Janet Wright looks at new research of interest to physiotherapy staff.
Frequent exercise keeps blood glucose steady
People with diabetes can improve control of their blood sugar levels by exercising more often, rather than more intensely, say researchers.
Exercise is already known to reduce the risk of developing diabetes. And for people who already have the condition, it can improve insulin action and reduce the risk of cardiovascular disease.
To find out more, a Brazilian team reviewed 26 randomised controlled trials of supervised exercise among 2,253 patients. All had type 2 diabetes – the form that can often be controlled by lifestyle changes rather than insulin injections.
‘The frequency of exercise is the specific factor more likely to underlie the beneficial effects of aerobic training, meaning that the repetition of exercise sessions may be more important than longer or more intense sessions,’ say Daniel Umpierre of the Hospital de Clínicas de Porto Alegre and colleagues.
An Australian team reviewed the Brazilian study for the physiotherapy evidence database, PEDro. Alison Harmer and Mark Elkins point out that patients who don’t keep up with their recommended exercise often cite lack of time, poor motivation and uncertainty about how to do the exercises. So they recommend helping patients feel more involved, setting goals and using problem-solving techniques.
For patients whose ability may be limited by other health conditions or diabetic complications, they say ‘The clinician’s role here is to tailor a feasible exercise programme, perhaps supplemented with other interventions to control glycaemia such as passive stretching and referral to a dietician.’ Umpierre D et al. Volume of supervised exercise training impacts glycaemic control in patients with type 2 diabetes: a systematic review with meta-regression analysis. Diabetologia 2013; Harmer AR & Elkins MR. Amount and frequency of exercise affect glycaemic control more than exercise mode or intensity - PEDro systematic review update. British Journal of Sports Medicine 2014.
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Comments & Conclusions
- Clinical balance testing may not tell the whole story for patients with amyotrophic lateral sclerosis (ALS). In a small study of ALS patients, who could walk and had passed normal balance tests, more than a third relied on visual cues because they could not use normal vestibular input – putting them at higher risk of falling. Sanjak M et al. Archives of Physical Medicine and Rehabilitation 2014.
- Reduced hip strength may be a result of patellofemoral pain, rather than a cause. Rathleff MS et al. British Journal of Sports Medicine 2014.
- Ballet students have a significantly higher risk of scoliosis than non-dancers of the same age, say Australian researchers who studied girls aged nine to 16. ‘Vigilant screening and improved education for dance teachers and parents of dance students may be beneficial in earlier detection,’ they conclude. Longworth B et al. Archives of Physical Medicine and Rehabilitation 2014.
- Patients miss one outpatient appointment in 12 without notice, the Health and Social Care Information Centre reports in ‘Provisional monthly topic of interest: outpatient did not attend (DNA) appointment’. That’s 6.8 million DNAs in the year to March 2014. One in 50 will miss at least three more in the following three months. Patients in their twenties miss the most appointments.
- Women with numerous moles on their skin are 34 per cent more likely to develop breast cancer than those with none, two large-scale long-term studies reveal. Though better known as a risk factor for skin cancer, moles have also been linked with hormone levels. et al. PLOS Medicine 2014.
- Only 44 per cent of knee replacements carried out in the United States are definitely ‘appropriate’, according to a patient classification system, with 34 per cent classed as inappropriate and the rest inconclusive. Riddle DL et al. Arthritis & Rheumatology 2014.
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