Comparison of home exercise under supervision and self home exercise in pregnant women with gestational diabetes: randomized controlled trial.

OBJECTIVE: Exercise programs at home are successful in treating gestational diabetes by controlling blood glucose. The aim is to compare the efficacy of the self-directed home exercise program, the standard care alone and the supervised home exercise program in pregnant women with gestational diabetes on blood glucose, quality of life and pregnancy outcomes. METHODS: This randomized, parallel, single-blind study included 45 pregnant women who were 24-28 weeks of gestation. Participants were randomly divided into the supervised home exercise group (SHEG), home exercise group (HEG) and control group (CG). While the home exercises program was taught and controlled by a physiotherapist in SHEG, the home exercise brochure was given without any training by the gynecologist in HEG. Control group maintained their usual daily care. The home exercise intervention included low to moderate structured exercise performed three days per week for 8 weeks. Their glucose responses, quality of life and pregnancy outcomes were assessed pre- and post intervention. RESULTS: Fasting glucose and 2 h postprandial glucose levels were improved statistically in SHEG and HEG groups after intervention (p < 0.05). Differences in SHEG were statistically higher than HEG (p < 0.017). When the HEG and CG were compared, there was no superiority between the two groups in all outcome measures except the physical health. Additionally, there were no statistically significant differences in values of cesarean birth and preterm birth between groups (p > 0.05). CONCLUSIONS: This study revealed that pregnant women should be under the supervision of physiotherapists while doing home exercises. Clinical Trial Registration The trial was approved by the registration of ClinicalTrials.gov and registration number: NCT05195333.

Comparison of the efficiency of core stabilization exercises and abdominal corset in the treatment of postpartum diastasis recti abdominis.

OBJECTIVE: To examine the feasibility of three physiotherapy interventions for the treatment of diastasis recti abdominis (DRA): core stabilization exercises, abdominal corset and a combination of exercise and abdominal corset. STUDY DESIGN: Forty-five women 6 to 12 weeks postpartum who were diagnosed with DRA by a gynecologist/obstetrician were recruited for the study. The women were randomly divided into three groups: core stabilization exercises (1st group), the combination of exercise and abdominal corset (2nd group) and abdominal corset (3rd group). The treatment session for each group continued for 8 weeks. Outcome measurements were pain evaluation, inter-rectus distance (IRD) measured using ultrasound, trunk flexion strength and endurance, balance with open eyes/closed with a balance board, and Oswestry Disability Index (ODI). RESULTS: Statistically significant difference was observed in all outcome measures except the balance eyes closed results in the first group (p < 0.05). There was a statistically significant difference in all outcome measures in the second group (p < 0.05). Also, there was a statistically significant difference in visual analog scale, trunk flexor endurance, IRD results, balance with open eyes and ODI results in the third group (p < 0.05). When the values pre and post-treatment between the groups were examined, a statistically significant change was observed in trunk flexion strength, trunk flexor endurance, and balance with open eyes/closed parameters (p < 0.05). CONCLUSIONS: Physiotherapy interventions as core stabilization exercises and the abdominal corset can positively impact IRD, trunk flexion muscle strength and endurance, balance and disability in DRA management. The combination of exercise and corset was found more effective in the postpartum process.

Investigation on the Efficiency of the Closed Kinetic Chain and Video-Based Game Exercise Programs in the Rotator Cuff Rupture: A Randomized Trial.

Objective: To examine the effectiveness of video-based game exercises and structured closed kinetic chain exercises in individuals with rotator cuff rupture. Materials and Methods: Forty-five individuals with rotator cuff rupture were included in this study. Individuals were randomly divided into three groups: a conventional exercise group (CEG), a structured closed kinetic chain exercise group (CKCEG), and a video-based game exercise group (VGEG). Interventions were performed twice a week for 6 weeks. Pain severity; pain threshold; disabilities of the arm, shoulder, and hand questionnaire (DASH); rotator cuff quality of life index (RCQOL); range of motion (ROM); and joint position sense and approximation force of all individuals were evaluated pre- and post-treatment. Results: There was a statistically significant difference in all values of the pre- and post-treatment of the groups (P < 0.05). When the differences between the groups were compared, CKCEG and VGEG values were more significant than CEG in all parameters (P < 0.017). Improvements in pain threshold, ROM in shoulder flexion and abduction, DASH score, and all parameters of the RCQOL questionnaire in VGEG were statistically more significant than CKCEG (P < 0.017). Conclusion: Individuals with rotator cuff rupture obtained more improvements in primary and secondary outcomes after closed kinetic chain exercise and video-based game exercise, rather than conventional methods. It was considered that video-based game exercise programs would be used in rotator cuff problems.

Effect of exercises according to the circadian rhythm in type 2 diabetes: Parallel-group, single-blind, crossover study.

BACKGROUND AND AIM: To evaluate the effectiveness of structured exercise appropriate the circadian rhythm in terms of blood sample test (BST), functionality and quality of life (QoL) in individuals with type 2 diabetes. METHODS AND RESULTS: This was a parallel-group, single-blind, crossover study. Thirty individuals with type 2 diabetes aged 35-65 years were enrolled in the study and allocated into 2 groups as the Morning Chronotype (MC) Group (n = 15) and the Evening Chronotype (EC) Group (n = 15) using Morningness-Eveningness Questionnaire which was used to determine the chronotypes. Participants were evaluated in terms of BST, functionality and QoL at the beginning of the study (T0), at 6 (T1), 12 (T2), and 18 (T3) weeks after the study started. A structured exercise program for 3 days a week over 6 weeks was applied in accordance with the chronotypes (T1-T2) and cross-controlled for the chronotypes (T2-T3). Significant differences were found in favor of the exercise given at the appropriate time for the chronotype in all parameters in both groups within groups (T0-T1-T2-T3) (p < 0.05). In the time∗group interactions, exercise in accordance with the appropriate chronotype in both groups provided the highest statistical improvement in all parameters (p < 0.05). CONCLUSION: It was concluded that structured exercise performed at the appropriate time for chronotype improves HbA1c, fasting blood glucose, HDL-LDL cholesterol, triglyceride, total cholesterol, functionality and quality of life in type 2 diabetes. This variation in blood values was observed to reflect the quantitative effects of exercise administered according to the circadian rhythm in individuals with type 2 diabetes. TRIAL REGISTRATION: ClinicalTrials.gov (NCT04427488). The protocol of the study was registered at ClinicalTrials.gov (NCT04427488).