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"[ABSTRAKPenderita neuropati perifer diabetik yang mengalami penurunan sensasi kaki dapatberakibat terjadinya luka diabetik. Penelitian ini bertujuan mengetahui efektivitaskombinasi senam kaki diabetik dan terapi SPA terhadap peningkatan sensasi kakipada pasien dengan neuropati perifer diabetik. Penelitian ini menggunakan kuasiexperimental pretest-posttest design with control group dengan jumlah sample 35orang yang didapat dengan tehnik purposive sampling. Pengukuran sensasi kakidilakukan pada hari pertama minggu ke-1 dan hari terakhir minggu ke-4 perlakuan.Sampel penelitian yaitu pasien neuropati perifer diabetik dengan skor sensasi kakimaksimal 8. Hasil uji mann whitney menunjukkan ada perbedaan reratapeningkatan sensasi kaki yang diberikan kombinasi senam kaki diabetik dan terapiSPA dibandingkan hanya diberikan tindakan senam kaki diabetik (p value < 0.05).Tindakan kombinasi senam kaki diabetik dan terapi SPA lebih efektif dalammeningkatkan sensasi kaki yang akan berpengaruh terhadap menurunnya resikoluka pada pasien DM.

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ABSTRACTDiabetic peripheral neuropathy patients with decreasing in foot sensation willimpact on diabetic ulcers. This study aims to explore the effect of combinationbetween diabetic legs exercise and SPA therapy on foot sensitivity escalationamong patients with diabetic peripheral neuropathy. This study used quasiexperimentalpretest-posttest design with control group with 35 respondents andrecruited by purposive sampling methode. Data were collected from patients withperipheral diabetic neuropathy and had 8 maximum score of foot sensitivity.. Footsensitivity was measured on the 1st day of intervention and end day of intervention.Mann whitney test analysis showed significant differences on foot sensitivity withcombination of diabetic legs exercise and SPA therapy compare to diabetic legsexercise only (p value < 0.05). It can be inferred that combination of diabetic legsexercise and SPA therapy are more effective to increase legs sensitivity. Therefore,combined effect of those therapies may eventually decrease diabetic ulcers risk., Diabetic peripheral neuropathy patients with decreasing in foot sensation willimpact on diabetic ulcers. This study aims to explore the effect of combinationbetween diabetic legs exercise and SPA therapy on foot sensitivity escalationamong patients with diabetic peripheral neuropathy. This study used quasiexperimentalpretest-posttest design with control group with 35 respondents andrecruited by purposive sampling methode. Data were collected from patients withperipheral diabetic neuropathy and had 8 maximum score of foot sensitivity.. Footsensitivity was measured on the 1st day of intervention and end day of intervention.Mann whitney test analysis showed significant differences on foot sensitivity withcombination of diabetic legs exercise and SPA therapy compare to diabetic legsexercise only (p value < 0.05). It can be inferred that combination of diabetic legsexercise and SPA therapy are more effective to increase legs sensitivity. Therefore,combined effect of those therapies may eventually decrease diabetic ulcers risk.]"

"Latar belakang:Kondisi hiperglikemia pada diabetes melitus (DM) yang tidak terkontrol dan berlangsung lama dapat menimbulkan dampak negatif. Salah satu konsekuensi dari DM adalah munculnya penyakit arteri perifer (PAP) dan neuropati perifer diabetik (NPD). NPD merupakan komplikasi diabetes yang menunjukkan tanda dan gejala gangguan motorik dan sensorik, sementara PAP adalah kondisi aterosklerosis yang berkembang perlahan pada pembuluh arteri. Kedua penyakit ini menunjukkan gejala kelainan motorik dan sensorik yang saling tumpang tindih.Tujuan:Penelitian ini bertujuan untuk mengetahui hubungan stenosis arteri yang dinilai menggunakan arteriografi terhadap gangguan saraf yang dinilai menggunakan pemeriksaan kecepatan hantar saraf (KHS) pada pasien DM tipe 2 dengan PAP dan NPD.Metode:Penelitian ini merupakan penelitian potong lintang yang mengambil data sekunder dari data penelitian sebelumnya yang dilakukan pada Juli 2018 hingga Juni 2021 RSUPN Cipto Mangunkusumo. Subjek penelitian ini adalah penyandang DM yang memiliki NPD dan PAP yang memenuhi kriteria inklusi dan tidak memenuhi kriteria eksklusi. Subjek penelitian kemudian menjalani pemeriksaan arteriografi untuk menilai stenosis pada A. Peroneal, A. Tibialis Anterior dan A. Tibialis Posterior. Subjek penelitian juga menjalani pemeriksaan kecepatan hantar saraf (KHS) pada N. Peroneal Communis, N. Peroneal Superficialis, N. Tibialis dan N. Suralis. Korelasi antar kedua variabel kemudian diuji dengan Uji Korelasi Spearman.Hasil:Hasil menunjukkan bahwa stenosis A. Peroneal memiliki korelasi negatif derajat sedang (r = - 0.420) dengan KHS sensorik N. Peroneal Superficialis yang bermakna secara statistik (p = 0.023). Sementara itu, hubungan stenosis dan gangguan KHS pada A. Peroneal dengan N. Peroneal Communis, A. Tibialis Anterior dengan N. Tibialis dan A. Tibialis Posterior dengan N. Suralis memiliki korelasi yang tidak bermakna secara statistik (p >0.05). Hal ini dapat dijelaskan oleh kemungkinan kolateral yang dapat muncul pada penyandang PAP, struktur anatomi vaskular terhadap syaraf, dan jumlah sampel yang kecil.Kesimpulan:Terdapat korelasi negatif derajat sedang antara derajat stenosis A. Peroneal dan KHS sensorik N. Peroneal Superficialis. Namun hasil yang tidak bermakna ditemukan pada hubungan A. Peroneal dengan N. Peroneal Communis, A. Tibialis Anterior dengan N. Tibialis dan A. Tibialis Posterior dengan N. Suralis.

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Background:

The condition of hyperglycemia in uncontrolled and prolonged diabetes mellitus (DM) can have negative impacts. One consequence of DM is the emergence of peripheral artery disease (PAD) and diabetic peripheral neuropathy (DPN). DPN is a complication of diabetes that presents signs and symptoms of motor and sensory disturbances, while PAD is an atherosclerosis condition that gradually develops in the arterial vessels. Both diseases exhibit overlapping symptoms of motor and sensory abnormalities.

Objective:

This study aims to determine the correlation of arterial obstruction assessed using arteriography and the nerve impairment assessed using nerve conduction velocity (NCV) in DM patients with PAD and DPN.

Methods:

This is a cross-sectional study that takes secondary data from previous research data conducted from July 2018 to June 2021 RSUPN Cipto Mangunkusumo. The subjects of this study were people with DM who had NPD and PAP who met the inclusion criteria and did not meet the exclusion criteria. The research subjects then underwent an arteriography examination to assess the stenosis in the peroneal artery, anterior tibial artery and posterior tibial artery. Research subjects also underwent nerve conduction velocity (KHS) examinations in the Peroneal N. Communis, N. Peroneal Superficialis, N. Tibialis and N. Suralis. The correlation between the two variables was then tested using the Spearman Correlation Test.

Results:

The results showed that the Peroneal Artery stenosis had a moderate negative correlation (r = - 0.420) with the sensory NCV of the Superficial Peroneal Nerve which was statistically significant (p = 0.023). Meanwhile, the correlation of stenosis and NCV disorders in the Peroneal Nerve with the Common Peroneal Nerve, Anterior Tibial Nerve with Tibialis Nerve and Posterior Tibial Nerve with Sural Nerve had a correlation that was not statistically significant (p > 0.05). This can be explained by the possibility of collaterals appearing in people with PAD, the structure of vasculature on the nerves, and the small number of samples.

Conclusion:

There is a moderate negative correlation between the degree of stenosis of the Peroneal nerve and the sensory NCV of the Peroneal Superficialis. However, insignificant results were found in the correlation between Peroneal Artery with Common Peroneal Nerve, Anterior Tibialis Artery with Tibial Nerve and Posterior Tibial Artery with Sural Nerve."