Effects of high intensity interval training and combined training associated with photobiomodulation therapy in type 2 diabetic (T2D) patients: protocol for a randomized controlled trial
DOI:
https://doi.org/10.17267/2238-2704rpf.2022.e4424Keywords:
Type 2 diabetes mellitus, Glycemic Control, High-Intensity Interval Training, Low-Level Light Therapy, Quality of LifeAbstract
BACKGROUND: Type 2 diabetes (T2D) can be responsible for a significant cardiometabolic dysfunction and reduction in the quality of life (QOL) due to its negative impact on functional exercise capacity. OBJECTIVE: To investigate the effects of different modes of physical training [high intensity interval training (HIIT) and combined training (CT)] associated with Light-Emitting Diode (LED) therapy on cardiometabolic status, functional capacity and QOL in T2D patients. METHODS: A randomized controlled trial will be conducted in a university cardiopulmonary rehabilitation laboratory with community-dwelling people with T2D confirmed diagnosis, aged 18 years, with sedentary lifestyle in the last six months. The participants will be randomly allocated to one of six groups: TIAI with and without LED therapy, CT with and without LED therapy, control group with and without LED therapy. The training protocol should be performed for 12 weeks, 3 times a week on alternate days, totaling 36 training sessions. The primary outcome will be functional exercise capacity and glycemic control. Secondary outcomes will be QOL, endothelial function, musculoskeletal function, autonomic nervous system modulation and body composition. The outcomes will be measured before and after 12 weeks of training. The SPSS® 19.0 software will be used for statistical analysis. The adopted significance level will be p0.05. PERSPECTIVES: The findings of this trial have the potential to provide important insights regarding the effects of different modes of physical training associated with LED therapy and may support the use of this therapy combination in T2D patients, improving their general health.
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(1) Wild S, Roglic G, Green A, Sicree R, King H. Global prevalence of diabetes: estimates for the year, and projections for 2030. Diab Car. 2004;2 (5):1047–1053. https://doi.org/10.2337/diacare.27.5.1047
(2) Schmidt MI, Duncan BB, Azevedo e Silva G, Menezes AM, Monteiro CA, Barreto SM, et al. Chronic non-communicable diseases in Brazil: burden and current challenges. Lancet. 2011;377(9781):1949–1961. https://doi.org/10.1016/S0140-6736(11)60135-9
(3) Stanford KI, Goodyear LJ. Exercise and type 2 diabetes: molecular mechanisms regulating glucose uptake in skeletal muscle. Adv Physiol Educ. 2014;38(4):308-314. https://doi.org/10.1152/advan.00080.2014
(4)Bertoluci MC, Rocha VZ. Cardiovascular risk assessment in patients with diabetes. Diabetol Metab Syndr. 2017;9(25). https://doi.org/10.1186/s13098-017-0225-1
(5)Abdul-Ghani M, DeFronzo RA, Prato SD, Chilton R, Singh R, Ryder REJ. Cardiovascular Disease and Type 2 Diabetes: Has the Dawn of a New Era Arrived? Diabetes Care. 2017;40(7):813–820. https://doi.org/10.2337/dc16-2736
(6) Seyoum B, Estacio RO, Berhanu P, Schrier RW. Exercise capacity is a predictor of cardiovascular events in patients with type 2 diabetes mellitus. Diab Vasc Dis Res. 2006;3(3):197–201. https://doi.org/10.3132/dvdr.2006.030
(7) Nadeau KJ, Zeitler PS, Bauer TA, Brown MS, Dorosz JL, Draznin B, et al. Insulin resistance in adolescents with type 2 diabetes is associated with impaired exercise capacity. J Clin Endocrinol Metab. 2009;94(10):3687–3695. https://doi.org/10.1210/jc.2008-2844
(8) Francisco CO, Catai AM, Moura-Tonello SC, Lopes SL, Benze BG, Del Vale AM, et al. Cardiorespiratory fitness, pulmonary function and C-reactive protein levels in nonsmoking individuals with diabetes. Braz J Med Biol Res. 2014;47(5):426–431. https://doi.org/10.1590/1414-431X20143370
(9) Brassard P, Ferland A, Bogaty P, Desmeules M, Jobin J, Poirier P. Influence of glycemic control on pulmonary function and heart rate in response to exercise in subjects with type 2 diabetes mellitus. Metabolism. 2006;55(11):1532-7. https://doi.org/10.1016/j.metabol.2006.06.025
(10) Góralczyk K, Szyma?ska J, Szot K, Fisz J, Ro?? D. Low-level laser irradiation effect on endothelial cells under conditions of hyperglycemia. Lasers Med Sci. 2016;31:825–831.https://doi.org/10.1007/s10103-016-1880-4
(11) Vincent AM, Edwards JL, McLean LL, Hong Y, Cerri F, Lopez I, et al. Mitochondrial biogenesis and fission in axons in cell culture and animal models of diabetic neuropathy. Acta Neuropathol. 2010;120(4):477-89. https://doi.org/10.1007/s00401-010-0697-7
(12) Chen L, Pei J-H, Kuang J, Chen H-M, Chen Z, Li Z-W, et al. Effect of lifestyle intervention in patients with type 2 diabetes: a meta-analysis. Metabolism. 2015;64(2):338–347. https://doi.org/10.1016/j.metabol.2014.10.018
(13) Boulé NG, Haddad E, Kenny GP, Wells GA, Sigal RJ. Effects of exercise on glycemic control and body mass in type 2 diabetes mellitus: a meta-analy¬sis of controlled clinical trials. JAMA. 2001;286(10):1218–1227. https://doi.org/10.1001/jama.286.10.1218
(14) Bassi D, Mendes RG, Arakelian VM, Caruso FCR, Cabiddu R, Bonjorno-Júnior JC, et al. Potential Effects on Cardiorespiratory and Metabolic Status After a Concurrent Strength and Endurance Training Program in Diabetes Patients — a Randomized Controlled Trial. Sports Med Open. 2016; 2:31. https://doi.org/10.1186/s40798-016-0052-1
(15) Francois ME, Little JP. Effectiveness and Safety of High-Intensity Interval Training in Patients With Type 2 Diabetes. Diabetes Spectrum. 2015; 28(1): 39-44. https://doi.org/10.2337/diaspect.28.1.39
(16) Colberg SR, Sigal RJ, Fernhall B, Regensteiner JG, Blissmer BJ, Rubin RR, et al. Exercise and type 2 diabetes: the American College of Sports Medicine and the American Diabetes Association: joint position statement executive summary. Diabetes Care. 2010;33(12):e147-67. https://doi.org/10.2337/dc10-9990
(17) Huang YY, Sharma SK, Carroll J, Hamblin MR. Biphasic Dose Response in Low Level Light Therapy - An Update. Dose-Response. 2011;9(4):602-618. https://doi.org/10.2203/dose-response.11-009.Hamblin
(18) Lizarelli RFZ, Miguel FAC, Freitas-Pontes KM, Villa GEP, Nunez SC, Bagnato VS. Dentin hypersensitivity clinical study comparing LILT and LEDT keeping the same irradiation parameters. Laser Physics Letters [Internet]. 2010;7(11):805-811. Available from: http://repositorio.ipen.br/handle/123456789/26635
(19) Ferraresi C, Santos RV, Marques G, Zangrande M, Leonaldo R, Hamblin MR, et al. Light-emitting diode therapy (LEDT) before matches prevents increase in creatine kinase with a light dose response in volleyball players. Lasers Med Sci. 2015;30(4):1281-1287. https://doi.org/10.1007/s10103-015-1728-3
(20) Miranda EF, Vanin AA, Tomazoni SS, Grandinetti VS, Paiva PRV, Machado CSM, et al. Using Pre-Exercise Photobiomodulation Therapy Combining Super-Pulsed Lasers and Light-Emitting Diodes to Improve Performance in Progressive Cardiopulmonary Exercise Tests. J Athl Train. 2016;51(2):129–135. https://doi.org/10.4085/1062-6050-51.3.10.
(21) Miranda EF, Leal ECP Jr, Marchetti PH, Corso SD. Acute effects of light emitting diodes therapy (LEDT) in muscle function during isometric exercise in patients with chronic obstructive pulmonary disease: preliminary results of a randomized controlled trial. Lasers Med Sci. 2014;29(1):359-365. https://doi.org/10.1007/s10103-013-1359-5
(22) Adamskaya N, Dungel P, Mittermayr R, Hartinger J, Feichtinger G, Wassermann K, et al. Light therapy by blue LED improves wound healing in an excision model in rats. Injury. 2011;42(9):917-921. https://doi.org/10.1016/j.injury.2010.03.023
(23) Haskell WL, Lee IM, Pate RR, Powell KE, Blair SN, Franklin BA, et al. Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Med Sci Sports Exerc. 2007 Aug;39(8):1423-34. https://doi.org/10.1249/mss.0b013e3180616b27.
(24) Sigal RJ, Kenny GP, Wasserman DH, Castaneda-Sceppa C, White RD. Physical activity/exercise and type 2 diabetes: a consensus statement from the American Diabetes Association. Diabetes Care. 2006;29(6):1433–1438. https://doi.org/10.2337/dc06-9910
(25) Borg GA. Psychophysical bases of perceived exertion. Med Sci Sports Exerc. 1982;14(5):377-381. Cited: PMID: 7154893.
(26) Leal EC Jr, Vanin AA, Miranda EF, Carvalho PT, Corso SD, Bjordal JM. Effect of phototherapy (low-level laser therapy and light-emitting diode therapy) on exercise performance and markers of exercise recovery: a systematic review with meta-analysis. Lasers Med Sci. 2015;30(2):925-939. https://doi.org/10.1007/s10103-013-1465-4
(27) Ferraresi C, Hamblin MR, Parizotto NA. Low-level laser (light) therapy (LLLT) on muscle tissue: performance, fatigue and repair benefited by the power of light. Photonics Lasers Med. 2012;1(4):267-286. https://doi.org/10.1515/plm-2012-0032
(28) Costa IP, Politti F, Cahalin LP, Carvalho EFT, Costa D, Corrêa JCF, et al. Acute Effects Using Light-Emitting Diode Therapy (LEDT) for Muscle Function during Isometric Exercise in Asthma Patients: A Pilot Study. BioMed Research International. 2019;2019. https://doi.org/10.1155/2019/7501870.
(29) Ferraresi C, Beltrame T, Fabrizzi F, Nascimento ESP, Karsten M, Francisco CO, et al. Muscular pre-conditioning using light-emitting diode therapy (LEDT) for high-intensity exercise: a randomized double-blind placebo-controlled trial with a single elite runner. Physiother Theory Pract. 2015;31(5):354-361. https://doi.org/10.3109/09593985.2014.1003118
(30) Singh SJ, Morgan MD, Scott S, Walters D, Hardman AE. Development of a shuttle walking test of disability in patients with chronic airways obstruction. Thorax. 1992;47(12):1019-1024. https://doi.org/10.1136/thx.47.12.1019
(31) Thijssen DH, Black MA, Pyke KE, Padilla J, Atkinson G, Harris RA, et al. Assessment of flow-mediated dilation in humans: a methodological and physiological guideline. Am J Physiol Heart Circ Physiol. 2011;300(1):H2-12. https://doi.org/10.1152/ajpheart.00471.2010
(32) Gibbs BB, Dobrosielski DA, Bonekamp S, Stewart KJ, Clark JM. A randomized trial of exercise for blood pressure reduction in type 2 diabetes: effect on flow-mediated dilation and circulating biomarkers of endothelial function. Atherosclerosis. 2012;224(2): 446–453. https://doi.org/10.1016/j.atherosclerosis.2012.07.035
(33) Madsen SM, Thorup AC, Overgaard K, Bjerre M, Jeppesen PB. Functional and structural vascular adaptations following 8 weeks of low volume high intensity interval training in lower leg of type 2 diabetes patients and individuals at high risk of metabolic syndrome. Arch Physiol Biochem. 2015;121(5):178-186. https://doi.org/10.3109/13813455.2015.1087033
(34) Matsudo S, Araujo T, Matsudo V, Andrade D, Andrade E, Oliveira LC, et al. Questionário Internacional de Atividade Física (IPAQ): Estudo de validade e reprodutibilidade no Brasil. Rev Bras Atividade Física e Saúde. 2001;6(2):5-18. https://doi.org/10.12820/rbafs.v.6n2p5-18
(35) Craig CL, Marshall AL, Sjöström M, Bauman AE, Booth ML, Ainsworth BE, et al. International physical activity questionnaire: 12-country reliability and validity. Med Sci Sports Exerc. 2003;35(8):1381-1395. https://doi.org/10.1249/01.MSS.0000078924.61453.FB
(36) Ciconelli RM, Ferraz MB, Santos W, Meinão I, Quaresma MR. Tradução para língua portuguesa e validação do questionário genérico de avaliação de qualidade de vida SF-36 (Brasil SF-36). Rev Bras Reumatol. [Internet] 1999; 39(3):143-150. Available from: https://www.ufjf.br/renato_nunes/files/2014/03/Valida%C3%A7%C3%A3o-do-Question%C3%A1rio-de-qualidade-de-Vida-SF-36.pdf
(37) Terada T, Friesen A, Chahal BS, Bell GJ, McCargar LJ, Boule NG. Feasibility and preliminary efficacy of high intensity interval training in type 2 diabetes. Diabetes Res Clin Pract. 2013;99(2):120-129. https://doi.org/10.1016/j.diabres.2012.10.019
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Copyright (c) 2022 Cauê Padovani, Regiane Maria da Costa Arruda, Shane Phillips, Nivaldo Antonio Parizotto, Luciana Maria Malosá Sampaio
This work is licensed under a Creative Commons Attribution 4.0 International License.
This work is licensed under a Creative Commons Attribution 4.0 International License.