Diabetes
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Publicado: 10 de julio de 2011
Diabetes Special Issue
Comparison of Combined Aerobic and High-Force Eccentric Resistance Exercise With Aerobic Exercise Only for People With Type 2 Diabetes Mellitus
Robin L Marcus, Sheldon Smith, Glen Morrell, Odessa Addison, Leland E Dibble, Donna Wahoff-Stice, Paul C LaStayo
RL Marcus, PT, PhD, is Associate Professor, Department of Physical Therapy and Department of Exercise and SportScience, University of Utah, 520 Wakara Way, Salt Lake City, UT 84108 (USA). Address all correspondence to Dr Marcus at: robin.marcus@hsc. utah.edu. S Smith, MS, CDE, is Certified Diabetes Educator, Department of Physical Therapy, University of Utah. G Morrell, MD, PhD, is Assistant Professor, Department of Radiology, University of Utah. O Addison, PT, DPT, is Physical Therapist, Department of PhysicalTherapy, University of Utah. LE Dibble, PT, PhD, is Associate Professor, Department of Physical Therapy and Department of Exercise and Sport Science, University of Utah. D Wahoff-Stice, FNP, is Family Nurse Practitioner, Diabetes Center, University of Utah. PC LaStayo, PT, PhD, is Associate Professor, Department of Physical Therapy, Department of Exercise and Sport Science, and Department ofOrthopedics, University of Utah. [Marcus RL, Smith S, Morrell G, et al. Comparison of combined aerobic and high-force eccentric resistance exercise with aerobic exercise only for people with type 2 diabetes mellitus. Phys Ther. 2008;88:1345–1354.] © 2008 American Physical Therapy Association
Background and Purpose. The purpose of this study was to compare the
outcomes between a diabetes exercisetraining program using combined aerobic and high-force eccentric resistance exercise and a program of aerobic exercise only.
Subjects and Methods. Fifteen participants with type 2 diabetes mellitus
(T2DM) participated in a 16-week supervised exercise training program: 7 (mean age 50.7 years, SD 6.9) in a combined aerobic and eccentric resistance exercise program (AE/RE group) and 8 (mean age58.5 years, SD 6.2) in a program of aerobic exercise only (AE group). Outcome measures included thigh lean tissue and intramuscular fat (IMF), glycosylated hemoglobin, body mass index (BMI), and 6-minute walk distance.
Results. Both groups experienced decreases in mean glycosylated hemoglobin
after training (AE/RE group: 0.59% [95% confidence interval (CI) 1.5 to 0.28]; AE group: 0.31% [95% CI0.60 to 0.03]), with no significant between-group differences. There was an interaction between group and time with respect to change in thigh lean tissue cross-sectional area, with the AE/RE group gaining more lean tissue (AE/RE group: 15.1 cm2 [95% CI 7.6 to 22.5]; AE group: 5.6 cm2 [95% CI 10.4 to 0.76]). Both groups experienced decreases in mean thigh IMF cross2.6 to 0.26]; AE group: 2.2 cm2sectional area (AE/RE group: 1.2 cm2 [95% CI [95% CI 3.5 to 0.84]) and increases in 6-minute walk distance (AE/RE group: 45.5 m [95% CI 7.5 to 83.6]; AE group: 29.9 m [95% CI 7.7 to 67.5]) after training, with no between-group differences. There was an interaction between group and time with respect to change in BMI, with the AE/RE group experiencing a greater decrease in BMI.
Discussion andConclusion. Significant improvements in long-term glycemic control, thigh composition, and physical performance were demonstrated in both groups after participating in a 16-week exercise program. Subjects in the AE/RE group demonstrated additional improvements in thigh lean tissue and BMI. Improvements in thigh lean tissue may be important in this population as a means to increase resting metabolic rate,protein reserve, exercise tolerance, and functional mobility.
Visit www.ptjournal.org for a podcast discussion focusing on fat, muscle, and the benefits of exercise for people with diabetes.
November 2008 Volume 88 Number 11
Post a Rapid Response or find The Bottom Line: www.ptjournal.org Physical Therapy f 1345
Combined Aerobic and Eccentric Resistance Exercise Versus Aerobic Exercise...
Comparison of Combined Aerobic and High-Force Eccentric Resistance Exercise With Aerobic Exercise Only for People With Type 2 Diabetes Mellitus
Robin L Marcus, Sheldon Smith, Glen Morrell, Odessa Addison, Leland E Dibble, Donna Wahoff-Stice, Paul C LaStayo
RL Marcus, PT, PhD, is Associate Professor, Department of Physical Therapy and Department of Exercise and SportScience, University of Utah, 520 Wakara Way, Salt Lake City, UT 84108 (USA). Address all correspondence to Dr Marcus at: robin.marcus@hsc. utah.edu. S Smith, MS, CDE, is Certified Diabetes Educator, Department of Physical Therapy, University of Utah. G Morrell, MD, PhD, is Assistant Professor, Department of Radiology, University of Utah. O Addison, PT, DPT, is Physical Therapist, Department of PhysicalTherapy, University of Utah. LE Dibble, PT, PhD, is Associate Professor, Department of Physical Therapy and Department of Exercise and Sport Science, University of Utah. D Wahoff-Stice, FNP, is Family Nurse Practitioner, Diabetes Center, University of Utah. PC LaStayo, PT, PhD, is Associate Professor, Department of Physical Therapy, Department of Exercise and Sport Science, and Department ofOrthopedics, University of Utah. [Marcus RL, Smith S, Morrell G, et al. Comparison of combined aerobic and high-force eccentric resistance exercise with aerobic exercise only for people with type 2 diabetes mellitus. Phys Ther. 2008;88:1345–1354.] © 2008 American Physical Therapy Association
Background and Purpose. The purpose of this study was to compare the
outcomes between a diabetes exercisetraining program using combined aerobic and high-force eccentric resistance exercise and a program of aerobic exercise only.
Subjects and Methods. Fifteen participants with type 2 diabetes mellitus
(T2DM) participated in a 16-week supervised exercise training program: 7 (mean age 50.7 years, SD 6.9) in a combined aerobic and eccentric resistance exercise program (AE/RE group) and 8 (mean age58.5 years, SD 6.2) in a program of aerobic exercise only (AE group). Outcome measures included thigh lean tissue and intramuscular fat (IMF), glycosylated hemoglobin, body mass index (BMI), and 6-minute walk distance.
Results. Both groups experienced decreases in mean glycosylated hemoglobin
after training (AE/RE group: 0.59% [95% confidence interval (CI) 1.5 to 0.28]; AE group: 0.31% [95% CI0.60 to 0.03]), with no significant between-group differences. There was an interaction between group and time with respect to change in thigh lean tissue cross-sectional area, with the AE/RE group gaining more lean tissue (AE/RE group: 15.1 cm2 [95% CI 7.6 to 22.5]; AE group: 5.6 cm2 [95% CI 10.4 to 0.76]). Both groups experienced decreases in mean thigh IMF cross2.6 to 0.26]; AE group: 2.2 cm2sectional area (AE/RE group: 1.2 cm2 [95% CI [95% CI 3.5 to 0.84]) and increases in 6-minute walk distance (AE/RE group: 45.5 m [95% CI 7.5 to 83.6]; AE group: 29.9 m [95% CI 7.7 to 67.5]) after training, with no between-group differences. There was an interaction between group and time with respect to change in BMI, with the AE/RE group experiencing a greater decrease in BMI.
Discussion andConclusion. Significant improvements in long-term glycemic control, thigh composition, and physical performance were demonstrated in both groups after participating in a 16-week exercise program. Subjects in the AE/RE group demonstrated additional improvements in thigh lean tissue and BMI. Improvements in thigh lean tissue may be important in this population as a means to increase resting metabolic rate,protein reserve, exercise tolerance, and functional mobility.
Visit www.ptjournal.org for a podcast discussion focusing on fat, muscle, and the benefits of exercise for people with diabetes.
November 2008 Volume 88 Number 11
Post a Rapid Response or find The Bottom Line: www.ptjournal.org Physical Therapy f 1345
Combined Aerobic and Eccentric Resistance Exercise Versus Aerobic Exercise...
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