title: Effects of Buerger Exercise Combined Health-Promoting Program on Peripheral Neurovasculopathy Among Community Residents at High Risk for Diabetic Foot Ulceration.
abstract: BACKGROUND
  Peripheral neuropathy and vasculopathy are important risk factors for diabetic foot ulceration (DFU). Buerger exercises for patients with arterial occlusive disease have previously been noted; however, current evidence to support this intervention is limited.
  
  
  OBJECTIVE
  We established a standardized procedure for Buerger exercises combined with a health-promoting program and investigated its effectiveness in reducing peripheral neurovasculopathy among rural Taiwanese residents with type 2 diabetes who were at high risk of developing DFU.
  
  
  METHODS
  A one group quasi-experimental pretest-posttest design was used. The Buerger exercise protocol composed of a three-step posture change with 9 minutes for each cycle. The health-promoting program composed of six dimensions of healthy habits. Outcome measurements 1 year after the beginning of the intervention included the ankle brachial pressure index (ABI), the Michigan neuropathy screening instrument (MNSI), blood pressure, frequency of self-reported leg discomfort, and a type 2 Diabetes Health Promoting Score.
  
  
  RESULTS
  Thirty-one of 66 (47%) subjects completed this study. Buerger exercises combined with the health-promoting program significantly improved (a) the ABI in the legs, (b) health-promoting behaviors, (c) MNSI values, and (d) leg discomfort symptoms.
  
  
  CONCLUSIONS
  This study supports the use of Buerger exercises combined with the health-promoting program to improve symptoms of peripheral neuropathy and peripheral circulation in patients with type 2 diabetes.
authors.affiliation: Nursing Instructor, Nursing Department, Min-Hwei College of Health Care Management, Tainan, Taiwan.
authors.forename: Chyong-Fang
authors.initials: CF
authors.lastname: Chang
authors.affiliation: Attending Surgeon, Plastic Surgery, Chang Gung Memorial Hospital, Chayi, Taiwan.
authors.forename: Chang-Cheng
authors.initials: CC
authors.lastname: Chang
authors.affiliation: Assistant Professor, College of Nursing, Chang Gung University of Science and Technology, Chayi, Taiwan.
authors.forename: Su-Lun
authors.initials: SL
authors.lastname: Hwang
authors.affiliation: Professor, Community Health Nursing, College of Nursing, Chang Gung University of Science and Technology, Chayi, Taiwan.
authors.forename: Mei-Yen
authors.initials: MY
authors.lastname: Chen
mesh_terms: D003256:Community Participation / Q000639:trends; D003430:Cross-Sectional Studies; D017719:Diabetic Foot / Q000517:prevention & control* / Q000628:therapy; D015444:Exercise; D005081:Exercise Therapy; D016523:Foot Ulcer / Q000517:prevention & control* / Q000628:therapy; D006293:Health Promotion / Q000379:methods* / Q000706:statistics & numerical data; D006801:Humans; D010523:Peripheral Nervous System Diseases / Q000628:therapy*; D013624:Taiwan
keywords: Buerger exercises; diabetic foot ulceration; diabetic peripheral neurovasculopathy; health-promoting program; type 2 diabetes