Buerger exercises

Buerger exercises is a system of exercises for arterial insufficiency of lower limbs, consisting of legs elevation, followed by dependency of the legs, and finally horizontal position of legs for rest. Published in 1924 by Leo Buerger (1879-1943), New York physician.

Buerger Allen exercises

Buerger exercises augmented by active exercises of the feet. These exercises consist in flexion, extension, and circumduction of the ankles and are done during the phase of dependency of the legs, as suggested in 1931 by Arthur W. Allen (1887-1958).

Buerger-Allen exercise - Specific exercises intended to improve circulation to the feet and legs. The lower extremities are elevated to a 45 to 90 degree angle and supported in this position until the skin blanches (appears dead white). The feet and legs are then lowered below the level of the rest of the body until redness appears (care should be taken that there is no pressure against the back of the knees); finally, the legs are placed flat on the bed for a few minutes. The length of time for each position varies with the patient's tolerance and the speed with which color change occurs. Usually the exercises are prescribed so that the legs are elevated for 2 to 3 minutes, down 5 to 10 minutes, and then flat on the bed for 10 minutes.

Instructions given to the Patient for Buerger exercises-

• 1, Elevate feet on padded chair or board for 1/2 to 3 minutes.
• 2, Sit in relaxed position while each foot is flexed and extended then pronated and supinated for 3 minutes. The feet should become entirely pink. If the feet are blue or painful, elevate them and relax as necessary.
• 3, Lie quietly for 5 minutes, keeping legs warm with a blanket. 

Ratschow's exercise

Specific exercises intended to improve circulation to the feet and legs. The lower extremities are elevated to a 45 to 90 degree angle and ankle joint rotation is exercised until the skin blanches (appears dead white). The feet and legs are then lowered below the level of the rest of the body until redness appears. A positive effect is achieved by repeating and carrying out this exercise several times a day.

The Buerger-Allen exercise and the Ratschow's exercise may be performed for the purpose of collateral blood circulation promotion of patients with peripheral circulatory disturbance. However, it may be difficult to perform these exercises in patients to whom ADL is decreased.

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