Comparison of two diabetes mellitus exercise programmes with respect to exercise adherence and physiological and psychological effects

Martinus, Robert (2003) Comparison of two diabetes mellitus exercise programmes with respect to exercise adherence and physiological and psychological effects. Masters thesis, University of Central Lancashire.

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The prevalence of type 2 diabetes mellitus (DM) has increased 5-fold over the last 20 years worldwide. Contributed to by an obesity epidemic and sedentary lifestyles, DM is costing the UK Government £5.2 billion a year and this amount is rising gradually. Exercise is a major cornerstone for treatment of DM, however, benefits derived from exercise have been shown to wane 3-10 days after exercise. Therefore, for exercise to be an effective form of treatment, it should be adopted as a lifestyle change. The aim of this study was to show how the aid of psychological intervention, in conjunction with exercise therapy, could be implemented in a cost-effective way into the Primary Care Trust (PCT) infrastructure. Forty newly diagnosed type 2 diabetic patients were assessed by physiological and psychological parameters over a period of 12-weeks.
Adherence to the programme was monitored, as well as adherence in a 6-month follow-up. Patients were allocated into two groups, namely exercise only and exercise with psychological intervention. The exercise only group comprised of 1 aerobic training session and I resistance training session while the psychological intervention group involved the same exercise training programme and different psychological intervention strategies. The results confirmed a significant (pc0.001)
improvement in physiological parameters (weight, percentage body fat, grip strength, peak flow, flexibility and V02 max) after the 12-week programme in both groups.
The psychological intervention group resulted in significant (pc0.05) changes in body fat, grip strength and peak flow in comparison to the exercise only group. In a small adjacent study conducted on 7 of the diabetic patients, average daily blood glucose levels showed a significant (pc0.01) reduction over the 12-week exercise period.
Psychological parameters, measuring mood state (anxiety, depression , anger, energy, fatigue and confusion) were all positively (pc0.001) influenced in both groups from the therapy programme. The main findings of the study revealed that psychological intervention had a significant (pc0.001) influence on attendance to the 12-week programme, and this also resulted in a significant better adherence 6-months later, upon follow-up. In contrast, the exercise only group shows a noteworthy decrease (pc0.05) in exercise adherence. In conclusion, the results of the study have demonstrated that psychological intervention is of paramount importance during exercise therapy for type 2 diabetic patients. Moreover, either with or without psychological intervention, exercise therapy is not only beneficial but it is also an important aid to treat type 2

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