Optimal Duration and Frequency of Buerger-Allen and Diabetic Foot Exercises for Foot Sensitivity in Diabetes Mellitus: A Scoping Review

Background: Diabetic peripheral neuropathy (DPN) reduces foot sensitivity and peripheral circulation, increasing ulceration and amputation risk. Buerger-Allen Exercise (BAE) and Diabetic Foot Exercise (DFE) are feasible non-pharmacological interventions. However, standardized evidence on their optimal duration and frequency remains unclear, limiting clinical decision-making and nursing protocols. This scoping review mapped evidence on BAE and DFE duration, frequency, and effects on foot sensitivity in people with diabetes Methods: This review followed Arksey and O’Malley’s framework, Joanna Briggs Institute methodology, Population, Concept, Context principles, and PRISMA-ScR guidelines. We searched PubMed, Scopus, ScienceDirect, ProQuest, and EBSCOhost from January to February 2025 and manually screened references. Eligible studies were English-language, open-access, full-text original studies from 2020 to 2025 that evaluated BAE or DFE duration or frequency and reported foot sensitivity, DPN, ankle-brachial index (ABI), peripheral circulation, plantar pressure, gait, or foot function outcomes. Two reviewers screened titles, abstracts, and full texts using Rayyan QCRI, and a third reviewer resolved disagreements. Data were charted using a standardized form, appraised using JBI checklists, and synthesized through descriptive mapping and thematic categorization. Results: Twelve studies met the criteria, including six DFE studies and six BAE studies. Evidence was organized into three themes: exercise prescription parameters, sensory outcomes, and circulatory or functional outcomes. BAE used variable short-duration protocols and mainly improved peripheral circulation, ABI, and short-term sensory response. DFE, commonly delivered for 20–30 minutes three to five times per week, consistently improved foot sensitivity, plantar balance, gait, and neuropathy outcomes. Gaps remained in standardized protocols, direct comparisons, combined interventions, long-term follow-up, and uniform measures. Conclusion: Moderate-duration DFE may provide consistent sensory benefits, while short-duration BAE may support immediate circulatory effects. Standardized nursing protocols and high-quality comparative trials are needed.