Sultana, Faria
(2018)
Efficacy of an aerobic and a combined aerobic resistance training intervention on middle aged type 2 diabetes mellitus people of Malaysia and Bangladesh - a cost effective approach.
Masters thesis, Universiti Sains Malaysia.
Abstract
This study compares the efficacy of a combined exercise training program
over low - moderate level aerobic exercise training in improving the health status of
sedentary middle–aged (40-60 years) individuals with T2DM and assess the cost
effectiveness of those exercise interventions. This research was conducted in
Kelantan, Malaysia and Dhaka, Bangladesh, based on 75 individuals with T2DM in
Kelantan, Malaysia and 75 individuals with T2DM in Dhaka, Bangladesh. They
were assessed and matched in the respective set-ups based on the extent of socioeconomic
and physiological status through preliminary testing according to
inclusion criterions. Participants were randomly categorized into three groups –
control group (Group A), and two experimental groups - Group B (Aerobic exercise
group subjected to low-moderate aerobic exercise -supervised walking at 40-60%
HRmax) and Group C (Combined exercise group subjected to supervised walking at
40-60% HRmax and resistance training exercises) comprising of 25 participants in
each of the group in Malaysia as well as in Bangladesh. After that pre –intervention
assessment was done with EuroQol 5D-5L (EQ 5D-5L), Brunel Mood States
(BRUMS), Glycosylated haemoglobin (HbA1c), Electromyography (EMG),
Bender-Gestalt II (BG- II) and Skin Conductance (Sc). Protocol for the exercise
interventions was scheduled as approximately 20-50 minutes/day; 3-4 days/ week;for 14 weeks. At the end of the 14th week, post intervention assessment was carried
out following pre-intervention protocol. With an interval of 14 weeks of no exercise
intervention, follow-up assessment was carried out on all the afore-mentioned
variables to verify the extent of sustainability of the interventions. Wilcoxon signedrank
test revealed that both Malaysian and Bangladeshi participants in group B (p
= .002; p = .000) and group C (p = .001; p = .010) had significant improvement in
the level of mobility. Two-way repeated measure of ANOVA/Mixed Factorial
ANOVA revealed that both group B (p = .000; p = .000) and group C (p = .000; p
= .000) had significant reduction in the level of Glycosylated hemoglobin (HbA1c)
and improvement in overall perceived health status in both the countries. Aerobic (p
= .000; p = .009) and combined (p = .008; p = .001) exercise interventions were
found as effective phase wise in reducing fatigability and activating peroneus brevis
muscle in Malaysian and Bangladeshi participants. Whereas, only combined
exercise intervention (p = .001; p = .000) has shown improvement in autonomic
response latency in Malaysian and Bangladeshi T2DM participants. Group C
participants had significant improvement (p = .000; p = .000) in Visual Motor
Abilities in Malaysia and Bangladesh. Finally, based on the cost incurred and
perceived health status, combined exercise program (group C) was observed to be
the most cost-effective among aerobic and no exercise program both in Malaysia and
Bangladesh.
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