EFFECTIVENESS OF A STRUCTURED TELE-PHYSIOTHERAPY PROGRAM ON MUSCLE STRENGTH AND FUNCTIONAL MOBILITY IN OLDER ADULTS WITH TYPE 2 DIABETES: A RANDOMIZED CONTROLLED TRIAL

Abstract

Background: Diabetes Mellitus type 2 (DM) accelerates the sarcopenia and functional worsening in the elderly population. The most critical is exercise although barriers such as access and poor compliance are derailing the effectiveness of the exercise. Tele-physiotherapy can be used to overcome these obstacles. Purpose: The study objective was to determine the comparability of 24-week, therapist-provided, tele-physiotherapy and usual care in terms of their efficacy in improving the knee extension strength and functional mobility of older adults with type 2 DM.

Objective: To evaluate effectiveness of a 24-week tele-physiotherapy program on muscle strength and functional mobility in older adults with Type 2 diabetes.

Methods: It was a multicenter, assessor-blind randomized, controlled clinical trial. ninety community-dwelling adults aged 50 years with T2DM and mild functional limitation (Short Physical Performance Battery [SPPB] score 4-10) were selected random in an Intervention Group (IG, n=45) or Control Group (CG, n=45). The IG received safe video-based training twice per week, personalized, strength, balance, and aerobic training, and behavioral coaching. The CG was provided with standard care and general activity advice. Its significant outcome was that it changed the isometric Knee Extension Force (KEF, Nm/kg). Others included SPPB, Timed Up and Go (TUG), 6-Minute Walk Test (6MWT), HbA1c, and adherence as some secondary outcomes. The time measurements used were the baseline, 12, 24 (post-intervention) and 36 weeks (follow-up).

Results: Eighty-three (92 per cent of all the participants) of the subjects successfully completed the trial. IG showed a significant improvement compared to CG in KEF at 24 weeks (mean difference: +0.22 Nm/kg, 95% CI: 0.10-0.34, p<0.001). Better changes in the IG were also observed in the SPPB score ( + 1.8 points, p=0.002), TUG (-1.4 s, p=0.013), and 6MWT ( + 34 m, p=0.005). HbA1C was reduced considerably in both groups and was not different between the groups. Exercise session 84 compliance in IG, 52 compliances in CG (p<0.001). Relatively, there was an improvement in KEF and SPPB at 36 weeks of follow-up.

Conclusion: A 12-week tele-physiotherapy program was established to be considerably superior in terms of lower-limb strength and functional mobility among older adults with Type 2 DM, than conventional care, and also demonstrated increased adherence rates. A scaled method of managing functional degradation in this cohort is tele-physiotherapy, which is a viable management method.