scholarly journals Effects of Moderate- Versus High-Intensity Exercise Training on Physical Fitness and Physical Function in People With Type 2 Diabetes: A Randomized Clinical Trial

2014 ◽  
Vol 94 (12) ◽  
pp. 1720-1730 ◽  
Author(s):  
J. David Taylor ◽  
James P. Fletcher ◽  
Ruth Ann Mathis ◽  
W. Todd Cade

Background Exercise training is effective for improving physical fitness and physical function in people with type 2 diabetes. However, limited research has been conducted on the optimal exercise training intensity for this population. Objective The primary study objective was to investigate the effects of moderate- versus high-intensity exercise training on physical fitness and physical function in people with type 2 diabetes. Design This was a randomized clinical trial. Setting The setting was a university campus. Participants Twenty-one people with type 2 diabetes were randomly allocated to receive either moderate-intensity training (MOD group) or high-intensity training (HIGH group). Intervention The MOD group performed resistance training at an intensity of 75% of the 8-repetition maximum (8-RM) and aerobic training at an intensity of 30% to 45% of the heart rate reserve (HRR). The HIGH group performed resistance training at an intensity of 100% of the 8-RM and aerobic training at an intensity of 50% to 65% of the HRR. Measurements Muscle strength (peak torque [newton-meters]), exercise capacity (graded exercise test duration [minutes]), and physical function (Patient-Specific Functional Scale questionnaire) were measured at baseline and 3 months later. Acute exercise-induced changes in glucose levels were assessed immediately before exercise, immediately after exercise, and 1 hour after exercise during the first exercise training session. Results Although both groups showed improvements in physical fitness and physical function, the between-group effect sizes were not statistically significant (exercise capacity estimated marginal mean [EMM] difference=2.1, 95% confidence interval [95% CI]=−0.2, 4.5; muscle strength EMM difference=20.8, 95% CI=−23.3, 65.0; and physical function EMM difference=0.1, 95% CI=−0.6, 0.9). Mean percent changes in glucose levels measured immediately before exercise and immediately after exercise, immediately after exercise and 1 hour after exercise, and immediately before exercise and 1 hour after exercise for the MOD group were −11.4%, −5.0%, and −15.8%, respectively; those for the HIGH group were −21.5%, 7.9%, and −15.3%, respectively. Limitations Sample size, lack of outcome assessor masking, and physical function measurement subjectivity were limitations. Conclusions Moderate- and high-intensity exercise training, as defined in this study, may lead to similar improvements in physical fitness and physical function in people with type 2 diabetes.

2018 ◽  
Vol 103 (7) ◽  
pp. 985-994 ◽  
Author(s):  
Ciarán E. Fealy ◽  
Stephan Nieuwoudt ◽  
Julie A. Foucher ◽  
Amanda R. Scelsi ◽  
Steven K. Malin ◽  
...  

2019 ◽  
Author(s):  
Joshua E. McGee ◽  
Savanna G. Barefoot ◽  
Nicole R. Gniewek ◽  
Patricia M. Brophy ◽  
Angela Clark ◽  
...  

Abstract Background African Americans have a disproportionate prevalence and incidence of type 2 diabetes compared to Caucasians. Recent evidence indicates low cardiorespiratory fitness (CRF) level, an independent risk factor for type 2 diabetes, is also more prevalent in African Americans than Caucasians. Numerous studies in Caucasian populations suggest vigorous exercise intensity may promote greater improvements in CRF and other type 2 diabetes risk factors (e.g. reduction of glucose/insulin levels, pulse wave velocity, body fat, etc.) than moderate intensity. However, current evidence comparing health benefits of different aerobic exercise intensities on type 2 diabetes risk factors in African Americans is negligible. This is clinically important as African Americans have a greater risk for type 2 diabetes and are less likely to meet public health recommendations for physical activity than Caucasians. The purpose of the High-Intensity exercise to Promote Accelerated improvements in CardiorEspiratory fitness (HI-PACE) study is to evaluate whether high-intensity aerobic exercise elicits greater improvements in CRF, insulin action, and arterial stiffness than moderate-intensity exercise in African Americans. Methods/Design­ A randomized controlled trial will be performed on overweight and obese (body mass index: 25-45 kg/m2) African Americans (35-65 years) (n=60). Participants will be randomized to moderate-intensity (MOD-INT) or high-intensity (HIGH-INT) aerobic exercise training, or a non-exercise control group (CON) for 24 weeks. Supervised exercise will be performed at a heart rate associated with 45-55% and 70-80% of VO2 max in the MOD-INT and the HIGH-INT groups, respectively, for an exercise dose of 600 MET-minutes/week (consistent with public health recommendations). The primary outcome is change in CRF. Secondary outcomes include change in insulin sensitivity (measured via an intravenous glucose tolerance test), skeletal muscle mitochondrial oxidative capacity (via near infrared spectroscopy), skeletal muscle measurements (i.e. citrate synthase, COX IV, GLUT-4, CPT-1, PGC1-α), arterial stiffness (via carotid-femoral pulse wave velocity), body fat, C-reactive protein, and psychological outcomes (quality of life/exercise enjoyment). Discussion The anticipated results of the HI-PACE study will provide vital information on the health effects of high-intensity exercise in African Americans. This study will advance health disparity research and has the potential to influence future public health guidelines for physical activity. Trial Registration ClinicalTrials.gov ID: NCT02892331. Registered on 8 September 2016, https://clinicaltrials.gov/ct2/show/NCT02892331


Author(s):  
Lora-Pozo ◽  
Lucena-Anton ◽  
Salazar ◽  
Galán-Mercant ◽  
Moral-Munoz

Abstract: This study aims to evaluate the effectiveness of high-intensity interval training compared with no intervention and other types of training interventions for people with Type 2 Diabetes. A systematic review and meta-analysis of randomized controlled trials that used high-interval intensity training to improve anthropometric, cardiopulmonary and metabolic conditions were conducted. The search was performed during October–December 2017 using the databases PubMed, Web of Science and Physiotherapy Evidence Database (PEDro). The methodological quality of the studies was evaluated using the PEDro scale. A total of 10 articles were included in this meta-analysis. After statistical analysis, favorable results were obtained for high-Intensity Interval Training compared with control (non-intervention): [Weight: Standardized mean difference (SMD) = −2.09; confidence interval (CI) 95%: (−3.41; −0.78); body-mass index: SMD = −3.73; CI 95%: (−5.53; −1.93); systolic blood pressure: SMD = −4.55; CI 95%: (−8.44; −0.65); VO2max: SMD = 12.20; CI 95%: (0.26; 24.14); HbA1c: SMD = −3.72; CI 95%: (−7.34; −0.10)], moderate intensity continuous training: [body-mass index: SMD = −0.41; CI 95%: (−0.80; −0.03); VO2max: SMD = 1.91; CI 95%: (0.18; 3.64)], and low intensity training: [Weight: SMD = −2.06; CI 95%: (−2.80; −1.31); body-mass index: SMD = −3.04; CI 95%: (−5.16; −0.92); systolic blood pressure: SMD = −2.17; CI 95%: (−3.93; −0.41); HbA1c: SMD = −1.58; CI 95%: (−1.84; −1.33)]. The results show that high-intensity interval training can be a useful strategy in order to improve anthropometric, cardiopulmonary and metabolic parameters in people with Type 2 diabetes. Despite this, it could be essential to clarify and unify criteria in the intervention protocols, being necessary new lines of research.


2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Seyedeh Hoda Seyedizadeh ◽  
Sadegh Cheragh-Birjandi ◽  
Mohammad Reza Hamedi Nia

Diabetic peripheral neuropathy is one of the most common chronic complications of diabetics which causes nerve damage and muscle strength decrease in patients. This in turn results in imbalance leading to the diabetic patients’ daily activity disparity. The present investigation was conducted to specifically study the effects of combined training (resistance-aerobic) on serum kinesin-1 and physical function in type 2 diabetes patients with diabetic peripheral neuropathy. 24 diabetic neuropathic females were randomly to be selected out and divided into two experimental and control groups. The experimental group received resistance-aerobic training for 3 sessions during eight weeks. The exercise training included resistance exercises with 2-3 sets, 6-7 exercise stations, 8-12 repetitions (reps), and 3-5 minutes of rest in between the exercises, and the aerobic exercises contained 50-65% of heart rate reserve (HRR) for 3 minutes with 30 seconds of rest interval between sets and 5-10 repetitions. Results show that the serum kinesin-1 level and aerobic endurance declined after eight weeks of combined (resistance-aerobic) exercise training, but this decrease was not significant. The upper body strength increased but it was not significant, while the lower body showed a significant strength increase. With regard to the progressive nature of diabetic peripheral neuropathy, it seems that even the little changes resulting from the combined exercise training can be useful. Nevertheless, more research is required in this area.


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