Diabetes Mellitus, Type 2 Clinical Trial
Official title:
Effects of Progressive vs. Non-progressive Water-based Aerobic Training on Type 2 Diabetes Control: a Randomized Clinical Trial
This is a randomized clinical trial with the aim to evaluate the effects of two water-based aerobic training programs (walking or running in shallow pool) on type 2 diabetes control. The sample will be composed by 50 individuals with type 2 diabetes, of both sexes, aged between 40 and 70 years, who will be randomized into water-based progressive aerobic training (PAT, n=25) and water-based non-progressive aerobic training (NPAT, n=25). Both trainings will have 12 weeks of duration with 3 weekly sessions (of 50 minutes each). Biochemical, cardiorespiratory fitness, maximum strength, body composition and functional mobility variables, as also quality of life, sleep quality and depressive symptoms will be analyzed before and after the 12 weeks of training.
Water-based aerobic training can provide benefits with important clinical implications for
type 2 diabetes (T2D) patients, as the aquatic environment provides some interesting
advantages to this population. The lower impact on joints and consequent reduced chance of
injury allows considering the aquatic environment favorable to the principle of continuity
with progression of physiological stimuli and metabolic benefits.
In T2D individuals, studies have been analyzing the effects of water-based aerobic training
in upright position, which have been promoting several results in metabolic parameters of T2D
individuals, including benefits in glucose and lipids levels and in cardiorespiratory
fitness.
The literature shows distinct exercise effects on glucose control of T2D patients, resulting
from different forms of training structuring, with and without progression of training
variables. Well-conducted clinical trials prescribing aerobic training according to American
Diabetes Association (ADA) recommendations (i.e. structured aerobic training with weekly
duration of at least 150 minutes of moderate to vigorous intensity performed in three or more
sessions per week) but with minimal or without progression in training load found no HbA1c
reductions, whereas some studies that did not meet the recommendations but progressed
training volume and/or intensity over time found interesting HbA1c reductions. With these
findings, it seems that the optimization of aerobic training benefits on glucose control may
not solely depend on a fixed training dosage, but also on the progression of the volume
and/or intensity of training.
Due to the associations between T2D with obesity and hypertension, conditions that create
difficulties for individuals performing exercise while supporting their own body mass, the
different responses arising from the studies investigating progressive and non-progressive
aerobic trainings in T2D patients, and with the important facilities that the aquatic
environment can promote during physical exercise performance, it becomes interesting to
investigate the effects of the application of two aquatic aerobic trainings on T2D treatment,
in which similar exercise programs are performed, with one of them having its training
variables fixed over time (non-progressive training) and the other with progression in the
variables (progressive training). To the present moment, no clinical trial has investigated
the comparison between aquatic aerobic training interventions with and without progression in
the training variables on glycemic control of T2D individuals, aiming at exploring the role
of training progression.
For this purpose, a randomized clinical trial with the aim to evaluate the effects of two
water-based aerobic training programs (walking or running in shallow pool) on T2D management
will be performed. The sample will be composed by 50 individuals with T2D, of both sexes,
aged between 40 and 70 years, who will be randomized into water-based progressive aeroibic
training (PAT, n=25) and water-based non-progressive aerobic training (NPAT, n=25). Both
trainings will have 12 weeks of duration with 3 weekly sessions (of 50 minutes each).
Biochemical, cardiorespiratory fitness, maximum strength, body composition and functional
mobility variables, as also quality of life, sleep quality and depressive symptoms will be
analyzed before and after the 12 weeks of training.
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