ACTIVE STEPS

Abstract

Purpose/Hypothesis: The American Diabetic Association (ADA) states that adults with type II diabetes (T2DM) should have at least 150 min of moderate intensity physical activity (PA) per week. While the benefits of PA for people with T2DM are well documented, the ability to generalize the evidence is limited to adults without existing comorbidities. This is an important consideration because many older adults with T2DM have mobility impairments from comorbidity that limits their exercise capacity. Active Steps for Diabetes Management is a program for people with T2DM and impaired mobility who may not be able to achieve an optimal amount of exercise on their own but who can participate in medically-supervised exercise and gradually increase their PA. The purpose of this project is to evaluate Active Steps participant outcomes. Subjects: Active Steps participants were at least 18 yrs old and free of conditions where moderate intensity PA was contraindicated. People needing supervised exercise were encouraged to enroll. Twenty of 26 (mean age=60±3yrs) enrollees in Active Steps completed the program. Seventy percent of people who completed Active Steps required an assistive device for walking. Materials/Methods: Active Steps was 12 weeks and included two group meetings per week consisting of 15 min of diabetes education and 45 min of group exercise and a home program for gradually increasing PA. Outcome measures evaluated before and after Active Steps were: (1) Summary of Diabetes Self-Care Measure, (2) average number of steps walked/day measured by pedometers, (3) Six Minute Walk Test (6MWT), and (4) body mass index (BMI). Paired t-tests were used to compare pre and post-intervention means. Results: There were significant increases (p<.001) in the mean number of days per week that participants performed 30 min of continuous PA, number of steps walked/day, and the mean 6MWT distance. A small improvement in mean BMI was not significant. Conclusions: Seventy seven percent of Active Steps enrollees completed the program which was considered good because of the participant demographics. Analyses of outcome data suggest that Active Steps is effective in increasing daily PA and improving cardiovascular fitness in people with T2DM and impaired mobility. The mean number of days per week that participants performed 30 min of continuous PA increased bringing their PA closer to the amount recommended by the ADA. Pedometer-determined PA increased from sedentary to low active. Although the change in PA was significant, it is possible that the intensity of participants PA was not high enough to affect BMI. Clinical Relevance: Outcome measures suggest that Active Steps helps increase PA in adults with T2DM and impaired mobility. Further research is needed to determine the impact of Active Steps on glycemic control, cardiovascular health, and health care costs.