Application Distal Leg Massage in Diabetes Mellitus Patient Post Lumbar Surgery with Peripheral Arterial Disease: Case Report
DOI:
https://doi.org/10.37287/ijghr.v8i4.1443Keywords:
ankle-brachial index (ABI), diabetes mellitus, distal limb massage, peripheral circulation, post-lumbar surgeryAbstract
Postoperative lumbar surgery patients with diabetes mellitus are at risk of developing complex neurovascular disorders. Neurological deficits caused by lumbar nerve compression or diabetic neuropathy often result in numbness and tingling in the distal limbs, while impaired peripheral circulation related to diabetes mellitus can delay tissue healing. Distal limb massage is a non-pharmacological intervention that may help improve blood circulation and support peripheral nerve function recovery. To determine the effect of distal limb massage on improving peripheral circulation in post-lumbar surgery patients with diabetes mellitus and peripheral arterial disease (PAD). This descriptive case report with a nursing care approach was conducted from September 13 to 16, 2025, in Room UBK 2 of Welas Asih Hospital. A 46-year-old woman with a lumbar abscess and diabetes mellitus received distal limb massage twice daily for three days (30 minutes/session). Peripheral circulation was assessed using Ankle-Brachial Index (ABI) and plantar temperature before and after intervention and analyzed descriptively. After the intervention, the Ankle-Brachial Index (ABI) increased in the right leg from 1.04 to 1.08 and in the left leg from 0.75 to 0.82. In addition, the average plantar temperature increased by 0.3–0.5°C, indicating improved peripheral perfusion. Distal limb massage demonstrated potential effectiveness in improving peripheral circulation, as reflected by increased ABI values and plantar temperature, and may help reduce numbness and tingling in post-lumbar surgery patients with diabetes mellitus and PAD.
References
Abdulghafoor, I., Agha, I., Ibrahim, M. A., Salim, Y. T., Ibrahim, K. W., Mohammed, O. M., & Mohammed, S. J. (2024). Septic paravertebral abscess and inferior vena cava thrombosis complicated by uro-sepsis : Case report. 23(September), 329–333. https://doi.org/10.37897/RJN.2024.3.16
Al-fahham, T. M., & Al-jubouri, M. B. (2023). Effectiveness of Foot Massage on Diabetic Patients ’ Peripheral Neuropathy : A Randomized Controlled Trial. 7, 458–469. https://doi.org/https://doi.org/10.59670/ml.v20iS7.4412
Chatchawan, U., Eungpinichpong, W., Plandee, P., & Yamauchi, J. (2015). Effects of Thai Foot Massage on Balance Performance in Diabetic Patients with Peripheral Neuropathy : A Randomized Parallel-Controlled. Medical Science Monitor Basic Resarch, 21, 68–75. https://doi.org/10.12659/MSMBR.894163
Chatchawan, U., Jarasrungsichol, K., & Yamauchi, J. (2020). Immediate Effects of Self-Thai Foot Massage on Skin Blood Flow, Skin Temperature, and Range of Motion of The Foot and Angkle in Type 2 Diabetic Patients. Journal of Alternative and Complementary Medicine, 26(6), 491–500. https://doi.org/10.1089/acm.2019.0328
Chatchawan, U., Narkto, P., Damri, T., & Yamauchi, J. (2018). An exploration of the relationship between foot skin temperature and blood flow in type 2 diabetes mellitus patients : a cross-sectional study. The Journal of Physical Therapy Science, 30(11), 1359–1363. https://doi.org/10.1589/jpts.30.1359
Chikubu, H., Inage, K., Orita, S., Shiga, Y., Inoue, M., & Okuyama, K. (2025). A Study on Subjective Symptoms and Plantar Temperature Imbalance in Lumbar Spinal Stenosis : A Preliminary Study. 17(2). https://doi.org/10.7759/cureus.79388
Ganesh, B. R., & Kothiwale, V. A. (2016). Reliability of ankle brachial index in patients with neurological deficits on ischemic episode of the limbs following Burgers exercises : open labelled clinical trial. International Journal of Research in Medical Sciences, 4(8), 3440–3443. https://doi.org/10.18203/2320-6012.ijrms20162308
Hall, J. E., & Guyton, A. C. (2011). Textbook Of Medical Physiology (12th ed.). Elsevier.
Kemenkes Indonesia. (2020). Pedoman Nasional Pelayanan Kedokteran Tata Laksana Diabetes Melitus Tipe 2 Dewasa. 1–183.
Khan, S. Z., Waris, N., Miyan, Z., Ulhaque, M. S., & Fawwad, A. (2019). Comparison of ankle-brachial index ( ABI ) measured by an automated oscillometric apparatus with that by standard hand-held doppler in patients with Type-2 diabetes. Pak J Med Sci, 35(4), 1167–1172. https://doi.org/: https://doi.org/10.12669/pjms.35.4.30
Khawaja, N., Shennar, J. A., Saleh, M., Dahbour, S. S., Khader, Y. S., & Ajlouni, K. M. (2018). The prevalence and risk factors of peripheral neuropathy among patients with type 2 diabetes mellitus ; the case of Jordan. Diabetology & Metabolic Syndrome, 1–10. https://doi.org/10.1186/s13098-018-0309-6
Komatsu, J., Sato, K., Iwabuchi, M., Fukuda, H., Kusano, K., Kaneko, K., & Shirado, O. (2019). Recovery of paraplegia following postoperative epidural hematomas in lumbar canal stenosis surgery by closed kinetic chain (CKC) exercises. 0–5. https://doi.org/10.1097/MD.0000000000015670
Libya, N. P. E. (2018). Pengaruh Senam Kaki Diabetik Terhadap Ankle Brachial Index (ABI) pada Pasien Diabetes Melitus Tipe II di UPT Kesmas Gianyar I Tahun 2018 [Poltekkes Denpasar]. http://repository.poltekkes-denpasar.ac.id/id/eprint/1348
Luna, R., Manjunatha, R. T., Bollu, B., Jhaveri, S., Avanthika, C., Reddy, N., Saha, T., & Gandhi, F. (2021). A Comprehensive Review of Neuronal Changes in Diabetics. 13(10). https://doi.org/10.7759/cureus.19142
Ngurah, I. G., Wijaya, P., & Yulian, K. (2025). Paraspinal Abscess Secondary to Spondylodiscitis : A Rare Presentation with Progressive Neurological Deficits and Systemic Infection. Indonesian Journal of Medicine, 10(2), 113–124. https://doi.org/https://doi.org/10.26911/theijmed.2025.10.2.842
Paju, W., Yusuf, R., Nurhidayah, J., Fauzi, A., & Bata, V. A. (2022). The Effect of Foot Massage on Peripheral Neuropathy in Patients With Diabetic Mellitus : A Systematic Review. Malaysian Journal of Medicine and Health Sciences, 18(9), 354–362.
Perez-martin, A., Ennaifer, H., Silva, H., & Knapp, Y. (2021). Mechanisms of Venoarteriolar Reflex in Type 2 Diabetes with or without Peripheral Neuropathy. MDPI, 10 (4), 1–11. https://doi.org/https://doi.org/10.3390/biology10040333
Ren, L., Guo, R., Fu, G., Zhang, J., & Wang, Q. (2022). The efficacy and safety of massage adjuvant therapy in the treatment of diabetic peripheral neuropathy. 101(10), 1–4. https://doi.org/10.1097/MD.0000000000029032
Roubin, S. (2025). Thai Foot Reflexology Guide. In Thai Massage Book. Thai Massage School of Chiang Mai.
Sassack, B., & Carrier, J. D. (2023). Anatomy, Back, Lumbar Spine. Treasure Island (FL). https://www.ncbi.nlm.nih.gov/books/NBK557616/
Soe, S. M., Wanpen, S., Thaweewannakit, T., Peungsuwan, P., & Chatchawan, U. (2025). Short-term Effects of Self-Thai Foot Massage and Foot Care on Balance and Proprioception Among Patients With Diabetic Peripheral Neuropathy. 39(1). https://doi.org/https://doi.org/10.56808/2586-940X.1115
Varaki, E. S., Gargiulo, G. D., Penkala, S., & Breen, P. P. (2018). Peripheral vascular disease assessment in the lower limb : a review of current and emerging non ‑ invasive diagnostic methods. BioMedical Engineering OnLine, 1–27. https://doi.org/10.1186/s12938-018-0494-4
Wang, R., Li, C., Yi, X., Lu, H., Wang, Y., & Li, H. (2020). Causes of lower extremity weaknesses after posterior lumbar spine fusion surgery and therapeutic effects of active surgical exploration. Journal of Orthopaedic Surgery and Research, 15(1), 435. https://doi.org/10.1186/s13018-020-01948-4
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Indonesian Journal of Global Health Research
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
