Article

Minimal difference between aerobic and progressive resistance exercise on metabolic profile and fitness in older adults with diabetes mellitus: a randomised trial

Department of Physiotherapy, Singapore General Hospital, Singapore.
Journal of physiotherapy (Impact Factor: 2.89). 01/2010; 56(3):163-70. DOI: 10.1016/S1836-9553(10)70021-7
Source: PubMed

ABSTRACT Is progressive resistance training as effective as aerobic training of similar duration in sedentary older adults with diabetes mellitus?
A randomised trial with concealed allocation, assessor blinding and intention-to-treat analysis.
Sixty people with Type 2 diabetes mellitus with glycosylated haemoglobin (HbA1c) between 8% and 10% in the past month.
One group undertook progressive resistance exercise and the other group undertook aerobic exercise. Both groups completed 18 sessions over 8 weeks. In each session, the progressive resistance exercise group did nine resistive exercises while the aerobic exercise group did 50 minutes of aerobic exercise.
HbA1c, blood glucose, lipid profile (total, high- and low-density cholesterol and triglycerides), weight, body mass index, body fat, waist circumference, waist:hip ratio, blood pressure, and peak oxygen consumption.
Forty-nine (82%) participants completed the intervention. HbA1c reduced by a similar amount in both groups (MD 0.1%, 95% CI -0.3 to 0.5). However, significant between-group differences occurred in change in waist circumference in favour of progressive resistance exercise (MD -1.8 cm, 95% CI -0.5 to -3.1), and in change in peak oxygen consumption in favour of aerobic exercise (MD 5.2 ml/kg, 95% CI 0.0 to 10.4).
Progressive resistance exercise has similar effects to aerobic exercise and therefore offers a useful alternative for patients unable to participate in aerobic exercise.
NCT01000519.

Full-text

Available from: Rahul Malhotra, Jun 03, 2015
1 Follower
 · 
102 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: Resistance and aerobic exercises are both recommended as effective treatments for people with type 2 diabetes. However, the optimum type of exercise for the disease remains to be determined to inform clinical decision-making and facilitate personalized exercise prescription. Our objective was to investigate whether resistance exercise is comparable to aerobic exercise in terms of effectiveness and safety in people with type 2 diabetes. PubMed, EMBASE, CENTRAL, CINAHL, and SPORTdiscus were systematically searched up to March 2013. The reference lists of eligible studies and relevant reviews were also checked. We used the following criteria to select studies for inclusion in the review: (i) the study was a randomized controlled trial; (ii) the participants were people with type 2 diabetes aged 18 years or more; (iii) the trial compared resistance exercise with aerobic exercise for a duration of at least 8 weeks, with pre-determined frequency, intensity, and duration; and (iv) the trial provided relevant data on at least one of the following: glycaemic control, blood lipids, anthropometric measures, blood pressure, fitness, health status, and adverse events. The assessment of study quality was based on the Cochrane Risk of Bias tool. For effectiveness measures, differences (resistance group minus aerobic group) in the changes from baseline with the two exercises were combined, using a random-effects model wherever possible. For adverse events, the relative risks (resistance group vs. aerobic group) were combined. Twelve trials (n = 626) were included. Following the exercise interventions, there was a greater reduction of glycosylated hemoglobin with aerobic exercise than with resistance exercise (difference 0.18 % (1.97 mmol/mol), 95 % confidence interval (CI) 0.01, 0.36). This difference became non-significant with sensitivity analysis (p = 0.14). The differences in changes from baseline were also statistically significant for body mass index (difference 0.22, 95 % CI 0.06, 0.39), peak oxygen consumption (difference -1.84 mL/kg/min, 95 % CI -3.07, -0.62), and maximum heart rate (difference 3.44 beats per minute, 95 % CI 2.49, 4.39). Relative risks for adverse events (all) and serious adverse events were 1.17 (95 % CI 0.77, 1.79) and 0.89 (95 % CI 0.18, 4.39), respectively. Most included trials were short term (8 weeks to 6 months), and seven had important methodological limitations. Additionally, the meta-analyses for some of the secondary outcomes had a small number of participants or substantial statistical heterogeneity. Although differences in some diabetic control and physical fitness measures between resistance exercise and aerobic exercise groups reached statistical significance, there is no evidence that they are of clinical importance. There is also no evidence that resistance exercise differs from aerobic exercise in impact on cardiovascular risk markers or safety. Using one or the other type of exercise for type 2 diabetes may be less important than doing some form of physical activity. Future long-term studies focusing on patient-relevant outcomes are warranted.
    12/2013; DOI:10.1007/s40279-013-0128-8
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Aims/hypothesis This study aimed to systematically review randomised controlled trials comparing the effects of aerobic exercise training (AET), resistance training (RT) and combined training (CT) on glycaemic control and blood lipids in patients with type 2 diabetes mellitus. Methods Searches were performed in MEDLINE, EMBASE and the Cochrane Library. Inclusion criteria were: type 2 diabetes mellitus, adult, supervised training and a minimum intervention period of 8 weeks. Pooled effects were calculated by fixed/random effect pairwise and Bayesian fixed/random effects network meta-analyses. Results A total of 14 trials enrolling 915 participants were included. AET was more effective than RT in improving HbA(1c) levels (mean difference [MD] -0.20% [-2.2 mmol/mol]; 95% CI -0.32, -0.08; p=0.0007, 10 trials/515 participants) and fasting glucose (MD -0.9 mmol/l; 95% CI -1.71, -0.09; p=0.03, 8 trials/245 participants). Compared with AET, CT resulted in a significantly more pronounced reduction in HbA(1c) (MD -0.17% [-1.87 mmol/mol]; 95% CI -0.31, -0.03; p=0.02, 9 trials/493 participants). Compared with RT, the MD of the change in HbA(1c) (MD -0.62%, [-6.82 mmol/mol]; 95% CI -0.95, -0.30; p=0.0002, 5 trials/362 participants], fasting glucose (MD -1.99 mmol/l; 95% CI -3.07, -0.90; p=0.0003, 3 trials/99 participants) and triacylglycerols (MD -0.28 mmol/l; 95% CI -0.46, -0.10; p=0.003, 4 trials/213 participants) were all in favour of CT. The exclusion of trials with a high risk of bias yielded only non-significant results. Conclusions/interpretation The present data suggest that CT might be the most efficacious exercise modality to improve glycaemic control and blood lipids. Interpretation with respect to clinical relevance is limited by the low quality of the studies included and the limited information on the clinically important outcomes or adverse effects of exercise.
    Diabetologia 07/2014; 57(9). DOI:10.1007/s00125-014-3303-z · 6.88 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: El presente trabajo es una revisión sistemática de la literatura específica, de los trabajos de investigación publicados en los últimos 5 años, de texto de acceso libre completo, en la base de datos de Pubmed; que contemplaran en su metodología la aplicación de ejercicios de resistencia aeróbica y de fuerza muscular, en personas con diabetes mellitus tipo 2 (DM-2). Se buscaron las palabras: diabetes type 2, resistance, aerobic, training. Luego de aplicar criterios de exclusión, quedaron 7 artículos. De los cuales se sintetizaron las características principales de los sujetos participantes; la magnitud de la carga del ejercicio: y las adaptaciones reportadas, referidas: al control de la glucemia, la composición corporal, y otras que los autores mencionaran como relevantes. El entrenamiento de fuerza y de resistencia, parecen tener similares efectos sobre la HbA1c; lo que no es igual respecto a la composición corporal, el consumo de oxígeno, y el torque muscular. Los datos presentados, dejan en claro que ambas orientaciones son relevantes para las personas con DM-2, y deben ser propuestas, en forma simultanea, desestimando el trabajo selectivo sobre una de ellas.
    3° Encuentro Nacional de Investigación e Investigadores. REDAF & IFES., Neuquén, Neuquén, Argentina; 10/2013