Regular Walking as an Intervention to Support the Quality of Life of Diabetics

Introduction

A randomized controlled trial conducted in Minnesota, USA, focused on the impact of regular physical activity in the form of walking on mobility and quality of life in diabetics. The six-month study included 145 participants with an average age of 66.5 years diagnosed with type 1 or type 2 diabetes mellitus or peripheral arterial disease. These conditions often negatively affect the walking speed and distance that patients can achieve. These functional deficits can greatly limit their level of independence, which has a significant impact on quality of life.

Study Objectives

The primary objective was to evaluate the impact of regular walking on the maximum distance covered on a treadmill after six months of training. The secondary objectives included assessing lower limb function (using the Walking Impairment Questionnaire), quality of life (according to the MOS 36-Item Short Form Survey), exercise habits (using the Stanford Patient Education Research Centre Exercise Behaviour Survey), symptoms of depression (according to the Geriatric Depression Score), and self-care ability (using the Self-Efficacy for Managing Chronic Disease scale) after 3 and 6 months of training.

Study Procedure

The six-month program began with two initial walking lessons with an instructor aimed at encouraging patient adherence. The regular activity consisted of walking with an instructor or other patients once a week and individual walking training three times a week.

Each walking session lasted 50 minutes, and participants were to increase their step count by 50 steps at each training session. They assessed their performance every two weeks during a phone interview, which was also attended by the control group that did not have a set exercise plan.

No adverse effects such as chest pain, dyspnea, or other issues requiring hospitalization were recorded during the observation period.

Results

The groups were evaluated by comparing values at the start, after 3 months, and after 6 months of observation. The results of the study group and the control group showed no significant differences in the maximum distance covered – the average distance of 448 meters on the treadmill at the start of the study changed only by tens of meters by the end of the observation. However, differences were noted in walking speed. The study group saw a 5.7 percentage point increase, whereas the control group showed a 1.9 percentage point decrease.

The mental health score measured by MOS SF-36 increased by 3.2 points on the 100-point scale in the training group, while it decreased by 2.4 points in the control group. Positive impacts of the training program were also seen in the assessment of walking impairments and exercise habits.

Discussion and Conclusion

Given the recorded results, the authors present regular walking as an intervention that physicians can recommend to their diabetic patients for numerous reasons. Walking is an important element that supports various aspects of quality of life, and confirming its positive impact on assessed parameters and exercise habits can be beneficial when creating an individual regimen. The improvement in mental health associated with walking demonstrates that engaging in physical activity is highly significant in the treatment of diabetic patients and contributes to improving their quality of life.

(pak)

Source: Collins T. C., Lunos S., Carlson T. et al. Effects of a home-based walking intervention on mobility and quality of life in people with diabetes and peripheral arterial disease: a randomized controlled trial. Diabetes Care 2011; 34 (10): 2174–2179, doi: 10.2337/dc10-2399.