Fitness consultations in routine care of patients with type 2 diabetes in general practice: an 18-month non-randomised intervention study
<p>Abstract</p> <p>Background</p> <p>Increasing physical activity is a cornerstone in the treatment of type 2 diabetes and in general practice it is a challenge to achieve long-term adherence to this life style change. The aim of this study was to investigate in a non-r...
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| Format: | Article |
| Language: | English |
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BMC
2010-11-01
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| Series: | BMC Family Practice |
| Online Access: | http://www.biomedcentral.com/1471-2296/11/83 |
| _version_ | 1811327371928666112 |
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| author | Siersma Volkert Lohmann Henning Olivarius Niels F |
| author_facet | Siersma Volkert Lohmann Henning Olivarius Niels F |
| author_sort | Siersma Volkert |
| collection | DOAJ |
| description | <p>Abstract</p> <p>Background</p> <p>Increasing physical activity is a cornerstone in the treatment of type 2 diabetes and in general practice it is a challenge to achieve long-term adherence to this life style change. The aim of this study was to investigate in a non-randomised design whether the introduction of motivational interviewing combined with fitness tests in the type 2 diabetes care programme was followed by a change in cardio-respiratory fitness expressed by VO<sub>2max</sub>, muscle strength of upper and lower extremities, haemoglobin A<sub>1c </sub>(HbA<sub>1c</sub>) and HDL-cholesterol.</p> <p>Methods</p> <p>Uncontrolled 18-month intervention study with follow-up and effect assessment every 3 months in a primary care unit in Denmark with six general practitioners (GPs). Of 354 eligible patients with type 2 diabetes, 127 (35.9%) were included. Maximum work capacity was tested on a cycle ergometer and converted to VO<sub>2max</sub>. Muscle strength was measured with an arm curl test and a chair stand test. The results were used in a subsequent motivational interview conducted by one of the GPs. Patients were encouraged to engage in lifestyle exercise and simple home-based self-managed exercise programmes. Data were analysed with mixed models.</p> <p>Results</p> <p>At end of study, 102 (80.3%) participants remained in the intervention. Over 18 months, VO<sub>2max </sub>increased 2.5% (p = 0.032) while increases of 33.2% (p < 0.001) and 34.1% (p < 0.001) were registered for the arm curl test and chair stand test, respectively. HDL-cholesterol increased 8.6% (p < 0.001), but HbA<sub>1c </sub>remained unchanged (p = 0.57) on a low level (6.8%). Patients without cardiovascular disease or pain from function limitation increased their VO<sub>2max </sub>by 5.2% (p < 0.0001) and 7.9% (p = 0.0008), respectively.</p> <p>Conclusions</p> <p>In this 18-month study, participants who had repeated fitness consultations, including physical testing and motivational interviewing to improve physical activity, improved VO<sub>2max</sub>, muscle strength, and lipid profile. Our results indicate that physical testing combined with motivational interviewing is feasible in a primary health care setting. Here, a fitness consultation tailored to the individual patient, his/her comorbidities and conditions in the local area can be incorporated into the diabetes programme to improve patients' muscle strength and cardio-respiratory fitness.</p> |
| first_indexed | 2024-04-13T15:05:32Z |
| format | Article |
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| institution | Directory Open Access Journal |
| issn | 1471-2296 |
| language | English |
| last_indexed | 2024-04-13T15:05:32Z |
| publishDate | 2010-11-01 |
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| series | BMC Family Practice |
| spelling | doaj.art-7bfb9d1f17314f57be4dbad2d3c2160d2022-12-22T02:42:10ZengBMCBMC Family Practice1471-22962010-11-011118310.1186/1471-2296-11-83Fitness consultations in routine care of patients with type 2 diabetes in general practice: an 18-month non-randomised intervention studySiersma VolkertLohmann HenningOlivarius Niels F<p>Abstract</p> <p>Background</p> <p>Increasing physical activity is a cornerstone in the treatment of type 2 diabetes and in general practice it is a challenge to achieve long-term adherence to this life style change. The aim of this study was to investigate in a non-randomised design whether the introduction of motivational interviewing combined with fitness tests in the type 2 diabetes care programme was followed by a change in cardio-respiratory fitness expressed by VO<sub>2max</sub>, muscle strength of upper and lower extremities, haemoglobin A<sub>1c </sub>(HbA<sub>1c</sub>) and HDL-cholesterol.</p> <p>Methods</p> <p>Uncontrolled 18-month intervention study with follow-up and effect assessment every 3 months in a primary care unit in Denmark with six general practitioners (GPs). Of 354 eligible patients with type 2 diabetes, 127 (35.9%) were included. Maximum work capacity was tested on a cycle ergometer and converted to VO<sub>2max</sub>. Muscle strength was measured with an arm curl test and a chair stand test. The results were used in a subsequent motivational interview conducted by one of the GPs. Patients were encouraged to engage in lifestyle exercise and simple home-based self-managed exercise programmes. Data were analysed with mixed models.</p> <p>Results</p> <p>At end of study, 102 (80.3%) participants remained in the intervention. Over 18 months, VO<sub>2max </sub>increased 2.5% (p = 0.032) while increases of 33.2% (p < 0.001) and 34.1% (p < 0.001) were registered for the arm curl test and chair stand test, respectively. HDL-cholesterol increased 8.6% (p < 0.001), but HbA<sub>1c </sub>remained unchanged (p = 0.57) on a low level (6.8%). Patients without cardiovascular disease or pain from function limitation increased their VO<sub>2max </sub>by 5.2% (p < 0.0001) and 7.9% (p = 0.0008), respectively.</p> <p>Conclusions</p> <p>In this 18-month study, participants who had repeated fitness consultations, including physical testing and motivational interviewing to improve physical activity, improved VO<sub>2max</sub>, muscle strength, and lipid profile. Our results indicate that physical testing combined with motivational interviewing is feasible in a primary health care setting. Here, a fitness consultation tailored to the individual patient, his/her comorbidities and conditions in the local area can be incorporated into the diabetes programme to improve patients' muscle strength and cardio-respiratory fitness.</p>http://www.biomedcentral.com/1471-2296/11/83 |
| spellingShingle | Siersma Volkert Lohmann Henning Olivarius Niels F Fitness consultations in routine care of patients with type 2 diabetes in general practice: an 18-month non-randomised intervention study BMC Family Practice |
| title | Fitness consultations in routine care of patients with type 2 diabetes in general practice: an 18-month non-randomised intervention study |
| title_full | Fitness consultations in routine care of patients with type 2 diabetes in general practice: an 18-month non-randomised intervention study |
| title_fullStr | Fitness consultations in routine care of patients with type 2 diabetes in general practice: an 18-month non-randomised intervention study |
| title_full_unstemmed | Fitness consultations in routine care of patients with type 2 diabetes in general practice: an 18-month non-randomised intervention study |
| title_short | Fitness consultations in routine care of patients with type 2 diabetes in general practice: an 18-month non-randomised intervention study |
| title_sort | fitness consultations in routine care of patients with type 2 diabetes in general practice an 18 month non randomised intervention study |
| url | http://www.biomedcentral.com/1471-2296/11/83 |
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