A pilot program for physical exercise promotion in adults with type 1 diabetes: the PEP-1 program

Abstract

[Purpose] The aim of this study was to compare age-related differences in balance and anthropometric posture measurements of the foot and to determine any relationship between them. [Subjects and Methods] Sixty-eight older and 42 younger adults participated in this study. Foot posture was tested for four domains: 1) hallux flexion and extension range of motion using a goniometer, 2) navicular height and 3) length of the foot using a pachymeter, and 4) footprint (width of forefoot, arch index and hallux valgus). Balance was tested under two conditions on a force platform: bipodal in 60-s trials and unipodal in 30-s trials. The sway area of the center of pressure and velocity in the anteroposterior and mediolateral directions were computed. [Results] Older individuals showed significantly poorer balance compared with younger adults under in the unipodal condition (center of pressure area 9.97 vs. 7.72 cm 2). Older people presented a significantly lower hallux mobility and higher values for width of the forefoot and transverse arch index than younger adults. The correlations between all foot posture and center of pressure parameters varied across groups, from weak to moderate (r −0.01 to −0.46). Low hallux mobility was significantly related to higher center of pressure values in older people. [Conclusion] These results have clinical implications for balance and foot posture assessments.

Feasibility and safety of a group physical activity program for youth with type 1 diabetes

“…Data from other age groups may also be informative. Group interventions including weekly MVPA and DSME sessions for adults and young children (9‐11 years) with type 1 diabetes did not increase MVPA outside the group sessions. Taken together, these data and ours indicate a personalized goal‐setting approach may be more effective at promoting habitual MVPA for type 1 diabetes …”

“…Nonetheless, participants in the previous group intervention for adults with type 1 diabetes improved peak oxygen uptake and systolic blood pressure compared with non‐participating controls . It is possible that even group interventions unable to promote MVPA more than once per week could still gain from this modest MVPA dose some positive impact on clinically important outcomes for type 1 diabetes.…”

“…Although our program was safe, some feasibility metrics were encouraging, and results indicated the potential for improving cardiopulmonary fitness score among those completing it, the major shortcoming we found was the inability to detect an increase in MVPA outside of intervention sessions. Given the success of personalized programs to promote MVPA outside of intervention sessions relative to less frequent group interventions such as this one and others, future MVPA interventions should consider personalized delivery. However, investigators should examine positive social interactions like our participants reported by hybridizing it with in‐person group sessions and other communication modes that are developmentally appropriate for adolescents with type 1 diabetes (eg, phone, email, text messaging, and social media) .…”

Exercise to preserve β‐cell function in recent‐onset Type 1 diabetes mellitus (EXTOD) – a randomized controlled pilot trial

“…In the pilot program for physical exercise promotion in adults with Type 1 diabetes: the PEP-1 program, the only other unsupervised exercise programme for adults with Type 1 diabetes, activity was not increased [20]. In four studies of unsupervised exercise studies in adolescents and/or children, two showed an increased activity at 3-4 months and two did not [21].…”

“…Any form of exercise could be undertaken and exercise could be accumulated throughout the day in bouts of at least 10 min. Participants met with the nurse for 20 min to discuss their exercise levels at 2,4,8,12,16,20,30, 36 and 42 weeks as specified in the protocol. Using a protocol similar to this, we have shown that we can increase and maintain exercise levels in a variety of patients with chronic diseases including patients with newly diagnosed Type 2 diabetes [8][9][10].…”