Personalized Digital Instructor Based on Arduino for Buerger Exercises in Older Adults with Diabetes: Feasibility Study

Authors

Keywords:

Arduino, Buerger exercises, Digital instructor, Gerontechnology, Older adult

Abstract

Diabetes in older adults can lead to complications such as peripheral artery disease, neuropathy, and foot ulcers. Accessing treatments can be challenging due to limited resources. Implementing low-cost preventive therapies like Buerger's exercises is essential. However, these exercises must be standardized. The purpose was to develop an Arduino-based electronic system as a gerontechnological tool for homologating Buerger’s exercises and facilitating their execution by older adults with diabetes mellitus. The Intervention Theory by Sidani guided the development of this study. A feasibility and pilot study with one group, pretest/posttest design, was conducted in twenty older adults with HbA1c ≤ 8% and their caregivers in Saltillo, Coahuila, Mexico, from November 2020 to June 2021. Feasibility was measured with an acceptability and satisfaction instrument; the ankle-arm index was measured with 8 Hertz Doppler and neuropathy symptoms with a modified Toronto Clinical Neuropathy Score. The mean age was 67.50 ± 5.61 years old in older adults and 48.32 ± 16.26 in caregivers. The digital instructor was accepted by 73.3% (11 older adults) without any issues; 47.4% (9 older adults) and 26.3% (6 caregivers) expressed high levels of satisfaction. Participants noted significant benefits such as improved peripheral circulation, reduced pain, numbness, and tingling. These promising results underscore the potential of the electronic system to make a noticeable improvement in the lives of older adults with diabetes mellitus and their caregivers. The device was meticulously designed to be user-friendly and accessible, making it ideal gerontechnological tool to manage  health at home.

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Author Biographies

Ernesto Ríos Willars, Autonomous University of Coahuila

Ernesto Rios Willars holds a Ph.D. degree in Biotechnology (2016) and a Master's degree (2012) in Computer Science with an emphasis in Information Systems from the Autonomous University of Coahuila (UAdeC). He received a Master's Degree in Education from the Interamerican University for Development (2009).
He is Professor of Systems Engineering and Electronics at the Faculty of Systems of the UAdeC and professor of Electronics at the Center for Technological and Services Baccalaureate (CBTiS 235).
Dr. Ríos is a member of both the Mexican Society of Biomedical Engineering, the State System of Researchers of Coahuila and the Multidisciplinary Network of Care, Technology, Behavior and Health.

Brandon Emmanuel Delabra Salinas, Autonomous University of Coahuila

Brandon Emmanuel Delabra Salinas received a B.S. in Computer Systems Engineering from the Autonomous University of Coahuila (2022).
He was winner of the 2021 Science and Engineering Fair. He is creator of short films with messages of social impact on issues of violence prevention and care for older adults, and their caregivers.

María Magdalena Delabra Salinas, Autonomous University of Coahuila

María Magdalena Delabra Salinas holds a PhD (2021) and a Master's degree (2005) in Nursing Sciences from the Autonomous University of Nuevo León.
She is a Professor-Researcher at the Autonomous University of Coahuila. She works on community and prevention projects such as diabetic foot risk, spiritual nursing care, urinary incontinence with older adults and their caregivers; Promotion of breastfeeding and respectful childbirth.
Dr. Delabra is a member of the NAB Master's Program in Nursing with a focus on the older adults care.

Daniel Sifuentes Leura, Autonomous University of Coahuila

Daniel Sifuentes Leura holds a PhD in Nursing Sciences from the University of Guanajuato (2019), and a Master's Degree in Nursing Sciences from the Autonomous University of Nuevo León (2005).
He is a Professor–Researcher at the Autonomous University of Coahuila. He is a nurse active in clinical practice at Saltillo General Hospital, expert in metabolic processes.
Dr. Sifuentes is a member of the NAB Master's Program in Nursing with a focus on the older adults care.

Nereyda Hernández Nava, Autonomous University of San Luis Potosí

Nereyda Hernández Nava holds a PhD (2023) in Mental Health from the Western Higher Studies Institute, a Master's Degree (2006) in Social Gerontology from the University of Guadalajara in México, and a Bachelor's Degree in Nursing (1997) from the Michoacan University of San Nicolas de Hidalgo.
She is a Professor-Researcher at the Autonomous University of San Luis Potosí.

Alejandro Martínez Ramírez, Universidad Autónoma de San Luis Potosí

Alejandro Martínez Ramírez holds a Ph.D. degree (2006) and a Master degree (2000) on Science of Electronics from the National Institute of Astrophysics, Optics, and Electronics (INAOE), México. Bachelor of Electronics (1996) from the Distinguished Autonomous University of Puebla.
He is a Professor-Researcher at the Autonomous University of San Luis Potosí..

Rosa Eréndira Fosado Quiroz, Autonomous University of San Luis Potosí

Rosa Eréndira Fosado Quiroz holds a PhD in Chemistry from the Metropolitan Autonomous University – Iztapalapa (2010), and a degree in Chemistry from the Autonomous University of the State of Hidalgo (1996).
She is a Professor–Researcher at the Autonomous University of San Luis Potosí.

Bertha Cecilia Salazar-González, Autonomous University of Nuevo León

Bertha Cecilia Salazar González holds a PhD (Nursing) from the Wayne State University: Detroit, MI, US (1999).
She is a Professor-Researcher at the Autonomous University of Nuevo León.
Dr. Salazar is a member of Red ESAM- México and Sigma Theta Tau International- Tau Alpha Chapter. Member of The Gerontological Society of America, USA. She has recognition from the National System of Researchers with level 1 (2024-2039).

References

N.C. Schaper et al., “Practical guidelines on the prevention and management of diabetes-related foot disease (IWGDF 2023 update).” Diabetes Metab. Res. Rev. 2024; e3657, doi: 10.1002/dmrr.3657.

CONEVAL. (2024, march). Personas adultas mayores en México, evidencia para la toma de decisiones, Primera edición, p.p. 10 – 12. [Online]. Available on:

https://www.coneval.org.mx/InformesPublicaciones/Documents/PAM_evidencia.pdf.

Ch. Chyong-Fang, Ch. Chang-Cheng, H. Su-Lun and Ch. Mei-Yen, "Effects of Buerger exercise combined health promoting program on peripheral neurovasculopathy among community residents at high risk for diabetic foot ulceration," Worldviews on Evidence Based Nursing, vol. 12, no. 3, pp. 145-153, 2015. doi: 10.1111/wvn.12091.

A. Thakur, R. Sharma, S. K. Sharma, K. Thakur and P. Jelly, "Effect of buerger allen exercise on foot perfusion among patient with diabetes mellitus: A systematic review & meta-analysis," Diabetes & Metabolic Syndrome: Clinical Research & Reviews, vol. 16, no. 2, 2022, doi: 10.1016/j.dsx.2022.102393.

S. Rusdianah, T. Tahir and S. Yusuf, "The effect of Buerger Allen exercise and the provision of oral vitamin C toward the improvement of peripheral tissue perfusion and healing of diabetic foot ulcers," Enfermería Clínica, vol. 31, no. 5, pp. S709-S712, 2021, doi: 10.1016/j.enfcli.2021.07.022.

J. Radhika, G. Poomalai, S. Nalini and R. Revathi, "Effectiveness of Buerger-Allen Exercise on Lower Extremity Perfusion and Peripheral Neuropathy Symptoms among Patients with Diabetes Mellitus," Iran J Nurs Midwifery Res., vol. 25, no. 4, pp. 291-295, Jun. 2020, doi: 10.4103/ijnmr.IJNMR_63_19.

M.L. Chen et al., "The application of wireless near-infrared spectroscopy on detecting peripheral circulation in patients with diabetes foot ulcer when doing Buerger’s exercise," Lasers Surg Med., vol. 49, no. 7, pp. 652-657, Sep. 2017, doi: 10.1002/lsm.22667.

S. Ahn and R. Song, "Effects of Tai Chi Exercise on glucosa control, neuropathy scores, balance, and quality of life in patients with type 2 diabetes and neuropathy," J Altern Complement Med., vol. 18, no. 12, pp. 1172-1178, Dec. 2012, doi: 10.1089/acm.2011.0690.

B.S. Lin et al., "The assessment of Buerger’s exercise on dorsal foot skin circulation in patients with vasculopathic diabetic foot ulcer by using Wireless vasculopathic diabetic foot ulcer by using Wireless near-infrared spectroscope: a cohort prospective study," Lasers Med Sci., vol. 33, no. 5, pp. 977-982, Jul. 2018, doi: 10.1007/s10103-017-2420-6.

F. De la Torre, D. Morales and C. P. Quiroz, “Gerontechnology: rapid review and global trends,” Rev Mex Ing Biomed, vol. 36, no. 3, pp. 171-179, 2015, doi: 10.17488/RMIB.36.3.3.

G. Huang and S.A. Oteng, “Gerontechnology for better elderly care and life quality: a systematic literature review,” Eur J. Ageing, vol. 20, no. 1, 2023, doi: 10.1007/s10433-023-00776-9.

A. Loya, J. Ríos and J. Gómez, "Interacción espacial humano-robot, robots de servicio en asistencia al adulto mayor," Komputer Sapiens, Año 14, vol. 1, pp. 28-32, 2022. [Online]. Available:

https://cudi.edu.mx/sites/default/files/adjuntos/noticias/ks141_2.64MB_compacta.pdf.

A. Mejía De Castro, J. Blanco Escobar y L.D. Díaz Charris, "Sistemas de monitoreo biomédico de bajo costo: Una revisión sistemática," Boletín De Innovación, Logística y Operaciones, vol. 2, no. 2, pp. 10-16, 2020, doi: 10.17981/bilo.2.2.2020.2.

M. Yavuz et al., "Temperature- and pressure-regulating insoles for prevention of diabetic foot ulcers," J Foot Ankle Surg., vol. 59, no. 4, pp. 685-688, Jul-Aug. 2020, doi: 10.1053/j.jfas.2019.05.009.

J. Esparza, P. Gudimetla, S. De Silva and C.A. Unsworth, "An early warning system for diabetic automobile drivers with peripheral neuropathy," Disabil Rehabil Assist Technol., vol. 16, no. 6, pp. 624-631, Aug. 2021, doi: 10.1080/17483107.2019.1686076.

M. Delabra-Salinas y B. Salazar-González, "Revisión sistemática de intervenciones para la prevención de pie diabético en adultos mayores con diabetes," SANUS, vol. 7, no. 18, 2022. doi: 10.36789/revsanus.vi1.292.

L. Lavery et al., "Preventing diabetic foot ulcer recurrence in high-risk patients," Diabetes Care, vol. 30, no. 1, pp. 14-20, 2007. doi: 10.2337/dc06.1600.

T. Orenius et al., "Pilotando un Smart rollator: experiencias del usuario con la motivación relacionada con la tecnología y la actividad física," Gerontechology, vol. 20, no. 2, pp. 1-10, 2021, doi: 10.4017/gt.2021.20.2.420.01.

Naciones Unidas. Informe de los Objetivos de Desarrollo Sostenible 2023. Edición Especial. (2023), [Online]. Available on: https://bit.ly/3WDP3b7.

M. M. Delabra-Salinas, "Estudio piloto y de factibilidad de una intervención domiciliaria con apoyo del cuidador en adultos mayores con riesgo de pie diabético", Tesis doctoral, Facultad de Enfermería, Universidad Autónoma de Nuevo León, Mex., 2021. [online]. Available:

http://eprints.uanl.mx/22561/1/1080315501.pdf.

S. Sidani and C. Braden, “Intervention Theory”, in Design, evaluation and translation of nursing interventions, UK: Willey-Blackwell, 2011, pp. 61-71.

L. Glitin and S. Czaja, "Theory: a driver of behavioral intervention research," in Behavioral intervention research; designing, evaluation and implementing, NY, USA: Springer Publishing Connect, 2015, doi: 10.1891/9780826126597.

V. Bril et al., "Reliability and validity of the modified Toronto Clinical Neuropathy Score in diabetic sensorimotor polyneuropathy," Diabet Med., vol. 26, no. 3, pp. 240-246, 2009, doi: 10.1111/j.1464-5491.2009.02667.x.

A. Quispe-Andía, K.M. Calla-Vasquez, J.S. Yangali-Vicente, J.L. Rodríguez-López y I. I. Pumacayo-Palomino, “La prueba de Wilcoxon” en Estadística no paramétrica aplicada a la investigación científica con software, vol. 1, Colombia: EIDEC, 2019, pp. 36-40, [Online]. Available: https://www.editorialeidec.com/wp-content/uploads/2020/01/Estad%C3%ADstica-no-param%C3%A9trica-aplicada.pdf.

S. Domínguez-Lara, “Magnitud del efecto, una guía rápida,” Educación Médica, vol. 19, no. 4, pp. 251-254, 2018, doi: 10.1016/j.edumed.2017.07.002.

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Published

2024-12-16

How to Cite

Ríos Willars, E., Delabra Salinas, B. E. ., Delabra Salinas, M. M., Sifuentes Leura, D., Hernández Nava, N., Martínez Ramírez, A., Fosado Quiroz, R. E., & Salazar-González, B. C. (2024). Personalized Digital Instructor Based on Arduino for Buerger Exercises in Older Adults with Diabetes: Feasibility Study. IEEE Latin America Transactions, 23(1), 78–85. Retrieved from https://latamt.ieeer9.org/index.php/transactions/article/view/8967

Issue

Vol. 23 No. 1 (2025): Ordinary Issue

Section

Electronics