Effects of 2 Models of Aquatic Exercise Training on Cardiorespiratory Responses of Patients With Type 2 Diabetes: The Diabetes and Aquatic Training Study—A Randomized Controlled Trial

2020 ◽  
Vol 17 (11) ◽  
pp. 1091-1099
Author(s):  
Rodrigo Sudatti Delevatti ◽  
Ana Carolina Kanitz ◽  
Cláudia Gomes Bracht ◽  
Salime Donida Chedid Lisboa ◽  
Elisa Corrêa Marson ◽  
...  

Background: There are a lack of clinical trials with suitable methodological quality that compare aquatic exercise training types in type 2 diabetes (T2D) treatment. This study aimed to compare the effects of aerobic and combined aquatic training on cardiorespiratory outcomes in patients with T2D. Methods: Untrained patients with T2D were randomized to receive an aerobic aquatic training, a combined aquatic training, or a procedure control in 3 weekly sessions for 15 weeks. The sessions were 50 minutes long. The intensities were from 85% to 100% of heart rate of anaerobic threshold and at maximal velocity for aerobic and resistance parts, respectively. Resting heart rate, peak oxygen uptake (VO2peak), and oxygen uptake corresponding to second ventilatory threshold and its relation with VO2peak were evaluated. Results: Participants were 59.0 (8.2) years old and 51% women. Intervention groups increased in VO2peak (aerobic aquatic training group: 4.48 mL·kg−1·min−1, P = .004; combined aquatic training group: 5.27 mL·kg−1·min−1; P = .006) and oxygen uptake corresponding to second ventilatory threshold, whereas the control group presented an increase in oxygen uptake corresponding to second ventilatory threshold and minimal change in VO2peak. Conclusions: Aerobic and combined aquatic exercise interventions improve the cardiorespiratory fitness of patients with T2D.

2020 ◽  
Vol 45 (8) ◽  
pp. 865-874 ◽  
Author(s):  
Simon Green ◽  
Catherine Kiely ◽  
Eamonn O’Connor ◽  
Norita Gildea ◽  
Donal O’Shea ◽  
...  

Effects of training and sex on oxygen uptake dynamics during exercise in type 2 diabetes mellitus (T2DM) are not well established. We tested the hypotheses that exercise training improves the time constant of the primary phase of oxygen uptake (τp oxygen uptake) and with greater effect in males than females. Forty-one subjects with T2DM were assigned to 2 training groups (Tmale, Tfemale) and 2 control groups (Cmale, Cfemale), and were assessed before and after a 12-week intervention period. Twelve weeks of aerobic/resistance training was performed 3 times per week, 60–90 min per session. Assessments included ventilatory threshold (VT), peak oxygen uptake, τp oxygen uptake (80%VT), and dynamic responses of cardiac output, mean arterial pressure and systemic vascular conductance (80%VT). Training significantly decreased τp oxygen uptake in males by a mean of 20% (Tmale = 42.7 ± 6.2 to 34.3 ± 7.2 s) and females by a mean of 16% (Tfemale = 42.2 ± 9.3 to 35.4 ± 8.6 s); whereas τp oxygen uptake was not affected in controls (Cmale = 41.6 ± 9.8 to 42.9 ± 7.6 s; Cfemale = 40.4 ± 12.2 to 40.6 ± 13.4 s). Training increased peak oxygen uptake in both sexes (12%–13%) but did not alter systemic cardiovascular dynamics in either sex. Training improved oxygen uptake dynamics to a similar extent in males and females in the absence of changes in systemic cardiovascular dynamics. Novelty Similar training improvements in oxygen uptake dynamics were observed in males and females with T2DM. In both sexes these improvements occurred without changes in systemic cardiovascular dynamics.


2012 ◽  
Vol 37 (4) ◽  
pp. 599-609 ◽  
Author(s):  
Oscar MacAnaney ◽  
Donal O’Shea ◽  
Stuart A. Warmington ◽  
Simon Green ◽  
Mikel Egaña

Supervised exercise (SE) in patients with type 2 diabetes improves oxygen uptake kinetics at the onset of exercise. Maintenance of these improvements, however, has not been examined when supervision is removed. We explored if potential improvements in oxygen uptake kinetics following a 12-week SE that combined aerobic and resistance training were maintained after a subsequent 12-week unsupervised exercise (UE). The involvement of cardiac output (CO) in these improvements was also tested. Nineteen volunteers with type 2 diabetes were recruited. Oxygen uptake kinetics and CO (inert gas rebreathing) responses to constant-load cycling at 50% ventilatory threshold (VT), 80% VT, and mid-point between VT and peak workload (50% Δ) were examined at baseline (on 2 occasions) and following each 12-week training period. Participants decided to exercise at a local gymnasium during the UE. Thirteen subjects completed all the interventions. The time constant of phase 2 of oxygen uptake was significantly faster (p < 0.05) post-SE and post-UE compared with baseline at 50% VT (17.3 ± 10.7 s and 17.5 ± 5.9 s vs. 29.9 ± 10.7 s), 80% VT (18.9 ± 4.7 and 20.9 ± 8.4 vs. 34.3 ± 12.7s), and 50% Δ (20.4 ± 8.2 s and 20.2 ± 6.0 s vs. 27.6 ± 3.7 s). SE also induced faster heart rate kinetics at all 3 intensities and a larger increase in CO at 30 s in relation to 240 s at 80% VT; and these responses were maintained post-UE. Unsupervised exercise maintained benefits in oxygen uptake kinetics obtained during a supervised exercise in subjects with diabetes, and these benefits were associated with a faster dynamic response of heart rate after training.


2008 ◽  
Vol 115 (9) ◽  
pp. 273-281 ◽  
Author(s):  
Matthew D. Hordern ◽  
Louise M. Cooney ◽  
Elaine M. Beller ◽  
Johannes B. Prins ◽  
Thomas H. Marwick ◽  
...  

The aim of the present study was to determine the effects of a 4-week exercise training intervention on blood glucose, insulin sensitivity, BMI (body mass index) and cardiorespiratory fitness in patients with Type 2 diabetes, and to identify and establish criteria for patients who are more likely to improve their blood glucose from short-term exercise training. A randomized, controlled trial of exercise training, comprising two supervised and one non-supervised sessions of individualized cardiorespiratory and resistance exercise per week, was performed in 132 healthy patients with Type 2 diabetes (exercise training group, n=68), with the aim of accumulating a minimum of 150 min of moderate-intensity exercise for 4 weeks. BMI, waist circumference, blood pressure, blood lipid profile, blood glucose, insulin, insulin sensitivity [calculated by HOMAIR (homoeostasis model assessment of insulin resistance) and QUICKI (quantitative insulin check index)], β-cell function (calculated by HOMAβ-Cell), HbA1c (glycated haemoglobin) and V̇O2max (maximal oxygen consumption) were measured at baseline and at 4 weeks. The exercise training group had significant improvements in V̇O2max, BMI and triacylglycerols (triglycerides). There were no significant changes in blood glucose, HOMAIR, QUICKI or HOMAβ-Cell. Decreases in blood glucose were significantly predicted by baseline blood glucose and HbA1c, with these variables accounting for 15.9% of the change in blood glucose (P<0.001). ROC (receiver operator characteristic) curve analysis revealed that patients with a blood glucose >8.85 mmol/l (sensitivity=73%, specificity=78%) and HbA1c >7.15% (sensitivity=79%, specificity=60%) were more likely to achieve a clinically significant decrease in blood glucose. In conclusion, in apparently healthy patients with Type 2 diabetes, a 4-week exercise intervention improved cardiorespiratory fitness, BMI and triacylglycerols. Elevated blood glucose and HbA1c predicted improvements in blood glucose.


2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Cider Åsa ◽  
Schaufelberger Maria ◽  
Stibrant Sunnerhagen Katharina ◽  
Andersson Bert

Background. Peak oxygen uptake (VO2peak) and muscle function are more decreased in patients with a combination of chronic heart failure (CHF) and type 2 diabetes mellitus (2DM) compared to patients with only one of the conditions. Further, patients with 2DM have peripheral complications that hamper many types of conventional exercises.Aim. To evaluate the efficacy and applicability of eight-week aquatic exercise in patients with the combination of CHF and 2DM.Methods. Twenty patients (four women) with both CHF and 2DM (age67.4±7.1, NYHA II-III) were randomly assigned to either aquatic exercise or a control group. The patients exercised for 45 minutes 3 times/week in 33–34°C, swimming pool.Results. The training programme was well tolerated. Work rate (+11.7±6.6versus−6.4±8.1 watt,P<0.001) andVO2peak(+2.1±0.8versus−0.9±1.4mL⋅kg−1⋅min−1,P<0.001) and walking capacity (P=0.01) increased significantly in the training group. Muscle function was also significantly improved and Hba1c decreased significantly (P<0.01) during training, while fasting glucose, insulin, c-peptide, and lipids were unchanged . Training also increased vitality measured by SF-36 significantly (P=0.05).Conclusion. Aquatic exercise could be used to improve exercise capacity and muscle function in patients with the combination of CHF and 2DM.


2009 ◽  
Vol 33 (10) ◽  
pp. 1198-1206 ◽  
Author(s):  
J A Kanaley ◽  
S Goulopoulou ◽  
R M Franklin ◽  
T Baynard ◽  
M E Holmstrup ◽  
...  

2015 ◽  
Vol 118 (8) ◽  
pp. 1031-1039 ◽  
Author(s):  
Eamonn O'Connor ◽  
Simon Green ◽  
Catherine Kiely ◽  
Donal O'Shea ◽  
Mikel Egaña

We investigated if the magnitude of the type 2 diabetes (T2D)-induced impairments in peak oxygen uptake (V̇o2) and V̇o2 kinetics was affected by age. Thirty-three men with T2D (15 middle-aged, 18 older), and 21 nondiabetic (ND) men (11 middle-aged, 10 older) matched by age were recruited. Participants completed four 6-min bouts of constant-load cycling at 80% ventilatory threshold for the determination of V̇o2 kinetics. Cardiac output (inert-gas rebreathing) was recorded at rest and 30 and 240 s during two additional bouts. Peak V̇o2 (determined from a separate graded test) was significantly ( P < 0.05) reduced in middle-aged and older men with T2D compared with their respective ND counterparts (middle-aged, 3.2 ± 0.5 vs. 2.5 ± 0.5 l/min; older, 2.7 ± 0.4 vs. 2.4 ± 0.4 l/min), and the magnitude of these impairments was not affected by age. However, the time constant of phase II of the V̇o2 response was only slowed ( P < 0.05) in middle-aged men with T2D compared with healthy counterparts, whereas it was similar among older men with and without T2D (middle-aged, 26.8 ± 9.3 vs. 41.6 ± 12.1 s; older, 40.5 ± 7.8 vs. 41.1 ± 8.5 s). Similarly, the “gains” in systemic vascular conductance (estimated from the slope between cardiac output and mean arterial pressure responses) were lower ( P < 0.05) in middle-aged men with T2D than ND controls, but similar between the older groups. The results suggest that the mechanisms by which T2D induces significant reductions in peak exercise performance are linked to a slower dynamic response of V̇o2 and reduced systemic vascular conductance responses in middle-aged men, whereas this is not the case in older men.


2015 ◽  
Vol 309 (8) ◽  
pp. R875-R883 ◽  
Author(s):  
Catherine Kiely ◽  
Joel Rocha ◽  
Eamonn O'Connor ◽  
Donal O'Shea ◽  
Simon Green ◽  
...  

We investigated if the magnitude of the Type 2 diabetes (T2D)-induced impairments in peak oxygen uptake (V̇o2) and V̇o2 kinetics was affected by menopausal status. Twenty-two women with T2D (8 premenopausal, 14 postmenopausal), and 22 nondiabetic (ND) women (11 premenopausal, 11 postmenopausal) matched by age (range = 30–59 yr) were recruited. Participants completed four bouts of constant-load cycling at 80% of their ventilatory threshold for the determination of V̇o2 kinetics. Cardiac output (CO) (inert gas rebreathing) was recorded at rest and at 30 s and 240 s during two additional bouts. Peak V̇o2 was significantly ( P < 0.05) reduced in both groups with T2D compared with ND counterparts (premenopausal, 1.79 ± 0.16 vs. 1.55 ± 0.32 l/min; postmenopausal, 1.60 ± 0.30 vs. 1.45 ± 0.24 l/min). The time constant of phase II of the V̇o2 response was slowed ( P < 0.05) in both groups with T2D compared with healthy counterparts (premenopausal, 29.1 ± 11.2 vs. 43.0 ± 12.2 s; postmenopausal, 33.0 ± 9.1 vs. 41.8 ± 17.7 s). At rest and during submaximal exercise absolute CO responses were lower, but the “gains” in CO larger (both P < 0.05) in both groups with T2D. Our results suggest that the magnitude of T2D-induced impairments in peak V̇o2 and V̇o2 kinetics is not affected by menopausal status in participants younger than 60 yr of age.


2012 ◽  
Vol 303 (1) ◽  
pp. R70-R76 ◽  
Author(s):  
Eamonn O'Connor ◽  
Catherine Kiely ◽  
Donal O'Shea ◽  
Simon Green ◽  
Mikel Egaña

The present study tested the hypothesis that the magnitude of the type 2 diabetes-induced impairments in peak oxygen uptake (V̇o2) and V̇o2 kinetics would be greater in females than males in middle-aged participants. Thirty-two individuals with type 2 diabetes (16 male, 16 female), and 32 age- and body mass index (BMI)-matched healthy individuals (16 male, 16 female) were recruited. Initially, the ventilatory threshold (VT) and peak V̇o2 were determined. On a separate day, subjects completed four 6-min bouts of constant-load cycling at 80% VT for the determination of V̇o2 kinetics using standard procedures. Cardiac output (CO) (inert gas rebreathing) was recorded at rest, 30, and 240 s during two additional bouts. Peak V̇o2 (ml·kg−1·min−1) was significantly reduced in men and women with type 2 diabetes compared with their respective nondiabetic counterparts (men, 27.8 ± 4.4 vs. 31.1 ± 6.2 ml·kg−1·min−1; women, 19.4 ± 4.1 vs. 21.4 ± 2.9 ml·kg−1·min−1). The time constant (s) of phase 2 (τ2) and mean response time (s) of the V̇o2 response (MRT) were slowed in women with type 2 diabetes compared with healthy women (τ2, 43.3 ± 9.8 vs. 33.6 ± 10.0 s; MRT, 51.7 ± 9.4 vs. 43.5 ± 11.4s) and in men with type 2 diabetes compared with nondiabetic men (τ2, 43.8 ± 12.0 vs. 35.3 ± 9.5 s; MRT, 57.6 ± 8.3 vs. 47.3 ± 9.3 s). The magnitude of these impairments was not different between males and females. The steady-state CO responses or the dynamic responses of CO were not affected by type 2 diabetes among men or women. The results suggest that the type 2 diabetes-induced impairments in peak V̇o2 and V̇o2 kinetics are not affected by sex in middle aged participants.


Diabetes Care ◽  
1999 ◽  
Vol 22 (10) ◽  
pp. 1640-1646 ◽  
Author(s):  
S. L. Brandenburg ◽  
J. E. Reusch ◽  
T. A. Bauer ◽  
B. W. Jeffers ◽  
W. R. Hiatt ◽  
...  

Author(s):  
Javier Brazo-Sayavera ◽  
Olga López-Torres ◽  
Álvaro Martos-Bermúdez ◽  
Lorena Rodriguez-Garcia ◽  
Marcela González-Gross ◽  
...  

Background: To evaluate the effectiveness of a multicomponent supervised and unsupervised training program focused on muscle power to counteract the potential changes in sedentary behavior, disability, physical activity (PA), and health-related quality of life (HRQoL) caused by the COVID-19 pandemic domiciliary confinement in prefrail older adults with type 2 diabetes mellitus. Methods: Thirty-five older adults with type 2 diabetes mellitus were assigned to 2 groups according to their frailty status: exercise training group (prefrail or frail; n = 21; 74.7 [4.5] y; 33.3% male) and control group (robust; n = 14; 73.1 [3.9] y; 42.9% male). The exercise training group followed a multicomponent training program focusing on muscle power: supervised (5 wk) and unsupervised (6 wk). The primary outcomes, including PA and sitting time, perceived disability, and HRQoL, were assessed at the baseline and after 11 weeks. Results: At the end of confinement, there were significant decreases in PA in both groups (P < .05). Thus, sitting time increased more in the control group than in the exercise training group (P < .05). The HRQoL measures remained unchanged. Conclusions: Muscle power training before and during mandatory COVID-19 self-isolation in type 2 diabetes mellitus older adults (1) attenuates the COVID-19 domiciliary confinement-related increase in sitting time and (2) slightly decreases the self-reported levels of disability and maintains HRQoL.


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