ORIGINAL ARTICLE   Open access

European Journal of Physical and Rehabilitation Medicine 2023 October;59(5):628-39

DOI: 10.23736/S1973-9087.23.07855-3

Copyright © 2023 THE AUTHORS

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language: English

Efficacy of supervised home-based, real time, videoconferencing telerehabilitation in patients with type 2 diabetes: a single-blind randomized controlled trial

Christina BLIOUMPA ¹, Evmorfia KARANASIOU ¹, Varsamo ANTONIOU ¹, Ladislav BATALIK ^{2, 3}, Konstantinos KALATZIS ⁴, Leonidas LANARAS ⁵, Garyfallia PEPERA ¹ ✉

¹ Clinical Exercise Physiology and Rehabilitation Laboratory, Department of Physiotherapy, Faculty of Health Sciences, University of Thessaly, Lamia, Greece; ² Department of Public Health, Faculty of Medicine, Masaryk University, Brno, Czech Republic; ³ Department of Rehabilitation, University Hospital of Brno, Brno, Czech Republic; ⁴ Medical Diabetology Practice, Lamia, Greece; ⁵ Department of Internal Medicine, General Hospital of Lamia, Lamia, Greece

BACKGROUND: Exercise-based interventions prevent or delay symptoms and complications of type 2 diabetes (T2D) and are highly recommended for T2D patients; though with very low participation rates. Τelerehabilitation (TR) could act as an alternative to overcome the barriers preventing the promotion of T2D patients’ well-being.
AIM: Determine the effects of a six-week TR program on glycemic control, functional capacity, muscle strength, PA, quality of life and body composition in patients with T2D.
DESIGN: A multicenter randomized, single-blind, parallel-group clinical study.
SETTING: Clinical trial.
POPULATION: Patients with T2D.
METHODS: Thirty T2D patients (75% male, 60.1±10.9 years) were randomly allocated to an intervention group (IG) and a control group (CG) with no exercise intervention. IG enrolled in a supervised, individualized exercise program (combination of aerobic and resistance exercises), 3 times/week for 6 weeks at home via a TR platform. Glycated hemoglobin (HbA1c), six-minute walk test (6MWT), muscle strength (Hand Grip Strength Test [HGS], 30-Second Chair Stand test [30CST] physical activity [IPAQ-SF]), quality of life (SF-36) and anthropometric variables were assessed.
RESULTS: Two-way repeated-ANOVA showed a statistically significant interaction between group, time and test differences (6MWT, muscle strength) (V=0.33, F [2.17]=4.14, P=0.03, partial η²=0.22). Paired samples t-test showed a statistically significant improvement in HbA1c (Z=-2.7), 6MWT (Μean ∆=-36.9±27.2 m, t=-4.5), muscle strength (Μean ∆=-1.5±1.4 kg, t=-2.22). Similarly, SF-36 (mental health [Μean ∆=-13.3±21.3%], general health [Μean ∆=-11.4±16.90%]) were statistically improved only in IG.
CONCLUSIONS: The findings of this study indicate that a 6-week supervised home-based TR exercise program induced significant benefits in patients with T2D, thus enabling telehealth implementation in rehabilitation practice as an alternative approach.
CLINICAL REHABILITATION IMPACT: Home-based exercise via the TR platform is a feasible and effective alternative approach that can help patients with T2D eliminate barriers and increase overall rehabilitation utilization.

KEY WORDS: Telerehabilitation; Diabetes mellitus, type 2; Walk test