Effects of a regular walking exercise program on behavioral and biochemical aspects in elderly people with type II diabetes

Department of Nursing, Catholic University of Daegu Department of Civil Engineering, Keimyung University, Daegu, Korea.
Nursing and Health Sciences (Impact Factor: 1.04). 06/2012; 14(4). DOI: 10.1111/j.1442-2018.2012.00690.x
Source: PubMed


The present study examined the effects of a regular walking exercise program on behavioral (daily physical activity, physical strength, energy consumption) and biochemical (fasting blood glucose [FBG], glycated hemoglobin [HbA1c], total cholesterol, triglycerides [TG], low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol) aspects of elderly people with type II diabetes. A randomized and stratified experimental design was used with experimental and control groups. The experimental group was subjected to a 6 month walking exercise program, involving walking exercise three times per week for 50 min, and a 4 week education program on diet control and the prevention of complications, once per week for 20 min. Post-test was conducted after 3 and 6 months to examine short- and long-term behavioral and biochemical effects. The regular walking exercise program effectively increased daily physical activity, physical strength, and energy consumption (behavioral aspects), and decreased FBG, HbA1c, and TG levels (biochemical aspects) in elderly people with type II diabetes. The incidence of type II diabetes complications might be reduced by implementing a regular walking exercise program.

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    • "A cross-sectional study indicated that each SD increment in steps/d (2,609) is associated with a 0.21% lower HbA1c, after adjusting some anthropometric parameters in patients with T2D [39]. Another randomized and stratified study indicated that step counter use increased daily walking, and improved glycemic control by decreasing HbA1c 0.26% in elderly patients with T2D [40]. However, this meta-analysis gave no strong or conclusive evidence to suggest that step counter use could improve glycemic control. "
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    ABSTRACT: BackgroundWhile step counter use has become popular among type 2 diabetes (T2D) patients, its effectiveness in increasing physical activity (PA) and improving glycemic control has been poorly defined. The aim of this meta-analysis of randomized controlled trials (RCTs) was to evaluate the association of step counter use with PA and glycemic control in T2D patients.MethodsArticles were identified by searches of PubMed, Web of Science and Cochrane Library from January 1994 to June 2013. RCTs in the English language were included, if they had assessed the effectiveness of step counters as motivating and monitoring tools in T2D patients, with reported changes in steps per day (steps/d) or glycosylated hemoglobin A1c (HbA1c), or both. Data were independently collected by 2 authors and overall estimates were made by a random-effects model.ResultsOf the 551 articles retrieved, 11 RCTs were included. Step counter use significantly increased PA by 1,822 steps/d (7 studies, 861 participants; 95% confidence interval (CI): 751 to 2,894 steps/d) in patients with T2D. Step counter use with a PA goal showed a bigger increase in PA (weighted mean difference (WMD) 3,200 steps/d, 95% CI: 2,053 to 4,347 steps/d) than without (WMD 598 steps/d, 95% CI: −65 to 1,260 steps/d). Further subgroup analysis suggested step counter use with a self-set PA goal (WMD 2,816 steps/d, 95% CI: 1,288 to 4,344 steps/d) made no difference in increasing PA from a 10,000 steps/d goal (WMD 3,820 steps/d, 95% CI: 2,702 to 4,938 steps/d). However, no significant HbA1c change was observed by step counter use (10 studies, 1,423 participants; WMD 0.02%, 95% CI: −0.08% to 0.13%), either with (WMD 0.04%, 95% CI: −0.21% to 0.30%) or without a PA goal (WMD 0.01%, 95% CI: −0.10% to 0.13%).ConclusionsStep counter use is associated with a significant increase in PA in patients with T2D. However, evidence regarding its effect in improving glycemic control remains insufficient.Trial registrationPROSPERO CRD42013005236
    BMC Medicine 02/2014; 12(1):36. DOI:10.1186/1741-7015-12-36 · 7.25 Impact Factor
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    • "Most exercise regimens feature walking, and it has been shown that a walking program improves the metabolic profile of patients with type 2 DM (Sung & Bae, 2012). Although prevalence varies, peripheral neuropathy (PN) is common in patients with type 2 DM. "
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    ABSTRACT: Distal symmetric polyneuropathy increases fall risk due to inability to cope with perturbations. We aimed to 1) identify the frontal plane lower limb sensorimotor functions which are necessary for robustness to a discrete, underfoot perturbation during gait; and 2) determine whether changes in the post-perturbed step parameters could distinguish between fallers and non fallers. Forty-two subjects (16 healthy old and 26 with diabetic PN) participated. Frontal plane lower limb sensorimotor functions were determined using established laboratory-based techniques. The subjects' most extreme alterations in step width or step length in response to a perturbation were measured. In addition, falls and fall-related injuries were prospectively recorded. Ankle proprioceptive threshold (APrT; p=.025) and hip abduction rate of torque generation (RTG; p=.041) independently predicted extreme step length after medial perturbation, with precise APrT and greater hip RTG allowing maintenance of step length. Injured subjects demonstrated greater extreme step length changes after medial perturbation than non-injured subjects (percent change = 18.5 ± 9.2 vs. 11.3 ± 4.57; p = .01). The ability to rapidly generate frontal plane hip strength and/or precisely perceive motion at the ankle is needed to maintain a normal step length after perturbation, a parameter which distinguishes between subjects sustaining a fall-related injury and those who did not.
    Journal of diabetes and its complications 10/2013; 28(1). DOI:10.1016/j.jdiacomp.2013.09.001 · 3.01 Impact Factor
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    ABSTRACT: The purpose of this study was to examine factors that influence the quality of life among Tianjin Chinese living with type 2 diabetes. In this study, the quality of life was assessed in 174 participants. The dependent variables included demographic and clinical data, depressive symptoms and lifestyle behavioral factors. Chi-square tests and logistic regression analysis were conducted to identify significant factors. Using multiple regression analyses, the odds ratios (ORs) of having low quality of life were 4.53 (95% confidence interval (CI) = 1.89-10.87), 2.83 (95% CI = 1.21-6.63), and 2.48 (95% CI = 1.03-5.96) for patients with microvascular complications, diabetic neuropathy, and peripheral vascular disease, respectively. Coronary heart disease, depression, and unhealthy eating habits were also found to have significant negative effects on quality of life. In addition, multiple regression analysis showed that regular exercise (OR = 0.29, 95% CI = 0.12-0.71) was a protective factor for health-related quality of life. The identification of these influencing factors will assist nurses to provide continuous care to people living with diabetes, thus to postpone or avoid complications as well as improve their quality of life.
    Nursing and Health Sciences 09/2012; 14(4). DOI:10.1111/j.1442-2018.2012.00734.x · 1.04 Impact Factor
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