The effect of a supported exercise programme in patients with newly diagnosed Type 2 diabetes: A pilot study

Abstract

The aim of this study was to examine the effectiveness of either a standard care programme (n?=?9) or a 12-week supported exercise programme (n?=?10) on glycaemic control, β-cell responsiveness, insulin resistance, and lipid profiles in newly diagnosed Type 2 diabetes patients. The standard care programme consisted of advice to exercise at moderate to high intensity for 30?min five times a week; the supported exercise programme consisted of three 60-min supported plus two unsupported exercise sessions per week. Between-group analyses demonstrated a difference for changes in low-density lipoprotein cholesterol only (standard care programme 0.01 mmol?·?L^?1, supported exercise programme –0.6 mmol?·?L^?1; P?=?0.04). Following the standard care programme, within-group analyses demonstrated a significant reduction in waist circumference, whereas following the supported exercise programme there were reductions in glycosylated haemoglobin (6.4 vs. 6.0%; P?=?0.007), waist circumference (101.4 vs. 97.2?cm; P?=?0.021), body mass (91.7 vs. 87.9?kg; P?=?0.007), body mass index (30.0 vs. 28.7?kg?·?m^?2; P?=?0.006), total cholesterol (5.3 vs. 4.6 mmol?·?L^?1; P?=?0.046), low-density lipoprotein cholesterol (3.2 vs. 2.6 mmol?·?L^?1; P?=?0.028), fasting β-cell responsiveness (11.5?×?10^?9 vs. 7.0?×?10^?9 pmol?·?kg^?1?·?min^?1; P?=?0.009), and insulin resistance (3.0 vs. 2.1; P?=?0.049). The supported exercise programme improved glycaemic control through enhanced β-cell function associated with decreased insulin resistance and improved lipid profile. This research highlights the need for research into unsupported and supported exercise programmes to establish more comprehensive lifestyle advice for Type 2 diabetes patients.     

Morphological and health-related changes associated with a 12-week self-guided exercise programme in overweight adults: a pilot study

Abstract

Over 12 weeks, supervised physical activity (PA) interventions have demonstrated improvements in morphological and health parameters, whereas community walking programmes have not. The present study piloted a self-guided programme for promoting PA and reducing sedentary behaviour in overweight individuals and measured its effect on a range of health outcomes. Six male and 16 female sedentary adults aged 48.5 ± 5.5 years with body mass index (BMI) 33.4 ± 6.3 kg m^?2 were assessed for anthropometric variables, blood pressure, functional capacity, well-being and fatigue. After an exercise consultation, participants pursued their own activity and monitored PA points weekly. At baseline, mid-point and 12 weeks, eight participants wore activity monitors, and all participants undertook a 5-day food diary to monitor dietary intake. In 17 completers, mass, BMI, sit-to-stand, physical and general fatigue had improved by 6 weeks. By 12 weeks, waist, sagittal abdominal diameter (SAD), diastolic blood pressure, well-being and most fatigue dimensions had also improved. Throughout the intervention, PA was stable, energy intake and lying time decreased and standing time increased; thus, changes in both energy intake and expenditure explain the health-related outcomes. Observed changes in function, fatigue and quality of life are consistent with visceral fat loss and can occur at levels of weight loss which may not be considered clinically significant.     

Antidepressant effects associated with different exercise conditions in participants with depression: a pilot study

In this article, we examined the antidepressant influence of an 8-week-long aerobic exercise intervention in which two training parameters were manipulated: exercise frequency and group environment. Twenty-three individuals with elevated symptoms of depression were recruited in a sport and fitness facility and agreed to participate in this 8-week study. They were randomly assigned to three groups: (a) low-frequency exercise (control) (n = 7), (b) high-frequency exercise (n = 8), and (c) high-frequency exercise + group-based intervention (n = 8). Participants completed the Beck Depression Inventory (BDI-II) at study entry, and at 4 and 8 weeks subsequently. The results showed that those in the high-frequency aerobic exercise experimental groups reported lower depression scores than those in the low-frequency (control) group at 4 weeks (13.2 +/- 7.3 and 11.7 +/- 3.1 vs. 22.4 +/- 7.5) and 8 weeks (10.9 +/- 8.1 and 9.6 +/- 2.5 vs. 20.7 +/- 6.3). However, alleviation in depressive symptoms was not found to be greater in those participants who received a group-based intervention.     

不同运动方式对2型糖尿病患者血糖相关指标的影响

目的:比较12周有氧运动和抗阻训练对2型糖尿病患者血糖相关指标影响的差异,为制定特异性的运动处方提供依据.方法:将符合标准的受试者随机分为有氧运动组(14人)、抗阻训练组(13人)、对照组(15人),有氧运动组和抗阻训练组进行每周3次、共12周的运动干预,对照组保持日常生活习惯不变.实验前后分别测定血糖(包括空腹血糖和运动后非空腹血糖)、糖化血红蛋白(HbA1c)、心率和血压等指标.结果:12周运动干预后,有氧运动组和抗阻训练组空腹血糖、运动后非空腹血糖、HbA1c均下降(P<0.05),但抗阻训练组运动后非空腹血糖、HbA1c降低的程度(分别为38%和21%)要大于有氧运动组(分别为26%和9%)(P<0.01),两组安静心率和血压无显著变化(P>0.05).对照组所有指标的变化不明显.结论:有氧运动和抗阻训练均能有效降低2型糖尿病患者的血糖和HbA1c水平,但抗阻训练对运动后非空腹血糖和HbA1c水平的改善要优于有氧运动.     

The effect of a cadence retraining protocol on running biomechanics and efficiency: a pilot study

Many studies have documented the association between mechanical deviations from normal and the presence or risk of injury. Some runners attempt to change mechanics by increasing running cadence. Previous work documented that increasing running cadence reduces deviations in mechanics tied to injury. The long-term effect of a cadence retraining intervention on running mechanics and energy expenditure is unknown. This study aimed to determine if increasing running cadence by 10% decreases running efficiency and changes kinematics and kinetics to make them less similar to those associated with injury. Additionally, this study aimed to determine if, after 6 weeks of cadence retraining, there would be carryover in kinematic and kinetic changes from an increased cadence state to a runner’s preferred running cadence without decreased running efficiency. We measured oxygen uptake, kinematic and kinetic data on six uninjured participants before and after a 6-week intervention. Increasing cadence did not result in decreased running efficiency but did result in decreases in stride length, hip adduction angle and hip abductor moment. Carryover was observed in runners’ post-intervention preferred running form as decreased hip adduction angle and vertical loading rate.     

Sleep quality improved following a single session of moderate-intensity aerobic exercise in older women: Results from a pilot study

BackgroundPoor sleep quality is associated with adverse effects on health outcomes. It is not clear whether exercise can improve sleep quality and whether intensity of exercise affects any of the effects.MethodsFifteen healthy, non-obese (body mass index = 24.4 ± 2.1 kg/m², mean ± SD), sedentary (<20 min of exercise on no more than 3 times/week) older women (66.1 ± 3.9 years) volunteered for the study. Peak oxygen consumption (VO_2peak) was evaluated using a graded exercise test on a treadmill with a metabolic cart. Following a 7-day baseline period, each participant completed two exercise sessions (separated by 1 week) with equal caloric expenditure, but at different intensities (60% and 45% VO_2peak, sequence randomized) between 9:00 and 11:00 am. A wrist ActiGraph monitor was used to assess sleep at baseline and two nights following each exercise session.ResultsThe average duration of the exercise was 54 and 72 min, respectively at 60% (moderate-intensity) and 45% VO_2peak (light-intensity). Wake time after sleep onset was significantly shorter (p = 0.016), the number of awakenings was less (p = 0.046), and total activity counts were lower (p = 0.05) after the moderate-intensity exercise compared to baseline no-exercise condition.ConclusionOur data showed that a single moderate-intensity aerobic exercise session improved sleep quality in older women.     

Effect of a health-improvement pilot programme for older adults delivered by a professional football club: the Burton Albion case study

Older adults are a priority within policy designed to facilitate healthy lifestyles through physical activities. Golden Goal is a pilot programme of physical activity-led health improvement for older adults, 55?years and older. Activities were delivered at Burton Albion Football Club. Sessions involved weekly moderate to vigorous intensity exercise sessions including exer-gaming (exercise-orientated video-games), indoor bowls, cricket, new age curling, walking football, and traditional board games and skittles. Secondary analysis of data collected through the original programme evaluation of Golden Goal investigated the impact of the intervention on participants. Older adults completed self-reports for demographics, health screening/complications and quality of life. Attendees, n?=?23 males (42.6%) and n?=?31 females (57.4%) with a mean age of 69.38 (±5.87) (n?=?40), ranging from 55–85?years took part. The mean attendance was 7.73 (±3.12) sessions for all participants, (n?=?51). Older adults with two or more health complications (n?=?22, 42.3%) attended fewer sessions on average (6.91?±?3.322) compared to those reporting less than two health complications (8.65?±?2.694). Self-rated health was higher for women (87.32?±?9.573) vs. men (80.16?±?18.557), although this was not statistically significant (U?=?223.500, p?=?0.350). Results support the potential of football-led health interventions for recruiting older adults, including those reporting health problems.     

Adipose tissue lipolytic inhibition enhances the glucoregulatory properties of exercise in type 2 diabetes patients

Aims: Exercise combined with adipose tissue lipolytic inhibition augments intramuscular lipid and glycogen use in type 2 diabetes patients. The present study investigates the impact of adipose tissue lipolytic inhibition during exercise on subsequent postprandial glycemic control in type 2 diabetes patients.

Methods: Fourteen male type 2 diabetes patients (age 65?±?2 years, HbA_1c 6.7?±?0.1% (50?±?2?mmol/mol)) participated in a double-blind placebo-controlled randomized cross-over study in which subjects performed endurance-type exercise after being administered 250?mg of a nicotinic acid analogue (acipimox; ACP) or a placebo (PLA). A control experiment was included in which no exercise was performed (CON).

Results: Sixty minutes of endurance-type exercise (at 45% W_peak) did not significantly lower circulating plasma glucose and insulin excursions in PLA when compared with CON (P?=?.300). Acipimox administration strongly reduced circulating plasma FFA concentrations during exercise (P?i.e. postprandial) in ACP when compared with either CON (P?=?.041 and P?=?.002, respectively) or PLA (P?=?.009 and P?=?.001, respectively).

Conclusions: Collectively, exercise with adipose tissue lipolytic inhibition reduces postprandial blood glucose and insulin excursions and, as such, further improves glycemic control in male type 2 diabetes patients.     

The effect of individualised sprint training in elite female team sport athletes: A pilot study

ABSTRACT

This study aimed to evaluate whether an individualised sprint-training program was more effective in improving sprint performance in elite team-sport players compared to a generalised sprint-training program. Seventeen elite female handball players (23 ± 3 y, 177 ± 7 cm, 73 ± 6 kg) performed two weekly sprint training sessions over eight weeks in addition to their regular handball practice. An individualised training group (ITG, n = 9) performed a targeted sprint-training program based on their horizontal force-velocity profile from the pre-training test. Within ITG, players displaying the lowest, highest and mid-level force-velocity slope values relative to body mass were assigned to a resisted, an assisted or a mixed sprint-training program (resisted sprinting in the first half and assisted sprinting in the second half of the intervention period), respectively. A control group (CG, n = 8) performed a generalised sprint-training program. Both groups improved 30-m sprint performance by ~1% (small effect) and maximal velocity sprinting by ~2% (moderate effect). Trivial or small effect magnitudes were observed for mechanical outputs related to horizontal force- or power production. All between-group differences were trivial. In conclusion, individualised sprint-training was no more effective in improving sprint performance than a generalised sprint-training program.     

哮喘病患者的运动疗效研究

为了探讨健身运动对哮喘病患康复治疗的作用，将22例42－46岁中老年轻、中度哮喘病患按病情等情况分为大体相同的治疗组和对照组（各11例），治疗组进行有针对性的有计划的健康运动治疗，对照组不进行有计划的体育锻炼，结果显示经2年的实验，治疗组的疗效显，明显优于对照组（P＜0．001），说明有针对性的有计划的健康运动对轻、中度哮喘病患康复治疗具有较好的疗效，是一种既经济又有效的康复疗法。     

Age-specific response of skeletal muscle extracellular matrix to acute resistance exercise: A pilot study

The extracellular matrix (ECM) plays an essential role in the development, growth and repair of skeletal muscles and serves to transmit contractile force. However, its regulation is poorly understood. This study investigates the age-specificity of the effects of acute resistance exercise on ECM gene expression. To this purpose, five young (YM, 23.8?±?2.2 yrs.) and 5 elderly (EM, 66.8?±?4.1 yrs.) men performed one session of unilateral leg press and leg extension exercises. Six hours post-exercise, biopsies were taken from the vastus lateralis muscles of both legs. A PCR array was used to profile the expression of 84 ECM-related genes, of which 6 were validated by qPCR. The PCR array found 9 and 4 ECM-associated genes to be selectively altered (>1.5-fold change) in YM or EM only. Four further genes were upregulated in YM but downregulated in EM. Of the 6 genes validated on individual samples MMP9 expression increased in YM (9.7-fold) and decreased (0.2-fold) in EM. MMP15 was downregulated in EM only (0.6-fold). A significant correlation between leg extension 1 RM and changes in COL7A1 expression (ρ?=?0.71) suggests a potential influence of fitness levels. In conclusion, acute resistance exercise affects ECM gene expression at least partly in an age-specific manner. The altered expression of genes encoding matrix metalloproteinases (MMP3, MMP9, MMP15) highlights the role of remodelling processes in the response to an acute bout of resistance exercise. Larger studies are required to verify the age-associated differences in gene expression profiles and establish their functional implications.     

Aerobic exercise did not have compensatory effects on physical activity levels in type 2 diabetes patients

Although exercise promotes beneficial effects in diabetic patients, some studies have questioned the degree of their importance in terms of the increase in total energy expenditure. In these studies, the decrease of physical activity levels (PAL) was referred as “compensatory effect of exercise”. However, our aim was to investigate whether aerobic exercise has compensatory effects on PAL in type 2 diabetes patients. Eight volunteers (51.1 ± 8.2 years) were enrolled in a supervised exercise programme for 8 weeks (3 d · wk^?1, 50–60% of VO₂ peak for 30–60 min). PAL was measured using tri-axial accelerometers in the 1st, 8th and 12th weeks. Biochemical tests, cardiorespiratory fitness, anthropometric assessment and body composition were measured in the 2nd and 11th weeks. Statistical analysis was performed using non-parametric tests (Friedman and Wilcoxon, P < 0.05). We found no significant differences in PAL between intervention periods, and participants spent the majority of their awake time in sedentary activities. However, the exercise programme generated a significant 14.8% increase in VO₂ peak and a 15% reduction in fructosamine. The exercise programme had no compensatory effects on PAL in type 2 diabetes patients, but improved their cardiorespiratory fitness and glycaemic control.     

Biological maturity status,body size,and exercise behaviour in British youth: A pilot study

In this study we examined the performance during, and the physiological and metabolic responses to, prolonged, intermittent, high-intensity shuttle running in hot (～30 C, dry bulb temperature) and moderate (～20 C) environmental conditions. Twelve male students, whose mean (s x ) age, body mass and maximal oxygen uptake (V O 2m ax ) were 22 ± 1 years, 69.8 ± 01.8 kg and 56.9 ± 1.1 ml . kg ?1 . min ?1 respectively, performed intermittent high- and low-speed running involving five sets of ～15 min of repeated cycles of walking and variable speed running followed by 60 s run/rest exercise until fatigue. The total distance completed in the hot and moderate trials was 8842 3790 m and 11,280 214 m respectively (P < 0.01). This decrement in performance occurred even though no differences existed in the level of dehydration, rating of perceived exertion, blood glucose and lactate, plasma free fatty acid and ammonia concentrations between the two trials. However, water consumption was almost twice as great in the hot trial (hot vs moderate: 1.18 ± 0.12 vs 0.63 ± 0.07 l . h ?1 , P < 0.01). Rectal temperature (hot vs moderate: 39.4 ± 0.1 vs 38.0 ± 0.1 C, P < 0.01) and heart rate (hot vs moderate: 186 ± 2 vs 179 ± 2 beats . min ?1 , P < 0.05) were higher at the end of the hot condition than at the same point in time in the moderate condition. The correlation between the rate of rise in rectal temperature and the distance completed during the hot condition was -0.94 (P < 0.01); for the moderate condition it was -0.65 (P <0.05). The reduced performance in the hot condition was associated with high body temperature; the precise mechanisms by which the performance decrement was brought about are, however, unclear.     

The effect of acute aerobic exercise on central arterial stiffness,wave reflections,and hemodynamics in adults with diabetes: A randomized cross-over design

BackgroundIndividuals with diabetes have greater central arterial stiffness, wave reflections, and hemodynamics, all of which promote the accelerated cardiovascular pathology seen in this population. Acute aerobic exercise has been shown to be an effective strategy for reducing central arterial stiffness, wave reflections, and hemodynamics in healthy individuals; however, the effects of acute aerobic exercise in reducing these outcomes is not well established in people with diabetes. Recently, implementation of high-intensity interval exercise (HIIE) has shown superior improvements in cardiovascular health outcomes when compared to traditional aerobic exercise. Yet, the effect of HIIE on the aforementioned outcomes in people with diabetes is not known. The purpose of this study was to (i) describe the central arterial stiffness, wave reflections, and hemodynamic responses to a bout of HIIE and moderate-intensity continuous exercise (MICE) in adults with diabetes; and (ii) compare the effects of HIIE and MICE on the aforementioned outcomes.MethodsA total of 24 adult men and women (aged 29–59 years old) with type 1 (n = 12) and type 2 (n = 12) diabetes participated in a randomized cross-over study. All participants completed the following protocols: (i) HIIE: cycling for 4 × 4 min at 85%–95% of heart rate peak (HR_peak), interspersed with 3 min of active recovery at 60%–70%HR_peak; (ii) MICE: 33 min of continuous cycling at 60%–70%HR_peak; and (iii) control (CON): lying quietly in a supine position for 30 min.ResultsA significant group × time effect was found for changes in central systolic blood pressure (F = 3.20, p = 0.01) with a transient reduction for the HIIE group but not for the MICE or CON groups. There was a significant group × time effect for changes in augmentation index at a heart rate of 75 beats/min (F = 2.32, p = 0.04) with a decrease following for HIIE and MICE but not for CON. For all other measures of central arterial stiffness and hemodynamics, no significant changes were observed (p > 0.05).ConclusionA bout of HIIE appears to lead to a greater transient reduction in central systolic blood pressure than the reduction observed following MICE; however, both HIIE and MICE improved augmentation index at a heart rate of 75 beats/min in people with diabetes. There was no significant difference in response to HIIE and MICE in all outcomes. This provides preliminary evidence on the role of HIIE on such outcomes in people with diabetes.     

Self-presentation in exercise: Changes over a 12-week cardiovascular programme for overweight and obese sedentary females

Abstract

Self-presentational concerns, shown to influence exercise-related cognitions and behaviours, are evaluated frequently in the absence of exercise or following a single bout of physical activity. The purpose of the present study was to examine longitudinally, the extent to which participating in a structured 12-week cardiovascular exercise intervention elicited changes in self-presentational efficacy expectancy (SPEE) and social physique anxiety (SPA). Participants were 80 sedentary women with overweight or obesity (mean body mass index 29.02 kg/m², SD=4.71) between the ages of 19 and 45 wanting to begin an exercise programme (mean age 33.4 years, SD=7.6). The Self-Presentational Efficacy Scale (SPES) and the Social Physique Anxiety Scale (SPAS) were completed by each participant prior to commencing the study, and at the 6- and 12-week time points. For those who completed the programme, repeated measures ANOVAs indicated significant increases in SPEE between baseline and week 6 (P<0.001, η²=0.37), and week 6 to 12 (P<0.05, η²=0.10), while SPA decreased significantly between baseline and week 6 (P<0.01, η²=0.16). Bivariate correlation analyses revealed that length of participation in the study was positively related to SPEE and negatively related to SPA. Implications of focusing on these variables within a physical activity intervention are discussed with respect to exercise behaviour, programme development and adherence.     

Interpreting the Dispositional Flow Scale-2 scores: a pilot study of latent class factor analysis

The present study examined the extent to which scores on the Dispositional Flow Scale-2 (DFS-2) could differentiate individuals who frequently experience flow characteristics in physical activity from those who do not. A total of 993 participants completed the Japanese version of the DFS-2. Latent class factor analysis (LCFA), which combines the strengths of both latent class analysis and factor analysis, was conducted on the DFS-2 responses. Six classes were identified through a series of LCFAs and the patterns of the item-average scores for the nine flow attributes were found to be parallel among these classes. The top two and bottom two classes (19.3% and 13.4% of the whole sample) were considered the groups who experience flow characteristics frequently and seldom, respectively. These results indicated that individuals who often experience flow attributes in physical activity could be differentiated from those who do not based on their DFS-2 scores.     

The effect of a resistance training programme on the grab,track and swing starts in swimming

The aim of this study was to establish the effectiveness of a resistance training programme, designed to improve vertical jumping ability, on the grab, swing and rear-weighted track starts in swimming. Twenty-three female non-competitive swimmers participated (age 19.9 +/- 2.4 years; mean +/- s). The diving techniques were practised weekly for 8 weeks. The participants were randomly assigned to a control group (n = 11) or a resistance-training group (n = 12), which trained three times a week for 9 weeks. The tests before and after the training programme involved performing each dive technique and six dry-land tests: two countermovement jumps (with and without arms), two isokinetic squats (bar speeds of 0.44 and 0.70 rad x s(-1)) and two overhead throws (with andwithout back extension). A repeated-measures multivariate analysis of variance was used to show that resistance training improved performance in the dry-land tests (P < 0.0001). No significant improvements due to training were found for any temporal, kinematic or kinetic variables within the grab or swing starts. Significant improvements (P < 0.05) were found for the track start for take-off velocity, take-off angle and horizontal impulse. The results suggest that the improved skill of vertical jumping was not transferred directly to the start, particularly in the grab technique. Non-significant trends towards improvement were observed within all starts for vertical force components, suggesting the need to practise the dives to retrain the changed neuromuscular properties.     

The effect of a fast bowling harness in cricket: an intervention study

The influence of a bowling harness, as a training aid, was assessed as a means of modifying bowling technique. Thirty-three 13-year-old bowlers received a standardized 15 min of bowling coaching twice a week for 8 weeks. They were randomly assigned to one of two groups. The 13 participants in the intervention group used the bowling harness throughout the coaching, while also receiving verbal and visual feedback. The 20 participants in the non-harness group received the same visual and verbal feedback. Three-dimensional videography (200 Hz) of each player's bowling action enabled the calculation of transverse plane shoulder alignment counter-rotation, separation angle, lateral flexion and hyperextension of the trunk before and after the intervention. The restriction applied by the harness produced a significant reduction (P= 0.006) in separation angle and forced the bowler to adopt a position at back-foot impact that reduced the 'twist' in the spine. However, it had no effect on restricting other aspects of trunk movement during the critical phases of the bowling action. No significant long-term modifications to technique were found after the coaching intervention when players were assessed without the harness.