This study evaluates the effects of the combined exercise training (aerobic more resistance) and of the aerobic exercise training isolated compared to control group, which performed only stretching and relaxation, in the treatment of type 2 diabetes (T2DM). The two exercise interventions and the control procedure are performed in aquatic environment.
The fact that aquatic training can provide similar benefits to land training has important clinical implications, because the aquatic environment provides some interesting advantages to this population, such as no impact on walking and running in deep water or reduced, as in water-based exercises. This minor impact and consequent reduced chance of injury allows consider the aquatic environment favorable to the principle of continuity with progression of physiological stimuli and metabolic benefits. From these peculiarities of the training in aquatic environment, and of the association between T2DM with obesity and hypertension, conditions that create difficulties for individuals performing exercise supporting their own body mass and need both benefits from aerobic and resistance training, is believed to be necessary to carry out physical training programs of the same duration, differing in training mode (aerobic or combined) in the aquatic environment in order to answer of in a adequated duration of training, the diabetes control through training differs between the different mode of exercise.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
60
Total duration of exercise sessions: 56 minutes (3 minutes of warming - 50 minutes of main part - 3 minutes of stretching); Method of training: Aerobic continuous in aquatic environment; Modality: Hydrogymnastics; Weekly frequency: 3; Intensity: 85% to 100% of the anaerobic threshold during the intervention.
Total duration of exercise sessions: 56 minutes (3 minutes of warming - 50 minutes of main part - 3 minutes of stretching); Method of training: Aerobic more resistance training. Aerobic component (between 30 and 40 minutes of the sessions): Method: Aerobic continuous in aquatic environment; Modality: Hydrogymnastics; Weekly frequency: 3; Intensity: 85% to 100% of the anaerobic threshold during the intervention. Resistance component (Between 10 and 20 minutes of the sessions): Method: Multiple sets (2 to 4 sets of 30 to 15 seconds) in aquatic environment; Modality: Hydrogymnastics; Weekly frequency: 3; Intensity: Maximum execution speed.
Changes in levels of glycated hemoglobin
Time frame: Change from Baseline levels of glycated hemoglobin at 15-weeks.
Fasting plasma glucose.
Time frame: At baseline and after a 15-week period.
Fasting insulin.
Time frame: At baseline and after a 15-week period.
Insulin-resistance index (HOMA-IR).
Time frame: At baseline and after a 15-week period.
Total cholesterol.
Time frame: At baseline and after a 15-week period.
high density lipoprotein.
Time frame: At baseline and after a 15-week period.
Low density lipoprotein.
Time frame: At baseline and after a 15-week period.
Triglycerides.
Time frame: At baseline and after a 15-week period.
Renin
Time frame: At baseline and after a 15-week period.
High sensitive C-reactive protein.
Time frame: At baseline and after a 15-week period.
Total testosterone.
Time frame: At baseline and after a 15-week period.
Cortisol
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Total duration of exercise sessions: 56 minutes (3 minutes of warming - 50 minutes of main part - 3 minutes of stretching); Activities performed in main part: Stretching and relaxation in aquatic environment.
Time frame: At baseline and after a 15-week period.
Testosterone/cortisol ratio.
Time frame: At baseline and after a 15-week period.
Peak oxygen uptake.
Time frame: At baseline and after a 15-week period.
Oxygen uptake at the second ventilatory threshold.
Time frame: At baseline and after a 15-week period.
Percentage of oxygen consumption in the second ventilatory threshold from the peak oxygen uptake.
Time frame: At baseline and after a 15-week period.
Systolic blood pressure.
Time frame: At baseline and after a 15-week period.
Diastolic blood pressure
Time frame: At baseline and after a 15-week period.
Heart rate at rest.
Time frame: At baseline and after a 15-week period.
Maximum dynamic muscle strength (1RM) in the knees extension exercise.
The test is characterized by greater load that can be supported in a single execution of knees extension exercise.
Time frame: At baseline and after a 15-week period.
Maximum dynamic muscle strength (1RM) in the elbows flexion exercise.
The test is characterized by greater load that can be supported in a single execution of elbows flexion exercise.
Time frame: At baseline and after a 15-week period.
Resistant dynamic muscle strength (maximal repetitions) in the knees extension exercise.
To determine the resistant dynamic muscle strength, it was considered the number of repetitions performed at 60% of 1RM, following a pace and breadth of pre-established execution. In the post-training evaluation, we used the load of 60% of 1RM test performed in the pre-training.
Time frame: At baseline and after a 15-week period.
Resistant dynamic muscle strength (maximal repetitions) in the elbows flexion exercise.
To determine the resistant dynamic muscle strength, it was considered the number of repetitions performed at 60% of 1RM, following a pace and breadth of pre-established execution. In the post-training evaluation, we used the load of 60% of 1RM test performed in the pre-training.
Time frame: At baseline and after a 15-week period.
Timed up and go test performed at the usual speed.
Time frame: At baseline and after a 15-week period.
Timed up and go test performed at the maximal speed.
Time frame: At baseline and after a 15-week period.
Sitting-rising test (SRT).
The SRT basically consists in the quantification of the number of support (hands and/or knees, or hands or forearms on knees) one utilizes in order to sit and to rise from the floor.
Time frame: At baseline and after a 15-week period.
Overall quality of life and in physical, psychological, social relationships and environment domains, evaluated by instrument of World Health Organization (WHOQOL).
To evaluate the quality of life we used the WHOQOL-brief instrument. This instrument is self-applicable, cross-cultural, translated and validated for Portuguese, consisting of 26 questions. Its score ranges from zero to 100 points, divided into the physical, psychological, social relationships and environment, as well as an assessment of the overall quality of life.
Time frame: At baseline and after a 15-week period.
Depressive symptoms, evaluated by Depression Inventory Patient Health Questionnarie (PHQ-9)
For evaluation of depressive symptoms was used the questionnaire PHQ-9 depression, which consists of nine items, including symptoms and attitudes whose intensity varies from zero to three, with 27 your score.
Time frame: At baseline and after a 15-week period.
Sleep quality, evaluated by Pittsburgh Sleep Scale
Sleep quality was assessed by Pittsburgh scale, consisting of 19 questions on the perception of oneself and five questions relating to the perception that the roommates of these individuals have about sleep the same. These questions are grouped into seven components, with score of zero to three.
Time frame: At baseline and after a 15-week period.
Levels of sleep Obstructive Apnea, evaluated by Berlin Questionnaire (BQ)
This questionnaire includes 10 items, organized in 3 categories related to snoring and apneas witnessed (5 items), daytime sleepiness (4 items) and high blood pressure (HTA) / obesity (1 item). Information on gender, age, height, weight, race neck circumference and is also requested. The determination of high or low risk to OSAS is based on responses in each category itens.
Time frame: At baseline and after a 15-week period.
Physical activity levels, evaluated by International Physical Activity Questionnaire (IPAQ) - Short Form.
The IPAQ short form asks about three specific types of activity undertaken in the three domains introduced above and sitting. The specific types of activity that are assessed are walking, moderate-intensity activities and vigorous intensity activities; frequency (measured in days per week) and duration (time per day) are collected separately for each specific type of activity.
Time frame: At baseline and after a 15-week period.