Predicting Aerobic Fitness Improvements after Participation in a Hybrid Supervised and Home-Based Exercise Program in People with Type 2 Diabetes

摘要

Objective: Structured, gym-based exercise training has been shown to be effective at improving aerobic fitness and glycemic control in persons with type 2 diabetes. However, community-based diabetes programs more commonly incorporate less structured programming, promoting exercise at home. The objectives of this study were to evaluate a community-based, hybrid exercise program encouraging home-based exercise for improving aerobic fitness, and to examine the components of exercise prescription that contribute to this fitness change.Methods: A retrospective analysis of 583 persons with type 2 diabetes who had participated in the Toronto Rehabilitation Institute's diabetes exercise program was performed. All subjects completed 6 months of structured aerobic and resistance exercise supervised once per week on-site, with 4 more unsupervised sessions per week completed at home. Cardiopulmonary fitness testing and anthropo-metric measures were performed at baseline and at program completion. A multivariate regression analysis examined the outcome of aerobic fitness (peak oxygen consumption), controlling for age, sex, body mass index, weight change, initial fitness at entry into the program and walking exercise performed (distance, duration and pace).Results: Peak oxygen consumption improved significantly from 19.1 ±0.2 at baseline to 21.9±0.3 mLkg~1min""1 at 6 months (p<0.001). Weight and body mass index also improved significantly (p<0.001). The regression model was able to predict 76.9% of the variance in aerobic fitness, with distance walked contributing the most to improved exercise capacity.Conclusions: A 6-month hybrid exercise program delivered in a community rehabilitation program setting successfully improved aerobic fitness in people living with type 2 diabetes.