The Effect of High-Intensity Power Training on Habitual, Intervention and Total Physical Activity Levels in Older Adults with Type 2 Diabetes: Secondary Outcomes of the GREAT2DO Randomized Controlled Trial.

Marjan Mosalman Haghighi,Steven N Blair,Bernhard T Baune,Nathan De Vos,Mike Climstein,Yi Wang,Michael K Baker,Ren Ru Zhao,Jeffrey Schlicht,Kylie A Simpson,Maria A Fiatarone Singh,Nalin Singh,Jacinda Meiklejohn,Shelley Kay,Anthony J O’Sullivan,David Simar,Yorgi Mavros

doi:10.3390/geriatrics6010015

Abstract

Background: We examined the effect of power training on habitual, intervention and total physical activity (PA) levels in older adults with type 2 diabetes and their relationship to metabolic control. Materials and Methods: 103 adults with type 2 diabetes were randomized to receive supervised power training or sham exercise three times/week for 12 months. Habitual, intervention, and total PA, as well as insulin resistance (HOMA2-IR) and glycosylated hemoglobin (HbA1c), were measured. Results: Participants were aged 67.9 ± 5.5 yrs, with well-controlled diabetes (HbA1c = 7.1%) and higher than average habitual PA levels compared to healthy peers. Habitual PA did not change significantly over 12 months (p = 0.74), and there was no effect of group assignment on change over time in habitual PA over 0–6 (p = 0.16) or 0–6–12 months (p = 0.51). By contrast, intervention PA, leg press tonnage and total PA increased over both 6- and 12-month timepoints (p = 0.0001), and these changes were significantly greater in the power training compared to the sham exercise group across timepoints (p = 0.0001). However, there were no associations between changes in any PA measures over time and changes in metabolic profile. Conclusion: Structured high-intensity power training may be an effective strategy to enhance overall PA in this high-risk cohort.

Highlights

Physical activity (PA) is a powerful non-pharmacological treatment for the management of impaired glucose tolerance and diabetes [1,2], yet individuals with type 2 diabetes are less likely to engage in physical activity (PA) than age-matched peers without diabetes [3,4], and this disparity has been shown to increase with age
Participant flow through the study is shown in the CONSORT flowchart (Figure 1)
The results showed there were no significant differences between Physical Activity Scale for the Elderly (PASE) scores of our participants and healthy older adults except that women aged 70–75 in GREAT2DO were significantly more active than healthy peers [29]

Summary

Introduction

Physical activity (PA) is a powerful non-pharmacological treatment for the management of impaired glucose tolerance and diabetes [1,2], yet individuals with type 2 diabetes are less likely to engage in PA than age-matched peers without diabetes [3,4], and this disparity has been shown to increase with age. Participation in supervised exercise may address physical and psychological barriers to PA in older adults with type 2 diabetes, promoting increased habitual PA. Four randomized control trials (RCTs) have reported the effect of supervised PRT on habitual PA in older adults with diabetes. We examined the effect of power training on habitual, intervention and total physical activity (PA) levels in older adults with type 2 diabetes and their relationship to metabolic control. Materials and Methods: 103 adults with type 2 diabetes were randomized to receive supervised power training or sham exercise three times/week for 12 months. Intervention PA, leg press tonnage and total PA increased over both 6- and 12-month timepoints (p = 0.0001), and these changes were significantly greater in the power training compared to the sham exercise group across timepoints (p = 0.0001). Conclusion: Structured high-intensity power training may be an effective strategy to enhance overall PA in this high-risk cohort

Methods

Results

Discussion

Conclusion