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DIABETES EM MOVIMENTO® - COMMUNITY-BASED EXERCISE PROGRAM FOR PATIENTS WITH TYPE 2 DIABETES
  1. Romeu Mendes1,
  2. Nelson Sousa1,
  3. Victor Machado Reis1,
  4. José Luís Themudo Barata2
  1. 1 Research Center in Sports, Health Sciences and Human Development, University of Trás-os-Montes e Alto Douro, Vila Real, Portugal
  2. 2 University of Beira Interior, Covilhã, Portugal

Abstract

Background Exercise is widely recommended as a nonpharmacological therapeutic strategy essential to control of type 2 diabetes and cardiovascular related risk. This study aims to present Diabetes em Movimento® a community-based group exercise program designed for patients with type 2 diabetes developed in the city of Covilhã, Portugal.

Program structure The content of this program has been prepared in accordance with international recommendations for physical activity and exercise to control diabetes type 2 and taking into consideration that the majority of this population is more than 60 years old, is overweight, sedentary and has low physical fitness. Exercise sessions are held three times per week on non consecutive days (Mondays, Wednesdays and Fridays) with a duration of around 70 minutes. Sessions consist of five phases: 1) Warm up (5 min), which includes brisk walking; 2) cardiovascular training with aerobic exercise (30 min), which includes walking at different speeds, relay races, obstacle and stairs courses; 3) Muscle strength training through resistance exercises (20 min) performed with chairs, dumbbells, fitness balls and bodyweight exercises; 4) Agility training (10 min) consisting of reduced, simplified and adapted team ball games; and 5) Cool down/flexibility (5 min) through static and dynamic stretching exercises.

Prevention of exercise-related acute adverse events.

Exercise intensity is monitored with Borg's Rating of Perceived Exertion Scale and hydration during exercise is encouraged in breaks designed for this purpose. Capillary blood glucose and blood pressure monitoring are performed regularly before and after exercise and patients are educated to recognize symptoms of hypoglycemia, hyperglycemia, hypotension, hypertensive crisis, myocardial ischemia and stroke. Patients are also educated to avoid the Valsalva maneuver either during resistance exercises either during flexibility exercises. Sessions are monitored and supervised by qualified exercise professionals trained to the potential acute adverse events associated with exercise in this population.

Conclusions This exercise program has a high applicability and involves minimal material resources and can be easily replicated in a community context. Type 2 diabetic patients can practice exercise safely with this type of supervised exercise programs.

Trial funding and registration Diabetes em Movimento® is funded by Portuguese Foundation for Science and Technology with reference SFRH/BD/47733/2008 and is registered in Current Controlled Trials with reference ISRCTN09240628.

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