The Effects of Water-based Exercise Training in People with Type 2 Diabetes

Abstract

Purpose: To investigate the effects of 8 weeks of upright water-based exercise training in people with type 2 diabetes.Methods: Thirteen participants with type 2 diabetes (54% male; 60.9 ± 9.6 years, mean ± standard deviation) completed eight weeks of upright water-based exercise training at a moderate intensity (60-80% of exercise test-derived maximum heart rate), for one hour, three times a week (TG). Fourteen participants (64% male; 63.9 ± 9.8 years) acted as a control group (CG) who maintained their usual activities. Pre-and post-intervention, participants performed cardiopulmonary exercise testing to determine VO2peak and one-repetition maximum testing to assess muscular strength. Blood profiles were assessed with standard assays. Body mass index and waist:hip ratio were employed as measures of anthropometry.Endothelium dependent (brachial artery flow mediated dilation (FMD)) and independent (GTN mediated) function were assessed using vascular ultrasound. Results:Water-based training increased VO2peak (18.5 ± 4.3 to 21.5 ± 5.4 ml.kg-1.min-1) (p=0.002), overall muscle strength (123 ± 44 to 139 ± 43kg) and leg strength (92 ± 28 to 104 ± 29kg), compared with the CG (p=0.001). The effect on pectoral strength (31 ± 17 to 35 ± 16kg) was not significantly different to the CG (24 ± 12 to 26 ± 14kg) (p=0.08). No change was observed in anthropometry, blood profiles, or GTN mediated vascular function. FMD was increased following training (6.1 ± 2.4 to 6.5 ± 3.0%), compared with controls who demonstrated a slight decrease (6.2 ± 1.6 to 5.4 ± 1.6%) (p=0.002). Conclusion:Water-based circuit training was well tolerated and appears to be an effective exercise modality for improving aerobic fitness, strength and vascular function in people with type 2 diabetes.

Association between physical exercise interventions and functional capacity in individuals with type 2 diabetes: a systematic review and meta-analysis of controlled trials

“…Out of the 29 included studies, three articles (95 patients) [28,49,53] demonstrated that structured physical exercise interventions were associated with an increase of 17.97 kg in the strength measures of lower limb muscle evaluated by 1RM of leg-press (95% CI 4.08% to 31.87%; I 2 0%; p for heterogeneity = 0.62) as compared with control (Figure 3).…”

“…The last two studies were transformed to mL/kg•min using the body weight presented by each of the studies. The other eight studies [31,40,42,45,46,[51][52][53] had the measure of oxygen consumption in VO 2peak and all of them with the unit of measure in mL/kg•min. The results of VO 2max and VO 2peak were combined in the same meta-analysis.…”

“…Out of the 29 included studies, 20 articles [31,35,36,[38][39][40][41][42][43][44][45][46][47][48][50][51][52][53]55,56] with 27 groups of comparison (932 patients) demonstrated that structured physical exercise interventions were associated with an increase of 2.41 mL/kg•min in the VO 2max (95% CI 1.89% to 2.92%; I 2 100%; p for heterogeneity = 0) as compared with control (Figure 4).…”

“…Remembering that the checklist consists of 27 questions, RCTs score up to 28 and NRS at most 25. Four studies [31,34,49,53] scored good (20)(21)(22)(23)(24)(25), 10 studies [29,30,32,33,[36][37][38]46,51,52] fair (15)(16)(17)(18)(19) and 15 studies [28,35,[39][40][41][42][43][44][45]47,48,50,[54][55][56] is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.…”

“…the 29 studies included, 13 studies used aerobic training[30,31,39-41,44- 46,48,50,52,55,56], six used combined training (aerobic and resistance)[32,35,38,43,47,53], four studies used resistance training[28,29,49,54], three studies used more intervention arms[36,42,51] (two studies with aerobic training groups and combined training, and one with aerobic, resistance and combined training groups) and three studies with another type of training (Pilates, Tai Chi, Whole-body vibration)[33,34,37] (Table2).The mean training duration was 27.9 weeks (range: 8 to 104 weeks). Training frequency ranged from one to seven days per week, being three days a week the most employed training frequency (n = 14).…”