Pariser Gina, Ann Demeuro Mary, Gillette Patricia, Stephen Winters
Physical Therapy Program, Bellarmine University, Louisville, KY.
Cardiopulm Phys Ther J. 2010 Jun;21(2):5-12.
Some adults with type 2 diabetes mellitus (T2DM) have comorbidities and mobility impairments that limit their exercise capacity. In consideration of this, we developed and piloted a program called Active Steps for Diabetes for people with T2DM, comorbidities, and mobility impairments. The purpose of this paper was to report outcomes for the pilot program.
Active Steps for Diabetes, an 8-week program, included instruction on diabetes self-care andgroup and home exercise programs. Twenty-two females (62.7 +/- 6.1yrs) with T2DM and self-reported mobility impairments completed the program. Six participants used a walking aid. Outcome measures included two risk factors for coronary artery disease [daily physical activity and body mass index (BMI)], cardiovascular fitness (6-minute walk distance), and knowledge of diabetes-specific exercise guidelines. A two-way repeated measures ANOVA was used to compare outcomes before and after the program and between participants who did and did not use a walking aid.
Active Steps for Diabetes was effective in increasing daily physical activity in both groups of subjects (walking aid group: 2.6 days/week [95% confidence interval (CI) = 2.1 to 3.3]; no walking aid group: 1.9 days/week [95% CI=1.2 to 2.5]). This was accompanied by increases in 6-minute walk distances (walking aid group: 54.0 m [95% CI = 36.4 to 71.6]; no walking aid group: 62.6 m [95% CI=55.7 to 69.4]). Changes in BMI were not significant (walking aid group: -0.4 [95% CI = -1.2 to 0.4]; no walking aid group: -.24[95% CI = -.91 to .44]). Increases in knowledge of diabetes-specific exercise guidelines were observed in both groups (walking aid group: 18.8% [95% CI = 11.3 to 26.4]; no walking aid group: 19.3% [95% CI = 16.1 to 22.5]).
: Physical inactivity and low cardiovascular fitness are predictors of CAD morbidity and mortality in adults with T2DM. This pilot program suggests that a model for diabetes education, incorporating exercise programs developed by a physical therapist, may increase physical activity, improve endurance, and thereby potentially reduce CAD risk in people with T2DM and mobility impairments from comorbidities.
一些成年2型糖尿病（T2DM）患者伴有合并症和行动障碍，这限制了他们的运动能力。考虑到这一点，我们开发并试点了一个名为“糖尿病积极行动”的项目，针对患有T2DM、合并症和行动障碍的人群。本文旨在报告该试点项目的结果。
“糖尿病积极行动”是一个为期8周的项目，包括糖尿病自我护理指导以及团体和家庭锻炼项目。22名患有T2DM且自我报告有行动障碍的女性（62.7±6.1岁）完成了该项目。6名参与者使用了助行器。结果指标包括冠状动脉疾病的两个风险因素[每日身体活动量和体重指数（BMI）]、心血管健康状况（6分钟步行距离）以及对糖尿病特定运动指南的了解程度。采用双向重复测量方差分析来比较项目前后的结果以及使用和未使用助行器的参与者之间的结果。
“糖尿病积极行动”项目在增加两组受试者的每日身体活动量方面均有效（使用助行器组：每周2.6天[95%置信区间（CI）=2.1至3.3]；未使用助行器组：每周1.9天[95%CI =1.2至2.5]）。同时，6分钟步行距离也有所增加（使用助行器组：54.0米[95%CI =36.4至71.6]；未使用助行器组：62.6米[95%CI =55.7至69.4]）。BMI的变化不显著（使用助行器组：-0.4[95%CI =-1.2至0.4]；未使用助行器组：-0.24[95%CI =-0.91至0.44]）。两组对糖尿病特定运动指南的了解程度均有所提高（使用助行器组：18.8%[95%CI =11.3至26.4]；未使用助行器组：19.3%[95%CI =16.1至22.5]）。
身体活动不足和心血管健康状况不佳是成年T2DM患者CAD发病和死亡的预测因素。这个试点项目表明，一种将物理治疗师制定的锻炼项目纳入其中的糖尿病教育模式，可能会增加身体活动量，提高耐力，从而有可能降低患有T2DM和因合并症导致行动障碍的人群患CAD的风险。
