Buerger Exercises

Original Editor - Khloud Shreif

Top Contributors - Khloud Shreif and Lucinda hampton  

Introduction[edit | edit source]

Buerger's exercise or Buerger-Allen exercises (BAE) was published for the first time by Leo Buerger in 1924 then modified by Arthur Allen to be a postural treatment option that is low cost and effective with low risk, for patients with lower limb arterial insufficiency. It is considered a conservative treatment for peripheral vascular disease, are active free exercises depend on the effect of the gravity on the smooth muscles of the valves. The exercises consist of leg elevation from 35-90 degrees followed by the dependency of the leg and finally resting with the leg in the horizontal position, aimed to improve leg and feet circulation.

Exercise Description[edit | edit source]

First, the patient lies flat on the plinth with legs elevated from 45 degrees until the skin turns pale, it will take approximately 2 minutes to occur and this time varies from one individual to another.

Then the patient turns to sit at the edge of the plinth with feet hanging and doing the following exercises; dorsiflexion, plantar flexion, inversion, eversion, and flexion the extension of toes, this phase may also be maintained for 2 minutes.

Finally, the patient lies flat with his leg rested in a horizontal position and covered with a warm blanket for about 5 minutes.

It is best to be repeated 2-4 times daily and each cycle repeated for 3-6 times. The time of every phase varies according to patient tolerance the speed with the color change[1].It will be difficult for patients with having difficulties with ADL.

[2]

Benefits[edit | edit source]

  • Buerger exercises are considered important prophylactic exercises for diabetic patients to improve circulation and control problems with diabetic foot later on.
  • Reduce peripheral neuropathy symptoms with diabetic patients.
  • Promote collateral blood circulation.
  • Improve skin pressure perfusion[3].
  • Improve peripheral circulation [4]
  • Reduce necrosis period, swelling.
  • Improve walking ability.
  • Post-operative after orthopedic surgeries, and gynecological surgeries, to improve local circulation.

Mechanism Of Exercise[edit | edit source]

The gravitational change of the position causes alternatively emptying and filling of the blood vessels as following:

During the elevation the gravity causes an emptying of the veins so increases the inflow of the right atrium and promote cardiac output. At leg dependency gravity will increase the inflows to the arterioles in addition to the ankle movement will force the muscles to contract and reinforce the distal circulation. The last step will promote leg reperfusion[5]. Further study methodologies are needed.

References[edit | edit source]

  1. Chang CF, Chang CC, Chen MY. Effect of Buerger’s exercises on improving peripheral circulation: a systematic review. Open Journal of Nursing. 2015 Feb 4;5(02):120.
  2. ladybessviernes. buerger allen's exercise.wmv . Available from: http://www.youtube.com/watch?v=jQUFmOmX35o[last accessed 19/8/2021]
  3. Kawasaki T, Uemura T, Matsuo K, Masumoto K, Harada Y, Chuman T, Murata T. The effect of different positions on lower limbs skin perfusion pressure. Indian Journal of plastic surgery. 2013 Sep;46(03):508-12.
  4. Radhika J, Poomalai G, Nalini S, Revathi R. Effectiveness of buerger-allen exercise on lower extremity perfusion and peripheral neuropathy symptoms among patients with diabetes mellitus. Iranian Journal of Nursing and Midwifery Research. 2020 Jul;25(4):291.
  5. Chang CC, Chen MY, Shen JH, Lin YB, Hsu WW, Lin BS. A quantitative real-time assessment of Buerger exercise on dorsal foot peripheral skin circulation in patients with diabetes foot. Medicine. 2016 Nov;95(46).