Type-2 Diabetes Clinical Trial
Official title:
The Effect of Supervised Exercise Programs on Exercise Capacity and Pulmonary Capacity in Type-2 Diabetic Patients
Diabetes, beyond glycemic control, is a complex chronic disease that requires continuous
medical care with multifactorial risk reduction strategies. It is necessary to reduce the
likelihood of complications and additional problems that may develop in the long term. For
this reason, guiding the patient to manage the disease process, equipping and supporting the
patient with the necessary information is critical to prevent acute problems.
Exercise is the primary treatment method for diabetes patients. Exercise; It is the main
treatment method used to increase aerobic capacity and improve respiratory capacity due to
the positive effect it has on the body's structure and systems.
Firstly, patients were examined by the specialist doctor. If patients appropriate for this
study according to inclusion and exclusion criteria, they were consulted to Cardiologist for
stress ECG test and acceptation report to high or moderate-intensity aerobic training.
After baseline testing (including aerobic capacity and lung capacity), appropriate patients
were randomized to HIIT or MICT groups involving sixteenth sessions of exercise performed
over 6 weeks The HIIT exercise protocol involved 28 minutes of treadmill efforts. The
patients performed the interval training for 4 minutes with 80%HRmax and active recovery
period maintained for 3 minutes with 60% HRmax on the treadmill. This protocol repeated 4
times in a session. The MICT exercise protocol performed with %60 HRmax for 28 minutes
similarly HIIT group. A 10-min warm-up and 10-min cool-down period were included for all
groups. All groups reassessed after the 6. weeks (end of the exercise program) and 12. weeks
(follow-up period).
Aerobic capacity assessed with an Incremental Shuttle Walk Test (ISWT). Clinicians need to 10
m field, audiotape recorder, chronometer, and two markers. This test consists of 12 levels,
every level maintains1 minute and the walking speed is increased after every1 minute
intervals. If the patients wanted to stop because of fell breathless or can't reach the end
of the 10 m line' last 0.5 m in the time allowed, the test was stopped.Estimated VO2max was
calculated a formula as "Estimated VO2max (ml/dk/kg)= 4.19 + (0.025 x ISWT distance)".
The patient's pulmonary functions assessed with a digital spirometer (Pony FX, COSMED Inc.,
Italy). Spirometer device measures FVC, FEV1, FEV1/FVC and PEF values. During the test, upper
extremity was straight and patients sitting straight position on the chair with their
vertical feet on the floor. The measurements were performed 3 times and the best score
recorded with mean and standard deviation.
The measurements were coded into the analysis program and checked by a second researcher.
Post-hoc power analysis was done using aerobic capacity data, which is the main output of our
study. The power of the study was determined as 94%.
Patients who had missing data, patients who did not complete the 6-weeks exercise program and
12. weeks follow-up period were excluded from the analysis. All analyses were performed using
the Statistical Package for the Social Sciences (SPSS) version 22. 0 for Windows. Data are
expressed as mean ± standard deviation. The one-sample Kolmogorov-Smirnov test was performed
to assess the distribution of data. Due to their distribution, numerical variables in
different subjects were compared with the t-test or Mann-Whitney U test. Comparison of
variables before and after the exercise program were compared by the paired t-test
(parametric variable) or Wilcoxon test (non-parametric variable). Probability values were
two-tailed, and a p-value of less than 0.05 was considered as significant.
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