PENGARUH SENAM KAKI DIABETES TERHADAP SENSITIVITAS KAKI DENGAN PENGUKURAN IPSWICH TOUCH TEST (IPTT)
DOI:
https://doi.org/10.37771/kjn.v7i2.1401Keywords:
diabetes mellitus, IPTT, neuropati perifer, pencegahan, senam kakiAbstract
Background: Diabetes mellitus (DM) is a chronic disease frequently associated with peripheral neuropathy, which manifests as reduced foot sensitivity and increases the risk of diabetic foot ulcers and amputations. The Ipswich Touch Test (IPTT) is a simple and low-cost screening method that is feasible to implement in primary health care settings in Indonesia. Objective: This study aimed to analyze the effect of diabetic foot exercise on foot sensitivity measured using IPTT and to highlight its contribution to evidence-based nursing practice. Methods: A quasi-experimental pretest–posttest control group design was applied. Thirty patients with type 2 DM from Kota Timur Health Center were recruited through purposive sampling and divided equally into intervention (n=15) and control (n=15) groups. The intervention group performed supervised diabetic foot exercises three times per week for four consecutive weeks, while the control group received standard education only. Foot sensitivity was assessed using IPTT before and after the intervention. Data were analyzed with the Wilcoxon signed-rank test and the Mann–Whitney U test at a significance level of ρ<0.05. Results: The intervention group demonstrated a significant improvement in foot sensitivity (p<0.001), while the control group showed no clinically meaningful change (p=0.008). Posttest scores differed significantly between groups (p<0.001). Conclusion: Diabetic foot exercise effectively improves foot sensitivity in patients with type 2 DM as measured by IPTT. This study emphasizes IPTT as a practical screening tool in Indonesian primary care and supports its integration into national diabetes programs such as Prolanis.
Latar belakang: Diabetes mellitus (DM) merupakan penyakit kronis yang sering menimbulkan komplikasi neuropati perifer berupa penurunan sensitivitas kaki. Kondisi ini meningkatkan risiko ulkus diabetikum hingga amputasi. Deteksi dini sensitivitas kaki menggunakan Ipswich Touch Test (IPTT) merupakan pendekatan sederhana yang relevan diterapkan di layanan primer Indonesia. Tujuan: Menganalisis pengaruh senam kaki diabetes terhadap sensitivitas kaki dengan menggunakan IPTT. Metode: Penelitian quasi-experiment dengan desain pretest–posttest control group. Sampel 30 pasien DM tipe 2 di Puskesmas Kota Timur, terdiri dari kelompok intervensi (n=15) yang melakukan senam kaki tiga kali seminggu selama empat minggu, dan kelompok kontrol (n=15) yang hanya menerima edukasi standar. Hasil: Uji Wilcoxon menunjukkan peningkatan signifikan sensitivitas kaki pada kelompok intervensi (p<0,001), sedangkan perubahan pada kelompok kontrol tidak bermakna secara klinis (p=0,008). Uji Mann–Whitney menunjukkan perbedaan signifikan skor posttest antar kelompok (p<0,001). Kesimpulan: Senam kaki efektif meningkatkan sensitivitas kaki pasien DM tipe 2. Penelitian ini berkontribusi terhadap praktik keperawatan berbasis bukti dengan menekankan IPTT sebagai alat skrining sederhana di layanan primer. Intervensi ini juga relevan diintegrasikan dalam program nasional seperti Prolanis.
References
2. Chinvattanachot, G., Rivas, D., & Duque, G. (2024). Mechanisms Of Muscle Cells Alterations And Regeneration Decline During Aging. Ageing Research Reviews, 102, 102589. https://doi.org/10.1016/j.arr.2024.102589
3. Grudniewicz, A., Gray, C. S., Boeckxstaens, P., De Maeseneer, J., & Mold, J. (2023). Operationalizing the Chronic Care Model with Goal-Oriented Care. The Patient, 16(6), 569–578. https://doi.org/10.1007/s40271-023-00645-8
4. Hu, A., Koh, B., & Teo, M.-R. (2021). A Review Of The Current Evidence On The Sensitivity and Specificity of The Ipswich Touch Test For The Screening of Loss of Protective Sensation In Patients With Diabetes Mellitus. Diabetology International, 12(2), 145–150. https://doi.org/10.1007/s13340-020-00451-9
5. International Diabetes Federation (IDF). (2025). IDF Diabetes Atlas 11th Edition - 2025. In D. J. Magliano, E. J. Boyko, I. Genitsaridi, L. Piemonte, P. Riley, & P. Salpea (Eds.), diabetesatlas.org (11th ed.). diabetesatlas.org.
6. Kandula, U. R. (2025). Impact Of Multifaceted Interventions On Pressure Injury Prevention: A Systematic Review. BMC Nursing, 24(1), 11. https://doi.org/10.1186/s12912-024-02558-9
7. Kanza Kazmi, S., Iqbal Naviwala, H., & Aziz, M. (2021). Ipswich touch test – A simple yet reliable indicator of diabetic neuropathy. Journal of Clinical & Translational Endocrinology, 23, 100252. https://doi.org/10.1016/j.jcte.2021.100252
8. Kusnanto, K., Alfaqih, M., Padoli, P., & Arifin, H. (2021). A Qualitative Study Inquiry among Patients with Diabetic Foot Ulcers: What have They Felt? Open Access Macedonian Journal of Medical Sciences, 9(E), 574–580. https://doi.org/10.3889/oamjms.2021.6262
9. Lee, J., & Kim, H.-J. (2022). Normal Aging Induces Changes in the Brain and Neurodegeneration Progress: Review of the Structural, Biochemical, Metabolic, Cellular, and Molecular Changes. Frontiers in Aging Neuroscience, 14, 931536. https://doi.org/10.3389/fnagi.2022.931536
10. Liu, S., Ding, H., Li, D., Lu, F., Luo, G., He, Y., Li, H., Zeng, X., Li, K., Gong, D.-E., Hu, X., Chen, Y., & Yang, X. (2025). Foot Screening And Customized Health Education Program For Patients With Diabetic Peripheral Neuropathy: A Nurse-Led, Real-World Observational Study. International Journal of Nursing Studies Advances, 8, 100291. https://doi.org/10.1016/j.ijnsa.2025.100291
11. Nguyen, V., Dinh, Q., Yu, F., Jia, S., & Wang, X. (2025). Interventional effects of exercise on neuropathy in patients with diabetes: a systematic review with meta-analysis. BMC Sports Science, Medicine & Rehabilitation, 17(1), 82. https://doi.org/10.1186/s13102-025-01136-z
12. Orem, D. E. (2001). Nursing Concepts of Practice (6th ed.). Mosby Inc.
13. Putri, Y. E., Sari, S. P., & Witdiawati, W. (2025). The Effect of Diabetic Foot Exercise on Peripheral Perfusion and Fall Risk in Elderly with Diabetes Mellitus: Case Report. Journal of Nursing Care, 8(2), 106–115. https://doi.org/10.24198/jnc.v8i2.64001
14. Renpenning, K. M., & Taylor, S. G. (2011). Self-care Theory in Nursing : Selected Papers of Dorothea Orem. In Nursing Science Quarterly (Vol. 26, Issue 3). Springer Publishing Company, Inc.
15. Riskesdas. (2018). Laporan Nasional Riset Kesehatan Dasar 2018. In Badan Penelitian dan Pengembangan Kesehatan. Lembaga Penerbit Badan Penelitian dan Pengembangan Kesehatan (LPB). http://labdata.litbang.kemkes.go.id/images/download/laporan/RKD/2018/Laporan_Nasional_RKD2018_FINAL.pdf
16. Seo, Y., & Roh, Y. S. (2020). Effects Of Pressure Ulcer Prevention Training Among Nurses In Long-Term Care Hospitals. Nurse Education Today, 84, 104225. https://doi.org/10.1016/j.nedt.2019.104225
17. Sun, H., Vamos, C. A., Flory, S. S. B., DeBate, R., Thompson, E. L., & Bleck, J. (2017). Correlates Of Long-Term Physical Activity Adherence In Women. Journal of Sport and Health Science, 6(4), 434–442. https://doi.org/10.1016/j.jshs.2016.01.009
18. Tri Lestari, D., & Mundriyastutik, Y. (2023). Motivasi Latihan Fisik Pada Penderita Diabetes Mellitus. Jurnal Ilmu Keperawatan Dan Kebidanan, 14(1), 269–280. https://doi.org/10.26751/jikk.v14i1.1703
19. Uysal, N., & Ünal Toprak, F. (2025). The effect of hand and foot exercises on peripheral neuropathy and quality of life in women with breast cancer: a randomized controlled trial. Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer, 33(2), 83. https://doi.org/10.1007/s00520-025-09145-x
20. World Health Organization. (2024). Guidance On Global Monitoring For Diabetes Prevention And Control: Framework, Indicators and Application. Geneva: World Health Organization. https://creativecommons.org/licenses/by-nc-sa/3.0/igo/
