The goal of this interventional study is to evaluate the long-term benefits of eccentric (ECC) cycling exercise on physiological responses, exercise capacity, and quality of life (QoL) in patients with type 2 diabetes mellitus (T2DM). The main questions it aims to answer are: * What are the effects of ECC cycling compared to concentric (CON) cycling on physiological responses, exercise capacity, and QoL in patients with T2DM? * What are the differential effects of moderate- and high-intensity ECC cycling compared to CON cycling on physiological responses, exercise capacity, and QoL in patients with T2DM? Researchers will compare moderate- and high-intensity ECC cycling to CON cycling (conventional cycling) to see if ECC cycling can be a viable alternative or complement to existing exercise protocols for managing T2DM. Participants will: * Undergo pre-, mid-, and post-intervention assessment * Perform either moderate- or high-intensity ECC cycling or moderate intensity CON cycling according to group randomisation by the researcher. * Start with two familiarisation sessions prior to the actual cycling training. * Perform cycling exercise twice per week for 10 weeks.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
PREVENTION
Masking
NONE
Enrollment
30
* This group will perform eccentric cycling exercise twice per week for ten weeks using the Cyclus2 standard eccentric ergometer. * The intensity will start at 60% of the peak power output (PPO) of the incremental concentric cycling test. * The intensity will progressively increase by 5% of PPO every 2 weeks (60%-80% PPO).
* This group will perform eccentric cycling exercise twice per week for ten weeks using the Cyclus2 standard eccentric ergometer. * The intensity will start at 80% of the peak power output (PPO) of the incremental concentric cycling test. * The intensity will progressively increase by 5% of PPO every 2 weeks (80%-100% PPO).
* This group will perform concentric cycling exercise twice per week for ten weeks using the Lode Excalibur sport ergometer. * The intensity will start at 60% of the peak power output (PPO) of the incremental concentric cycling test. * The intensity will progressively increase by 5% of PPO every 2 weeks (60%-80% PPO).
Cardio and Muscle Function Laboratory, Pusat Perubatan USM Bertam
Kepala Batas, Pulau Pinang, Malaysia
Glycated haemoglobin (HbA1C)
Time frame: Baseline and post-intervention at 10 weeks
Lipid profile
Time frame: Baseline and post-intervention at 10 weeks
Maximal voluntary contraction (MVC)
isometric quadriceps peak torque (QPT) and isokinetic QPT
Time frame: Baseline, mid-intervention (6 weeks), and post-intervention (10 weeks).
Exercise capacity
6-minute walk test (6-MWT)
Time frame: Baseline, mid-intervention (6 weeks), and post-intervention (10 weeks)
13-item Revised Version of Diabetes Quality of Life (RV-DQOL13)
Scores range from 13 to 65, with higher scores reflecting reduced quality of life
Time frame: Baseline, mid-intervention (6 weeks), and post-intervention (10 weeks)
Short Form-12 (SF-12) health survey
Scoring ranges from 0 to 100, with higher scores indicating better physical and mental health.
Time frame: Baseline, mid-intervention (6 weeks), and post-intervention (10 weeks)
Electromyography (EMG) for muscle activity assessment
To assess quadriceps muscle activity (rectus femoris, vastus medialis oblique, and vastus lateralis) during maximal voluntary contraction.
Time frame: Baseline, mid-intervention (6 weeks), and post-intervention (10 weeks)
Blood pressure
systolic blood pressure (SBP), diastolic blood pressure (DBP),
Time frame: Baseline and up to 10 weeks
Heart rate
Time frame: Baseline and up to 10 weeks
Borg Category-Ratio scale (Borg CR-10)
The scale ranges from 0 (nothing at all) to 10 (extremely strong) to represent the participants' subjective feelings of breathlessness and leg fatigue.
Time frame: Every cycling training session from week 1 to week 10
Body weight
Body weight in kilograms (kg)
Time frame: Baseline, mid-intervention (6 weeks), and post-intervention (10 weeks)
Height
Height in centimeters (cm)
Time frame: Baseline, mid-intervention (6 weeks), and post-intervention (10 weeks)
Body mass index (BMI)
BMI is calculated as weight (kg) divided by height (m²).
Time frame: Baseline, mid-intervention (6 weeks), and post-intervention (10 weeks)
Body circumference
Measure the waist circumference (WC), hip circumference (HC), and thigh circumference (TC) in centimetres with a measuring tape.
Time frame: Baseline, mid-intervention (6 weeks), and post-intervention (10 weeks)
The short version of the physical activity enjoyment scale (PACES-S)
Exercise enjoyment will be assessed using a five-point Likert scale (1 = strongly disagree to 5 = strongly agree), with total scores ranging from 4 to 20; higher scores indicate greater enjoyment.
Time frame: Mid-intervention (6 weeks), and post-intervention (10 weeks)
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