Diabetes and therapeutic exercise

Diabetes mellitus is the ninth leading cause of mortality in the world today. It is an epidemic that has quadrupled its prevalence in the last three decades. This increase is observed especially in type II diabetes, coinciding with an increase in the prevalence of obesity in both developed and developing countries.

The therapeutic strategy must be comprehensive and includes, together with pharmacotherapy, introducing the patient to a self-care education program, smoking cessation, as well as the substitution of bad eating habits and sedentary habits towards a balanced diet and an active life. (American Diabetes Association, 2018).

Studies investigating perceived barriers and facilitators of diabetic patients engaging in exercise suggest that support from family members and a greater overall sense of well-being and fitness were the main factors associated with greater exercise adherence (Sasan A et al, 2020), as well as recommending the use of new portable technologies and web applications to enhance education and encourage patients to exercise and adhere to their treatment guidelines. (American Diabetes Association, 2019).

Therapeutic exercise recommendations range from moderate aerobic exercise to strength training. Aerobic exercises are activities that involve more muscles and rely primarily on energy generated by aerobic metabolism. The intensity of the training can vary from mild to vigorous intensity and generally involves a long duration.

Resistance training includes activities aimed at improving muscular power and endurance through the use of one’s own body weight, machines or elastic bands.

Exercise protocols in diabetes mellitus

Physical exercise is a tool for both prevention and treatment when it comes to diabetes. It is capable of reversing pre-diabetes states and improving the quality of life and life expectancy of the diabetic patient.

Evidence suggests that the protocolization and supervision of therapeutic exercise programs substantially increases adherence to therapeutic exercise in patients with this pathology compared to uncontrolled groups (Bei P et al, 2018).

Physiotherapy undoubtedly plays an important role in the prevention, treatment and management of diabetes mellitus and its associated complications. Physiotherapy management techniques and rehabilitation interventions, including exercise prescription and education, will help facilitate patient participation in programs that improve and maintain physical well-being, which has a significant impact on the patient’s activities of daily living.

The recommendations of the American Diabetes Association (ADA) regarding the creation of therapeutic exercise protocols in physiotherapy (Yitayeh A et al, 2017) would be as follows:

  • Encourage the patient to increase physical activity and reduce sedentary time.
  • Initiate you into a regular physical activity program: 3 to 4 days a week, 10 to 15 minutes per session.
  • Introduce also preliminary resistance exercise: it can be performed 1 to 2 days a week, for 15 to 30 minutes.
  • Implement aerobic exercise with a minimum duration of 30 minutes per session, 5 days a week.
  • Condition you to perform regular resistance exercise for a minimum of 30 minutes per session up to 2 or more days per week.

TRAK: the app to increase adherence

As we have mentioned, the evidence supports the use of web applications to increase adherence to treatment in patients with diabetes mellitus.

In this context we present TRAK, the telerehabilitation software, as a tool to ensure the monitoring and correct application of the therapeutic exercise protocols prescribed to diabetics.

Without the need for other detection devices and only with the camera of a laptop, tablet or smartphone, TRAK’s artificial intelligence identifies up to 20 joint points of the patient and corrects their movements in real time while obtaining metrics and measurements of range of motion and adherence that it will then send to the healthcare professional for study.

It also has an alert system so that patients do not forget their session and an integrated chat that will put them in contact with the professional handling their case whenever they need it.

Do not hesitate and join digital physiotherapy!

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