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| Impact of physical therapist-directed exercise counseling combined with fitness center-based exercise training on muscular strength and exercise capacity in people with type 2 diabetes: a randomized clinical trial [with consumer summary] |
| Taylor JD, Fletcher JP, Tiarks J |
| Physical Therapy 2009 Sep;89(9):884-892 |
| clinical trial |
| 5/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: No; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed* |
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BACKGROUND: Assessing muscular strength (force-generating capacity) and exercise capacity in response to an intervention for people with type 2 diabetes is clinically important in the prevention of type 2 diabetes-related complications. OBJECTIVE: The purpose of this study was to investigate the impact of physical therapist-directed exercise counseling combined with fitness center-based exercise training on muscular strength and exercise capacity in people with type 2 diabetes. DESIGN: This study was a randomized clinical trial. SETTING: The study was conducted on a university campus, with patient recruitment from the local community. PATIENTS: Twenty-four people with type 2 diabetes were randomly allocated to either a group that received physical therapist-directed exercise counseling plus fitness center-based exercise training (experimental group) or a group that received laboratory-based, supervised exercise (comparison group). INTERVENTION: The experimental group received physical therapist-directed exercise counseling on an exercise program and was provided access to a fitness center. The comparison group received the same exercise program as the experimental group while under supervision. MEASUREMENTS: For all participants, chest press, row, and leg press muscular strength (1-repetition maximum (in kilograms)) and exercise capacity (graded exercise test duration (in minutes)) testing were conducted at baseline and 2 months later. RESULTS: No significant differences in improvements in muscular strength were found for the chest press (adjusted mean difference 1.2; 95% confidence interval (CI) -5.5 to 7.8), row (adjusted mean difference 0.1; 95% CI -9.0 to 9.1), or leg press (adjusted mean difference 2.7; 95% CI -9.1 to 14.6) between the groups. No significant difference in improvement in exercise capacity (adjusted mean difference 0.2; 95% CI -0.9 to 1.2) was found between the groups. LIMITATIONS: Lack of group allocation blinding and the small sample size were limitations of this study. CONCLUSIONS: The results suggest that physical therapist-directed exercise counseling combined with fitness center-based exercise training can improve muscular strength and exercise capacity in people with type 2 diabetes, with outcomes comparable to those of supervised exercise.
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