Effect of Ankle Range of Motion Exercises Combined with Warm Water Foot Soaking on Ankle–Brachial Index in Patients with Type 2 Diabetes Mellitus

Putu Septa Ayu  Diana; Nova Nurwinda Sari; Herlina Herlina

doi:10.56359/gj.v7i2.1074

Authors

Putu Septa Ayu Diana Universitas Mitra Indonesia
Nova Nurwinda Sari Universitas Mitra Indonesia
Herlina Universitas Mitra Indonesia

DOI:

https://doi.org/10.56359/gj.v7i2.1074

Keywords:

ankle brachial index (ABI), ankle rom, type 2 diabetes mellitus, warm water foot

Abstract

Introduction: Diabetes mellitus has attracted global attention due to the increasing prevalence of cases and the potential complications it can cause, such as microangiopathy and macroangiopathy. One non-pharmacological intervention that can be applied to improve peripheral circulation is the combination of ankle range of motion (ROM) exercises and warm water foot soaking.

Objective: This study aimed to determine the effect of the combined ankle ROM exercises and warm water foot soaking on Ankle Brachial Index (ABI) values in patients with Type 2 Diabetes Mellitus at Kedaton Public Health Center, Bandar Lampung, in 2025.

Method: This study employed a quantitative approach with a pre-experimental design using a one-group pretest and posttest without control. A total of 30 respondents were selected using purposive sampling techniques. Data analysis included descriptive statistical analysis, a normality test using Shapiro Wilk, and a non-parametric test using the Wilcoxon Signed Rank Test.

Result The results showed that the mean ABI value before the intervention was 0.0093 ± 0.04265, while after the intervention the mean ABI value improved to 0.0012 ± 0.03038. The Wilcoxon test revealed a p-value of 0.025, indicating a statistically significant difference between ABI values before and after the intervention.

Conclusion: It can be concluded that the combination of ankle range of motion (ROM) exercises and warm water foot soaking has a significant effect on improving ABI values in patients with Type 2 Diabetes Mellitus, and therefore can be applied as a non-pharmacological nursing intervention to enhance peripheral blood circulation.

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References

ADA. (2021). ADA Releases 2021 Standards of Medical Care in Diabetes Centered on Evolving Evidence , Technology , and Individualized. 2–7.

Bahjatun Nadrati, Ners., M. K., & Lalu Dedy Supriatama, S.Kep., M. K. (2023). Buerger Allen Exercise dan Ankle Brachial Indeks (ABI) pada Penyandang Diabetes Melitus.

Basri, B., Arlis, A., & Yongki, P. (2024). Effect of Lower Extremity Range of Motion (ROM) Exercise on Improving Blood Circulation. Jurnal Keperawatan Priority, 7(2), 87–97. https://doi.org/10.34012/jukep.v7i2.5414

Borhade, M. B., Yashi, K., & Singh, S. (2025). Diabetes dan Olahraga. 1–10. https://www.ncbi.nlm.nih.gov/books/NBK526095/

Deski, F. I., & Yendrial, V. A. (2025). Upaya Peningkatan Sirkulasi Darah Perifer Pada Pasien Diabetes Melitus Tipe 2 Melalui Edukasi Therapeutic Exercise Walking dan Rendam Kaki Air Hangat. Jurnal Pengabdian Ilmu Kesehatan (JPIK), 4(1), 1–7. https://doi.org/10.33757/jpik.v4i1.87

Dinas Kesehatan Prov.Lampung, K. (2024). Profil Kesehatan Provinsi Lampung Tahun 2024. 44.

Fauziani, A. N., Adelia, A., Ardika, O. B., Himayani, R., & Rahmanisa, S. (2024). Pengenalan Diabetes Mellitus Tipe 1 , Mutasi Genetik. Medula, 14(2), 442–446.

Firmansyah, D., & Dede. (2022). Teknik Pengambilan Sampel Umum dalam Metodologi. Jurnal Ilmiah Pendidikan Holistik (JIPH), 1(2), 85–114.

Hamdani, H., & Sa’diyah, H. (2025). Konsep Dasar Penyusunan Hipotesis dan Kajian Teori dalam Penelitian. Journal of Linguistics and Social Studies, 2(2), 64–73. https://doi.org/10.52620/jls.v2i2.93

Handoko, Rahardjo, S. S., & Murti, B. (2022). Predictors of Macro and Microvascular Complication in Type 2 Diabetes Mellitus Patients at Dr . Moewardi Hospital , Surakarta. 1–13.

Harahap, N. H., Harahap, I., Siregar, R., Nasution, N. A., Almadany, U. H., & Dongoran, R. F. (2025). Gambaran Pengetahuan Ibu Hamil Tentang Diabetes Gestasional Di Puskesmas Sipiongot Tahun 2024. Jurnal Kesehatan Ilmiah Indonesia (Indonesian Health Scientific Journal), 10(1). https://doi.org/10.51933/health.v10i1.1661

Harrington, D. (2021). Physical activity and exercise in the management of type 2 diabetes : where to start ? 38(5). https://doi.org/10.1002/pdi.2361

Hendro Djoko Tjahjono. (2019). 88-Article Text-505-1-10-20200827.

Hossain, M. J., Al-Mamun, M., & Islam, M. R. (2024). Diabetes mellitus, the fastest growing global public health concern: Early detection should be focused. Health Science Reports, 7(3), 5–9. https://doi.org/10.1002/hsr2.2004

Ibrahim, A., Alang, A. H., Madi, Baharuddin, Ahmad, M. A., & Darmawati. (2018). Metodologi Penelitian (M. S. Dr. H. Ilyas Ismail, M.Pd. (ed.)). Gunadarma Ilmu.

IDF. (2023). IDF Clinical Practice Recommendations on the Diabetic Foot.

International Diabetes Federation. (2021). IDF Diabetes Atlas 2021 _ IDF Diabetes Atlas. In IDF official website.

Inyatul, M., Mohammad, A. N., Indah, S. W., & Fitria, E. J. (2022). Pengaruh Kombinasi Latihan Range Of Motion (ROM) Kaki Dan Senam Kaki Terhadap Sensitivitas Kaki Pada Pasien Diabetes Melitus Di Wilayah Puskesmas Demak II. Bima Nursing Journal, 3(2), 85. https://doi.org/10.32807/bnj.v3i2.817

Ir. S. Benny Pasaribu, M.Ec., P. ., Herawati, D. A., Dr. Kabul Wahyu Utomo, M. S., & Rizqon Halal Syah Aji, M.Si., P. . (2022). Metodologi Penelitian (Ahmad Muhaimin (ed.)). MEDIA EDU PUSTAKA.

Jaya, I. M. L. M. (2020). Metode penelitian kuantitatif dan Kualitatif. Anak Hebat Indonesia. https://books.google.co.id/books?id=yz8KEAAAQBAJ&hl=id&source=gbs_navlinks_s

Kurnia, E., & Fitri, D. E. (2023). Penerapan Kombinasi Senam Kaki dan Rendam Air Hangat terhadap Sensitivitas Kaki Pasien Diabetes Mellitus. Jurnal Pustaka Keperawatan, 2(1), 27–32.

Laili, D. R., Kurniawan, C., & G.A.Putra, M. (2024). IMPLEMENTASI DIABETIC FOOT EXERCISE MENINGKATKAN ANKLE BRACHIAL INDEX PADA KASUS KETIDAKEFEKTIFAN PERFUSI PERIFER. 15(2), 199–205.

Leeper, N. J., & Chang, T. I. (2020). Arterial Disease Events : a Reanalysis of the ALLHAT Data. 138(17), 1805–1814.

https://doi.org/10.1161/CIRCULATIONAHA.118.033348.Association

Mardhalena, A. A., & Kurnia, A. (2025). Penerapan Electrical Foot Bath Pada Penderita Diabetus Militus Dengan Nyeri Neuropati Application of Electrical Foot Bath in Diabetes Mellitus Patients with. 185–194.

Maryama, N., Sulistini, R., & Ikob, R. (2021). PENGARUH RENDAM KAKI AIR HANGAT TERHADAP ANKLE BRACHIAL INDEX PADA PASIEN DIABETES MELITUS. 9(1), 1–13.

Nurul Melani Haifa, Indah Nabilla, Virda Rahmatika, Rully Hidayatullah, & Harmonedi Harmonedi. (2025). Identifikasi Variabel Penelitian, Jenis Sumber Data dalam Penelitian Pendidikan. Dinamika Pembelajaran : Jurnal Pendidikan Dan Bahasa, 2(2), 256–270. https://doi.org/10.62383/dilan.v2i2.1563

Ogurtsova, K., Guariguata, L., Barengo, N. C., Ruiz, P. L. D., Sacre, J. W., Karuranga, S., Sun, H., Boyko, E. J., & Magliano, D. J. (2022). IDF diabetes Atlas: Global estimates of undiagnosed diabetes in adults for 2021. Diabetes Research and Clinical Practice, 183(January), 1–7. https://doi.org/10.1016/j.diabres.2021.109118

Rahmadi, S.Ag., M. P. I. (2011). Pengantar Metodologi Penelitian (Syahrani (ed.)). Antasari Press.

Rahman, A., Maryuni, S., & Rahmadhani, D. (2021). Pengaruh Latihan Senam Kaki Diabetes Terhadap Sensitivitas Kaki pada Penderita Diabetes Mellitus Tipe II. 2(1), 7–14.

Ramayanti, E. D., Karingga, D. D., & Wahdi, A. (2024). EFEKTIVITAS PEMBERIAN TERAPI ROM AKTIF TERHADAP NILAI ABI ( ANKLE BRACHIAL INDEX ) PADA PENDERITA. 5, 3411–3419.

Rif’at1, I. D., N2, Y. H., & Indriati3, G. (2023). GAMBARAN KOMPLIKASI DIABETES MELITUS PADA. 11.

Rita, N. (2021). HUBUNGAN JENIS KELAMIN , OLAH RAGA DAN OBESITAS. 2(April), 93–100.

Rosalinda, J. (2023). Faktor-Faktor yang Mempengaruhi Tingkat Kepatuhan Pengobatan Pasien Diabetes Melitus Tipe 2 di Puskesmas Kotagede II Yogyakarta. 15(2), 1–16.

Samapati, R. U. R., Putri’, R. M., & Devi, H. M. (2023). Perbedaan Kadar Gula Darah Berdasarkan Jenis Kelamin dan Status Gizi ( IMT ) Lansia Penderita Diabetes Melitus Tipe 2. 12(September), 417–425.

Sari, R., Sofiani, Y., Yunitri, N., Kurniasari, S., & Sari, R. (2025). Efektivitas latihan ankle pump terhadap pencegahan neuropati perifer pada pasien diabetes mellitus tipe 2. 19(9), 2592–2599.

Simanjuntak, G. V., & Simamora, M. (2020). Lama menderita diabetes mellitus tipe 2 sebagai faktor risiko neuropati perifer diabetik. 14(1), 96–100.

Sriyati, S. (2024). Neuropati Diabetes Sebagai Faktor Predisposisi Terjadinya Luka Pada Kaki. Jurnal Ilmiah STIKES Yarsi Mataram, 14(1), 46–52. https://doi.org/10.57267/jisym.v14i1.336

Suryani, M., Samekto, W., Heri-Nugroho, Susanto, H., & Dwiantoro, L. (2021). Effect of foot-ankle flexibility and resistance exercise in the secondary prevention of plantar foot diabetic ulcer. Journal of Diabetes and Its Complications, 35(9), 1–7. https://doi.org/10.1016/j.jdiacomp.2021.107968

Syah, I., & Oktorina, R. (2022). Efektifitas Buerger Allen Exercise Dengan Range of Motion (Rom) Terhadap Nilai Sensitifitas Kaki Pada Pasien Diabetes Melitus Tipe Ii. Jurnal Endurance, 6(1), 135–143. https://doi.org/10.22216/jen.v6i1.150

Tinungki, Y. L., & Hinonaung, J. S. H. (2023). DETEKSI DINI DIABETES MELITUS (DM) DAN OBAT TRADISIONAL DM PADA LANSIA DI KABUPATEN KEPULAUAN SANGIHE (Efitra (ed.)). PT. Sonpedia Publishing Indonesia.

Trianto & Hastuti. (2022). Pengaruh Senam Kaki Terhadap Nilai Ankle Brachial Index (ABI) pada Pasien DM Tipe II. 21101070, 79–85.

Utomo, A. dkk. (2020). Faktor Risiko Diabetes Mellitus Tipe 2: A Systematic Review. AN-Nur: Jurnal Kajian Dan Pengembangan Kesehatan Masyarakat, 1(1), 44–52.

Wang, W., Zhao, T., Geng, K., Yuan, G., Chen, Y., & Xu, Y. (2021). Smoking and the Pathophysiology of Peripheral Artery Disease. 8(August), 1–17. https://doi.org/10.3389/fcvm.2021.704106

WHO. (2022). General guidelines for methodologies on research and evaluation of traditional medicine. November, 1–2.

WHO, 2024. (2024). Diabetes. 10–14.

Yuliantini, P. D., Kusuma, P. W., & Wijaya, I. P. A. (2023). Effect of Giving Active Lower ROM on Changes In Ankle Brachial Index ( Abi ) Values In Diabetes Melitus Type II Patients at Mangusada Hospital Badung. 6(1), 89–96.

Zemaitis, M. R., Boll, J. M., Kato, M., & Golla, M. S. G. (2025). Peripheral Arterial Disease. 1–12.