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Home-based resistance training is not sufficient to maintain improved glycemic control following supervised training in older individuals with type 2 diabetes
Dunstan DW, Daly RM, Owen N, Jolley D, Vulikh E, Shaw J, Zimmet P
Diabetes Care 2005 Jan;28(1):3-9
clinical trial
3/10 [Eligibility criteria: No; Random allocation: Yes; Concealed allocation: No; Baseline comparability: No; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

OBJECTIVE: To examine whether improvements in glycemic control and body composition resulting from 6 months of supervised high-intensity progressive resistance training could be maintained after an additional 6 months of home-based resistance training. RESEARCH DESIGN AND METHODS: We performed a 12-month randomized controlled trial in 36 sedentary, overweight men and women with type 2 diabetes (aged 60 to 80 years) who were randomly assigned to moderate weight loss plus high-intensity progressive resistance training (RTandWL group) or moderate weight loss plus a control program (WL group). Supervised gymnasium-based training for 6 months was followed by an additional 6 months of home-based training. Glycemic control (HbA1c), body composition, muscle strength, and metabolic syndrome abnormalities were assessed at 0, 3, 6, 9, and 12 months. RESULTS: Compared with the WL group, HbA1c decreased significantly more in the RTandWL group (-0.8%) during 6 months of supervised gymnasium-based training; however, this effect was not maintained after an additional 6 months of home-based training. In contrast, the greater increase in lean body mass (LBM) observed in the RTandWL group compared with the WL group (0.9 kg, p < 0.05) after the gymnasium-based training tended to be maintained after the home-based training (0.8 kg, p = 0.08). Similarly, the gymnasium-based increases in upper body and lower body muscle strength in the RTandWL group were maintained over the 12 months (p < 0.001). There were no between-group differences for changes in body weight, fat mass, fasting glucose, or insulin at 6 or 12 months. CONCLUSIONS: In older adults with type 2 diabetes, home-based progressive resistance training was effective for maintaining the gymnasium-based improvements in muscle strength and LBM but not glycemic control. Reductions in adherence and exercise training volume and intensity seem to impede the effectiveness of home-based training for maintaining improved glycemic control.
Copyright American Diabetes Association. Reprinted with permission from The American Diabetes Association.

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