Evaluation of Changes in the Ankle–Brachial Index Before and After Active Plantar Flexion in Patients with Hypertension

Yekefallah, Leili; Mohammadi, Sareh; Heidari, simin

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Volume 4, Issue 2 (Summer 2026)

Health Res Develop 2026, 4(2): 1-10

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Evaluation of Changes in the Ankle–Brachial Index Before and After Active Plantar Flexion in Patients with Hypertension

Leili Yekefallah

, Sareh Mohammadi

, Simin Heidari ^*¹

1- & Master of Nursing, School of Nursing and Midwifery, Qazvin University of Medical Sciences, Qazvin, Iran) Corresponding Author. , sheidari404@gmail.com

Abstract: (134 Views)

Background: Early detection of peripheral vascular disorders in patients with hypertension is clinically important. The ankle–brachial index (ABI) is a simple and non-invasive tool used for screening peripheral arterial disease. This study aimed to determine changes in ABI before and after the active plantar flexion (APP) technique in patients with hypertension.
Methods: This semi-experimental before–after study was conducted on 147 patients with hypertension referred to medical centers in Karaj, Iran. Systolic blood pressure of the upper and lower limbs was measured using a sphygmomanometer and handheld Doppler, and ABI was calculated at baseline. Participants then performed 50 repetitions of active plantar flexion, after which ABI measurements were repeated. Data were analyzed using SPSS version 25.
Results: The mean right ankle–brachial index (ABI) decreased from 1.087 ± 0/12 at baseline to 1.067 ± 0/13 after performing the active plantar flexion (APP) technique (P = 0/03). Similarly, the mean left ABI decreased from 1/066 ± 0/10 before the intervention to 1.043 ± 0.109 after the APP technique (P = 0/006). Although the number of abnormal ABI values increased after the intervention (from 8 to 12 cases on the right side and from 5 to 13 cases on the left side), these changes were not statistically significant (P > 0/05).
Conclusion: The findings suggest that resting ABI measurement alone is an appropriate and cost-effective method for initial screening of peripheral vascular disorders in patients with hypertension. Although the APP technique resulted in statistically significant changes in ABI, its additional clinical value in improving detection of abnormal cases was limited. The use of this technique may be considered as a complementary approach in specific populations, such as older patients.

Keywords: Hypertension, Ankle–Brachial Index, Peripheral Arterial Disease, Screening, Active Plantar Flexion

Full-Text [PDF 851 kb] (16 Downloads)

Type of Study: Original |
Received: 2025/12/29 | Accepted: 2026/02/14 | Published: 2026/03/21

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Yekefallah L, Mohammadi S, Heidari S. (2026). Evaluation of Changes in the Ankle–Brachial Index Before and After Active Plantar Flexion in Patients with Hypertension. Health Res Develop. 4(2), 1-10.
URL: http://jhrd.trjums.ac.ir/article-1-162-en.html

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