The effect of concurrent resistance-aerobic training on serum cortisol level, anxiety, and quality of life in pediatric type 1 diabetes

Abstract

BackgroundGiven the importance of anxiety and quality of life for the mental health of children with type 1 diabetes (T1D), exercise prescription can be of crucial significance. The present study aims to explore the effect of concurrent resistance-aerobic training on serum cortisol level, anxiety, and quality of life among pediatric T1D.MethodsForty children (aged 8–14 years) were randomly assigned to experimental (n = 20) and control groups (n = 20) for 16 weeks. The exercise training program was composed of 16 weeks of interval concurrent resistance-aerobic training with a duration of 60 min performed three times a week. The subjects first performed the resistance training (20 min of Pilates exercises and 20 min of body weight-bearing exercises). Then, the aerobic exercises were performed with an intensity of 50–75% of maximum heart rate. Before and after the training, blood tests including cortisol were carried out on the subjects by RIA kit. Anxiety and quality of life were measured by the Revised Children’s Manifest Anxiety Scale (RCMAS) and Pediatric Quality of Life (PedsQL), respectively. Body composition was measured by InBody. Data were analyzed by paired and independent t-test at p < 0.05 significance level.ResultsSixteen weeks of concurrent resistance-aerobic exercise significantly reduced the anxiety index (p = 0.001) and increased the quality of life (p = 0.003). Although the cortisol index was increased, it did not reveal any significant differences between the experimental and control groups (p = 0.781). No significant differences were observed in the indices of quality of life, anxiety, and cortisol in the control group.ConclusionsA 16-week program of concurrent resistance-aerobic training can improve the quality of life and anxiety among children suffering from T1D, but it may not influence the cortisol level (p > 0.05).

Effects of Training with Different Modes of Strength Intervention on Psychosocial Disorders in Adolescents: A Systematic Review and Meta-Analysis

“…Likewise, Goldfield et al [ 58 ] showed an unclear risk of bias for dropout bias. On the other hand, the rest of the studies [ 56 , 57 , 60 , 61 , 62 ] showed a low risk of bias for all domains. Full details of each study and domain are presented in Figure 3 and Figure 4 .…”

“…Besides, one article evaluated mental health (emotional, psychological, and social well-being) [ 64 ], which is commonly associated with psychosocial anxiety disorders and depression [ 65 ]. On the other hand, strength training was reflected through the following intervention modes: CrossFit Teens™ [ 64 ], concurrent training (CT) combining aerobic and strength exercises [ 56 , 57 , 58 , 61 , 63 ], vibration platform strength training [ 60 , 62 ], and conventional strength training [ 58 , 59 , 62 ]. The characteristics and type of strength training protocol of the studies selected in this systematic review and meta-analysis are presented in Table 1 and Table 2 .…”

“…Four studies were considered for this analysis [ 56 , 61 , 62 , 63 ]. However, Suh et al [ 63 ] included three anxiety questionnaires in the research with different results.…”

“…Out of the seven studies analyzed, six reported a beneficial effect of different strength training methods on anxiety levels [ 56 , 61 , 62 , 63 ]. These six studies showed a large ES in anxiety levels: ES = −6.93 through the K10 after concurrent training [ 61 ]; ES = −2.06 through the PMSIS on both the group that received strength training on the vibration platform and the group that performed conventional strength training [ 62 ]; ES = −1.04 through the CMAS for the group undergoing concurrent training [ 56 ]; and ES = 1.15 and ES = 1.06 through the STAI for trait and state, respectively, in a group that carried out concurrent training [ 63 ]. However, the research of Costigan et al [ 61 ] presented a higher ES (−6.93) than the rest.…”

“…Regarding the studies included in the systematic review and meta-analysis, the results showed that concurrent training [ 56 , 57 , 58 , 61 , 63 ], conventional strength training [ 58 , 59 , 62 ], vibration platform strength training [ 60 , 62 ], and strength training through Crossfit™ Teens [ 64 ] had been used to control or decrease the levels of anxiety and depression. Thus, it was possible to demonstrate that physical exercise, through strength training independent of its modality, produces decreases in the levels of anxiety (ES = −1.75) and depression (ES = −1.61) in 448 adolescent subjects (142 and 306, respectively).…”