Faculty of Medicine, Health and Human Sciences, Macquarie University, Macquarie Park, Australia.
Diabetes NSW & ACT, Glebe, Australia.
J Med Internet Res. 2022 Sep 23;24(9):e39800. doi: 10.2196/39800.
The COVID-19 pandemic created unprecedented shifts in the way health programs and services are delivered. A national lockdown to prevent the spread of COVID-19 in Australia was introduced in March 2020. This lockdown included the closure of exercise clinics, fitness centers, and other community spaces, which, before the pandemic, were used to deliver Beat It. Beat It is an 8-week in-person, community-based, and clinician-led group exercise and education program for adults self-managing diabetes. To continue offering Beat It, it was adapted from an in-person program to a fully web-based supervised group exercise program for adults with type 2 diabetes (T2DM).
This study aims to assess whether the Beat It Online program produced comparable health outcomes to the Beat It in-person program in terms of improving physical fitness (muscular strength and power, aerobic endurance, balance, and flexibility) and waist circumference in older adults with T2DM.
Australians with T2DM who were aged ≥60 years were included. They were enrolled in Beat It Online, a twice-weekly supervised group exercise and education program conducted via videoconference over 8 weeks. Anthropometric measurements and physical fitness parameters were assessed at baseline and completion. The adaptations to Beat It are reported using the Model for Adaptation, Design, and Impact, including the type of changes (what, where, when, and for whom), the criteria for making those changes (why and how), and the intended and unintended outcomes. The intended outcomes were comparable functional fitness as well as physical and mental health improvements across demographics and socioeconomic status.
A total of 171 adults (mean 71, SD 5.6 years; n=54, 31.6% male) with T2DM were included in the study, with 40.4% (n=69) residing in lower socioeconomic areas. On the completion of the 8-week program, significant improvements in waist circumference, aerobic capacity, muscular strength, flexibility, and balance were observed in both male and female participants (all P<.001). The Model for Adaptation, Design, and Impact reports on 9 clinical, practical, and technical aspects of Beat It that were adapted for web-based delivery.
This study found that Beat It Online was just as effective as the in-person program. This adapted program produced comparable health benefits across demographics and socioeconomic status. This study offers important findings for practitioners and policy makers seeking to maintain independence of older people with T2DM, reversing frailty and maximizing functional and physical fitness, while improving overall quality of life. Beat It Online offers a flexible and inclusive solution with significant physical and mental health benefits to individuals. Further evaluation of Beat It (both in-person and Online) adapted for culturally and linguistically diverse communities will provide greater insights into the efficacy of this promising program.
新冠疫情大流行导致卫生项目和服务的提供方式发生了前所未有的变化。为防止新冠病毒在澳大利亚的传播，该国于 2020 年 3 月实施了全国封锁。这一封锁包括关闭运动诊所、健身中心和其他社区场所，而在疫情之前，这些场所曾被用于开展“战胜糖尿病”（Beat It）项目。“战胜糖尿病”是一项为期 8 周的、以社区为基础、由临床医生主导的成人 2 型糖尿病自我管理团体运动和教育计划。为继续提供“战胜糖尿病”项目，我们将其从面对面的项目改编为适用于 2 型糖尿病成年人的完全基于网络的监督团体运动项目。
本研究旨在评估“战胜糖尿病”在线项目在改善身体机能（肌肉力量和力量、有氧耐力、平衡和灵活性）和 2 型糖尿病老年人腰围方面，是否与面对面的“战胜糖尿病”项目产生相当的健康结果。
纳入年龄≥60 岁、患有 2 型糖尿病的澳大利亚成年人。他们参加了“战胜糖尿病”在线项目，这是一项为期 8 周的、每周两次的、通过视频会议进行的监督团体运动和教育计划。在基线和完成时评估人体测量学测量和身体机能参数。使用适应模式、设计和影响报告“战胜糖尿病”的改编，包括更改的类型（什么、哪里、何时以及针对谁）、进行这些更改的标准（为什么以及如何）以及预期和非预期的结果。预期的结果是在人口统计学和社会经济地位方面具有相当的功能性体能以及改善身体和心理健康。
共有 171 名患有 2 型糖尿病的成年人（平均年龄 71 岁，标准差 5.6 岁；54 名男性，31.6%）参加了这项研究，其中 40.4%（69 名）居住在较低的社会经济地区。在完成 8 周的项目后，男女参与者的腰围、有氧能力、肌肉力量、灵活性和平衡都有显著改善（均 P<.001）。适应模式、设计和影响报告了 9 个与临床、实践和技术方面有关的“战胜糖尿病”的改编，这些改编是为网络交付而进行的。
本研究发现“战胜糖尿病”在线项目与面对面项目一样有效。该改编项目在人口统计学和社会经济地位方面产生了相当的健康益处。这项研究为寻求维持 2 型糖尿病老年患者独立性、逆转虚弱、最大限度地提高功能和身体机能以及改善整体生活质量的从业者和政策制定者提供了重要的发现。“战胜糖尿病”在线项目为个人提供了具有显著身心益处的灵活和包容性解决方案。进一步评估针对文化和语言多样化社区改编的“战胜糖尿病”（面对面和在线）将为该有前途的项目提供更深入的疗效见解。
