Original Article
Supervised group-exercise therapy versus home-based exercise therapy: Their effects on Quality of Life and cardiovascular risk factors in women with type 2 diabetes

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Abstract

Objectives

Exercise is an integral part of diabetes care. In Iranian women with type II diabetes, we compared the effects of supervised group exercise therapy with the effects of home-based exercise therapy on health-related quality of life (HRQOL), anthropometric parameters, glycaemic control and lipid profile.

Materials and methods

One hundred and two diabetic women were randomised to supervised and home-based groups.

Methods

Over 12 weeks, participants received supervised group-exercise therapy or a home-based exercise-therapy program. During the intervention, they were assessed three times: at baseline, and at weeks 6 and 12. Generalized Estimating Equation models were used to examine the associations between the type of exercise-therapy program and changes over time in anthropometric and biochemical outcomes, and in HRQOL scales of SF36 questionnaire.

Results

Relative to home-based group, supervised group improved significantly regarding role-physical, general health, mean body weight and body mass index from baseline to week 12 (p = 0.01). Their reduction in mean body-fat mass from baseline to week 6 (p = 0.04) was greater. Similarly, their role-physical, general health and role-emotional improved significantly during the intervention (p < 0.05). From baseline to the twelfth week, the HbA1c level fell significantly (p < 0.05) in both groups.

Conclusions

Supervised group-exercise therapy was more effective than home-based exercise therapy in improving HRQOL and body composition in diabetic women.

However, home-based exercise therapy also produced significant improvements in glycaemic control, body composition and lipid profile. Whether in a supervised or home-based setting, the exercise intervention can therefore be effective in improving health outcomes in diabetic patients.

Introduction

In combination with dietary and pharmacological treatment, exercise is an integral part of diabetes care [1], [2]. Although people with type II diabetes are generally recommended to exercise according to clinical guidelines, these guidelines contain no particular information on the types of exercise that will maximise clinical benefits [3]. The few studies to have compared the effects of supervised group exercise therapy with home-based programs on health-related quality of life (HRQOL) have published contradictory results. For example, while Vadstrup et al. found no significant differences between the two groups [4]. Nicolucci et al. found the supervised exercise program to improve quality of life more effectively than counselling alone [5].

Patients with diabetes need the best possible exercise program, i.e., programs that are appropriate to the demographic, social, cultural and ethnic characteristics’ of their population. Those programs should be designed on the basis of a number of studies with a specific focus on these variables in each country. Therefore, we compared the effects of supervised group-exercise therapy (SET) and home-based exercise therapy (HET) in Iranian women with type II diabetes over 12 weeks, focusing specifically on health-related quality of life (HRQOL), glycaemic control, lipid profile and anthropometric parameters.

Section snippets

Methods

This randomized clinical trial study was carried out for 12 weeks after approval by the Ethics Committee at Iran University of Medical Sciences. Iran registry of clinical trials number of this research is 201011044251N3. The study included 102 women with type 2 diabetes who had been referred to the following institutes between October 2011 and October 2012: the Endocrine Research Centre at Firouzgar Hospital, Endocrine and Metabolic clinics in the southern districts of Tehran, Imam Khomeini

Results

After screening 589 diabetic women, we enrolled 102 eligible participants in this study, who were randomly allocated to two exercise-therapy groups. After the baseline visit, 36 patients in the HET group and 38 patients in the SET group attended at least one of the pre-determined exercise-therapy visits (in week 6 and week 12).

Discussion

Our findings show that, over the 12 weeks of the intervention, the SET program improved some of the HRQOL items and anthropometric parameters in diabetic women more effectively than the HET program did. Nonetheless, the HET program also improved a number of outcomes, especially lipid profile, HbA1c, and FBG; and also some HRQOL items and anthropometric parameters.

With regard to HRQOL, comparison of our study with other studies showed a wider variety of QOL outcomes between studies. In our own

Comments

Our findings demonstrated that supervised group-exercise therapy is more effective than home-based exercise therapy in improving QOL and body composition in diabetic II women.

However, the effectiveness of home-based exercise therapy on glycaemic control, body composition and lipid profile is also significant. Important roles in promoting physical activity and health outcomes of diabetic patients in supervised or home-based exercise settings can thus be played (1) by minimal interventions such

Conflict of interest

There is no conflict of interest.

References (17)

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