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Yang J, Tan H, Yu H, Li J, Cui Y, Lu Y, Liu X, Chen Q, Zhou D. Association between remote resistance exercises programs delivered by a smartphone application and skeletal muscle mass among elderly patients with type 2 diabetes- a retrospective real-world study. Front Endocrinol (Lausanne) 2024; 15:1407408. [PMID: 38919474 PMCID: PMC11196602 DOI: 10.3389/fendo.2024.1407408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2024] [Accepted: 05/29/2024] [Indexed: 06/27/2024] Open
Abstract
Objective We aimed to explore the relationship between remote resistance exercise programs delivered via a smartphone application and skeletal muscle mass among elderly patients with type 2 diabetes, utilizing real-world data. Methods The resistance exercises were provided through Joymotion®, a web-based telerehabilitation smartphone application (Shanghai Medmotion Medical Management Co., Ltd). The primary outcome was the changes in skeletal muscle index (SMI) before and after the remote resistance exercises programs. The secondary outcomes were changes in skeletal muscle cross-sectional area (SMA), skeletal muscle radiodensity (SMD) and intermuscular adipose tissue (IMAT). Results A total of 101 elderly patients with type 2 diabetes were analyzed. The participants had an average age of 72.9 ± 6.11 years for males and 74.4 ± 4.39 years for females. The pre- and post-intervention SMI mean (± SE) was 31.64 ± 4.14 vs. 33.25 ± 4.22 cm2/m2 in male, and 22.72 ± 3.24 vs. 24.28 ± 3.60 cm2/m2 in female respectively (all P < 0.001). Similarly, a statistically significant improvement in SMA, IMAT, and SMD for both male and female groups were also observed respectively (P < 0.001). Multiple linear regression models showed potential confounding factors of baseline hemoglobin A1c and duration of diabetes with changes in SMI in male, while hemoglobin A1c and high density lipoprotein cholesterol with changes in SMI in female. Conclusion Remote resistance exercises programs delivered by a smartphone application were feasible and effective in helping elderly patients with type 2 diabetes to improve their skeletal muscle mass.
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Affiliation(s)
- Jing Yang
- Department of Rehabilitation, The Third Affiliated Hospital of Jinzhou Medical University, Liaoning, China
| | - Hongyu Tan
- Postgraduate Training Basement, Jinzhou Medical University, Liaoning, China
| | - Haoyan Yu
- Department of Radiology, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jingshuo Li
- Department of Traditional Chinese Medicine, The First Affiliated Hospital of Guangxi Medical University, Guangxi, China
| | - Yang Cui
- Department of Orthopedics, The Third Affiliated Hospital of Jinzhou Medical University, Liaoning, China
| | - Yuanjian Lu
- Department of Orthopedics, The Third Affiliated Hospital of Jinzhou Medical University, Liaoning, China
| | - Xin Liu
- Department of Rehabilitation, The Third Affiliated Hospital of Jinzhou Medical University, Liaoning, China
| | - Qimin Chen
- Department of Rehabilitation, The Third Affiliated Hospital of Jinzhou Medical University, Liaoning, China
| | - Daan Zhou
- Department of Rehabilitation, The Third Affiliated Hospital of Jinzhou Medical University, Liaoning, China
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Gao S, Yu L, Yi G, Li T, Chen Z, Ding J. Exercise Intervention as a Therapy in Patients with Diabetes Mellitus and Sarcopenia: A Meta-Analysis. Diabetes Ther 2022; 13:1311-1325. [PMID: 35648376 PMCID: PMC9240178 DOI: 10.1007/s13300-022-01275-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 05/12/2022] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Sarcopenia is defined as a progressive and generalized muscle disorder that involves accelerated loss of muscle mass and impaired function. It is believed to influence the ability to carry out daily activities, muscle strength, and physical capacity in the elderly. Studies have shown that sarcopenia has been implicated as both a cause and a consequence of diabetes mellitus. In this analysis, we aimed to systematically show the impact of exercise intervention as a therapy for patients with diabetes mellitus and sarcopenia. METHODS Electronic databases, including PubMed, EMBASE, Web of Science, and the Cochrane database, were searched from November to December 2021 for publications based on exercise intervention in patients with sarcopenia. After the selection of studies for this analysis, patients with diabetes mellitus were retrieved. Since dichotomous data including mean and standard deviation were reported, weighted mean difference (MD) with 95% confidence intervals (CI) were used to represent the data following analysis. RESULTS A total of 431 participants with diabetes mellitus and sarcopenia were included in this meta-analysis. A statistical analysis was carried out on patients with diabetes mellitus who were assigned to the exercise intervention group. Our analysis showed that "sit-to-stand test" and "timed up and go" were significantly in favor of exercise intervention: MD -1.57, 95% confidence interval (CI) -2.26 to -0.87 (P = 0.0001) versus MD -0.61, 95% CI -1.21 to -0.01 (P = 0.05), respectively. Handgrip strength, walking speed and leg strength were also assessed. Another statistical analysis was carried out, this time on patients with diabetes mellitus and sarcopenia who were not assigned to an exercise intervention. The results showed no significant difference among sit-to-stand test, timed up and go, handgrip strength, and leg strength. CONCLUSION Exercise intervention significantly improved the time taken to stand up from a sitting position, and to "stand up and go" in patients with diabetes mellitus and sarcopenia. Therefore, exercise intervention should be considered a relevant therapy for such patients.
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Affiliation(s)
- Siyao Gao
- Department of Physical Education, Central South University, Changsha, 410083 Hunan People’s Republic of China
| | - Ling Yu
- Department of Physical Education, Central South University, Changsha, 410083 Hunan People’s Republic of China
| | - Guozhong Yi
- Department of Physical Education, Central South University, Changsha, 410083 Hunan People’s Republic of China
| | - Tong Li
- Department of Physical Education, Central South University, Changsha, 410083 Hunan People’s Republic of China
| | - Zhenyin Chen
- Department of Physical Education, Central South University, Changsha, 410083 Hunan People’s Republic of China
| | - Jiawang Ding
- Department of Internal Medicine, Beijing Chaoyang Hospital, Chaoyang, Beijing, 100020 People’s Republic of China
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Study on Influencing Factors of Frailty in Elderly Patients with Type II Diabetes. JOURNAL OF HEALTHCARE ENGINEERING 2022; 2022:7244847. [PMID: 35132360 PMCID: PMC8817860 DOI: 10.1155/2022/7244847] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 01/05/2022] [Accepted: 01/12/2022] [Indexed: 02/07/2023]
Abstract
The purpose of this study was to analyze the influencing factors of frailty in elderly patients with type II diabetes. 332 elderly patients with type II diabetes admitted to our hospital from May 2018 to December 2019 were selected as the study subjects. The degree of frailty was evaluated by the Fried fragility phenotype scale, and the general information and the clinical data of patients were collected by inquiry and questionnaire survey. After that, all the data were analyzed by SPSS 20.0. Univariate analysis showed that there were significant differences in age, medication types, dietary habits, exercise tolerance, exercise capacity, body balance, coordination ability, urinary incontinence, anxiety, etc., in elderly patients with type II diabetes who suffered from different degrees of frailty (P < 0.01). In addition, there were significant differences in the presence of coronary heart disease, heart failure, atrial fibrillation, pulmonary diseases, osteoarticular diseases, anemia, and other blood diseases of elderly patients with type II diabetes who suffered from different degrees of frailty (P < 0.01). Multiple Logistic regression analyses indicated that weakened exercise tolerance, reduced exercise capacity, atrial fibrillation, anemia, and other blood diseases were the influencing factors of the frailty in elderly patients with type II diabetes. The degree of frailty in elderly patients with diabetes is affected by many factors, such as exercise tolerance, exercise capacity, atrial fibrillation, anemia, and other blood diseases; thus, reasonable intervention should be implemented for elderly patients with type II diabetes according to the influencing factors so as to effectively relieve frailty.
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Supriya R, Singh KP, Gao Y, Gu Y, Baker JS. Effect of Exercise on Secondary Sarcopenia: A Comprehensive Literature Review. BIOLOGY 2021; 11:biology11010051. [PMID: 35053049 PMCID: PMC8773430 DOI: 10.3390/biology11010051] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 12/24/2021] [Accepted: 12/28/2021] [Indexed: 01/01/2023]
Abstract
Simple Summary Sarcopenia is an inevitable component of aging. It is officially recognized as a muscle disease with an ICD-10-MC diagnosis code that can be used to bill for care in some countries. Sarcopenia can be classified into primary or age-related sarcopenia and secondary sarcopenia. The condition is referred to as secondary sarcopenia when any other comorbidities are present in conjunction with aging. Secondary sarcopenia is more prevalent than primary sarcopenia and requires special attention. Exercise interventions may help in our understanding and prevention of sarcopenia with a specific morbidity Glomerular filtration rate that exercise improves muscle mass, quality or physical function in elderly subjects with cancer, type 2 diabetes, kidney diseases and lung diseases. In this review, we summarize recent research that has studied the impact of exercise on patients with secondary sarcopenia, specifically those with one comorbid condition. We did not discover any exercise intervention specifically for subjects with secondary sarcopenia (with one comorbidity). Even though there is a strong argument for using exercise to improve muscle mass, quality or physical function in subjects with cancer, type 2 diabetes, kidney diseases, lung diseases and many more, very few studies have reported baseline sarcopenia assessments. Based on the trials summarized in this review, we may propose but not conclude that resistance, aerobic, balance training or even walking can be useful in subjects with secondary sarcopenia with only one comorbidity due to the limited number of trials. This review is significant because it reveals the need for broad-ranging research initiatives involving secondary sarcopenic patients and highlights a large secondary sarcopenia research gap. Abstract Background: Sarcopenia has been recognized as an inevitable part of aging. However, its severity and the age at which it begins cannot be predicted by age alone. The condition can be categorized into primary or age-related sarcopenia and secondary sarcopenia. Sarcopenia is diagnosed as primary when there are no other specific causes. However, secondary sarcopenia occurs if other factors, including malignancy or organ failure, are evident in addition to aging. The prevalence of secondary sarcopenia is far greater than that of primary sarcopenia and requires special attention. To date, nutrition and exercise have proven to be the best methods to combat this disease. The impact of exercise on subjects suffering from sarcopenia with a specific morbidity is worthy of examination for understanding and prevention. The purpose of this review, therefore, is to summarize recent research that has investigated the impact of exercise in patients with secondary sarcopenia, specifically with one comorbidity. Methods: Pubmed, Web of Science, Embase and Medline databases were searched comprehensively with no date limit for randomized controlled trials. The literature was specifically searched for clinical trials in which subjects were sarcopenic with only one comorbidity participating in an exercise intervention. The most visible comorbidities identified and used in the search were lung disease, kidney disease, heart disease, type 2 diabetes, cancer, neurological diseases, osteoporosis and arthritis. Results: A total of 1752 studies were identified that matched the keywords. After removing duplicates, there were 1317 articles remaining. We extracted 98 articles for full screening. Finally, we included 21 relevant papers that were used in this review. Conclusion: Despite a strong rationale for using exercise to improve muscle mass, quality or physical function in subjects with cancer, type 2 diabetes, kidney disease, lung disease and many more, baseline sarcopenia evaluation has been reported in very few trials. The limited number of studies does not allow us to conclude that exercise can improve sarcopenia in patients with other comorbidities. This review highlights the necessity for wide-ranging research initiatives involving secondary sarcopenic patients.
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Affiliation(s)
- Rashmi Supriya
- Faculty of Sports Science, Ningbo University, Ningbo 315211, China; (Y.G.); (Y.G.); (J.S.B.)
- Centre for Health and Exercise Science Research, Sarcopenia Research Unit, Department of Sport, Physical Education and Health, Hong Kong Baptist University, Kowloon Tong 999077, Hong Kong
- Correspondence:
| | - Kumar Purnendu Singh
- FEBT, School of Environment, Resources and Development, Asian Institute of Technology, Klong Luang, Pathum Thani 12120, Thailand;
| | - Yang Gao
- Faculty of Sports Science, Ningbo University, Ningbo 315211, China; (Y.G.); (Y.G.); (J.S.B.)
- Centre for Health and Exercise Science Research, Sarcopenia Research Unit, Department of Sport, Physical Education and Health, Hong Kong Baptist University, Kowloon Tong 999077, Hong Kong
| | - Yaodong Gu
- Faculty of Sports Science, Ningbo University, Ningbo 315211, China; (Y.G.); (Y.G.); (J.S.B.)
| | - Julien S. Baker
- Faculty of Sports Science, Ningbo University, Ningbo 315211, China; (Y.G.); (Y.G.); (J.S.B.)
- Centre for Health and Exercise Science Research, Sarcopenia Research Unit, Department of Sport, Physical Education and Health, Hong Kong Baptist University, Kowloon Tong 999077, Hong Kong
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Daryanti Saragih I, Yang YP, Saragih IS, Batubara SO, Lin CJ. Effects of resistance bands exercise for frail older adults: A systematic review and meta-analysis of randomised controlled studies. J Clin Nurs 2021; 31:43-61. [PMID: 34289511 DOI: 10.1111/jocn.15950] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 05/20/2021] [Accepted: 06/22/2021] [Indexed: 01/16/2023]
Abstract
AIMS AND OBJECTIVES Research examining the effectiveness of resistance band exercises for improving physical and psychological dimensions among frail older adults has been inconsistent. We aimed to examine the effects of resistance band exercises for improving outcomes in frail older adults. BACKGROUND To provide robust evidence regarding the effectiveness of resistance band exercises and explore other potential outcomes in frail older adults, a systematic review of RCTs remains necessary. DESIGN Systematic literature review and meta-analysis were conducted in accordance with the PRISMA guidelines. METHODS Four databases were searched. English language papers were retrieved from 2006 to 2020. Three reviewers reviewed the methodology of the selected studies using the Joanna Briggs Institute tool for randomised controlled trials. The pooled standardised mean difference was calculated using a random-effects model. Heterogeneity among pooled studies was assessed using the τ2 , Q and I2 statistics, and publication bias was evaluated using Egger's test and the visual inspection of funnel plots. RESULTS A total of 15 studies met the eligibility criteria for this study. Overall, resistance band exercise reduced frailty after 24 weeks (SMD: -0.29; 95% CI: -0.55 to -0.03) and reduced depression after both 12 weeks (SMD: -0.19; 95% CI: -0.38 to -0.01) and 24 weeks (SMD: -0.30; 95% CI: -0.52 to -0.09). However, no significant effects were observed for frailty after 12 weeks, and no significant effects were observed for grip strength, leg strength, activities of daily living or quality of life at any time. CONCLUSION Resistance band exercise might be considered a viable strategy for frail older adults in the community or in long-term care facilities. More research implementing a standardised protocol remains necessary to identify the effects of different training volumes and the dose-response relationship for the very old and frail population. RELEVANCE TO CLINICAL PRACTICE As a safe complementary intervention for frail older adults, health providers should consider resistance band exercises when caring for frail older adults because this intervention has clinical benefits.
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Affiliation(s)
| | - Ya-Ping Yang
- National Tainan Junior College of Nursing (NTIN), Tainan, Taiwan
| | | | | | - Chia-Ju Lin
- School of Nursing, Kaohsiung Medical University, Kaohsiung City, Taiwan.,Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung City, Taiwan
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