Hsieh Ping-Lun, Tseng Chin-Hsiao, Tseng Yufeng Jane, Yang Wei-Shiung
School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.
Department of Rehabilitation, Keelung Hospital, Ministry of Health and Welfare, Keelung, Taiwan.
J Geriatr Phys Ther. 2018 Apr/Jun;41(2):65-76. doi: 10.1519/JPT.0000000000000107.
In older people with type 2 diabetes mellitus (T2DM), the effects of aging and T2DM may compromise the function of skeletal muscle, deteriorate metabolic status, and jeopardize physical performance, aerobic capacity, and quality of life (QoL). The purpose of this study was to investigate the effects of 12 weeks of resistance training (RT) on muscle function, physical performance, cardiometabolic risks, and QoL in older people with T2DM.
This study was a randomized controlled trial that employed block randomization, assessor blinding, and the intention-to-treat principle. Thirty people 65 years or older with a diagnosis of T2DM were randomly assigned to either an exercise group or a control group and were further stratified by gender. The exercise group performed 8 RT exercises in 3 sets of 8 to 12 repetitions at 75% 1-repetition maximum (1-RM) 3 times per week for 12 weeks. The control group received usual care and maintained their daily activities and lifestyle. Muscle function (1-RM and muscle oxygenation responses), physical performance (5-repetition sit-to-stand test and Timed Up and Go test), cardiometabolic risks (aerobic capacity, blood pressure, body composition, glycemic control, lipids levels, and high-sensitivity C-reactive protein levels), and QoL (Audit of Diabetes-Dependent Quality of Life 19) were assessed at baseline (week 0) and after the 12-week interventions (week 12).
The 1-RM chest-press and leg-press strength and physical performance in 5-repetition sit-to-stand test were significantly improved in the exercise group compared with the controls after the interventions. The exercise group had significantly lower resting systolic blood pressure (by -12.1 mm Hg, P = 0.036) than did the controls after 12 weeks of RT, without any significant within-group change in either group after intervention. The waist circumference, fasting glucose levels, and peak diastolic blood pressure tended to favor RT over usual care after the interventions.
Twelve weeks of RT increased the maximal strength in chest-press and leg-press tests, and improved 5-repetition sit-to-stand performance in older people with T2DM. Our study demonstrated that supervised, structured RT was able to promote muscle function and alleviate cardiometabolic risks in people with T2DM 65 years or older.
在老年2型糖尿病（T2DM）患者中，衰老和T2DM的影响可能会损害骨骼肌功能、恶化代谢状况，并危及身体机能、有氧能力和生活质量（QoL）。本研究的目的是调查12周抗阻训练（RT）对老年T2DM患者肌肉功能、身体机能、心脏代谢风险和生活质量的影响。
本研究为一项随机对照试验，采用区组随机化、评估者盲法和意向性分析原则。30名65岁及以上诊断为T2DM的患者被随机分为运动组或对照组，并进一步按性别分层。运动组每周进行3次8种抗阻训练，每组8至12次重复，强度为1次重复最大值（1-RM）的75%，共进行12周。对照组接受常规护理，并维持其日常活动和生活方式。在基线（第0周）和12周干预后（第12周）评估肌肉功能（1-RM和肌肉氧合反应）、身体机能（5次坐立试验和计时起立行走试验）、心脏代谢风险（有氧能力、血压、身体成分、血糖控制、血脂水平和高敏C反应蛋白水平）和生活质量（糖尿病相关生活质量19项问卷）。
干预后，运动组的1-RM卧推和腿举力量以及5次坐立试验中的身体机能与对照组相比有显著改善。抗阻训练12周后，运动组的静息收缩压显著低于对照组（降低12.1 mmHg，P = 0.036），干预后两组组内均无显著变化。干预后，腰围、空腹血糖水平和舒张压峰值倾向于抗阻训练优于常规护理。
12周的抗阻训练增加了老年T2DM患者卧推和腿举试验的最大力量，并改善了5次坐立表现。我们的研究表明，有监督的、结构化的抗阻训练能够促进65岁及以上T2DM患者的肌肉功能并减轻心脏代谢风险。
