Evaluation of a Community Based Exercise Programme for People with Type 2 Diabetes

Abstract

Effective interventions are required to promote physical activity in people with Type 2 diabetes. A community based exercise and education was developed involving 6 weeks of education and supervised exercise followed by a physical activity consultation to support long term maintenance of physical activity behavior change. PURPOSE: To provide a 1 year evaluation of this programme. METHODS: Changes from baseline at 6 and 12 weeks were assessed in physical activity levels (7 day recall), stage of exercise behavior change, exercise capacity (shuttle walk), diabetes and physical knowledge, body mass index (BMI), waist circumference, blood pressure and wellbeing (wellbeing questionnaire). Participants completed an evaluation questionnaire at 12 weeks and attendance at the programme was recorded. RESULTS: In 1 year 42 people had participated. Mean age was 62.4yrs; 76% were obese, 22% overweight, 2% normal weight. Distribution by stage of exercise behaviour change was: contemplation 29%, preparation 39%, Action 5% and maintenance 27%. Participants attended on average 67% of organised classes at 6 and 12 weeks. No significant changes were recorded in BMI or waist circumference at any time point. Decreases were recorded in systolic and diastolic blood pressure from baseline to 6 and 12 weeks (6wk systolic 98%CI = 1.43, 11.91, diastolic 98%CI = 3.02,8.50), (12wk systolic 98%CI = 7.99, 20.15, diastolic 98%CI = 5.36, 13.35). From baseline to 6 and 12 weeks 66% of the group had progressed to a higher stage of exercise behavior change, 31% reported no change and 3% had regressed to a lower stage. Mean minutes of moderate to vigorous physical activity increased from baseline 6 (98% CI = −403.7,-71.7) and 12 weeks (98% CI = −465.9,-9.9, p=0.04). Lower heart rate and rate of perceived exertion values recorded at the end of each stage of the shuttle walk test indicated improvements in exercise capacity. From baseline to 6 weeks all sub scales on the wellbeing questionnaire, except depression, recorded a significant improvement (98% CI = Anxiety 0.7,3.4, Energy −3.9,-0.8, Positive wellbeing −3.3,0, Total wellbeing −11.2,-2.3). These positive changes were not maintained at 12 weeks. Knowledge of physical activity and diabetes had improved with the median score on a 10 item questionnaire changing from 8 at baseline to 9 and 10 at 6 and 12 weeks respectively. Participant evaluation of the programme was very positive with several benefits and no negative effects being reported. CONCLUSIONS: A safe, enjoyable and effective programme has been developed with evidence of positive effects in physical activity behavior. Future research will evaluate the long term effectiveness of this programme.