ABSTRACT
BACKGROUND AND OBJECTIVE: Type 2 diabetes is one of the main causes of peripheral vascular disease. The beneficial effects of exercise on glucose homeostasis include a marked stimulation of blood glucose utilization during and after its performance. The objective of this study was to determine the effects of a program of 3 physical therapy modalities on blood circulation in patients with type 2 diabetes with peripheral arterial disease. SUBJECTS AND METHOD: A randomized controlled trial was undertaken. Sixty-eight patients with type 2 diabetes with Leriche-Fontaine stage I or IIa peripheral arterial disease were randomly assigned to an exercise or placebo group. For 20 weeks, the exercise group underwent treatment comprising 3 exercises at proximal, medium, and distal segments of the lower limbs, and the placebo group received sham treatment with disconnected ultrasound equipment. Peripheral arterial disease was determined by evaluating the ankle/brachial index (ABI), Doppler flow velocity, blood parameters, cardiovascular risk score, and heart rate during exercise test. RESULTS: After 20 weeks of treatment, significant differences between groups were found in the following: right (P < .039) and left (P < .023) ABI; Doppler flow velocity (cm/s) in the right (P < .010) and left (P < .026) posterior tibial artery and in the right (P < .012) and left (P < .022) dorsalis pedis artery; and fibrinogen (P < .045), hemoglobin (P < .021), cholesterol (P < .012), high-density lipoprotein cholesterol (P < .031), and HbA1c (P < .034) values. There was no significant difference in low-density lipoprotein cholesterol values (P < .110) between the groups. CONCLUSION: A program of these physical therapy modalities improves ABI, Doppler flow velocity, and blood parameters in patients with type 2 diabetes.
Subject(s)
Diabetic Angiopathies/therapy , Exercise Therapy/methods , Peripheral Arterial Disease/therapy , Adult , Aged , Diabetes Mellitus, Type 2/complications , Diabetic Angiopathies/etiology , Female , Humans , Male , Middle Aged , Peripheral Arterial Disease/etiology , Single-Blind MethodABSTRACT
The objective of this study was to evaluate the efficacy of connective tissue massage to improve blood circulation and intermittent claudication symptoms in type 2 diabetic patients. A randomized, placebo-controlled trial was undertaken. Ninety-eight type 2 diabetes patients with stage I or II-a peripheral arterial disease (PAD) (Leriche-Fontaine classification) were randomly assigned to a massage group or to a placebo group treated using disconnected magnetotherapy equipment. Peripheral arterial circulation was determined by measuring differential segmental arterial pressure, heart rate, skin temperature, oxygen saturation and skin blood flow. Measurements were taken before and at 30 min, 6 months and 1 year after the 15-week treatment. After the 15-week program, the groups differed (P < .05) in differential segmental arterial pressure in right lower limb (lower one-third of thigh, upper and lower one-third of leg) and left lower limb (lower one-third of thigh and upper and lower one-third of leg). A significant difference (P < .05) was also observed in skin blood flow in digits 1 and 4 of right foot and digits 2, 4 and 5 of left foot. ANOVA results were significant (P < .05) for right and left foot oxygen saturation but not for heart rate and temperature. At 6 months and 1 year, the groups differed in differential segmental arterial pressure in upper third of left and right legs. Connective tissue massage improves blood circulation in the lower limbs of type 2 diabetic patients at stage I or II-a and may be useful to slow the progression of PAD.
ABSTRACT
Fundamento y objetivo: La diabetes mellitus tipo 2 es una enfermedad con una elevada prevalencia y puede favorecer la aparición de enfermedad arterial periférica. El objetivo del presente estudio fue analizar la eficacia de un programa de ejercicios y masaje reflejo del tejido conjuntivo sobre el índice tobillo/brazo y los valores de presión arterial de pacientes con diabetes mellitus tipo 2 y enfermedad arterial periférica. Pacientes y método: Se realizó un estudio experimental con grupo control placebo. Se asignaron de forma aleatorizada 66 pacientes diabéticos tipo 2 con enfermedad arterial periférica en estadio II-b de Leriche-Fontaine a un grupo de intervención (ejercicio y masaje) y a un grupo control placebo (programa de magnetoterapia simulada). Las dimensiones de medida fueron la presión arterial e índice tobillo/brazo. Resultados: Finalizadas las 10 semanas de tratamiento, en el grupo de intervención se obtuvieron diferencias significativas (p<0,05) en el índice tobillo/brazo derecho e izquierdo y en la presión arterial sistólica y diastólica en el miembro inferior derecho e izquierdo. Conclusiones: Un programa combinado de ejercicios y masaje mejora la presión arterial y el índice tobillo/brazo en pacientes diabéticos tipo 2 con enfermedad arterial periférica (AU)
Background and Objective: Type 2 diabetes mellitus is a highly prevalent disease that can favour the development of peripheral arterial disease. The objective of this study was to analyse the efficacy of a massage and exercise programme on the ankle-brachial index and arterial pressure of patients with diabetes mellitus type 2 and peripheral arterial disease. Material and Methods: An experimental study with placebo control group was performed. Sixty-six type 2 diabetes patients with Leriche-Fontaine stage II peripheral arterial disease were randomly assigned to an intervention (exercise and massage) or placebo control (simulated magnetotherapy) group. Study variables were arterial pressure and ankle-brachial index. Results: After 10 weeks of treatment, significant (P<0.05) differences between the intervention and placebo groups were found in right and left ankle-brachial index values and in systolic and diastolic pressures in right and left lower extremities. Conclusions: A combined programme of exercise and massage improves arterial blood pressure and ankle brachial index values in type 2 diabetics with peripheral arterial disease (AU)
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Massage , Exercise Therapy , Diabetes Mellitus, Type 2/therapy , Peripheral Vascular Diseases/therapy , Diabetes Mellitus, Type 2/physiopathology , Peripheral Vascular Diseases/physiopathology , Blood Pressure , Mid-Upper Arm Circumference , Diabetic Angiopathies/therapyABSTRACT
BACKGROUND AND OBJECTIVE: Type 2 diabetes mellitus is a highly prevalent disease that can favour the development of peripheral arterial disease. The objective of this study was to analyse the efficacy of a massage and exercise programme on the ankle-brachial index and arterial pressure of patients with diabetes mellitus type 2 and peripheral arterial disease. MATERIAL AND METHODS: An experimental study with placebo control group was performed. Sixty-six type 2 diabetes patients with Leriche-Fontaine stage II peripheral arterial disease were randomly assigned to an intervention (exercise and massage) or placebo control (simulated magnetotherapy) group. Study variables were arterial pressure and ankle-brachial index. RESULTS: After 10 weeks of treatment, significant (P<0.05) differences between the intervention and placebo groups were found in right and left ankle-brachial index values and in systolic and diastolic pressures in right and left lower extremities. CONCLUSIONS: A combined programme of exercise and massage improves arterial blood pressure and ankle brachial index values in type 2 diabetics with peripheral arterial disease.
Subject(s)
Ankle Brachial Index , Blood Pressure , Diabetes Mellitus, Type 2/physiopathology , Diabetes Mellitus, Type 2/therapy , Diabetic Angiopathies/physiopathology , Diabetic Angiopathies/therapy , Exercise Therapy , Massage , Peripheral Vascular Diseases/physiopathology , Peripheral Vascular Diseases/therapy , Adult , Aged , Female , Humans , Male , Middle AgedABSTRACT
El objeto de este trabajo es analizar el efecto del ascenso súbito a una altura moderada sobre la mecánica muscular en distintos niveles de sobrecarga. Para ello, 5 varones deportistas, participaron en este estudio. Utilizando el ejercicio de sentadilla a 900 con barra libre, los participantes ejecutaron una curva de fuerza-velocidad, a partir de la cual se determinó la potencia máxima con un dinamómetro electrónico. En una jornada diferente se realizó una sesión de entrenamiento de fuerza con el método de 10x10, con elmismoejercicio y con la carga asociada a la potencia máxima.Ambos test se ejecutaron en condiciones de normoxia(N) (690m) y de hipoxia (H) súbita moderada(232Om).La potencia desarrollada, la velocidad de desplazamientode la sobrecarga y la percepción de esfuerzo diferenciadafueron registradas. La potencia máxima alcanzaday la carga a la que se obtuvo fueron significativamentesuperiores en H que en N(9l6,64+/-146,14 vs 823,85+/-118,38W y 110,00+/-12,24104,00+/-11,40Kg respectivamente)(p<0,05). La sesión de fuerza no mostró un efecto significativo de la hipoxia en las variables analizadas, a excepción de la percepción de esfuerzo local, la cual se mostró significativamente reducida en altitud (12,98+/-0,44 vs 11,54+/-0,46 para N e H respectivamente)(p<0,05). Por tanto, sobre la base de los resultados obtenidos y, siendo conscientes de las limitaciones ocasionadas por el tamaño de la muestra empleada, podemos concluir que la exposición a una altura moderada parece mejorar la potencia máxima y la carga a la que se localizaron respecto a la generada a nivel del mar. Tanto la hipoxia, como los cambios en la densidad del aire generados con el ascenso, podrían favorecer el reclutamiento selectivo de fibras de perfil mono-funcional anaeróbico en acciones muscularesde corta duración, justificando éste resultado. La fatigagenerada por la acumulación de repeticiones en lasesión podría enmascarar el efecto "facilitador" de la altura en la aplicación de fuerza a gran velocidad, pudiendo ser necesario en tales casos, acortar el volumen de las series
The aim of this study is to analyze the effect of acute ascent to moderate altitude on muscular mechanisms using different levels of resistance. Five healthy athletes participated in this study. Using back squat 90º flexion with free weights, participants executed a force-velocity curve to determine maximum power. On a different day a strength workout (10xl0) was performed with the same exercise using a maximum power load. Both tests were carried out in normoxia (690m) as well as in hypoxia (2320m). Power, speed and the diferenciated Ratings of Perceived Exertion (RPE) were recorded. Maximum power and the maximum power load, were significantly higher in hypoxia than innormoxia (916.64+/-146.14 vs 823.85+/-118.38 W and 110.00+/-12.24 vs 104.00+/-11.40 Kg respectively) (p<0.05).The variables analyzed in the strength workout didn't show any significant difference between normoxia and hypoxia, with the exception of fue local RPE which was reduced in hypoxic conditions (12.98+/-0.44 vs 11.54+/-0.46)( p<0.05). Therefore, based on fuese results, and taking into consideration the limits of the sample size, we can conclude that exposure to moderate alititude seems to improve maximum power and the maximum power load with respect to sea level. Hypoxia, as well as the changes in air density with ascent to a higher altitude, favour the selective recruitment of anaerobic morfo-functional fibers in short muscular action, justifying this result. The fatigue generated after repetitions in the workout could mask the "facilitator" effect of altitude in the application of strength in high speed movements. In fuese cases it could be necessary to reduce the number of sets