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Adoption and maintenance of gym-based strength training in the community setting in adults with excess weight or type 2 diabetes: a randomized controlled trial.

Teychenne M, Ball K, Salmon J, Daly RM, Crawford DA, Sethi P, Jorna M, Dunstan DW - Int J Behav Nutr Phys Act (2015)

Bottom Line: In those with T2DM, there was a significant reduction in HbA1c in the EST compared to SST group during the adoption phase (net difference, -0.13 % [-0.26 to -0.01]), which persisted after 12-months (-0.17 % [-0.3 to -0.05]).A behaviorally-focused community-based EST intervention was more effective than a SST program for the adoption of ST in adults with excess weight or T2DM and led to greater improvements in glycemic control in those with T2DM.Registered at ACTRN12611000695909 (Date registered 7/7/2011).

View Article: PubMed Central - PubMed

Affiliation: Deakin University, Centre for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Melbourne, Victoria, Australia. mteych@deakin.edu.au.

ABSTRACT

Background: Participant adoption and maintenance is a major challenge in strength training (ST) programs in the community-setting. In adults who were overweight or with type 2 diabetes (T2DM), the aim of this study was to compare the effectiveness of a standard ST program (SST) to an enhanced program (EST) on the adoption and maintenance of ST and cardio-metabolic risk factors and muscle strength.

Methods: A 12-month cluster-randomized controlled trial consisting of a 6-month adoption phase followed by a 6-month maintenance phase. In 2008-2009, men and women aged 40-75 years (n‚ÄČ=‚ÄČ318) with T2DM (n‚ÄČ=‚ÄČ117) or a BMI >25 (n‚ÄČ=‚ÄČ201) who had not participated in ST previously were randomized into either a SST or an EST program (which included additional motivationally-tailored behavioral counselling). Adoption and maintenance were defined as undertaking‚ÄČ‚Č•‚ÄČ3 weekly gym-based exercise sessions during the first 6-months and from 6-12 months respectively and were assessed using a modified version of the CHAMPS (Community Healthy Activity Models Program for Seniors) instrument.

Results: Relative to the SST group, the adjusted odds ratio (OR) of adopting ST for all participants in the EST group was 3.3 (95 % CI 1.2 to 9.4). In stratified analyses including only those with T2DM, relative to the SST group, the adjusted OR of adopting ST in the EST group was 8.2 (95 % CI 1.5-45.5). No significant between-group differences were observed for maintenance of ST in either pooled or stratified analyses. In those with T2DM, there was a significant reduction in HbA1c in the EST compared to SST group during the adoption phase (net difference, -0.13 % [-0.26 to -0.01]), which persisted after 12-months (-0.17 % [-0.3 to -0.05]).

Conclusions: A behaviorally-focused community-based EST intervention was more effective than a SST program for the adoption of ST in adults with excess weight or T2DM and led to greater improvements in glycemic control in those with T2DM.

Trial registration: Registered at ACTRN12611000695909 (Date registered 7/7/2011).

No MeSH data available.


Related in: MedlinePlus

Forrest plot showing odds ratio of adherence to strength training at 2-, 4-, 6- and 12- months*. * based on the mixed model with random effects; Adherence‚ÄČ=‚ÄČ‚Č•3 sessions per week. ‚Ä° p‚ÄČ<‚ÄČ0.05 difference between the Enhanced and Standard ST group
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Fig2: Forrest plot showing odds ratio of adherence to strength training at 2-, 4-, 6- and 12- months*. * based on the mixed model with random effects; Adherence‚ÄČ=‚ÄČ‚Č•3 sessions per week. ‚Ä° p‚ÄČ<‚ÄČ0.05 difference between the Enhanced and Standard ST group

Mentions: In the adoption phase, 127 (40¬†%) participants completed 3 sessions of ST per week (SST, n‚ÄČ=‚ÄČ49; EST, n‚ÄČ=‚ÄČ78). The odds ratio (OR) of adopting ST were 3.3 times (95¬†% CI 1.2 to 9.4) higher for participants in the EST compared to SST group. At 12-months, the number of participants maintaining ST (3 sessions/week) was reduced to 47 (15¬†%; SST, n‚ÄČ=‚ÄČ15; EST, n‚ÄČ=‚ÄČ32), with the OR of maintaining the program greater (but not significant) for the EST compared to SST group (OR 2.0, 95¬†% CI 0.6 to 6.5) (Fig.¬†2). The median odds ratio (MOR) of adherence between two randomly selected participants from the same leisure centre was 1.7 (95¬†% CI 1.4 to 2.1). The MOR between two randomly selected participants from two different centres was 1.8 (95¬†% CI 1.5 to 2.3). The between-persons variation in adherence odds was of the same order of magnitude as the intervention effect, indicating that the intervention effect was quite substantial.Fig 2


Adoption and maintenance of gym-based strength training in the community setting in adults with excess weight or type 2 diabetes: a randomized controlled trial.

Teychenne M, Ball K, Salmon J, Daly RM, Crawford DA, Sethi P, Jorna M, Dunstan DW - Int J Behav Nutr Phys Act (2015)

Forrest plot showing odds ratio of adherence to strength training at 2-, 4-, 6- and 12- months*. * based on the mixed model with random effects; Adherence‚ÄČ=‚ÄČ‚Č•3 sessions per week. ‚Ä° p‚ÄČ<‚ÄČ0.05 difference between the Enhanced and Standard ST group
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4549007&req=5

Fig2: Forrest plot showing odds ratio of adherence to strength training at 2-, 4-, 6- and 12- months*. * based on the mixed model with random effects; Adherence‚ÄČ=‚ÄČ‚Č•3 sessions per week. ‚Ä° p‚ÄČ<‚ÄČ0.05 difference between the Enhanced and Standard ST group
Mentions: In the adoption phase, 127 (40¬†%) participants completed 3 sessions of ST per week (SST, n‚ÄČ=‚ÄČ49; EST, n‚ÄČ=‚ÄČ78). The odds ratio (OR) of adopting ST were 3.3 times (95¬†% CI 1.2 to 9.4) higher for participants in the EST compared to SST group. At 12-months, the number of participants maintaining ST (3 sessions/week) was reduced to 47 (15¬†%; SST, n‚ÄČ=‚ÄČ15; EST, n‚ÄČ=‚ÄČ32), with the OR of maintaining the program greater (but not significant) for the EST compared to SST group (OR 2.0, 95¬†% CI 0.6 to 6.5) (Fig.¬†2). The median odds ratio (MOR) of adherence between two randomly selected participants from the same leisure centre was 1.7 (95¬†% CI 1.4 to 2.1). The MOR between two randomly selected participants from two different centres was 1.8 (95¬†% CI 1.5 to 2.3). The between-persons variation in adherence odds was of the same order of magnitude as the intervention effect, indicating that the intervention effect was quite substantial.Fig 2

Bottom Line: In those with T2DM, there was a significant reduction in HbA1c in the EST compared to SST group during the adoption phase (net difference, -0.13 % [-0.26 to -0.01]), which persisted after 12-months (-0.17 % [-0.3 to -0.05]).A behaviorally-focused community-based EST intervention was more effective than a SST program for the adoption of ST in adults with excess weight or T2DM and led to greater improvements in glycemic control in those with T2DM.Registered at ACTRN12611000695909 (Date registered 7/7/2011).

View Article: PubMed Central - PubMed

Affiliation: Deakin University, Centre for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Melbourne, Victoria, Australia. mteych@deakin.edu.au.

ABSTRACT

Background: Participant adoption and maintenance is a major challenge in strength training (ST) programs in the community-setting. In adults who were overweight or with type 2 diabetes (T2DM), the aim of this study was to compare the effectiveness of a standard ST program (SST) to an enhanced program (EST) on the adoption and maintenance of ST and cardio-metabolic risk factors and muscle strength.

Methods: A 12-month cluster-randomized controlled trial consisting of a 6-month adoption phase followed by a 6-month maintenance phase. In 2008-2009, men and women aged 40-75 years (n‚ÄČ=‚ÄČ318) with T2DM (n‚ÄČ=‚ÄČ117) or a BMI >25 (n‚ÄČ=‚ÄČ201) who had not participated in ST previously were randomized into either a SST or an EST program (which included additional motivationally-tailored behavioral counselling). Adoption and maintenance were defined as undertaking‚ÄČ‚Č•‚ÄČ3 weekly gym-based exercise sessions during the first 6-months and from 6-12 months respectively and were assessed using a modified version of the CHAMPS (Community Healthy Activity Models Program for Seniors) instrument.

Results: Relative to the SST group, the adjusted odds ratio (OR) of adopting ST for all participants in the EST group was 3.3 (95 % CI 1.2 to 9.4). In stratified analyses including only those with T2DM, relative to the SST group, the adjusted OR of adopting ST in the EST group was 8.2 (95 % CI 1.5-45.5). No significant between-group differences were observed for maintenance of ST in either pooled or stratified analyses. In those with T2DM, there was a significant reduction in HbA1c in the EST compared to SST group during the adoption phase (net difference, -0.13 % [-0.26 to -0.01]), which persisted after 12-months (-0.17 % [-0.3 to -0.05]).

Conclusions: A behaviorally-focused community-based EST intervention was more effective than a SST program for the adoption of ST in adults with excess weight or T2DM and led to greater improvements in glycemic control in those with T2DM.

Trial registration: Registered at ACTRN12611000695909 (Date registered 7/7/2011).

No MeSH data available.


Related in: MedlinePlus