Buerger exercise reduces the risk of neuropathy in people with diabetes mellitus

BACKGROUND: Diabetes mellitus (DM) remains the major global health problem, predicted to exceed half a billion people in 2040. One of the major complications was lower extremity neuropathy leading to foot ulcer and amputation. AIM: This study aimed to investigate the effect of routine Buerger exercise (BE) on the neuropathy index of people with DM. METHODS: A pre-and post-test quasi-experimental study between May and August 2018 involving DM patients in primary health center was conducted. They were prospectively recruited and either be allocated into the intervention group where the monitored routine BE was performed or control group with the standard education on DM. Michigan Neuropathy Screening Instrument (MNSI) with subjective and objective measurement was used to evaluate the neuropathy index. RESULTS: Seventy-seven participants (63 females) with a mean age of 58.2 ± 7.2 years completed the study with similar characteristics. Mean pre-test MNSI score for intervention and control group was 3.8 ± 1.7 and 3.9 ± 1.6, respectively, and was not different (p = 0.561). At the end of follow-up, significant decrease was observed in the intervention group (2.8 ± 2.2, p = 0.011) but not in control group (4.0 ± 1.9, p = 0.947). Physical examination according to MNSI guideline showed a significant reduction in the neuropathy score for the intervention group from 1.8 ± 1.4 at the start to 1.3 ± 1.1 at the end of the study (p < 0.001), but this was not seen in the control group. CONCLUSION: BE had a beneficial effect on improving the neuropathy index and symptoms of DM patients with high risk of diabetic foot ulcer.