Background: Exercise training programs have emerged as a useful therapeutic regimen for the management of type 2 diabetes mellitus (T2DM). Majority of the Western studies highlighted the effective role of exercise in T2DM. Therefore, the main aim was to focus on the extent, type of exercise and its clinical significance in T2DM in order to educate the clinicians from developing countries, especially in Asians.
Methods: Pubmed, Science Direct, Scopus, ISI Web of Knowledge and Google scholar were searched using the terms "type 2 diabetes mellitus," "type 2 DM," "exercise," and/or "physical activity," and "type 2 diabetes mellitus with exercise." Only clinical or human studies published in English language between 2000 and 2012 were included. Certain criteria were assigned to achieve appropriate results.
Results: Twenty five studies met the selected criteria. The majority of the studies were randomized controlled trial study design (65%). Most of the aerobic exercise based studies showed a beneficial effect in T2DM. Resistance exercise also proved to have positive effect on T2DM patients. Minimal studies related to other types of exercises such as yoga classes, joba riding and endurance-type exercise were found. On the other hand, United States of America (USA) showed strong interest of exercise management towards T2DM.
Conclusion: Aerobic exercise is more common in clinical practice compared to resistance exercise in managing T2DM. Treatment of T2DM with exercise training showed promising role in USA. A large number of researches are mandatory in the developing countries for incorporating exercise in the effective management of T2DM.
Several studies have shown a positive association between variable resistance training (VRT) and improvements in muscular performance. However, the effects of VRT on body composition among untrained individuals remain unclear. The objective of this study was to examine the comparison between of methods of VRT on body composition, muscular strength and functional capacity among untrained male adults. Fifty healthy untrained males (age: 21.5 ± 1.95 years) were selected randomly and assigned into three groups: combined weight and chain (WC), combined weight and elastic band (WE), and free-weight (CG). All three groups completed 12 weeks of high intensity resistance training (70-80% of one-repetition maximum) with three sets of 8-12 repetitions two times per week. Approximately 65% of the whole resistance was provided by free-weights, while the other 35% of the resistance was provided by chains and elastic bands for the WC and WE groups, respectively. Dependent variables including body composition, muscular strength and functional capacity using bioelectrical impedance analyzer, one-repetition maximum and maximum repetitions to muscular fatigue were measured, respectively in pre-test, post-test 1 (week 6) and post-test 2. Significance level was set at P < 0.05. No differences existed among all groups at baseline for depended variables. A mixed model ANOVA with repeated measurements analysis revealed that although there were not significant differences in body composition among the groups (P > 0.05), all groups showed a significant reduction in fat mass and significant increase in fat-free mass during and after the intervention (P = 0.0001), and these differences were insignificantly greater in WE and WC groups compared with CG group. Furthermore, all three groups showed significant improvements in muscular strength and functional capacity during and after intervention (P = 0.0001), and muscular strength and functional capacity were greater in WE and WC groups compared with the CG group, but there were not significant differences in muscular strength and functional capacity between WE and WC groups. However, the WE group showed insignificantly more improvement in muscular strength and functional capacity compared with the WC group during and after the intervention. The results of this study show that VRT has a slightly better effect than free-weight to improve body composition during and after 12 weeks intervention. Also, WE training had a slightly better effect than WC training in improving muscular strength and functional capacity during and after 12 weeks of VRT among untrained male adults.
Resistance training (RT) refers to a method of physical conditioning of complex programming which consists of progressive and various training techniques to achieve the desired training goals. An appropriate programme design is the key to success; where exercise selection is one of the critical factors. The selection of exercise will expose different stimulation as in the application of the specific adaptation on imposed demand principle. The option of choosing either bilateral (BI) or unilateral (UNI) exercise is an important decision to perform in the construction of any strength or RT programme. This study aimed to investigate the physiological responses of unilateral versus bilateral acute RT on heart rate (HR), blood pressure (BP) and rate of perceived exertion (RPE). Sixteen (n = 16) trained women with mean age of 23.31 (SD = 1.35) years old went through a total body exercise session for each unilateral and bilateral protocols which both consisted of major muscles group for 80% 1RM, 10 repetitions to maximal effort for 3 sets. The results revealed that all variables examined including HR, systolic blood pressure (SBP), diastolic blood pressure (DBP) and RPE were statistically changed (p < .001) across the times. Apart from that, unilateral and bilateral RT imposed significantly different stimulus on SBP (p < .05).
Exercise has been suggested as the best and the most affordable way for managing blood pressure. The insertion/ deletion of angiotensin I-converting enzyme (ACE) I/D gene polymorphism had been reported to be linked with sev- eral diseases such as hypertension and diabetic nephropathy. Several studies showed that blood pressure response to exercise training for health management also vary among individuals with different genotypes of ACE I/D gene poly- morphism. A study of 9 months of endurance exercise training at 75 to 85 % of VO2max showed that the decrease of resting blood pressure in I allele carriers wass greater than D allele carriers. In contrast, other study discovered that adult women with D allele had greater reduction in resting blood pressure than those with I allele, following a 12-week combined aerobic and resistance exercise training. Despite the inconsistencies of some findings, it has remained unknown if the ACE I/D gene polymorphism would also influence blood pressure response to isometric handgrip training that had been found to be superior to the dynamic resistance exercise training in controlling and preventing high blood pressure. Thus, this article was to review the literature on ACE I/D gene polymorphism and blood pressure response to exercise training that could serve as the basis for future research to identify individuals who will lower resting blood pressure the most with exercise training program for health management.
The aims of the current study, therefore, were to compare (1) free-living MPS and (2) muscle and metabolic adaptations to resistance exercise in South Asian and white European adults. Eighteen South Asian and 16 White European men were enrolled in the study. Free-living muscle protein synthesis was measured at baseline. Muscle strength, body composition, resting metabolic rate, VO2max and metabolic responses (insulin sensitivity) to a mixed meal were measured at baseline and following 12 weeks of resistance exercise training. Free-living muscle protein synthesis was not different between South Asians (1.48 ± 0.09%/day) and White Europeans (1.59 ± 0.15%/day) (p = 0.522). In response to resistance exercise training there were no differences, between South Asians and White Europeans, muscle mass, lower body strength or insulin sensitivity. However, there were differences between the ethnicities in response to resistance exercise training in body fat, resting carbohydrate and fat metabolism, blood pressure, VO2max and upper body strength with responses less favourable in South Asians. In this exploratory study there were no differences in muscle protein synthesis or anabolic and metabolic responses to resistance exercise, yet there were less favourable responses in several outcomes. These findings require further investigation.
This study aimed to determine the factors associated with exercise behavior based on the theory of planned behavior (TPB) among the sarcopenic elderly people in Cheras, Kuala Lumpur. A total of 65 subjects with mean ages of 67.5±5.2 (men) and 66.1±5.1 (women) years participated in this study. Subjects were divided into two groups: 1) exercise group (n=34; 25 men, nine women); and 2) the control group (n=31; 22 men, nine women). Structural equation modeling, based on TPB components, was applied to determine specific factors that most contribute to and predict actual behavior toward exercise. Based on the TPB's model, attitude (β=0.60) and perceived behavioral control (β=0.24) were the major predictors of intention to exercise among men at the baseline. Among women, the subjective norm (β=0.82) was the major predictor of intention to perform the exercise at the baseline. After 12 weeks, attitude (men's, β=0.68; women's, β=0.24) and subjective norm (men's, β=0.12; women's, β=0.87) were the predictors of the intention to perform the exercise. "Feels healthier with exercise" was the specific factor to improve the intention to perform and to maintain exercise behavior in men (β=0.36) and women (β=0.49). "Not motivated to perform exercise" was the main barrier among men's intention to exercise. The intention to perform the exercise was able to predict actual behavior regarding exercise at the baseline and at 12 weeks of an intervention program. As a conclusion, TPB is a useful model to determine and to predict maintenance of exercise in the sarcopenic elderly.
Stress is a common problem among university students and studies showed that involvement in exercise could help in reducing stress. However, information regarding the effect of high intensity progressive resistance training (PRT) using a resistant tube on stress among inactive and moderate active young male university students is limited. Hence, the aim of this study is to examine the effect of high intensity PRT using a resistant tube on psychological stress level, cortisol, DHEA and physical fitness in this population. A total of 30 male university students were participated in this quasi-experiment study. Intervention group (n = 14, age: 21.50 ± 1.37 yr) was participaned to carry out high intensity PRT by using resistant tube 3 times per week for 10 weeks; control group (n = 16, age: 21.29 ± 1.86 yr) was asked to continue their current lifestyle as usual. Before and after 10 weeks of intervention, psychological stress was measured by using PSS and SLSI questionnaires; cortisol and DHEA level were measured by using ELISA method. Timed up-and-go (TUG) used to examine dynamic balance and handgrip strength test used to measure muscle strength. Findings showed that the increased of DHEA level after 10 weeks of intervention was significantly difference between control and intervention groups (p < 0.05). There was no significant group difference in changes over time in anthropometric and body composition measurements, stress scores, cortisol level and physical fitness. High intensity PRT using resistant tube may be beneficial in increasing DHEA level among young male adults, which can act as a stress biochemical indicator.
This paper aims to determine acute responses of standardized resistance training load on cardio-respiratory variables in recreationally active participants. The methodology involved twelve recreationally active males with an age of 23.5 (± 4.07) years, a mass of 70.5 (± 7.84 kg), a height of 1.69 (± 0.06 m), and a body mass index of 24.8 (± 2.14) kg/m2). The participants performed an exercise protocol that comprises five exercises on a standardized load. Each exercise was performed in a duration of 60 seconds with uncontrolled lifting velocity. Cardio-respiratory responses were measured using a portable metabolic system analyzer during the exercises. A wrist digital blood pressure monitor was used to determine pre- and postprotocol blood pressure responses. Based on the results, pre- and postprotocol systolic (p=0.744) and diastolic (p=0.758) blood pressure indicated no significant responses. However, significant differences were observed in pre- and post-heart rate responses (p=0.000). Peak cardio-respiratory responses recorded during the protocol were 30.2 (± 4.02) ml/Kg/min for oxygen consumption, 138 (± 61.9) bpm for heart rate, and 633 (± 71.2) kcal for energy expenditure (estimated per hour). On average, the Metabolic Equivalent of Task (MET) was recorded at a value of 8.62 (± 1.19). For a short duration standardized load circuit training exercise protocol, cardio respiratory responses were similar to other protocols. The metabolic cost of the predefined exercises was nearly half of the recommended energy expenditure through exercise per week. The prescribed protocol was comparable with other exercise protocols for cardiorespiratory variables. The single set protocol used was efficient in terms of caloric expenditure, and was less strenuous over similar exercise duration. Furthermore, the prescribed protocol is applicable and beneficial for active and healthy individuals.
INTRODUCTION: osteoarthritis (OA) of knee has been reported as a risk factor for falls and reduced balance in the elderly. This systematic review evaluated the effectiveness of physical therapies in improving balance and reducing falls risk among patients with knee OA.
METHODS: a computerised search was performed to identify relevant studies up to November 2013. Two investigators identified eligible studies and extracted data independently. The quality of the included studies was assessed by the PeDro score.
RESULTS: a total of 15 randomised controlled trials involving 1482 patients were identified. The mean PeDro score was 7. The pooled standardised mean difference in balance outcome for strength training = 0.3346 (95% CI: 0.3207-0.60, P = 0.01 < 0.00001, P for heterogeneity = 0.85, I(2) = 0%). Tai Chi = 0.7597 (95% CI: 0.5130-1.2043, P<=0.0014, P for heterogeneity = 0.26, I(2) = 0%) and aerobic exercises = 0.6880 (95% CI: 0.5704-1.302, P < 0.00001, P for heterogeneity = 0.71, I(2) = 0%). While pooled results for falls risk outcomes in, strength training, Tai chi and aerobics also showed a significant reduction in reduced risk of falls significantly with pooled result 0.55 (95% CI: 0.41-0.68, P < 0.00001, P for heterogeneity = 0.39, I(2) = 6%).
CONCLUSION: strength training, Tai Chi and aerobics exercises improved balance and falls risk in older individuals with knee OA, while water-based exercises and light treatment did not significantly improve balance outcomes. Strength training, Tai Chi and aerobics exercises can therefore be recommended as falls prevention strategies for individuals with OA. However, a large randomised controlled study using actual falls outcomes is recommended to determine the appropriate dosage and to measure the potential benefits in falls reduction.
KEYWORDS: Tai Chi; elderly; exercises; falls; older people; osteoarthritis