EFFECT OF STRUCTURED HOME-BASED EXERCISE PROGRAM ON QUALITY OF LIFE IN MIDDLE AGED ADULTS WITH TYPE 2 DIABETES MELLITUS

R. Pandya¹, M. Sheth¹

¹SBB College of Physiotherapy, Ahmedabad, India

Background: Type 2 Diabetes mellitus (T2DM) is a multifactorial disease characterized by β cell dysfunction, chronic inflammation and insulin resistance which eventually leads to increased glucose content in blood called hyperglycaemia. Asians are at a high risk of developing T2DM because of greater abdominal obesity, less muscle mass and high percentage of body fat compared to individuals with the same BMI of another region’s population. After the age of 40 years, both males and females are at high risk of cardiovascular morbidity and this risk increases 2-4 times in patients having diabetes for more than 5-10 years. Diabetes type 2 is accompanied by a wide range of impairments and several studies have shown that T2DM is associated with a loss of mobility, decrease muscle strength, loss of independence and poorer health related quality of life. Regular physical activity and exercises are important to prevent the complications in patients with T2DM. Many studies have shown effectiveness of structured home-based exercise protocol in geriatric population. Exercises done at their pace, at home, with easily available equipment in the middle aged population with diabetes are less.

Purpose: The aim of the study was to see the effect of structured homebased exercises on Quality-Of-life domain in patients with type 2 diabetes mellitus.

Methods: An experimental study was conducted in the community of Ahmedabad, India, on 50 individuals divided in to 2 groups, Group A (Exercise group) and Group B (Control group). The participants were randomly allocated into either group by envelope method. Individuals were explained the study protocol on the first day. Home based Exercises including both aerobic (walking) (5 days/week) and strength exercises (with body weight) (3 days /week) as per ACSM guidelines for patients with Diabetes were taught to the participants in group A. Group B was kept in the waiting period, with exercises given after the 4 week program. Total 20 sessions of training, were completed. Quality of life was measured using EQ-5D-5Lboth pre and post intervention. It is a short and clear questionnaire with good validity and reliability. Data analysis was done using Microsoft excel 2019 and SPSS 20. Level of significance was kept at 5%.

Results: Mann Whitney U test was applied to compare the mean differences of all five components of EQ-5D-5L between both groups after 4 weeks. Analysis of components showed statistically significant differences for scores of Mobility (U=250, p=0.02), Self-care (U=287.5, p=0.153), Usual activities (U=275.5, p=0.07), Pain/discomfort (U=250, p=0.02), Anxiety/depression (U=250, p=0.02) between the two groups. Analysis of mean difference between groups in EQ-VAS showed statistically significant difference (U=12.5, p=0.0001).

Conclusions: Middle aged diabetic population of Ahmedabad showed improvement in quality of life by implementing structured home-based exercises.

Implications: Home-based exercise program can be given to middle aged population with diabetes to improve quality of life. Exercises provided through tele-rehab can be tried. Glycaemic control can be monitored every 3 months by HbA1c with home-based exercise program.

Funding acknowledgements: None

Keywords:
Diabetes mellitus
Home based exercise program
Quality of life

Topics:
Non-communicable diseases (NCDs) & risk factors
Community based rehabilitation
Health promotion & wellbeing/healthy ageing/physical activity

Did this work require ethics approval? Yes

Institution: SBB College of Physiotherapy, VS hospital campus Ahmedabad, Gujarat, India.

Committee: The Institutional Review Board of SBB College of Physiotherapy, Ahmedabad-380006.

Ethics number: PT-14/RP/MS/DM/2021-22.