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The relative efficacy of land-based and water-based exercise training on macro- and microvascular functions in older patients with type 2 diabetes
Suntraluck S, Tanaka H, Suksom D
Journal of Aging and Physical Activity 2017 Jul;25(3):446-452
clinical trial
4/10 [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: 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*

Microvascular and macrovascular dysfunction plays an important role in the pathogenesis of diabetic vascular disease. Twenty-nine older patients with type 2 diabetes were randomly assigned into the land-based (LB; n = 14) or water-based (WB; n = 15) groups. Both groups completed supervised aerobic cycling exercises three times per week for 12 weeks. The WB group performed cycling exercise training in warm water (36 degrees C) immersed to the hip level. After 12 weeks, blood glucose concentration and insulin resistance did not change but hemoglobin A1c levels decreased (p < 0.05) in both groups. Plasma nitric oxide concentrations increased (p < 0.05) in both groups. Flow-mediated dilation in the popliteal artery increased and arterial stiffness decreased (p < 0.05) in both exercise groups. Indices of microvascular reactivity improved (p < 0.05) only in the WB group. The benefits of warm water-based training were similar in general, and superior in some measures, to the more established land-based cycling exercise.

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