OJN  Vol.5 No.2 , February 2015
Effect of Buerger’s Exercises on Improving Peripheral Circulation: A Systematic Review
ABSTRACT
The aim of this study was to systematically review the evidence for the effectiveness of Buerger’s exercise on the peripheral circulation or diabetic foot ulceration. A systematic search and 18 electronic databases were conducted. The intervention was predominantly focused on Buerger’s exercise as an outcome. Due to high heterogeneity, data were synthesized in a narrative format rather than by statistical methods. Nine studies that covered 592 participants were selected in the analysis, of which 8 of the 9 found an effect of Buerger’s exercise on peripheral circulation. The positive effects were indicative of improving blood flow, walking ability, reducing necrosis, reducing venous embolism, pain, swelling, cyanosis and the bed-rest times. However, the study design and quality appraisal were limited to Jadad score 2 and the sample size was small. Findings provide some evidence of the beneficial effects of Buerger’s exercises. It was seen as a low cost and low risk physical activity that most diabetic patients could undertake at home. This review highlighted a need for further investigation of standardized procedures of Buerger’s exercises. More high quality studies on the prevention of diabetic foot are required regarding Buerger’s exercises.

Cite this paper
Chang, C. , Chang, C. and Chen, M. (2015) Effect of Buerger’s Exercises on Improving Peripheral Circulation: A Systematic Review. Open Journal of Nursing, 5, 120-128. doi: 10.4236/ojn.2015.52014.
References
[1]   International Diabetes Federation (IDF) (2013) The Global Burden.
http://www.idf.org/diabetesatlas/5e/the-global-burden.

[2]   Boulton, A.J.M., Vileikyte, L., Ragnarson-Tennvall, G. and Apelqvist, J. (2005) The Global Burden of Diabetic Foot Disease. Lancet, 366, 1719-1724.
http://dx.doi.org/10.1016/S0140-6736(05)67698-2

[3]   Health Promotion and Administration, Ministry of Health and Welfare (2014) Diabetes.
http://www.hpa.gov.tw/BHPNet/Web/HealthTopic/Topic.aspx?id=201409290001

[4]   Harrington, C., Zagari, M., Corea, J. and Klitenic, J. (2000) A Cost Analysis of Diabetic Lower-Extremity Ulcers. Diabetes Care, 23, 1333-1338.
http://dx.doi.org/10.2337/diacare.23.9.1333

[5]   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.
http://dx.doi.org/10.1186/1475-2840-11-18

[6]   Lavery, L.A. (2012) Effectiveness and Safety of Elective Surgical Procedures to Improve Wound Healing and Reduce Re-Ulceration in Diabetic Patients with Foot Ulcers. Diabetes/Metabolism Research and Reviews, 28, 60-63.
http://dx.doi.org/10.1002/dmrr.2241

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

[8]   Bernheim, A.R. and London, I.M. (1937) Arteriosclerosis and Thromboangiitis Obliterans. JAMA, 108, 2102-2109.
http://dx.doi.org/10.1001/jama.1937.02780250016005

[9]   Bierman, W. (1949) Physical Medicine in Peripheral Vascular Diseases. JAMA, 141, 318-320.
http://dx.doi.org/10.1001/jama.1949.02910050018005

[10]   Brandaleone, H., Standard, S. and Ralli, E.P. (1937) Prophylactic Foot Treatment in Patients with Diabetes Mellitus. Annals of Surgery, 105, 120-124.
http://dx.doi.org/10.1097/00000658-193701000-00011

[11]   Buerger, L. (1926) The Circulatory Disturbances of the Extremities. Annals of Surgery, 83, 157.

[12]   McKittrick, L.S. and Pratt, T.C. (1930) The Operative Treatment of Lesions of the Lower Extremities in Diabetes Mellitus. JAMA Surgery, 21, 555-581.
http://dx.doi.org/10.1001/archsurg.1930.01150160002001

[13]   Edwards, L. and Crisenberry, H. (1938) Vascular Disorders of the Extremities: A Discussion of Nursing Care. American Journal of Nursing, 38, 13s-17s.
http://dx.doi.org/10.2307/3414247

[14]   Lloyd, J.T. (1957) Traumatic Peripheral Aneurysms. American Journal of Surgery, 93, 755-764.
http://dx.doi.org/10.1016/0002-9610(57)90546-9

[15]   Conti, A.A., Macchi, C., Conti, A. and Gensini, G.F. (2007) Relationship between Physical Activity and Cardiovascular Disease: Selected Historical Highlights. The Journal of Sports Medicine and Physical Fitness, 47, 84-90.

[16]   Jackson, B.S. (1972) Chronic Peri-pheral Arterial Disease. American Journal of Nursing, 72, 928-934.

[17]   Bottomley, J.M. (2007) The Insensitive Foot. In: Timothy, L.K., John, O.B. and Michael, L.M., Eds., Geriatric Rehabilitation Manual, 2nd Edition, Churchill Livingstone, Edinburgh, 333-343.
http://dx.doi.org/10.1016/B978-0-443-10233-2.50058-4

[18]   Sommers, M.S., Johnson, S.A. and Berry, T.A. (2007) Arterial Occlusive Disease. In: Diseases & Disorders: A Nursing Therapeutics Manual, 3rd Edition, F.A. Davis Company, Philadelphia, 102-106.

[19]   Wright, I. (1940) Conservative Treatment of Occlusive Arterial Disease. JAMA Surgery, 40, 163-189.
http://dx.doi.org/10.1001/archsurg.1940.04240010003002

[20]   Ventura, E. (1978) Adult Diabetes: Foot Care for Diabetics. American Journal of Nursing, 78, 886-888.

[21]   Locke, R.K. (1963) Foot Care for Diabetics. American Journal of Nursing, 63, 107-110.

[22]   Jordan, W.R. (1936) Neuritic Manifestations in Diabetes Mellitus. JAMA Internal Medicine, 57, 307-366.
http://dx.doi.org/10.1001/archinte.1936.00170060069004

[23]   Wu, Y.T. and Wang, S.S. (1996) Effects of Buerger-Allen Exercises on Peripheral Vascular Function in Patients with Peripheral Arterial Insufficiency. National Science Council Report, Taipei, 1-15.

[24]   Liu, J.Z., Zhao, Y.Z., Chen, J.H., Chen, L.X. and Liu, F. (2010) The Care of Patients with Diabetic Foot after Balloon Dilatation Operation. Hebei Medical Journal (Chinese), 32, 2296-2297.

[25]   Jadad, A.R., Moore, R.A., Carroll, D., Jenkinson, C., Reynolds, D.J.M., Gavaghan, D.J., et al. (1996) Assessing the Quality of Reports of Randomized Clinical Trials: Is Blinding Necessary? Controlled Clinical Trials, 17, 1-12.
http://dx.doi.org/10.1016/0197-2456(95)00134-4

[26]   Bjerre-Jepsen, K., Faris, I., Henriksen, O. and Paaschburg-Nielsen, B. (1984) Effect of Therapy on 24-h Subcutaneous Blood Flow in the Leg in Patients with Severe Ischemia. European Journal of Nuclear Medicine, 9, 413-415.
http://dx.doi.org/10.1007/BF00295576

[27]   Wisham, L.H., Abramson, A.S. and Ebel, A. (1953) Value of Exercise in Peripheral Arterial Disease. JAMA, 153, 10-12.
http://dx.doi.org/10.1001/jama.1953.02940180012003

[28]   Fan, Y.C. and Zhang, G.P. (2005) Effect of Buerger Exercise of Delay Gangrene for Patients with Arteriosclerosis Obliterans. Chinese Journal of Surgery of Integrated Traditional and Western Medicine (Chinese), 11, 124-125.

[29]   Guan, X.L., Zhu, L.P., Huang, Y.C., Cheng, M.Y. and Liu, M.M. (2007) Effect of Buerger Exercise for Patients with Above Knee Fracture in Lower Extremities after Internal Fixation. The Journal of Medical Theory and Practice (Chinese), 20, 809-810.

[30]   Jiang, W.Y., Zhang, R.H., Liu, J.J., Li, F.Y., Wang, B.Q., Chen, J. and Chen, Y. (2009) The Influence of Buerger Exercise on the Post-Surgery Swelling and Pain in Patients with Lower Limb Fractures. Journal of Nursing (Chinese), 16, 1-3.

[31]   Ou, X.Q., Chen, C.F., Wang, L.L., Yu, G.Q. and Luo, W.J. (2006) Effect of Buerger Exercise for Patients with Gynecologic Tumor to Prevention of Deep Venous Thrombosis after Operation. Modern Nursing (Chinese), 12, 839-840.

[32]   Zhang, R.H., Jiang, W.Y., Liu, J.J., Li, F.Y., Liu, H.E. and Zhu, C.Y. (2009) Effect of Buerger Training on Hemorheology for Patients with Multiple Fractures in Lower Extremities after Internal Fixation. Nursing and Rehabilitation Journal (Chinese), 8, 903-905.

[33]   Zhu, L.P., Guan, X.L., Xiao, X.J., Huang, Y.C., Lian, M.R., Liu, M.M., et al. (2006) The Clinical Study of Buerger Training as Rehabilitation Method in Leg Trauma Patients. Chinese Journal of Practical Nursing (Chinese), 22, 6-8.

[34]   Altman, D.G. (1997) Clinical Trials. In: Altman, D.G., Ed., Practical Statistics for Medical Research, Chapman & Hall/CRC, London, 455.

[35]   Chen, M.Y., Huang, W.C., Peng, Y.S., Guo, J.S., Chen, C.P., Jong, M.C. and Lin, H.C. (2011) Effectiveness of a Health Promotion Program for Farmers and Fishermen with Type 2 Diabetes in Taiwan. Journal of Advanced Nursing, 67, 2060-2067.
http://dx.doi.org/10.1111/j.1365-2648.2011.05678.x

 
 
Top