Handgrip Strength in Individuals with Long- Standing Type 2 Diabetes Mellitus: A preliminary report

Adequate muscle strength is required for optimum productivity and low muscle strength is a predictor of physical limitations. Individuals with long-standing type 2 diabetes mellitus have been found to have an increased risk of developing functional disabilities. Handgrip strength is a reliable measurement of the disability index. This study was designed to determine the effect of type 2 diabetes on handgrip strength in adults. Twenty adult patients with a clinical diagnosis of type 2 diabetes mellitus (10 males, mean age: 52.9 ± 9.01 years and 10 females, mean age: 52.6 ± 5.71 years) and 20 apparently healthy adults (10 males, mean age: 53.1 ± 8.94 years and 10 females, mean age 54.5yrs±5.56 years) who met the inclusion criteria participated in the study. Handgrip strength was measured with an isometric hand dynamometer and comparisons were made between diabetic and non-diabetic males as well as between diabetic and non-diabetic females. Thev independent t-test were used to analyse the significance difference in hand grip strength between the diabetic and the non- diabetic subjects (p=0.05). Results showed significant differences in the mean handgrip strength between the male diabetic and nondiabetic subjects (p<0.004), as well as between the female diabetic and non-diabetic subjects (p<0.002). Long-standing type 2 diabetes mellitus seems to result in a decrease in handgrip strength in both male and female adults. This physical limitation may contribute to low productivity in people with type 2 diabetes mellitus

Effect of behavior-change interventions on daily physical activity in patients with intermittent claudication:the OPTIMA systematic review and meta-analysis

Aims: The study aimed to synthesize evidence of daily physical activity (PA) following Behavior-change technique (BCT)-based interventions compared to any control in individuals with peripheral arterial disease/intermittent claudication (PAD/IC); and examine the relationship between BCTs and daily PA. Methods: Systematic search of 11 databases from inception to 30/11/2022 was conducted, plus weekly email alerts of new literature until 31/8/2023. Studies comparing BCT-based interventions with any control were included. Primary analysis involved a pairwise random-effects meta-analysis. Risk of bias was assessed using the Cochrane-RoB-2 and ROBINS-I tools. Certainty of evidence was evaluated with the GRADE system. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guideline was followed. Outcome measures were short-term (<6 months) change in daily PA, and maintenance of the daily PA (6 months or longer) reported as standardized mean differences (SMDs) with 95% confidence intervals (95%CIs). Results: Forty-one studies (4,339 patients; 26 RCTs/3,357 patients; 15 non-RCTs/982 patients; study mean age 60.3 to 73.8, 29.5% female) were included. Eleven RCTs (15 comparisons, 952 participants) suggested that BCT-based interventions increased daily PA in the short term compared to non-SET [increase of 0.20 SMD (95%CI: 0.07 to 0.33), ~473 steps/day] with high certainty. Evidence of maintenance of daily PA (≥6 months) is unclear [increase of 0.12 SMD (95%CI: -0.04 to 0.29); ~288 steps/day; 6RCTs, 8 comparisons, 899 participants], with moderate certainty. For daily PA, compared to SET it was inconclusive both for < 6months change [-0.13 SMD, 95%CI: -0.43 to 0.16); 3RCTs, 269 participants; low certainty] and ≥6months [-0.04 SMD, 95%CI: -0.55 to 0.47); 1 RCT, 89 participants; very low certainty]. It was unclear whether the number of BCTs or any BCT domain were independently related to an increase in PA. Conclusion: BCT-based interventions improve short-term daily PA in people with PAD/IC compared to non-SET controls. Evidence for maintenance of the improved PA at 6 months or longer and comparison with SET is uncertain. BCT-based interventions are effective choices for enhancing daily PA in PAD/IC

Are we missing opportunities? Physiotherapy and physical activity promotion: a cross-sectional survey

Abstract Background Physical activity (PA) promotion in healthcare is an important strategy for increasing PA levels. Physiotherapists are well-positioned to promote PA, however no studies have investigated PA promotion by physiotherapists Australia-wide. Methods An online survey of practicing Australian physiotherapists was conducted to investigate knowledge of the Australian Physical Activity and Sedentary Behaviour (PASB) guidelines and factors associated with increased promotion frequency. Participants were asked to state the PASB guidelines and a 4-component scoring system was used to measure knowledge. Multivariate logistic regression analysis was conducted to assess factors associated with frequency of promotion. Results 257 Australian physiotherapists completed the survey. Only 10% were able to accurately state the PASB guidelines and 54% reported promoting PA to 10 or more patients per month. Males were nearly three times more likely than females to promote PA to 10 or more patients per month (OR 2.68, 95% CI 1.25–5.74). Those who lacked counselling skills and felt PA promotion wouldn’t change their patients’ behaviour were much less likely to promote PA. Conclusion Australian physiotherapists have poor knowledge of the Australian PASB guidelines and infrequently promote PA. Education and training in PA counselling and behaviour change strategies is indicated to enhance PA promotion by Australian physiotherapists