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| Nordic walking in water on cerebrovascular reactivity and cognitive function in elderly patients with type 2 diabetes |
| Ploydang T, Khovidhunkit W, Tanaka H, Suksom D |
| Medicine and Science in Sports and Exercise 2023 Oct;55(10):1803-1811 |
| 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* |
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INTRODUCTION: Aquatic Nordic walking (ANW) is a novel whole-body low-impact exercise that can be practiced by a variety of older adults with chronic conditions. However, its efficacy on several aspects of health is largely unknown. PURPOSE: To determine the effects of regular ANW on glycemic control and vascular function in older adults with type 2 diabetes and mild cognitive impairment. METHODS: Thirty-three older adults with type 2 diabetes aged 60 to 75 years were randomly allocated to non-exercising control (n = 17) or aquatic Nordic walking (ANW n = 16) groups. Nordic walking was performed in a pool at water temperature of 34 to 36 degreeC 3 times per week for 12 weeks. RESULTS: Measures of functional physical fitness including chair stand, timed up and go, chair sit and reach, reach and back scratch, and 6 minute walk test scores were all improved after ANW (all p < 0.05). Plasma glucose, glycosylated hemoglobin (HbA1c), and homeostasis model assessment of insulin resistance (HOMA-IR) decreased (all p < 0.05) in ANW. Vascular reactivity as assessed by brachial flow-mediated dilation (FMD) increased, and arterial stiffness as assessed by brachial-ankle pulse wave velocity decreased in ANW (all p < 0.05). No significant changes were observed in the control group. Middle cerebral artery pulsatility index decreased with ANW under normocapnia condition (p < 0.05). Cerebrovascular conductance increased with ANW under hypercapnia condition. Montreal cognitive assessment (MoCA) score increased in the ANW group (p < 0.001). Changes in MoCA scores were positively associated with corresponding changes in brain-derived neurotrophic factor (BDNF) (r = 0.540, p = 0.031). CONCLUSIONS: Nordic walking in water was a safe and effective innovative exercise modality to improve glycemic control, vascular function, physical fitness, cerebrovascular reactivity and cognitive function in older adults with type 2 diabetes.
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