Effect of a 6-week strength-training program on neuromuscular efficiency in type 2 diabetes mellitus patients

Can 12-Week Resistance Training Improve Muscle Strength, Dynamic Balance and the Metabolic Profile in Older Adults with Type 2 Diabetes Mellitus?

The present study aimed to evaluate the effects of 12-week resistance training (RT) on muscle strength, dynamic balance, glycemic control and the lipid profile.

METHODS

The Laboratory of Movement Studies in the University of São Paulo, Brazil, developed this longitudinal study between 2021 and 2023. It assessed 62 males with type 2 diabetes mellitus pre and post an RT protocol. The participants, who were 69.8 (±3.9) years old, took part in a 12-week twice-weekly RT program. Three sets of eight to twelve repetitions each were executed for eight exercises targeting the large muscle groups. The intensity was set between 7 and 8 out of 10 for perceived effort, according to the Omni Resistance Exercise Scale. All participants were evaluated pre and post in knee extensor and flexor strength by isokinetic dynamometry, handgrip strength by manual dynamometry and dynamic postural balance by a force platform, as well as blood tests to determine the lipid and glycemic profiles. For comparison, paired t or Wilcoxon tests were used at an alpha of 5%.

RESULTS

There was an improvement in muscular strength by handgrip restricted to the non-dominant side (p = 0.033) and for the bilateral knee flexors (p < 0.001) and extensors (p < 0.001), as determined by isokinetic dynamometry. There was no improvement in dynamic postural balance, glycemic control or lipid control.

CONCLUSIONS

The 12-week RT promoted improved muscle strength in knee extension and flexion and non-dominant grip pressure but did not affect dynamic balance, glycemic control or the lipid profile.

Acute short term effects of endurance and resistance training on balance control in patients with diabetic peripheral neuropathy

PURPOSE

Exercise training have numerous beneficial effects on the complications of diabetic peripheral neuropathy. Exercise training may cause immediate effects on balance control in DPN patients. This study aims to assess the Acute Short Term effects of endurance and resistance exercise training on balance control in DPN patients.

METHODS

In this study, 11 patients with DPN and 11 healthy subjects participated. Patients and healthy subjects did endurance and resistance training in two separate exercise sessions. Dynamic balance and functional balance test were assessed before and after the interventions. Independent t-test was used to compare balance indices before and after training, the intervention effects were examined using ANOVA repeated measure test. The statistical significance level was set at p < 0.05.

RESULTS

The results showed that dynamic and functional balance in DPN patients were significantly lower than in healthy subjects. Anterior-posterior stability and total stability indices and functional balance test deteriorated significantly after training.

CONCLUSION

Endurance or resistance training may lead to acute disturbance of dynamic and functional balance in DPN patients. Hence, immediately after exercise, patients with diabetes are at an increased risk of falling, therefore, preventive considerations are necessary.

The Influence of Hip and Knee Joint Angles on Quadriceps Muscle-Tendon Unit Properties during Maximal Voluntary Isometric Contraction

Determining how the quadriceps femoris musculotendinous unit functions, according to hip and knee joint angles, may help with clinical decisions when prescribing knee extension exercises. We aimed to determine the effect of hip and knee joint angles on structure and neuromuscular functioning of all constituents of the quadriceps femoris and patellar tendon properties. Twenty young males were evaluated in four positions: seated and supine in both 20° and 60° of knee flexion (SIT20, SIT60, SUP20, and SUP60). Peak knee extension torque was determined during maximal voluntary isometric contraction (MVIC). Ultrasound imaging was used at rest and during MVIC to characterize quadriceps femoris muscle and tendon aponeurosis complex stiffness. We found that peak torque and neuromuscular efficiency were higher for SUP60 and SIT60 compared to SUP20 and SIT20 position. We found higher fascicle length and lower pennation angle in positions with the knee flexed at 60°. The tendon aponeurosis complex stiffness, tendon force, stiffness, stress, and Young's modulus seemed greater in more elongated positions (60°) than in shortened positions (20°). In conclusion, clinicians should consider positioning at 60° of knee flexion rather than 20°, regardless if seated or supine, during rehabilitation to load the musculotendinous unit enough to stimulate a cellular response.