The effect of golf ball foot exercise on ankle brachial index in diabetes mellitus: a pilot study

Introduction: Insulin dysregulation in diabetes mellitus (DM) contributes to peripheral circulation disturbances, which can be quantified using the Ankle-Brachial Index (ABI). Regular foot exercise is essential for enhancing blood flow and preventing vascular complications. This study aimed to evaluate the effect of foot exercise using a golf ball on ABI in patients with type 2 DM (T2DM). Methods: A quantitative, one-group pre and post-test design was employed. A total of 137 T2DM patients, aged 36–59 years, were recruited from four primary health centers in Surabaya, Indonesia. All participants had fasting blood glucose levels above 126 mg/dL in the preceding month. The intervention comprised foot exercises using a golf ball performed twice daily for 5 minutes over 14 consecutive days. ABI measurements were obtained before and after the intervention, and Wilcoxon signed-rank test was used to analyze the data. Results: A total of 137 participants (mean age 53.4 ± 5.3 years, 69% female) completed the 14‑day intervention. The median ABI significantly increased from 0.94 (IQR: 0.3) pre‑intervention to 1.08 (IQR: 0.2) post‑intervention (p < 0.001), indicating improved peripheral arterial function. Binary logistic regression showed that participants had greater odds of achieving a normal post‑intervention ABI (OR 14.9; 95% CI, 3.3–66.4; p < 0.001) after intervention. Gender‑stratified analyses confirmed significant ABI improvements in both males and females (p < 0.001). Conclusion: A 14-day foot exercise regimen using a golf ball effectively improved ABI in T2DM patients, suggesting a potential reduction in the risk of peripheral arterial disease..