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.
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.


METHODS
This study was a randomized clinical trial.


METHODS
The study was conducted on a university campus, with patient recruitment from the local community.


METHODS
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).


METHODS
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.


METHODS
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.


CONCLUSIONS
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.
Taylor
J David
JD
Department of Physical Therapy, University of Central Arkansas, 201 Donaghey Ave, Physical Therapy Center, Room 319, Conway, AR 72035 USA. dtaylor@uca.edu
Fletcher
James P
JP
Tiarks
Jakesa
J
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D001131:Arkansas; D003376:Counseling; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology / Q000628:therapy*; D005081:Exercise Therapy / Q000379:methods*; D005260:Female; D020446:Fitness Centers; D006801:Humans; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength / Q000502:physiology*; D010807:Physical Endurance / Q000502:physiology*; D026741:Physical Therapy Modalities; D055070:Resistance Training / Q000379:methods*; D016896:Treatment Outcome; D014495:Universities