total of 120 respondents were divided into 2 groups: intervention and control. The intervention group was given diabetic foot exercises with a combination of electrophysical therapy, while the control group was given a standard intervention. The diabetic foot exercise was conducted daily in the morning for 4 weeks and lasted 20-30 minutes. Subsequently, the ABI score was assessed. Prior to the intervention, respondents’ ABI scores were measured. Data were analyzed using SPSS version 26.0 for Windows.

Result:  We found that an increase in the ABI score by 0.113 was statistically significant at a p-value <0.05. After a month of the initial state, the ABI score by 0.758, and the p-value shows significance at <0.05. In comparison, an increased ABI score was observed after a month of the first intervention. There was an increase in the ABI score by 0.654 (p<0.05).

Conclusion: Foot exercise therapy combined with electrophysical therapy was shown significantly increased repetitive muscle contractions and improve blood circulation, thus increasing the ABI score, which was ​​higher than the control group.

Keywords: Ankle-Brachial Index Electrophysical Therapy Leg Exercise

References

  1. Perkeni. Pedoman Pengelolaan dan Pencegahan Diabetes Melitus Tipe 2 Dewasa di Indonesia 2021. PB Perkeni. Jakarta: PB PERKENI; 2021:1–104.
  2. Chiu H, Tsai HJ, Huang JC, Wu PY, Hsu WH, Lee MY, et al. Associations between the triglyceride-glucose index and micro-and macro-angiopathies in type 2 diabetes mellitus. Nutrients. 2020;12(2):328.
  3. Damayanti S. Diabetes Melitus dan Penatalaksanaan Keperawatan. Yogyakarta: Nuha Medika. 2015.
  4. Kementerian Kesehatan Republik Indonesia. Riskesdas 2018. Riset Kesehatan Dasar. Jakarta: Badan Penelitian dan Pengembangan Kesehatan. 2019.
  5. Gainey A, Himathongkam T, Tanaka H, Suksom D. Complementary Therapies in Medicine Effects of Buddhist walking meditation on glycemic control and vascular function in patients with type 2 diabetes. Complement Ther Med. 2016;26:92–97.
  6. Lou Y, Xu S, Wang L, Ping Z, Zhao D. Association between brachial- ­ ankle pulse wave velocity and risk of type 2 diabetes mellitus : results from a cohort study. BMJ Open Diabetes Research and Care. 2020;8(1):e001317.
  7. Zhang P, Lu J, Jing Y, Tang S, Zhu D, Bi Y. Global epidemiology of diabetic foot ulceration: a systematic review and meta-analysis. Ann Med. 2017;49(2):106–116.
  8. Girsang R, Sitorus FE. Pengaruh Senam Kaki Diabetik Terhadap Ankle Brachial. J Penelit Keperawatan Med. Jurnal Penelitian Keperawatan Medik. 2020;2(2):21–26.
  9. Henni S, Ammi M, Gourdier A, Besnier L, Signolet I, Colas-ribas C, et al. Journal of Diabetes and Its Complications Ankle brachial index is equally predictive of exercise-induced limb ischemia in diabetic and non-diabetic patients with walking limitation. J Diabetes Complications. 2018;32(7):702–707.
  10. Chen S, Lee M, Huang J, Mai H. Association of diabetes mellitus with decline in ankle-brachial index among patients on hemodialysis : A 6-year follow-up study. Plos One. 2017;12(4):1–15.
  11. Hicks CW, Selvin E. Epidemiology of Peripheral Neuropathy and Lower Extremity Disease in Diabetes. Curr Diab Rep. 2019;19(10):86.
  12. Smeltzer B, Hinkle C. Brunner and Suddarth’s texsbook of medical-surgical nursing (12th ed). Philadelphia: Lipponcott Williams & Wilkins. 2016.
  13. Şahin S, Cingil D. Evaluation of the relationship among foot wound risk, foot self-care behaviors, and illness acceptance in patients with type 2 diabetes mellitus. Prim Care Diabetes. 2020;14(5):469–475.
  14. Jakubiak GK, Pawlas N, Stanek A. Chronic Lower Extremity Ischemia and Its Association with the Frailty Syndrome in Patients with Diabetes. Int J Environ Res Publik Heal. 2020;17(24):2–17.
  15. Soegondo. Penatalaksanaan Diabetes Melitus Terpadu. Jakarta: FKUI. 2009.
  16. Kwan RL, Cheing GL, Vong SK, Lo SK. Electrophysical therapy for managing diabetic foot ulcers: a systematic review. Int Wound J. 2012;10(2):121–131.
  17. Grenon SM, Gagnon J, Hsiang Y. Ankle-Brachial Index for Assessment of Peripheral Arterial Disease. N Engl J Med. 2009;361(19):e40.
  18. Yuanto HH, Bakar A, Astuti P. Pengaruh Kombinasi Senam Kaki Dan Aromaterapi Terhadap Abi Dan Tingkat Stres Pada Penderita DM Di Puskesmas Jajag. J Ilm Keperawatan (Scientific J Nursing). 2018;4(2):131–140.
  19. Dinata IMCD, Achjar KAH, Gama IK, Sudiantara K. Gambaran Pemberian Terapi Senam Kaki Diabetes Pada Lansia Dengan Diabetes Melitus Tipe II. J Gema Keperawatan. 2022;15(2):305–319.
  20. Wahyuni S, Alkaff RN. Diabetes Melitus Pada Perempuan Usia Reproduksi Di Indonesia. J Kesehat Reproduksi. 2013;3(1):46–51.
  21. Hijriana I, Sahara T. Gambaran Nilai Ankle Brachial Index (ABI) Pada Pasien Dm Tipe 2. Idea Nurs J. 2020;11(3):56–61.
  22. Zulfahmi Z, Mardia AI, Handayani S, Syafril S, Gatot D. Comparison of antithrombin III levels in type 2 diabetes mellitus patients with and without ulcers at Haji Adam Malik Hospital Medan Indonesia from may to july 2017. Bali Medical Journal. 2019;8(2):646–651.
  23. Mendes R, Sousa N, Reis VM, Themudo-Barata JL. Implementing low-cost, community-based exercise programs for middle-aged and older patients with type 2 diabetes: What are the benefits for glycemic control and cardiovascular risk? Int J Environ Res Public Health. 2017;14(9):3–4.
  24. Do JG, Noh SU, Chae SW, Yoon KJ, Lee YT. Excessive walking exercise precipitates diabetic neuropathic foot pain: hind paw suspension treadmill exercise experiment in a rat model. Sci Rep. 2020;10(1):1–12.
  25. Monteiro RL, Ferreira JSSP, Silva ÉQ, Donini A, Cruvinel-Júnior RH, Verissímo JL, et al. Feasibility and preliminary efficacy of a foot-ankle exercise program aiming to improve foot-ankle functionality and gait biomechanics in people with diabetic neuropathy: A randomized controlled trial. Sensors (Switzerland). 2020;20(18):1–18.
  26. Kementrian kesehatan republik indonesia. Tetap Produktif, Cegah Dan Atasi Diabetes Mellitus. Pusat Data dan Informasi Kementerian Kesehatan RI. 2020.
  27. Prihastini TP. Pengaruh Latihan Senam Kaki Diabetes Terhadap Perubahan Kualitas Hidup Pada Pasien Diabetes Mellitus [Skripsi]. Universitas Muhammadiyah Jember. 2017..
  28. Francia P, De Bellis A, Iannone G, Sinopoli R, Bocchi L, Anichini R. The Role of New Technological Opportunities and the Need to Evaluate the Activities Performed in the Prevention of Diabetic Foot with Exercise Therapy. Medicines. 2021;8(12):76.
  29. Abdul M, Khan B, Hashim MJ, King JK, Govender RD, Mustafa H, et al. Epidemiology of type 2 diabetes – Global burden of disease and forecasted trends. J Epidemiol Glob Health. 2020;10:107–111.
  30. Monteiro RL, Sartor CD, Ferreira JSSP, Dantas MGB, Bus SA, Sacco ICN. Protocol for evaluating the effects of a foot-ankle therapeutic exercise program on daily activity, foot-ankle functionality, and biomechanics in people with diabetic polyneuropathy: A randomized controlled trial. BMC Musculoskelet Disord. 2018;19(1):1–13.
  31. Zhao Y, Huang L, Zhou X, Liu J, Yu J. The early diagnostic value of ankle-brachial index combined with feet electrochemical skin conductance for peripheral artery disease in type 2 diabetes. J Diabetes Investig. 2021;13(3):525–532.
  32. Tran MM, Haley MN. Does exercise improve healing of diabetic foot ulcers? A systematic review. J Foot Ankle Res. 2021;14(1):1–10.
  33. Putri DS, Nugroho EGZ. Senam Kaki Diabetik Sebagai Upaya Peningkatan Self Care pada Pasien Diabetes Mellitus di Rumah Sakit Mardi Rahayu Kudus. J Pengabdi Kesehat. 2020;3(2):132–140.
  34. Flora R, Purwanto S. Pelatihan Senam Kaki Pada Penderita Diabetes Komplikasi Diabetes Pada Kaki (Diabetes Foot). UnsriAcId. 2013;1(1):7–15.
  35. Thakral G, LaFontaine J, Najafi B, Talal TK, Kim P, Lavery LA. Electrical stimulation to accelerate wound healing. Diabet Foot Ankle. 2013;4(1):1–9.
  36. Iskandar, Dharmajaya R, Ariani Y. Increasing Foot Circulation With Electrical Stimulation In Patients With Diabetes Mellitus. 2020;4(3):343–349.
  37. Artha IMJR, Bhargah A, Dharmawan NK, Pande UW, Triyana KA, Prabawa IPY, et al. High level of individual lipid profile and lipid ratio as a predictive marker of poor glycemic control in type-2 diabetes mellitus. Vascular Health and Risk Management. 2019;15:149-157.
  38. Gracia-Sánchez A, López-Pineda A, Chicharro-Luna E, Gil-Guillén VF. A delphi study protocol to identify recommendations on physical activity and exercise in patients with diabetes and risk of foot ulcerations. Int J Environ Res Public Health. 2021;18(20):10988.
  39. Kawamori D, Katakami N, Takahara M, Miyashita K, Sakamoto F, Yasuda T, et al. Dysregulated plasma glucagon levels in Japanese young adult type 1 diabetes patients. J Diabetes Investig. 2019;10(1):62–66.
  40. Mirza R. Memaksimalkan Dukungan Keluarga Guna Meningkatkan Kualitas Hidup Pasien Diabetes Mellitus. J JUMANTIK. 2017;2(2):12–30.
  41. Arini HN, Anggorowati A, Pujiastuti RSE. Dukungan keluarga pada lansia dengan Diabetes Melitus Tipe II: Literature review. NURSCOPE J Penelit dan Pemikir Ilm Keperawatan. 2022;7(2):172–180.

How to Cite

Dewi Astuti, A., Utama, N. R. ., & Aridamayanti, B. G. . (2023). Diabetic ulcers prevention in the elderly for improving blood circulation of lower extremities with combination foot exercise therapy and electrophysical therapy. Bali Medical Journal, 12(1), 737–743. https://doi.org/10.15562/bmj.v12i1.4099
ACM ACS APA ABNT Chicago Harvard IEEE MLA Turabian Vancouver
Download Citation
Endnote/Zotero/Mendeley (RIS) BibTeX

HTML
3

Total
1

Share

Search Panel

Agnes Dewi Astuti
Google Scholar
Pubmed
BMJ Journal

Nang Randu Utama
Google Scholar
Pubmed
BMJ Journal

Bernadetta Germia Aridamayanti
Google Scholar
Pubmed
BMJ Journal