Effects of physical-cognitive training on physical and psychological functions among older adults with type 2 diabetes and balance impairment: a randomized controlled trial

Abstract

Risks of falls among older adults are multifactorial in nature. A combined training program might be beneficial on fall-related outcomes. This study aimed to explore the effects of group-based physical-cognitive trainings on physical and psychological outcomes among older adults with type 2 diabetes mellitus (T2DM) and balance impairment. Fall incidence were also determined. Thirty-seven older adults with T2DM and balance impairment were randomly assigned to control and intervention groups. The intervention program comprised of 24 training sessions of 45-60 min exercise for 8 weeks. The exercise consisted of warm-up, aerobic exercise by nine square stepping, resistance exercise combined with cognitive training and cool down. All participants were assessed at baseline, 4 and 8 weeks after intervention, and 1-year follow-up. Both groups reported similar rates of falls. Global cognition, depressive symptoms, and fear of falling did not differ between groups at any time. The Timed Up & Go (TUG) test, alternate stepping test (AST), knee extensors, ankle plantarflexors, and dorsiflexors strength differed at 4 weeks. TUG, AST, hip abductors, knee flexors, ankle plantarflexors, and dorsiflexors strength differed at 8 weeks. The activity of daily living (ADL), TUG test (P= 0.002) and AST, hip extensors and abductors, knee extensors and flexors, ankle plantarflexors and dorsiflexors were different at 1-year follow-up. The group-based physical-cognitive training could benefit older adults with T2DM in terms of maintaining ADL. The intervention could reduce fall risk factors by improving balance and lower limb muscle strength among older adults with T2DM and balance impairment.

Effect of Physical Activities Training and Massages on the Physical Fitness of Elderly People

“…The findings were in accordance with the work by Saetae et al, (2018) that found that Qi Gong and Yoga could have a positive impact on health, making the person physically and mentally healthy. Consistent with the study balance and resistance training could reduce risk factor of fall by improving balance and lower limb strength among old adults with T2DM and balance impairment including effectiveness of band exercise in improving muscle strength (Kraiwong et al, 2021;. The finding was also supported by the research of Thaiprasert et al (2019) which found that yoga practice made the elderly healthier physically, mentally and socially.…”

Effectiveness of physical activity in managing co-morbid depression in adults with type 2 diabetes mellitus: A systematic review and meta-analysis

“…Out of 18 studies, 17 reported post treatment results while only one study reported results at one-year follow up (Vucic Lovrencic et al, 2015). Of the included studies, 10 reported effects of physical activity on glycaemic control (Aylin et al, 2009, De Groot et al, 2019b, Duruturk and Ozkoslu, 2019, Kempf and Martin, 2013, Piette et al, 2011, Putiri et al, 2012, Schneider et al, 2016, Vucic Lovrencic et al, 2015, Yucel and Uysal, 2016, Kraiwong et al, 2021. All these 10 studies used HbA1c.…”

“…Thirteen studies used a physical activity intervention alone. Of the remaining 5 studies, 2 combined physical activity with cognitive behavioural therapy (CBT) (Piette et al, 2011;De Groot et al, 2019b), one study combined it with behavioural activation (Schneider et al, 2016), one study combined it with dietary measures (Osama and Shehab, 2015), while one study combined physical activity with cognitive training (Kraiwong et al, 2021). Eleven studies used aerobic exercises as an intervention, 2 studies used resistance exercises (Lincoln et al, 2011;Putiri et al, 2012) while 5 studies used mixed types of exercises as the intervention (Martinez-Velilla et al, 2021;Kraiwong et al, 2021;Duruturk and Ozkoslu, 2019;Vucic Lovrencic et al, 2015;Aylin et al, 2009).…”

“…Four studies provided purely supervised physical activity (Lincoln et al, 2011;Duruturk and Ozkoslu, 2019;Gilani and Feizabad, 2019;Kraiwong et al, 2021), 3 studies provided purely unsupervised physical activity (Kempf and Martin, 2013;Piette et al, 2011), 3 studies provided mixed supervised and unsupervised physical activity (Aylin et al, 2009;Martinez-Velilla et al, 2021;Putiri et al, 2012), while the remaining 8 studies did not provided explicit information about supervision. A large proportion (n = 13) of studies applied low to moderate intensity exercise (McKay et al, 2001, Saiiari et al, 2011, Osama and Shehab, 2015, Sardar et al, 2014, De Groot et al, 2019b, Kraiwong et al, 2021, Schneider et al, 2016, Kempf and Martin, 2013, Vucic Lovrencic et al, 2015, Yucel and Uysal, 2016, Duruturk and Ozkoslu, 2019, Aylin et al, 2009, Gilani and Feizabad, 2019, 1 study applied high intensity exercises while the remaining 4 did not reported intensity of physical activity (Abdelbasset et al, 2020;Martinez-Velilla et al, 2021;Piette et al, 2011;Putiri et al, 2012).…”

“…Seventeen studies with 1362 subjects (705 in the physical activity group, 657 in the control condition) were included in the quantitative synthesis. One study (Kraiwong et al, 2021) was excluded from the meta-analysis because it lacked useable depression data to measure posttreatment means and standard deviations (SD). Of the included 17 studies, 13 clearly reported the post-treatment means and SD for both the physical activity group and the control group.…”