The effect of sedentary time on the results of exercise therapy in patients with peripheral arterial disease complicated with type 2 diabetes.

Abstract

Peripheral artery disease (PAD) is a common chronic complication of type 2 diabetes (T2DM). This study sought to evaluate the effect of supervised exercise therapy (SET) on patients with PAD complicated with T2DM, and to assess the effect of changes in sedentary time on the results of SET treatment. A total of 100 PAD patients who were treated in our hospital from January 2019 to October 2020 were included, and the age, gender, body mass index (BMI), hypertension, smoking, and ankle brachial index (ABI) were collected. The patients were required to complete SET treatment 2-3 times a week for 12 weeks. Subsequently, the objective 6-minute walk test (6MWT) and Short Physical Performance Battery (SPPB) were used to assess body function. After adjusting for other key confounding variables such as age, gender, and smoking status, linear regression analysis was used to evaluate the effects of changes in sedentary time on the total distance of the 6MWT. After 12 weeks of treatment, the total SPPB score of the patients increased from a baseline of 9.3±2.7 to 10.1±2.3 (P=0.025), the normal walking distance in the 6MWT increased from 108.9±26.8 to 148.9±29.5 m (P<0.001), the total walking distance increased from 322.5±93.4 to 348.5±86.1 m (P=0.042), and at the same time, the metabolic equivalent on the treadmill increased from 2.6±0.7 to 3.9±1.4 (P<0.001). Compared with the baseline data, the proportion of time that patients spent engaged in mild physical activity at 6 weeks increased by 20%±10% (P=0.003), and the average daily sedentary time decreased by 6.5±2.8 minutes (P=0.008), or by 3.1%±2.1% (P=0.04). Furthermore, compared with the baseline, the proportion of time that patients spent engaged in light and moderate physical activity at 12 weeks increased by 10%±3% (P=0.007) and 20%±10% (P=0.006), respectively, while the average sedentary time per day reduced by 6.8±3.1 minutes (P=0.03), or by 3.6%±1.8% (P=0.005). The reduction of sedentary time can significantly improve the effectiveness of exercise therapy in patients with PAD complicated by T2DM, and compared with patients with PAD alone, the improvement in patients complicated with T2DM is more significant.