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2 型糖尿病衰弱患者功能能力和肌肉力量的多模式干预的两年随访。

Two-Year Follow-up of a Multimodal Intervention on Functional Capacity and Muscle Power in Frail Patients With Type 2 Diabetes.

机构信息

Navarrabiomed, Complejo Hospitalario de Navarra (CHN)-Universidad Pública de Navarra (UPNA), IDISNA, Pamplona, Spain; CIBER of Frailty and Healthy Aging (CIBERFES), Institute of Health Carlos III, Madrid, Spain.

CIBER of Frailty and Healthy Aging (CIBERFES), Institute of Health Carlos III, Madrid, Spain; Geriatric Research Group, Biomedical Research Foundation at Getafe University Hospital, Getafe, Spain.

出版信息

J Am Med Dir Assoc. 2021 Sep;22(9):1906-1911. doi: 10.1016/j.jamda.2021.06.022. Epub 2021 Jul 12.

Abstract

OBJECTIVES

To analyze the effects of a program composed of resistance training and nutritional interventions on functional capacity, maximal strength, and power output after 2 years of follow-up, including 2 periods of 16 weeks of intervention followed by several weeks of intervention cessation in frail patients with type 2 diabetes.

DESIGN

MIDPOW is a substudy of a multicenter, multimodal intervention composed of resistance training combined with a structured diabetes and nutritional education program in frail and prefrail older people with type 2 diabetes (MID-Frail).

SETTING AND PARTICIPANTS

This study recruited 52 participants (mean age: 79 ± 5.6, 63% women), with type 2 diabetes mellitus, frail or prefrail using Fried's frailty phenotype.

METHODS

Primary outcomes of this substudy were Short Physical Performance Battery (SPPB) and maximal power output at 30% and 80% of 1RM.

RESULTS

Each set of 16 weeks of intervention resulted in significant improvements in SPPB performance by a mean of 36.1% at week 18 (P < .001) and 10.2% at week 68 (P < .05). Maximal power output improvements at 30% and 80% of the 1RM ranged from 45.2% to 57.2% at week 18 (P < .01-.001); and no significant changes were observed after the second period of intervention. After 2 years of follow-up, the SPPB and maximal power values observed remained significantly higher than the baseline.

CONCLUSIONS AND IMPLICATIONS

Resistance training combined with nutritional program improved SPPB, maximal strength, and power output in older frail patients with diabetes. These improvements were maintained above the basal levels after several weeks of intervention cessation during a 2-year follow-up.

摘要

目的

分析包括 2 个 16 周干预期和随后几周干预暂停期在内的为期 2 年的随访中,针对 2 型糖尿病虚弱患者的阻力训练和营养干预方案对功能能力、最大力量和功率输出的影响。

设计

MIDPOW 是一项多中心、多模式干预的子研究,该干预包括阻力训练以及针对 2 型糖尿病虚弱和亚虚弱老年人的结构化糖尿病和营养教育计划(MID-Frail)。

地点和参与者

本研究纳入了 52 名参与者(平均年龄:79 ± 5.6 岁,63%为女性),这些参与者患有 2 型糖尿病,使用 Fried 衰弱表型评估为衰弱或亚衰弱。

方法

本亚研究的主要结局指标是短体适能表现测试(SPPB)和最大力量在 1RM 的 30%和 80%时的功率输出。

结果

每组 16 周的干预都导致 SPPB 表现显著改善,第 18 周时的平均改善幅度为 36.1%(P <.001),第 68 周时的改善幅度为 10.2%(P <.05)。最大力量在 1RM 的 30%和 80%时的功率输出改善幅度在第 18 周时为 45.2%至 57.2%(P <.01-.001);而在第二个干预期后没有观察到显著变化。在 2 年的随访后,SPPB 和最大力量值仍显著高于基线水平。

结论和意义

阻力训练联合营养方案改善了 2 型糖尿病虚弱老年患者的 SPPB、最大力量和功率输出。这些改善在 2 年随访中干预停止数周后仍保持在基础水平之上。

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