The Physiological Effects of a Walking to Music Intervention in Adults with Intermediate Hyperglycemia

Abstract

Purpose: Overweight individuals are at risk of intermediate hyperglycemia (IHG) [1]. Increasing physical activity (PA) in IHG is one method to reduce the risk of glucometabolic and cardiovascular (CV) complications [2]. This study investigates walking to music as a modality to increase moderate intensity PA and regulate glucometabolic disturbances. Patients and Methods: Participants were randomized to usual care (UC) or intervention group (IG) who completed a 6 month walking to music program. Physiological assessments for a range of variables (DEXA, flow mediated dilatation (FMD) and glucometabolic biomarkers) were completed at baseline, 4, 6 and 9 months (follow-up). Results: For IG group, walking compliance decreased with time however 71.4%, 79.5% and 73% of walking completed was moderate intensity at 4, 6 and 9 months. At 6 months IG FMD was significantly lower than UC and HbA 1C was 5% lower. Other physiological markers were not altered. Conclusion: Walking to music may be a novel method to encourage moderate intensity PA. However, the majority of results demonstrate that this intervention was not more effective than UC in managing glucometabolic and CV biomarkers in IHG. Future interventions should include additional support for the entire study duration however this has cost implications.

Recruitment, Retention and Compliance of Overweight Inactive Adults with Intermediate Hyperglycaemia to a Novel Walking Intervention

“…IG participants received an individualised progressive weekly walking programme designed to increase moderate intensity walking to 30 min per day based on current physical activity guidelines for health [27]. IG participants used an MP3 music player (iPod touch 4, Apple Inc., Cupertino, CA, USA) with individually selected music set to a predetermined beat to regulate walking cadence [5]. Music tempo was individually established in accordance with previous height-related stride rate recommendations determined by Rowe and colleagues [28] to elicit moderate intensity exercise for each individual (50-70% maximum heart rate: 90-113 steps/min −1 ).…”

“…Assessment of RCT outcome measures included a range of clinical, physiological and behaviour change parameters at baseline, four, six and nine (follow-up) months as outlined in Figure 1 (full details of outcome measures are available in a previous publication [5]). At baseline, four-and six-month assessments, the IG participants received physical activity consultations.…”

“…At baseline, four-and six-month assessments, the IG participants received physical activity consultations. Between assessment points IG participants received booster sessions via their preferred mode of contact identified during Study Phase Two (Figure 1) [5] and were asked to complete their walking programme to music (an overview of behaviour change techniques and strategies used was previously published [5]). UC participants received no contact between assessments.…”

“…Therefore, a total of 37 participants (n = 37) progressed through the intervention (Figure 3). IG participants (n = 17) walked to selfselected music with a predetermined tempo based upon Rowe et al [28] height related stride rate guidelines and received behavioural change support [5]. UC participants (n = 20) received a standard PA information sheet only.…”

“…A constant state of hyperglycaemia can cause glucometabolic dysfunction leading to damaged organs associated with cardiovascular disease including the heart and its blood vessels [3,4]. In overweight populations during the intermediate state, adaptations in response to chronic exposure to excess adipose tissue may cause impaired glucometabolic responses, increased oxidative stress, increased inflammation, endothelium dysfunction as well as impaired behavioural and psychological effects [4][5][6][7][8][9]. It is therefore salient that IHG sufferers are identified to reduce the risk of type 2 diabetes and developing associated comorbidities.…”