• A 12-week prospective randomized controlled trial to investigate the effects of aerobic training on type 2 diabetes patients

      Sykes, Kevin; Yeung, Tin L. V.; Ko, Gary T. C.; University College Chester (Weston Medical Publishing, 2004)
      This study was undertaken to investigate the effects of a 12-week aerobic exercise program in the management of patients with type 2 diabetes. A prospective randomized controlled trial with repeated measures was conducted. Thirty-six Hong Kong Chinese patients with type 2 diabetes (mean age, 58.1 yr) were randomized into Group 1 (exercise, n = 24) and Group 2 (controls, n = 16). Assessments at baseline and at three months included anthropometry, body fat measurement, biochemistry, six-minute walking distance (6MWD) assessment, exercise capacity, and SF-36® quality of life assessment (QualityMetric Inc., Lincoln, RI). Blood glucose was monitored before and after each exercise session. The immediate response to one hour of moderate aerobic exercise was a significant decrease in blood glucose (10.4 ± 3.5 mmol/L to 7.1 ± 2.7 mmol/L, p < 0.05). After 12 weeks, significant differences were noted between the groups in 6MWD (498 ± 128 m versus 299 ± 75 m, p = 0.000), exercise capacity in terms of metabolic equivalent units (5.1 ± 1.0 METs versus 2.8 ± 0.8 METs, p = 0.001), and insulin sensitivity (1.7 ± 1.0 S1 versus 4.3 ± 2.5 S1, p = 0.048). Group 1 also demonstrated an increase in HDL (1.16 ± 0.30 mmol/L to 1.27 ± 0.33 mmol/L, p = 0.002), lower body weight (67.3 ± 12.8 kg to 66.9 ± 12.8 kg, p = 0.045), lower body mass (26.5 ± 4.6 BMI to 26.3 ± 4.6 BMI), reduced glycosylated hemoglobin HbA1c) (8.1 ± 1.3 percent to 7.7 ± 1.0 percent), and improved quality of life. In contrast, participants in Group 2 showed a significant decrease in the SF-36 social functioning domain (p = 0.035), lowered scores in all eight quality of life domains, and no changes in other variables. We conclude that moderate aerobic exercise should be advocated in the management of patients with type 2 diabetes.
    • Exercise training and fall-risk prevention for community-dwelling elders

      Sykes, Kevin; Ling, Wai Mun; University College Chester (Weston Medical Publishing, 2004)
      Purpose: To investigate how a group of community-dwelling Hong Kong Chinese elderly persons with a history of falling can benefit from an eight-week home-based program of exercise. Methods: From an initial group of 69 volunteers, 40 participants (mean age = 80 ± 4.5years) with a history of falling were selected and randomly assigned into Group 1—the exercise group (n = 20) and Group 2—the control group (n = 20). Following an introductory talk and exercise instruction session, Group 1 engaged in a daily 45-minute home-based exercise session, plus a 30-minute walk twice per week, for eight weeks. Measurements, taken at baseline and after eight weeks, included strength of hip flexors and knee extensors, mobility, dynamic balance, and functional reach. Participants were requested to complete a daily activity diary. Physiotherapists followed up by phone in the first, second, fourth, and sixth week, with regard to the exercise program, health status, motivation, and advice if necessary. Results: Twenty-seven participants successfully completed the eight-week program (Group 1 = 5; Group 2 = 12). There was no difference between the groups in any outcome measure at baseline. However, following the eight-week intervention, Group 1 demonstrated significant improvements in strength of hip flexors and knee extensors (p < 0.000). Performance in Functional Reach (p = 0.008), Time to Get-up and Go (p = 0.034), and Berg Balance Scale (p = 0.022) test scores improved markedly. There was no significant change in any outcome measures in Group 2. Conclusion: Participation in a home-based exercise program is an effective intervention to enhance strength, gait, and balance and to reduce the functional declines associated with aging in the elderly. Lower-limb strength, gait, and balance training exercises should be a major component within a fall-risk reduction program for the elderly.