Exploring the Impact of Combined Thai Yoga and Elastic Band Exercise on Physical Fitness and Exercise Capacity in Older Patients with Type 2 Diabetes
DOI:
https://doi.org/10.17309/tmfv.2023.6.11Keywords:
exercise, yoga, resistance training, diabetes mellitus, exercise toleranceAbstract
Study purpose. Although it is acknowledged that exercise can positively affect both physical and biochemical markers in older individuals with type 2 diabetes (T2DM), there are still uncertainties about the specific impacts of combining Thai yoga with an elastic band exercise in this population. The objective of the study was to assess the impact of a 12-week program involving Thai yoga combined with an elastic band exercise on the physical fitness and functional exercise capacity among older individuals with T2DM.
Materials and methods. A total of 42 participants, consisting of 20 men and 22 women with T2DM and a mean age of 64.6±3.6 years, were randomly assigned to two groups: the control group and the exercise group. The exercise group engaged in a daily regimen of Thai yoga combined with an elastic band exercise for 40 minutes, 5 days a week, over a 12-week period. In contrast, the control group maintained their regular routines. Physical fitness and functional exercise capacity were assessed both before and after the 12-week intervention.
Results. The exercise group showed significant reductions in body weight (58.7±11.9 vs. 58.0±12.0 kg), body mass index (24.2±3.0 vs. 23.9±3.0 kg/m2), waist circumference (33.6±3.6 vs. 33.1±3.6 in), and waist-hip ratio (0.90±0.06 vs. 0.89±0.06) (p < 0.001). Additionally, there were notable improvements in physical fitness parameters, including hand grips, back strength, leg strength (p < 0.01), and trunk flexibility (p < 0.001). Functional exercise capacity, indicated by the 6-minute walk test and estimated peak oxygen consumption (p < 0.01), also improved significantly.
Conclusions. Thai yoga combined with an elastic band exercise enhances physical fitness and functional exercise capacity in older individuals with T2DM. This improvement has the potential to enhance their cardiopulmonary performance. Consequently, this exercise regimen is considered a health alternative for older individuals with T2DM.
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Howe, T. E., Rochester, L., Neil, F., Skelton, D. A., & Ballinger, C. (2011). Exercise for improving balance in older people. The Cochrane Database of Systematic Reviews, (11), CD004963. https://doi.org/10.1002/14651858.CD004963.pub3 DOI: https://doi.org/10.1002/14651858.CD004963.pub3
Kim, S. H., Kim, T., Park, J. C., & Kim, Y. H. (2022). Usefulness of hand grip strength to estimate other physical fitness parameters in older adults. Scientific Reports, 12, 17496. https://doi.org/10.1038/s41598-022-22477-6 DOI: https://doi.org/10.1038/s41598-022-22477-6
Parraca, J. A., Adsuar, J. C., Domínguez-Muñoz, F. J., Barrios-Fernandez, S., & Tomas-Carus, P. (2022). Test-retest reliability of isokinetic strength measurements in lower limbs in elderly. Biology (Basel), 11(6), 802. https://doi.org/10.3390/biology11060802 DOI: https://doi.org/10.3390/biology11060802
Duray, M., Şimşek, Ş., Yağcı, N., & Şenol, H. (2020). The examination of the relationship between flexibility and stability of trunk in older adults. Journal of Basic and Clinical Health Sciences, 4, 140-144. https://doi.org/10.30621/jbachs.2020.978 DOI: https://doi.org/10.30621/jbachs.2020.978
American Thoracic Society. ATS statement: Guidelines for the six-minute walk test. (2002). American Journal of Respiratory and Critical Care Medicine, 166(1), 111-117. https://doi.org/10.1164/ajrccm.166.1.at1102 DOI: https://doi.org/10.1164/ajrccm.166.1.at1102
American Thoracic Society, & American College of Chest Physicians. ATS/ACCP Statement on cardiopulmonary exercise testing. American Journal of Respiratory and Critical Care Medicine, 167(2), 211-77. https://doi: 10.1164/rccm.167.2.211 DOI: https://doi.org/10.1164/rccm.167.2.211
Poncumhak, P., Amput, P., Sangkarit, N., Promsrisuk, T., & Srithawong, A. (2023). Predictive ability of the 2-minute step test for functional fitness in older individuals with hypertension. Annals of Geriatric Medicine and Research, 27(3), 228-234. https://doi: 10.4235/agmr.23.0070 DOI: https://doi.org/10.4235/agmr.23.0070
Balaji, P. A., Smitha, R. V., & Syed, S. A. (2011). Effects of yoga-pranayama practices on metabolic parameters and anthropometry in type 2 diabetes. International Multidisciplinary Research Journal, 1(10), 1-4.
Xiao, C., Zhuang, C., & Kang, Y. (2017). Effects of ba duan jin qigong on balance and fitness ability in older adults with type 2 diabetes mellitus. Journal of Traditional Medicine and Clinical Naturopathy, 6(1), 206. https://doi: 10.4172/2573-4555.1000206 DOI: https://doi.org/10.4172/2573-4555.1000206
Leite, R., Banzato, L. R., Galendi, J. S. C., Mendes, A. L., Bolfi, F., Veroniki, A. A., Thabane, L., & Nunes-Nogueira, V. D. S. (2020). Effectiveness of non-pharmacological strategies in the management of type 2 diabetes in primary care: a protocol for a systematic review and network meta-analysis. BMJ Open, 10(1), e034481. https://doi.org/10.1136/bmjopen-2019-034481 DOI: https://doi.org/10.1136/bmjopen-2019-034481
Mogharnasi, M., TaheriChadorneshin, H., Papoli-Baravati, S. A., & Teymuri, A. (2019). Effects of upper-body resistance exercise training on serum nesfatin-1 level, insulin resistance, and body composition in obese paraplegic men. Disability and Health Journal, 12(1), 29-34. https://doi.org/10.1016/j.dhjo.2018.07.003 DOI: https://doi.org/10.1016/j.dhjo.2018.07.003
Barrows, J., & Fleury, J. (2022). Pilot randomized controlled trial of the Yoga for HEART intervention in community-dwelling older adults. Geriatric Nursing, 44, 184-191. https://doi.org/10.1016/j.gerinurse.2022.02.003 DOI: https://doi.org/10.1016/j.gerinurse.2022.02.003
Fuentes-Lopez, J., Vidal-Espinoza, R., Alvear-Vasquez, F., Sanchez-Macedo, L., Mamani Velasquez, D., Rivera Pacco, W., Cossio-Bolanos, M., & Gomez Campos, R. (2021). Systematic review of aquatic physical exercise programs on functional fitness in older adults. European Journal of Translational Myology, 31(4), 10006. https://doi.org/10.4081/ejtm.2021.10006 DOI: https://doi.org/10.4081/ejtm.2021.10006
Honda, H., Igaki, M., Komatsu, M., & Tanaka, S. I. (2021). Seasonal variations on endothelium-dependent flow-mediated vasodilation in adults with type 2 diabetes and nondiabetic adults with hypertension and/or dyslipidaemia who perform regular exercise. Endocrinology, Diabetes and Metabolism, 4(1), e00168. https://doi.org/10.1002/edm2.168 DOI: https://doi.org/10.1002/edm2.168
American College of Sports Medicine. (2013). ACSM’s health-related physical fitness assessment manual. (4th ed). Philadelphia: Lippincott Williams & Wilkins.
Phoosuwan, M., Yuktanandana, P., & Kritpet, T. (2021). The effects of modified yoga pose training on bone remodeling of elderly women with osteopenia. Journal of Exercise Physiology Online, 24(1), 25-35.
McCaffrey, R., Park, J., Newman, D., & Hagen, D. (2014). The effect of chair yoga in older adults with moderate and severe Alzheimer’s disease. Research in Gerontological Nursing, 7(4), 171-177. https://doi.org/10.3928/19404921-20140218-01 DOI: https://doi.org/10.3928/19404921-20140218-01
Posadzki, P., & Parekh, S. (2009). Yoga and physiotherapy: a speculative review and conceptual synthesis. Chinese Journal of Integrative Medicine, 15(1), 66-72. https://doi.org/10.1007/s11655-009-0066-0 DOI: https://doi.org/10.1007/s11655-009-0066-0
Satyanarayana, P., Vijaya Benerji, G., Rekha Kumari, D., Meka, F. B., & Kummari, N. (2013). Effect of yoga on heart rate, blood pressure, body mass index. IOSR Journal of Dental and Medical Sciences, 8(2), 36-39. DOI: https://doi.org/10.9790/0853-0823639
Balk, J., & Bernardo, L. M. (2011). Using yoga to promote bone health and reduce fracture risk in the geriatric population. Topics in Geriatric Rehabilitation, 27(2), 116-123. https://doi.org /10.1097/TGR.0b013e31821bff95 DOI: https://doi.org/10.1097/TGR.0b013e31821bff95
Chen, K. M., Tseng, W. S., Ting, L. F., & Huang, G. F. (2007). Development and evaluation of a yoga exercise programme for older adults. Journal of Advanced Nursing, 57(4), 432-441. https://doi.org/10.1111/j.1365-2648.2007.04115.x DOI: https://doi.org/10.1111/j.1365-2648.2007.04115.x
Hovsepian, V., Marandi, S. M., Kelishadi, R., & Zahed, A. (2013). A comparison between yoga and aerobic training effects on pulmonary function tests and physical fitness parameters. Pakistan Journal of Medical Sciences, 29(1)Suppl, 317-320. https://doi.org/10.12669/pjms.291(Suppl).3524 DOI: https://doi.org/10.12669/pjms.291(Suppl).3524
Angadi, P., Jagannathan, A., Thulasi, A., Kumar, V., Umamaheshwar, K., & Raghuram, N. (2017). Adherence to yoga and its resultant effects on blood glucose in Type 2 diabetes: A community-based follow-up study. International Journal of Yoga, 10(1), 29-36. https://doi.org/10.4103/0973-6131.186159 DOI: https://doi.org/10.4103/0973-6131.186159
Bauer, J., Schwiertz, G., & Muehlbauer, T. (2021). Effects of an Elastic Resistance Band Intervention in Adolescent Handball Players. Sports Medicine International Open, 5(2), E65-E72. https://doi.org/10.1055/a-1541-2916 DOI: https://doi.org/10.1055/a-1541-2916
Church, T. S., Blair, S. N., Cocreham, S., Johannsen, N., Johnson, W., Kramer, K., Mikus, C. R., Myers, V., Nauta, M., Rodarte, R. Q., Sparks, L., Thompson, A., & Earnest, C. P. (2010). Effects of aerobic and resistance training on hemoglobin A1c levels in patients with type 2 diabetes: a randomized controlled trial. Journal of the American Medical Association, 304(20), 2253-2262. https://doi.org/10.1001/jama.2010.1710 DOI: https://doi.org/10.1001/jama.2010.1710
Phillips, S. M., & Winett, R. A. (2010). Uncomplicated resistance training and health-related outcomes: evidence for a public health mandate. Current Sports Medicine Reports, 9(4), 208-213. https://doi.org/10.1249/JSR.0b013e3181e7da73 DOI: https://doi.org/10.1249/JSR.0b013e3181e7da73
García, D. E., Alonso, R. J., Herrera, F. N., Peinado, G. C., & Pérez, H. D. G. (2019). Effect of strength exercise with elastic bands and aerobic exercise in the treatment of frailty of the elderly patient with type 2 diabetes mellitus. Endocrinology, Diabetes and Nutrition, 66(9), 563-570. https://doi.org/10.1016/j.endinu.2019.01.010 DOI: https://doi.org/10.1016/j.endien.2019.01.008
Reid, R. D., Tulloch, H. E., Sigal, R. J., Kenny, G. P., Fortier, M., McDonnell, L., Wells, G. A., Boule, N. G., Phillips, P., & Coyle, D. (2010). Effects of aerobic exercise, resistance exercise or both, on patient-reported health status and well-being in type 2 diabetes mellitus: A randomised trial. Diabetologia, 53(4), 632-640. https://doi.org/10.1007/s00125-009-1631-1 DOI: https://doi.org/10.1007/s00125-009-1631-1
Pratiwi, R. M., & Hasinuddin, M. (2018). The effect of resistance exercise on blood glucose and HbA1C of patient with type 2 diabetes mellitus: Systematic review. The 9th International Nursing Conference 2018: “Nurses at The Forefront in Transforming Care, Science, and Research”.
Bandinelli, S., Benvenuti, E., Del Lungo, I., Baccini, M., Benvenuti, F., Di Iorio, A., & Ferrucci, L. (1999). Measuring muscular strength of the lower limbs by hand-held dynamometer: a standard protocol. Aging (Milano), 11(5), 287-293. https://doi.org/10.1007/BF03339802 DOI: https://doi.org/10.1007/BF03339802
Dawes, J. J., Lockie, R. G., Kornhauser, C. L., Holmes, R. J., & Orr, R. M. (2019). Relationships Between Absolute and Relative Strength and Power in Male Police Officers of Varying Strength Levels. Journal of Science in Sport and Exercise, 1(3), 281-288. https://doi.org/10.1007/s42978-019-00033-5 DOI: https://doi.org/10.1007/s42978-019-00033-5
Clark, B. A. (1989). Tests for Fitness in Older Adults. Journal of Physical Education, Recreation & Dance, 60(3), 66-71. https://doi.org/10.1080/07303084.1989.10603976 DOI: https://doi.org/10.1080/07303084.1989.10603976
Carter, R., Holiday, D. B., Nwasuruba, C., Stocks, J., Grothues, C., & Tiep, B. (2003). 6-minute walk work for assessment of functional capacity in patients with COPD. Chest, 123(5), 1408-1415. https://doi.org/10.1378/chest.123.5.1408 DOI: https://doi.org/10.1378/chest.123.5.1408
Enright, P. L., McBurnie, M. A., Bittner, V., Tracy, R. P., McNamara, R., Arnold, A., Newman, A. B., & Cardiovascular Health, S. (2003). The 6-min walk test: a quick measure of functional status in elderly adults. Chest, 123(2), 387-398. https://doi.org/10.1378/chest.123.2.387 DOI: https://doi.org/10.1378/chest.123.2.387
Rocha, V., Paixao, C., & Marques, A. (2022). Physical activity, exercise capacity and mortality risk in people with interstitial lung disease: A systematic review and meta-analysis. Journal of Science and Medicine in Sport, 25(11), 903-910. https://doi.org/10.1016/j.jsams.2022.10.002 DOI: https://doi.org/10.1016/j.jsams.2022.10.002
Whittaker, R. L., Sonne, M. W., & Potvin, J. R. (2019). Ratings of perceived fatigue predict fatigue induced declines in muscle strength during tasks with different distributions of effort and recovery. Journal of Electromyography and Kinesiology, 47, 88-95. https://doi.org/10.1016/j.jelekin.2019.05.012 DOI: https://doi.org/10.1016/j.jelekin.2019.05.012
Ross, R. M., Murthy, J. N., Wollak, I. D., & Jackson, A. S. (2010). The six minute walk test accurately estimates mean peak oxygen uptake. BioMed Central Pulmonary Medicine, 10, 31. https://doi.org/10.1186/1471-2466-10-31 DOI: https://doi.org/10.1186/1471-2466-10-31
Raveendran, A. V., Chacko, E. C., & Pappachan, J. M. (2018). Non-pharmacological treatment options in the management of diabetes mellitus. European Endocrinology, 14(2), 31-39. https://doi.org/10.17925/EE.2018.14.2.31 DOI: https://doi.org/10.17925/EE.2018.14.2.31
Raveendran, A. V., Deshpandae, A., & Joshi, S. R. (2018). Therapeutic Role of Yoga in Type 2 Diabetes. Endocrinology and Metabolism (Seoul), 33(3), 307-317. https://doi.org/10.3803/EnM.2018.33.3.307 DOI: https://doi.org/10.3803/EnM.2018.33.3.307
Shantakumari, N., Sequeira, S., & El deeb, R. (2013). Effects of a yoga intervention on lipid profiles of diabetes patients with dyslipidemia. Indian Heart J, 65(2), 127-131. https://doi.org/10.1016/j.ihj.2013.02.010 DOI: https://doi.org/10.1016/j.ihj.2013.02.010
Subba, R., Sandhir, R., Singh, S. P., Mallick, B. N., & Mondal, A. C. (2021). Pathophysiology linking depression and type 2 diabetes: Psychotherapy, physical exercise, and fecal microbiome transplantation as damage control. The European Journal of Neuroscience, 53(8), 2870-2900. https://doi.org/10.1111/ejn.15136 DOI: https://doi.org/10.1111/ejn.15136
Oh, S. L., Kim, H. J., Woo, S., Cho, B. L., Song, M., Park, Y. H., Lim, J. Y., & Song, W. (2017). Effects of an integrated health education and elastic band resistance training program on physical function and muscle strength in community-dwelling elderly women: Healthy aging and happy aging II study. Geriatrics and Gerontology International, 17(5), 825-833. https://doi.org/10.1111/ggi.12795 DOI: https://doi.org/10.1111/ggi.12795
Park, B. S., Khamoui, A. V., Brown, L. E., Kim, D. Y., Han, K. A., Min, K. W., & An, G. H. (2016). Effects of elastic band resistance training on glucose control, body composition, and physical function in women with short- vs. long-duration type-2 diabetes. Journal of Strength and Conditioning Research, 30(6), 1688-1699. https://doi.org/10.1519/JSC.0000000000001256 DOI: https://doi.org/10.1519/JSC.0000000000001256
Promsrisuk, T., Kongsui, R., Sriraksa, N., Boonla, O., & Srithawong, A. (2023). Elastic band resistance combined with modified Thai yoga exercise to alleviate oxidative stress and airway inflammation in type 2 diabetes mellitus. Journal of Exercise Rehabilitation, 19(2), 114-125. https://doi.org /10.12965/jer.2346040.020 DOI: https://doi.org/10.12965/jer.2346040.020
Kirwan, J. P., Sacks, J., & Nieuwoudt, S. (2017). The essential role of exercise in the management of type 2 diabetes. Cleveland Clinic Journal of Medicine, 84(7 Suppl 1), S15-S21. https://doi.org/10.3949/ccjm.84.s1.03 DOI: https://doi.org/10.3949/ccjm.84.s1.03
Amanat, S., Ghahri, S., Dianatinasab, A., Fararouei, M., & Dianatinasab, M. (2020). Exercise and type 2 diabetes. Advances in Experimental Medicine and Biology, 1228, 91-105. https://doi.org/10.1007/978-981-15-1792-1_6 DOI: https://doi.org/10.1007/978-981-15-1792-1_6
Stanford, K. I., & Goodyear, L. J. (2014). Exercise and type 2 diabetes: molecular mechanisms regulating glucose uptake in skeletal muscle. Advances in Physiology Education, 38(4), 308-14. https://doi.org/10.1152/advan.00080.2014 DOI: https://doi.org/10.1152/advan.00080.2014
Herriott, M. T., Colberg, S. R., Parson, H. K., Nunnold, T., & Vinik, A. I. (2004). Effects of 8 weeks of flexibility and resistance training in older adults with type 2 diabetes. Diabetes Care, 27(12), 2988-2989. https://doi.org/10.2337/diacare.27.12.2988 DOI: https://doi.org/10.2337/diacare.27.12.2988
AminiLari, Z., Fararouei, M., Amanat, S., Sinaei, E., Dianatinasab, A., AminiLari, M., Daneshi, N., & Dianatinasab, M. (2017). Corrigendum: Author’s name and affiliation correction. The effect of 12 weeks aerobic, resistance, and combined exercises on omentin-1 levels and insulin resistance among type 2 diabetic middle-aged women. Diabetes and Metabolism Journal, 41(5), 422. https://doi.org/10.4093/dmj.2017.41.5.422 DOI: https://doi.org/10.4093/dmj.2017.41.5.422
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