The Effect of Walking Exercise on the Decreased Risk of Peripheral Artery Disease (PAD) based on the Value of Ankle Brachial Index (ABI) in Type 2 Diabetes Mellitus Patients in Lerep Village, West Ungaran Subdistrict

Abstract

Diabetes Mellitus will cause complication factor in arterial blood vessels, such as atherosclerosis and arteriosclerosis. Atherosclerosis that occurs can cause Peripheral Artheri Disease (PAD). One way to prevent the occurrence of PAD is by doing a physical activity such as a walking exercise, where while doing a walking exercise, it can increase the production of Nitric Oxide plasma so it can improve PAD by increasing the value of Ankle Brachial Index (ABI). The purpose of this study was to analyze the effect of the walking exercise to decrease the risk of PAD in patients with type 2 diabetes in Lerep Village, West Ungaran District. Research design used Quasi experiment, with pretest- posttest nonequivalent control group design. The population was clients of diabetes type II in Lerep Village, West Ungaran subdistrict. Samples of this research were 32 respondents divided into control and intervention groups. The sampling method used purposive sampling while data collecting tool used a stetoscope. Data analysis used Mann Whitney U-test. Based on the research, it was found that there was a difference of risk level of PAD before and after the research in intervention group with p value 0,002 < α 0,05. There was no difference in PAD risk level in the control group with p value 0,269 < α 0,05. There was an effect of walking exercise on the risk of PAD in patients of Diabetes Mellitus type 2 with p value 0,000001 < α 0,05. Diabetes Mellitus is one of the factors that affect blood flow because the increase of viscosity factor due to hyperglikemia. The increased blood viscosity can cause impaired blood flow throughout the body and causes a decrease in perfusion to body tissues. The heaviest decrease in perfusion is in the distal or leg area if this condition persists can cause complications such as PAD and in DM it can cause gangrene injury. Gangren wounds occur due to a decrease in perfusion so the tissue does not get nutrients and lacks oxygen and neuropathy. The conclutions of the study showed that there was an influence on the walking exercise towards increasing the value of ABI which had an effect on reducing the risk of PAD. Suggestion : Based on this research, walking exercise can be used as non pharmacologic therapy and be applied correctly to reduce the risk of PAD in Diabetes Mellitus type 2.