Effect of progressive pedometer based walking intervention on quality of life and general well being among patients with type 2 diabetes

Abstract

BackgroundTo determine the effectiveness of two goal setting pedometer based walking program for people with type 2 diabetes, one employing supervised exercise group with pedometer and the other employing self reported group with pedometer.MethodsA total of 102 type 2 diabetic outpatients (28 women, 74 men) between the age of 40-70 years were recruited and randomly allocated into 3 groups: supervised exercise group with pedometer (Group A), self reported exercise group with pedometer (Group B) and a control group (Group C) for 16 weeks. Subjects were asked to respond to the Audit of Diabetes Dependent Quality of Life (ADDQoL) and well being questionnaire at two occasions i.e. 0 week and after 16 weeks of intervention. Paired t test were used within the groups to compare Mean ± SD for all the parameters at baseline and at the end of 16 weeks. Differences between the groups were compared using analysis of variance (ANOVA). Statistical difference was further analyzed by Post hoc analysis using Bonferroni method.ResultsThe item “Freedom to eat” had the highest negative impact among all the subgroups. Other domains that were adversely affected by diabetes are ‘leisure activity’, ’do physically’, ‘physical appearance’, ‘self confidence’, ‘future’ and ‘financial situation’. In the group A significant reduction were noted among all the items except long distance journey (p<0.05). In the group B participants experienced reduction among all the domains except long distance journey, sex life and living condition.ConclusionPedometer determined activity has the potential to improve the quality of life. Supervised Walking using a pedometer was found more effective in improving quality of life and general wellbeing for Asian Indians with type 2 diabetes.Clinical trial registry India (CTRI)[CTRI/2012/10/003034].

The effectiveness of structured exercise in the south Asian population with type 2 diabetes: a systematic review

“…The 18 trials included 1063 participants, of whom 959 (90%) were Indian. The time since diagnosis of T2DM was at least six months in seven trials (16,(22)(23)(24)(30)(31)(32). The remaining studies did not report T2DM duration.…”

“…Of the included 18 trials, 15 compared exercise to control situations. Two trials compared the efficacy of two different exercise programs (17,31) and one trial with three intervention arms examined the efficacy of two exercise programs compared to usual care (23). The programs involved aerobic exercise (n=10) (17,23,(29)(30)(31)33,(35)(36)(37), resistance exercise (n=7) (19)(20)(21)(22)(23)26,27), combined aerobic and resistance (n=3) (16)(17)(18), and balance exercise training (n=1) (38).…”

“…Aerobic exercise programs were prescribed in ten trials (17,23,(29)(30)(31)(33)(34)(35)(36)(37), of which eight programs were fully supervised, while two studies prescribed either partially supervised (29) or unsupervised programs (35). The length of aerobic programs varied ranging from 4 to 52 weeks (29,30).…”

“…Nine trials reported session duration ranging from 30 to 60 minutes and a frequency of three to five days per week (17,23,(29)(30)(31)33,34,36,37). Similarly, the intensity was defined as moderate in five exercise trials according to heart-rate reserve (32,33) or the Borg Rating of Perceived Exertion Scale (29,31,36), while intensity was not reported in four trials (17,23,30,37). Only one study included people with mobility limitations, which reported daily, light intensity exercise of five minutes of walking every hour for most waking hours (35).…”

“…Nine trials assessed quality of life and/or well-being (17,19,23,26,29,(31)(32)(33). Six trials found aerobic (n=4), resistance (n=1) or combined exercise (n=1) significantly improved quality of life compared to control (17,19,23,26,29,(31)(32)(33). Three trials did not report significant between group differences, yet reported significant improvements compared to baseline (19,28,35) , .…”