背景:有强有力的证据表明肥胖之间存在关联,2型糖尿病(T2DM),和骨关节炎导致的膝盖疼痛。据报道,定期运动是膝关节骨关节炎(KOA)患者预防性治疗难题的基础。尽管如此,有合并症的人的基于证据的锻炼方案,比如肥胖,T2DM,KOA是有限的。因此,本试验旨在评估一项为期12周的家庭电路训练(HBCT)方案对与心脏代谢健康相关的各种指标的有效性,肌肉骨骼健康,在COVID-19锁定期间,超重/肥胖的老年KOA和T2DM患者的健康相关生活质量(HRQoL)。
方法:这是一项在国家医学研究注册中心(ID:RSCHID-21-01180-KGTNMRRID-21-02367-FUM)注册的随机对照试验研究,并于2021年12月9日获得批准。将70名超重或肥胖的KOA和T2DM患者(62.2±6.1岁;56%为女性)随机分配到干预组(n=35,HBCT)或无运动对照组(n=35,CON)。HBCT进行了12周的渐进式方案(七次练习;每次练习15-30次重复,练习之间被动休息1分钟;每节2-4轮;总持续时间20-60分钟)。采集血样,并进行分析以评估脂质分布,肝功能,空腹血糖(FBG)。此外,30-s椅子站立测试(30CST)用于评估下半身肌肉力量和耐力,而定时起跑(TUG)测试用于评估下肢功能,移动性,以及所有参与者跌倒的风险。使用骨关节炎膝关节和髋关节生活质量(OAKHQoL)评估HRQoL。所有的评估都是在之前进行的,mid-,以及锻炼方案应用或实践期间的训练后阶段,而不是在培训期间。
结果:HBCT显着降低总胆固醇(TC),甘油三酯(TG),低密度脂蛋白胆固醇(LDL-C),转氨酶,丙氨酸氨基转移酶,FBG和膝关节疼痛(p<0.05)。此外,HBCT诱导高密度脂蛋白(HDL-C)有意义的增加,下半身肌肉力量,耐力,函数,移动性,超重/肥胖老年T2DM和KOA患者的HRQoL(p<0.05)。
结论:目前的结果表明,无损伤的HBCT计划可能会改善与心脏代谢健康相关的各种指标,肌肉骨骼健康,和老年人超重/肥胖的HRQoL,T2DM和KOA。这些发现为临床医生和从业者寻求基于证据的运动干预措施提供了有价值的见解,这些干预措施适用于在临床实践中管理大量代谢和肌肉骨骼健康挑战的患者。
BACKGROUND: There is strong evidence showing the association between obesity, type 2 diabetes mellitus (T2DM), and knee pain resulting from osteoarthritis. Regular exercise has been reported as a foundational piece of the preventive therapy puzzle for knee osteoarthritis (KOA) patients. Nonetheless, evidence-based exercise protocols for people with comorbidities, such as obesity, T2DM, and KOA are limited. Therefore, the present trial aimed to assess the effectiveness of a 12-week home-based circuit training (HBCT) protocol on various indices related to cardiometabolic health, musculoskeletal fitness, and health-related quality of life (HRQoL) among overweight/obese older adult patients with KOA and T2DM during the COVID-19 lockdown.
METHODS: This is a randomized controlled trial study registered at the National Medical Research Register (ID: RSCH ID-21-01180-KGTNMRR ID-21-02367-FUM) and obtained approval on December 9, 2021. Seventy overweight or obese patients with KOA and T2DM (62.2 ± 6.1 years; 56% female) were randomly assigned to the intervention group (n = 35, HBCT) or the no-exercise control group (n = 35, CON). HBCT performed a 12-week progressive protocol (seven exercises; 15-30 repetitions per exercise, 1 min passive rest between exercises; 2-4 rounds per session; 20-60 min total session duration). Blood samples were collected, and assays were performed to assess the lipid profile, liver function, and fasting blood glucose (FBG). In addition, the 30-s Chair Stand Test (30CST) was used to evaluate lower body muscular strength and endurance while the Timed Up and Go (TUG) test was used to evaluate lower limb function, mobility, and the risk of falls for all the participants. HRQoL was assessed using the Osteoarthritis Knee and Hip Quality of Life (OAKHQoL). All the assessments were conducted at pre-, mid-, and post-training stages during the application or practice of the exercise protocol, rather than during the training sessions themselves.
RESULTS: HBCT significantly reduced total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), aminotransferase, alanine aminotransferase, FBG and knee pain (p < 0.05). Furthermore, HBCT induced meaningful increases in high-density lipoprotein (HDL-C), lower body muscular strength, endurance, function, mobility, and HRQoL in overweight/obese older adults with T2DM and KOA (p < 0.05).
CONCLUSIONS: The present outcomes recommend that an injury-free HBCT program may improve various indicators related to cardiometabolic health, musculoskeletal fitness, and HRQoL in elderly with overweight/obesity, T2DM and KOA. These findings offer valuable insights for clinicians and practitioners seeking evidence-based exercise interventions tailored for patients managing substantial metabolic and musculoskeletal health challenges in clinical practice.