Exercise Counseling and Fitness Center Training Equally Effective as Supervised Exercise Program
ALEXANDRIA, VA, September 22, 2009 — Physical
therapist-directed exercise counseling combined with fitness
center-based exercise training can improve muscular strength and
exercise capacity in people with type 2 diabetes, with outcomes similar
to those of supervised exercise, according to a randomized clinical
trial published in the September issue of Physical Therapy, the
scientific journal of the American Physical Therapy Association
(APTA).
Type 2 diabetes is associated with numerous health complications,
including a decline in muscular strength and exercise capacity. Studies
show that a decline in muscular strength increases the risk of loss of
physical function and that a decline in exercise capacity increases the
risk of cardiovascular and all-cause mortality. "Improving muscular
strength and exercise capacity in people with type 2 diabetes is crucial
to preventing loss of physical function and decreasing comorbidity and
mortality in these patients," said lead researcher J. David Taylor, PT,
PhD, CSCS, assistant professor in the Department of Physical Therapy at
the University of Central Arkansas.
Supervised exercise programs improve both muscular strength and
exercise capacity in people with type 2 diabetes; however, Medicare and
other health insurance programs do not currently reimburse physical
therapists and other clinicians for these exercise programs.
In this study, 24 people with type 2 diabetes were randomly allocated
to either an experimental group that received two months of physical
therapist-directed exercise counseling and fitness center-based exercise
training or a comparison group that received two months of
laboratory-based, supervised exercise. Exercise training for all
participants consisted of resistance training (chest press, row, and leg
press exercises) and aerobic training (walking or jogging on a
treadmill) as recommended for people with type 2 diabetes by the
American Diabetes Association and the American College of Sports
Medicine. Participants in the experimental group received a face-to-face
counseling session at baseline and one month after baseline, weekly
10-minute telephone calls, and seven-day-per-week access to a local
fitness center. Each participant in the comparison group received the
same prescribed exercise program as the experimental group, but in a
supervised environment.
Although both groups had significant improvements in muscular
strength and exercise capacity following exercise training, the results
showed no significant differences in improvements between these two
groups. "The fact that there were no significant differences in
improvements between patients who received exercise counseling and those
in a supervised program suggests that physical therapists may make an
evidence-based choice of prescribing either exercise counseling combined
with fitness center-based training or supervised exercise training for
patients with type 2 diabetes," said Taylor.
Physical therapists are highly-educated, licensed health care
professionals who can help patients reduce pain and improve or restore
mobility -- in many cases without expensive surgery or the side effects
of prescription medications. APTA represents more than 72,000 physical
therapists, physical therapist assistants, and students of physical
therapy nationwide. Its purpose is to improve the health and quality of
life of individuals through the advancement of physical therapist
practice, education, and research. In most states, patients can make an
appointment directly with a physical therapist, without a physician
referral. Learn more about conditions physical therapists can treat and
find a physical therapist in your area at www.moveforwardpt.com.