Type 2 Diabetes Mellitus Clinical Trial
Official title:
Effects of Concurrent Resistance Exercise and High-intensity Interval Exercise Training on Skeletal Muscle Adaptations in Individuals With Type 2 Diabetes Mellitus
It is recommended that individuals perform a combination of resistance exercise (RE) and
endurance exercise. Lack of time is often cited as a reason for being unable to meet current
exercise guidelines. Therefore, combining both forms in one session may be beneficial.
However, research continues to elucidate whether interference of adaptive outcomes occurs
when RE and endurance exercise are performed concurrently. A proposed interference effect
suggests that concurrent training may dampen RE-induced adaptations (e.g., muscle strength
and growth) compared to RE only.
The propose of this investigation is to determine the effects of concurrent RE and
high-intensity interval training (HIIT), compared to RE only, on muscle health and
cardiovascular risk in sedentary, middle-aged (40-65 years) who are overweight/obese with
type 2 diabetes mellitus (T2DM). The investigators will measure the effects on muscle
strength, muscle growth, cardiovascular fitness, glycaemic control and markers of
cardiovascular risk before and after an 8-week training program. Data will be obtained
through the analysis of skeletal muscle samples, blood samples, magnetic resonance imaging,
questionnaires and exercise performance tests.It is hypothesized that concurrent RE + HIIT
will amplify the exercise-induced muscle growth response, which will result in greater
satellite cell content, compared to RE alone. As a result, this will lead to greater skeletal
muscle mass and strength after RE + HIIT compared to RE in isolation.
A finding that concurrent resistance training and HIIT does not impede muscle adaptations
could offer future strategies to minimize exercise time commitment whilst still maximizing
the physiological benefits of both resistance and endurance exercise through a single
training session. This may therefore provide an effective exercise strategy in the prevention
and/or treatment of T2DM.
Data analysis will be performed using IBM SPSS statistical software (IBM Corp., Armonk, New
York, USA). All data will be checked for normality and appropriate log transformations
applied prior to analysis of variance (ANOVA) for primary and secondary outcomes. Satellite
cell content will be compared using a two-way, mixed-model ANOVA with one within (2 levels;
pre- and post-training) and one between factor (2 level; exercise group) with significance
set at P < 0.05.
Based on a mixed ANOVA with between- and within-participant factors, and previously published
data (Babcock et al. 2012), a sample size of 24 participants (12 per group) will provide a
power of 84%. This sample size will allow detection of a mean change in satellite cell
content of 2.35, assuming standard deviations of the change from pre- to post-training as
2.266 and 1.331 in the two exercise groups. Sample size calculation was performed with an
alpha error of 0.05. SamplePower 2.0 (SPSS Inc., Chicago, Illinois, USA) software was used to
determine sample size.
This study will combine data collected at the University of Birmingham with previously
collected data from an identical study design performed by a co-investigator (Dr Pugh) in
Rome, Italy. The previous study has collected data from 10 participants across both exercise
groups (RE, N = 7; RE + HIIT, N = 3). Therefore, it is necessary for the present study to
recruit a further 14 participants (RE, N = 5, RE + HIIT, N = 9) in order to achieve a sample
size of 24 participants (12 per group). However, based on an assumption of a 25% drop-out
rate, the total minimal sample necessary will be 19 participants (RE, N = 7; RE + HIIT, N =
12).
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