Diah Ratnawati, Sang Ayu Made Adyani, Ritanti Ritanti



Elderly with Diabetes mellitus (DM) is experienced for decreasing the quality of peripheral blood flows that identified numbness, tingling, and decreased foot sensitivity. This condition is impacted by the occurrence of leg ulcer complications and to worsen for amputating for the lower extremities. This research purpose to exam the effectiveness of a combination of foot spa therapy and Bueger's Allen Exercises on the value of the ankle-brachial index in the elderly with diabetes mellitus. The method used in this research is quasi-experimental (pre-test and post-test comparison group design). The population in this study was elderly with DM type 2. The number of sample in this study were 114 samples, were divides into 3 groups, each group consisting of 38 respondents. The first group was foot spa therapy intervention, the second group was Bueger’s Allen Exercise intervention, and the third group was the combination group. The data was collected by measuring the ABI pre-test and post-test in each group. The interventions were carried out about 24 sessions for 8 weeks. The results of the study obtained in pairs of T-test results showed a meaningful difference before and after the therapy with the value P = 0,000 (P < 0.05). In addition, the LSD test received the data mean difference combination therapy compared with Bueger's Allen Exercises of 0.0571 (Sig. = 0,000) and compared to the Foot Spa of 0.0796 (Sig. = 0,000). The therapeutic combination Method (combined foot spa therapy and Bueger's Allen Exercises) is very effective in increasing the value of ABI in elderly DM. It is important for families and nurses to give motivation to the elderly with DM type 2 to do foot spa and Allen Bueger’s Exercise as alternative therapies to prevent foot complications.

Keywords: Diabetes Mellitus; Elderly; Foot Spa; Bueger’s Allen Exercises; Ankle Brachial Index/ABI.

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Affiani, R., & Astuti, P. . (2017). Efektivitas Spa Kaki Diabetik Terhadap Sirkulasi Darah Perifer pada Pasien Diabetes Mellitus Tipe 2 di Wilayah Kerja Puskesmas. Jurnal Ilmiah Kesehatan, 10(120–129).

Allen, A.W. (1930). Recent Advances in the Treatment of Circulatory Disturbances of the Extremities. Annals of Surgery, 92, 931–946.

Alvarsson, A., Sandgren, B., Wendel, C., Alvarsson, M. and Brismar, K. (2012). A Retrospective Analysis of Amputation Rates in Diabetic Patients: Can Lower Extremity Amputations Be Further Prevented? Cardiovascular Diabetology, 11, 1–11.

American Heart Association /AHA. (2013). ACCF/AHA guideline for the management of heart failure: Areport of the American College of Cardiology Foundation/American Heart Association task force on practice guidelines. J Am Coll Cardio, 62(16), e240–e327.

Antono, D., & Hamonangani, R. (2014). Penyakit Arteri Perifer. In S. Setiati, I. Alwi, A. W. Sudoyo, & Simadibrata (Eds.), (VI, Vol. 2, p. 1591). Jakarta: Interna Publishing.

Black, J.M., & Hawks, J. H. (2014). Keperawatan medikal bedah: Manejemen klinis untuk hasil yang diharapkan (A. Suslia & P.P. Lestari, Eds.) (8th ed.). Singapore: Elsevier, Pte Ltd.

Bottomley, J.M. (2007). The Insensitive Foot. In: Timothy, L.K., John, O.B. and Michael, L.M., Eds., (2nd ed.). Churchill Livingstone: Edinburgh.

BPS. (2018). Statistik Usia Lanjut 2017.

Brunner & Suddarth. (2013). Buku Ajar Keperawatan Medikal Bedah (Vol. 2). Jakarta: EGC.

Chang, C. C., et al. (2016). A quantitative real-time assessment of Buerger exercise on dorsal foot peripheral skin circulation in patients with diabeter foot. Medicine, 95(46).

Chang, C.F., Chang, C.C., Hwang, S. L. & Chen, M.Y. (2015). Effect of Buerger’s Exercise on Improving Peripheral Circulation: A Systematic Review. Worldviews on Evidence-Based Nursing, 12(3), 145–153.

Chen, M. Y., et al. (2011). Effectiveness of a Health Promotion Program for Farmers and Fishermen with Type 2 Diabetes in Taiwan. Journal of Advanced Nursing, 67(9), 2060–2067.

Chevtchouk, L., Silva, M. H. S. da, & Nascimento, O. J. M. do, . (2017). Ankle-brachial index and diabetic neuropathy: study of 225 patients. Arq Neuropsiquiat, 75(8), 533–538.

Clayton W. & Elasy T. A. (2009). A Review of The Pathophysiology, Classification, And Treatment of Foot Ulcers in Diabetic Patients. Clin Diabetes, 27(2), 52–58.

Depok Health Office. (2017). Profil Kesehatan Kota Depok 2017.

Edward, B. G. & Palmer, J. (2010). Massage Therapy Effects on African Americans with Type 2 Diabetes Mellitus: A Pilot Study. Journal of Evidence-Based Complementary & Alternative. Med Journal, 15(3), 149–155.

Efendi, F., & Makhfudli. (2009). Keperawatan Komunitas Teori & Praktek Dalam Keperwatan. Jakarta: Salemba Medika.

Fan, L. C, et al. (2013). Pulse Pressure and Michigan Neuropathy Screening Instrument are Independently Associated with Asymptomatic Peripheral Arterial Disease among Type 2 Diabetes Community Residents: A Community‑based Screening Program in Taiwan. Biomed Journal, 36(6), 282–288.

Gilden, J.L, & Gupta, A. Non-ICU hospital care of diabetes mellitus in the elderly population. Curr diab Rep. 2015;15(5):26

Gitarja, W. S. (2015). Perawatan Luka Certified Wound Care Clinician Assosiate (3rd ed.). Bogor: Yayasan Wocare Indonesia.

IDF /International Diabetes. (2013). The Global Burden. In 2013. Retrieved from Internasional Diabetes Federatio IDF, 2014

IDF Atlas. (2015). Diabetes atlas 2015.

Irawan. (2015). Penerapan Efektivitas Spa Kaki Diabetik Terhadap Gangguan Perfusi Jaringan Pada Pasien Diabetes Mellitus Tipe 2 Di Ruang Paviliun 3 RSAL Dr. Ramelan Surabaya. Retrieved July 8, 2019, from

Jannaim, Dharmajaya, R., dan Asrizal. (2018). Pengaruh Buerger Allen Exercise Terhadap Sirkulasi Ektremitas Bawah Pada Pasien Luka Kaki Diabetik. Jurnal Keperawatan Indonesia, 21(2), 101–108.

Kumari, A., Rai, K., Kumari, V. dan Sarin, J. (2019). A Study to Assess the Effectiveness of Buerger Allen Exercise on Foot Perfusion among Patients with Diabetes Mellitus Admitted in Selected Hospital of Ambala, Haryana. International Journal of Health Sciences & Research, 9(1), 112–119. Retrieved from www.ijhsr

Michaels, J., Churgin, S. S., Blechman, K. M., Greives, M. R., Aarabi, S., Galiano, R. D., dkk. (2007). db/db mice exhibit severe wound-healing impairments compared with other murine diabetic strains in a silicone-splinted excisional wound model. Wound Rep Reg, 15(5), 665-670.

Miller, C. A. (2012). Nursing Wellness in Older Adults : Theory and Practice. Wolter Kluwer.

Papalia, D.E., Olds, S.W., & Feldman, R. D. (2008). Human Development: Pekembangan Manusia, 10th ed, 2. Jakarta: Salemba Humanika.

Patidar, V. (2018). A study to assess the effectiveness of burger allen exercise on improving peripheral circulation among type 2 Diabetes Mellitus patients in selected hospitals of Nadiad city. Clin. Pract., 15(6), 895–900.

Potter, Perry, Stockert, & H. (2011). Fundamental of Nursing. Mosby: Elsevier Ltd.

Santrock, J. W. (2009). Psikologi Perkembangan.Jilid 1. Jakarta: Erlangga.

Susanti, N. (2012). Efektifitas Kompres Dingin dan Hangat pada Penatalaksanan Demam. Saintis, 1(1).

Suyanto. (2017). Pengaruh Terapi Spa dan Senam Kaki Diabetik Pada Pasien Neuropati Perifer Diabetik. Jurnal Keperawatan Dan Pemikiran Ilmiah, 3(4), 29–36.

Utoyo, B. (2013). Buku Ajar Spa Diabetik : Konsep, Proses & Praktik, Vol 1 (EGC, Ed.). Jakarta.

Wardani, E. M., Wijayanti, L., dan Ainiyah, N. (2019). The Effect Of Diabetic Foot Spa On Ankle Brachial Index And Foot Sensitivity Of Diabetes Mellitus Type 2. Jurnal Keperawatan Respati Yogyakarta, 6(3), 672–676.

Wisham, L.H., Abramson, A. S. (1953). Value of Exercise in Peripheral Arterial Disease. JAMA, 153, 10–11.


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Jurnal JKFT

Fakultas Ilmu Kesehatan

Universitas Muhammadiyah Tangerang

Jl. Perintis Kemerdekaan 1 No.33 Cikokol Tangerang, Indonesia


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