title: Effects of moderate- versus high-intensity exercise training on physical fitness and physical function in people with type 2 diabetes: a randomized clinical trial.
abstract: BACKGROUND
  Exercise training is effective for improving physical fitness and physical function in people with type 2 diabetes. However, limited research has been conducted on the optimal exercise training intensity for this population.
  
  
  OBJECTIVE
  The primary study objective was to investigate the effects of moderate- versus high-intensity exercise training on physical fitness and physical function in people with type 2 diabetes.
  
  
  METHODS
  This was a randomized clinical trial.
  
  
  METHODS
  The setting was a university campus.
  
  
  METHODS
  Twenty-one people with type 2 diabetes were randomly allocated to receive either moderate-intensity training (MOD group) or high-intensity training (HIGH group).
  
  
  METHODS
  The MOD group performed resistance training at an intensity of 75% of the 8-repetition maximum (8-RM) and aerobic training at an intensity of 30% to 45% of the heart rate reserve (HRR). The HIGH group performed resistance training at an intensity of 100% of the 8-RM and aerobic training at an intensity of 50% to 65% of the HRR.
  
  
  METHODS
  Muscle strength (peak torque [newton-meters]), exercise capacity (graded exercise test duration [minutes]), and physical function (Patient-Specific Functional Scale questionnaire) were measured at baseline and 3 months later. Acute exercise-induced changes in glucose levels were assessed immediately before exercise, immediately after exercise, and 1 hour after exercise during the first exercise training session.
  
  
  RESULTS
  Although both groups showed improvements in physical fitness and physical function, the between-group effect sizes were not statistically significant (exercise capacity estimated marginal mean [EMM] difference=2.1, 95% confidence interval [95% CI]=-0.2, 4.5; muscle strength EMM difference=20.8, 95% CI=-23.3, 65.0; and physical function EMM difference=0.1, 95% CI=-0.6, 0.9). Mean percent changes in glucose levels measured immediately before exercise and immediately after exercise, immediately after exercise and 1 hour after exercise, and immediately before exercise and 1 hour after exercise for the MOD group were -11.4%, -5.0%, and -15.8%, respectively; those for the HIGH group were -21.5%, 7.9%, and -15.3%, respectively.
  
  
  CONCLUSIONS
  Sample size, lack of outcome assessor masking, and physical function measurement subjectivity were limitations.
  
  
  CONCLUSIONS
  Moderate- and high-intensity exercise training, as defined in this study, may lead to similar improvements in physical fitness and physical function in people with type 2 diabetes.
authors.affiliation: J.D. Taylor, PT, PhD, CSCS, Department of Physical Therapy, University of Central Arkansas, 201 Donaghey Ave, Physical Therapy Center, Room 319, Conway, AR 72035 (USA). dtaylor@uca.edu.
authors.forename: J David
authors.initials: JD
authors.lastname: Taylor
authors.affiliation: J.P. Fletcher, PT, PhD, ATC, Department of Physical Therapy, University of Central Arkansas.
authors.forename: James P
authors.initials: JP
authors.lastname: Fletcher
authors.affiliation: R.A. Mathis, PT, PhD, Physical Therapy Program, Harding University, Searcy, Arkansas.
authors.forename: Ruth Ann
authors.initials: RA
authors.lastname: Mathis
authors.affiliation: W.T. Cade, PT, PhD, Program in Physical Therapy, Washington University, St Louis, Missouri.
authors.forename: W Todd
authors.initials: WT
authors.lastname: Cade
mesh_terms: D000328:Adult; D000368:Aged; D003924:Diabetes Mellitus, Type 2 / Q000534:rehabilitation*; D005081:Exercise Therapy / Q000379:methods*; D017079:Exercise Tolerance; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength; D010809:Physical Fitness; D055070:Resistance Training; D016896:Treatment Outcome