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• Vandanam. S & Shahnaz A. (2018). Buerger Allen Exercise for
improving peripheral circulation: Nightingale Nursing Times XIII(12),

Peripheral vascular disease is the serious complication of

diabetes but early detection and intervention may reduce
this morbidity. Buerger - Allen exercise helps in potential
mechanisms like formation of collateral circulation and
increased blood flow, changes microcirculation and
endothelial functions, changes in muscle metabolism and
oxygen extraction, prevention of inflammation and muscle
injury, and preventing atherosclerosis.
Buerger - Allen exercise

Specific exercises intended to improve circulation to the feet and legs.

The Buerger Allen exercise protocol composed of a 3 step posture
change with 12 minutes for each cycle. The lower extremities are
elevated to a 45 to 90 degree angle and ankle joint rotation is exercised
until the skin blanches (appears dead white). The feet and legs are then
lowered below the level of the rest of the body until redness appears. A
positive effect is achieved by repeating and carrying out this exercise
several times a day.

• Elevate feet on padded chair or board for 1/2 to 3 minutes.

• Sit in relaxed position while each foot is flexed and extended then
pronated and supinated for 3 minutes. The feet should become
entirely pink. If the feet are blue or painful, elevate them and relax
as necessary.
• Lie quietly for 5 minutes, keeping legs warm with a blanket.

• To assess the peripheral circulation among elderly patients with

diabetes mellitus before demonstration of Buerger Allen exercise.
• To demonstrate Buerger Allen exercise among elderly patients with
diabetes mellitus.
• To assess the peripheral circulation among elderly patients with
diabetes mellitus after demonstration of Buerger Allen exercise .
• To find out the association between interventional scores of Buerger
Allen exercise with selected socio demographic variables.
• Research Approach : Quantitative approach design
• Research Design : One group pre test post test
• Population : Elderly diabetic patient
• Sampling Technique : Purposive sampling technique
• Sample : 60 elderly diabetic patient (60 years and
above) residing in old age home, Hyderabad
• Setting : Gold age Home Sarnoornagar,
Hyderabad, Telangana
• Tool : Lower Extremity Perfusion Assessment

There was a significant improvement in peripheral

circulation among patients with diabetes mellitus after
performing Buerger Allen exercise at the level of P<0.05
and also there is a significant association between the age,
duration of diabetes mellitus and the interventional scores
of Buerger Allen exercise.

In the present study there is a significant difference between pre test and
post test scores of lower extremity perfusion. The findings are consistent
with the findings of the study by Bjerre Jepsen K, et al to find out the
effectiveness of the Buerger's Allen Exercise among PVD patients. The
experimental study was conducted among 14 patients. The study showed
that increased subcutaneous blood flow during the patients doing the
exercise. The study also revealed that the increased ankle pressure and
toe pressure during the exercise. The overall benefits are seen in 7
patients after 24 hours. The study concluded the Buerger's Allen exercise
is effective for improving the lower extremity circulation.

• Majority of the elderly patients with elderly patients with diabetes mellitus have
mild peripheral vascular disease which can be effectively managed.
• On conducting post test after performance of Buerger Allen exercise 4 times a
day for 7 days, there had been significant improvement in the scores of peripheral
circulation. Thus showing the effectiveness of Buerger Allen exercise in
improving peripheral circulation.
• There was no association between post test scores of peripheral circulation and
demographic variables such as gender, educational status, dietary pattern,
smoking and performance of other exercise previously