• J David Taylor, James P Fletcher, Ruth Ann Mathis, and W Todd Cade.
• J.D. Taylor, PT, PhD, CSCS, Department of Physical Therapy, University of Central Arkansas, 201 Donaghey Ave, Physical Therapy Center, Room 319, Conway, AR 72035 (USA). dtaylor@uca.edu.
• Phys Ther. 2014 Dec 1; 94 (12): 1720-30.

BackgroundExercise training is effective for improving physical fitness and physical function in people with type 2 diabetes. However, limited research has been conducted on the optimal exercise training intensity for this population.ObjectiveThe primary study objective was to investigate the effects of moderate- versus high-intensity exercise training on physical fitness and physical function in people with type 2 diabetes.DesignThis was a randomized clinical trial.SettingThe setting was a university campus.ParticipantsTwenty-one people with type 2 diabetes were randomly allocated to receive either moderate-intensity training (MOD group) or high-intensity training (HIGH group).InterventionThe MOD group performed resistance training at an intensity of 75% of the 8-repetition maximum (8-RM) and aerobic training at an intensity of 30% to 45% of the heart rate reserve (HRR). The HIGH group performed resistance training at an intensity of 100% of the 8-RM and aerobic training at an intensity of 50% to 65% of the HRR.MeasurementsMuscle strength (peak torque [newton-meters]), exercise capacity (graded exercise test duration [minutes]), and physical function (Patient-Specific Functional Scale questionnaire) were measured at baseline and 3 months later. Acute exercise-induced changes in glucose levels were assessed immediately before exercise, immediately after exercise, and 1 hour after exercise during the first exercise training session.ResultsAlthough both groups showed improvements in physical fitness and physical function, the between-group effect sizes were not statistically significant (exercise capacity estimated marginal mean [EMM] difference=2.1, 95% confidence interval [95% CI]=-0.2, 4.5; muscle strength EMM difference=20.8, 95% CI=-23.3, 65.0; and physical function EMM difference=0.1, 95% CI=-0.6, 0.9). Mean percent changes in glucose levels measured immediately before exercise and immediately after exercise, immediately after exercise and 1 hour after exercise, and immediately before exercise and 1 hour after exercise for the MOD group were -11.4%, -5.0%, and -15.8%, respectively; those for the HIGH group were -21.5%, 7.9%, and -15.3%, respectively.LimitationsSample size, lack of outcome assessor masking, and physical function measurement subjectivity were limitations.ConclusionsModerate- and high-intensity exercise training, as defined in this study, may lead to similar improvements in physical fitness and physical function in people with type 2 diabetes.© 2014 American Physical Therapy Association.

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