دوره 29، شماره 142: هفته دوم مرداد ماه 1390:722-732

تأثیر 8 هفته ورزش در آب بر فاکتورهای فیزیولوژیکی منتخب و قند خون بیماران مبتلا به دیابت نوع II

ناصر رحیمی, سید محمد مرندی, مهدی کارگرفر

چکیده


مقدمه: با وجودی که از دیرباز نقش فعالیت بدنی در کنترل و بهبود دیابت نوع II و افزایش حساسیت انسولین مورد توجه بوده است، ولی انجام فعالیت‌های ورزشی در محیط‌های آبی با توجه به وضعیت روحی و جسمانی این بیماران کمتر مورد بررسی قرار گرفته است. بنابراین هدف از انجام تحقیق حاضر، بررسی تأثیر 8 هفته ورزش در آب بر روی عوامل فیزیولوژیک منتخب و قند خون در بیماران مبتلا به دیابت نوع II بود.

روش‌ها: در این تحقیق نیمه تجربی، از بین مردان 50 تا60 ساله‌ی مبتلا به دیابت نوع II شهرستان خمینی‌شهر، تعداد30 نفر به صورت داوطلبانه و در دسترس انتخاب و در دو گروه مداخله (15بیمار) و شاهد (15بیمار) قرار گرفتند. گروه تجربی به مدت 8 هفته (3جلسه در هفته، هر جلسه 45 تا60 دقیقه با شدت 80-60 درصد حداکثر ضربان قلب) تمرینات ورزشی ویژه در آب انجام دادند، در حالی که گروه شاهد هیچ فعالیت بدنی منظمی‌نداشتند. در این تحقیق متغیرهای مورد بررسی شامل وزن، شاخص توده‌ی بدنی، حداکثر اکسیژن مصرفی، فشار خون سیستول و دیاستول، قندخون ناشتا و همچنین هموگلوبین گلیگوزیله‌، قبل و بعد از دوره‌ی تمرینی اندازه‌گیری شد. در نهایت داده‌ها با استفاده‌ از آزمون ANCOVA مورد تجزیه و تحلیل آماری قرار گرفت.

یافته‌ها: نتایج تحقیق بیانگر تفاوت معنی‌داری بین میانگین حداکثر اکسیژن مصرفی، فشار خون سیستول، دیاستول، قندخون ناشتا و هموگلوبین گلیگوزیله بین دو گروه‌ه تجربی و شاهد بود، در حالی که این تفاوت در متغیرهای وزن و شاخص توده‌ی بدنی در گروه معنی‌دار نبود (05/0 > P).

نتیجه‌گیری: نتایج تحقیق نشان داد که یک دوره‌ی ورزش در آب باعث بهبود معنی‌دار میزان قند خون بیماران مبتلا به دیابت II می‌گردد.


واژگان کلیدی


ديابت نوع II؛ عوامل فيزيولوژيکي منتخب؛ ورزش در آب؛ قند خون

تمام متن:

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مراجع


American Diabetes Association: clinical practice recommendations 1999. Diabetes Care 1999; 22(Suppl 1): S1-114.

Lambers S, Van Laethem C, Van Acker K, Calders P. Influence of combined exercise training on indices of obesity, diabetes and cardiovascular risk in type 2 diabetes patients. Clin Rehabil 2008; 22(6): 483-92.

Grundy SM, Benjamin IJ, Burke GL, Chait A, Eckel RH, Howard BV, et al. Diabetes and cardiovascular disease: a statement for healthcare professionals from the American Heart Association. Circulation 1999; 100(10): 1134-46.

Yang K, Bernardo LM, Sereika SM, Conroy MB, Balk J, Burke LE. Utilization of 3-month Yoga Program for Adults at High Risk for Type 2 Diabetes: A Pilot Study. Evid Based Complement Alternat Med 2009.

Larijani B, Abolhasani F, Mohajeri-Tehrani MR, Tabtabaie O. Prevalece of Diabetes Mellitus in Iran in 2000. Iranian Journal of Diabetes and Lipid Disorders 2005; 4(3): 75-83.

Kim HJ, Lee JS, Kim CK. Effect of exercise training on muscle glucose transporter 4 protein and intramuscular lipid content in elderly men with impaired glucose tolerance. Eur J Appl Physiol 2004; 93(3): 353-8.

Gordon LA, Morrison EY, McGrowder DA, Young R, Fraser YT, Zamora EM, et al. Effect of exercise therapy on lipid profile and oxidative stress indicators in patients with type 2 diabetes. BMC Complement Altern Med 2008; 8: 21.

Peirce NS. Diabetes and exercise. Br J Sports Med 1999; 33(3): 161-72.

Carey VJ, Walters EE, Colditz GA, Solomon CG, Willett WC, Rosner BA, et al. Body fat distribution and risk of non-insulin-dependent diabetes mellitus in women. The Nurses' Health Study. Am J Epidemiol 1997; 145(7): 614-9.

Stortenbeek AJ, van den Hamer CJ. Binders of intravenously administered 65-zinc in rat liver cytoplasm. Bioinorg Chem 1976; 6(4): 313-27.

Da Costa D, Dritsa M, Ring A, Fitzcharles MA. Mental health status and leisure-time physical activity contribute to fatigue intensity in patients with spondylarthropathy. Arthritis Rheum 2004; 51(6): 1004-8.

Sigal RJ, Kenny GP, Wasserman DH, Castaneda-Sceppa C. Physical activity/exercise and type 2 diabetes. Diabetes Care 2004; 27(10): 2518-39.

Eves ND, Plotnikoff RC. Resistance training and type 2 diabetes: Considerations for imple-mentation at the population level. Diabetes Care 2006; 29(8): 1933-41.

Vickers KS, Nies MA, Patten CA, Dierkhising R, Smith SA. Patients with diabetes and depression may need additional support for exercise. Am J Health Behav 2006; 30(4): 353-62.

Raffaelli C, Lanza M, Zanolla L, Zamparo P. Exercise intensity of head-out water-based activities (water fitness). Eur J Appl Physiol 2010; 109(5): 829-38.

Sharifi Gh, Yazdani F, Shokravi M. Fild and laboratory tests in exercise physiology. 1st ed. Isfahan: Islamic azad university khorasgan branch; 2007. p. 67.

Tokmakidis SP, Zois CE, Volaklis KA, Kotsa K, Touvra AM. The effects of a combined strength and aerobic exercise program on glucose control and insulin action in women with type 2 diabetes. Eur J Appl Physiol 2004; 92(4-5): 437-42.

Misra A, Alappan NK, Vikram NK, Goel K, Gupta N, Mittal K, et al. Effect of supervised progressive resistance-exercise training protocol on insulin sensitivity, glycemia, lipids, and body composition in Asian Indians with type 2 diabetes. Diabetes Care 2008; 31(7): 1282-7.

Cauza E, Hanusch-Enserer U, Strasser B, Ludvik B, Metz-Schimmerl S, Pacini G, et al. The relative benefits of endurance and strength training on the metabolic factors and muscle function of people with type 2 diabetes mellitus. Arch Phys Med Rehabil 2005; 86(8): 1527-33.

Vasheghani Farahani A, Mansournia MA, Asher H, Fotouhi A, Yunesian M, Jamali M, et al. The Effects of a 10-Week Water Aerobic Exercise on the Resting Blood Pressure in Patients with Essential Hypertension. Asian Journal of Sports Medicine 2010; 1(3): 159-67.

Dunstan DW, Daly RM, Owen N, Jolley D, De Court, Shaw J, et al. High-intensity resistance training improves glycemic control in older patients with type 2 diabetes. Diabetes Care 2002; 25(10): 1729-36.

Cuff DJ, Meneilly GS, Martin A, Ignaszewski A, Tildesley HD, Frohlich JJ. Effective exercise modality to reduce insulin resistance in women with type 2 diabetes. Diabetes Care 2003; 26(11): 2977-82.

Romijn JA, Coyle EF, Sidossis LS, Rosenblatt J, Wolfe RR. Substrate metabolism during different exercise intensities in endurance-trained women. J Appl Physiol 2000; 88(5): 1707-14.

Boule NG, Kenny GP, Haddad E, Wells GA, Sigal RJ. Meta-analysis of the effect of structured exercise training on cardiorespiratory fitness in Type 2 diabetes mellitus. Diabetologia 2003; 46(8): 1071-81.

Kirk A, Mutrie N, MacIntyre P, Fisher M. Increasing physical activity in people with type 2 diabetes. Diabetes Care 2003; 26(4): 1186-92.

Khan S, Rupp J. The effect of exercise conditioning, diet, and drug therapy on glycosylated hemoglobin levels in type 2 (NIDDM) diabetics. J Sports Med Phys Fitness 1995; 35(4): 281-8.

Bweir S, Al Jarrah M, Almalty AM, Maayah M, Smirnova IV, Novikova L, et al. Resistance exercise training lowers HbA1c more than aerobic training in adults with type 2 diabetes. Diabetol Metab Syndr 2009; 1: 27.

Jarrett RJ. Cardiovascular disease and hypertension in diabetes mellitus. Diabetes Metab Rev 1989; 5(7): 547-58.

Tanaka H, Bassett DR, Jr., Howley ET, Thompson DL, Ashraf M, Rawson FL. Swimming training lowers the resting blood pressure in individuals with hypertension. J Hypertens 1997; 15(6): 651-7.

Adler AI, Stratton IM, Neil HA, Yudkin JS, Matthews DR, Cull CA, et al. Association of systolic blood pressure with macrovascular and microvascular complications of type 2 diabetes (UKPDS 36): prospective observational study. BMJ 2000; 321(7258): 412-9.

Estacio RO, Jeffers BW, Gifford N, Schrier RW. Effect of blood pressure control on diabetic microvascular complications in patients with hypertension and type 2 diabetes. Diabetes Care 2000; 23 Suppl 2: B54-B64.

Schotte DE, Stunkard AJ. The effects of weight reduction on blood pressure in 301 obese patients. Arch Intern Med 1990; 150(8): 1701-4.

Chen H, Chen YL, Huang CY, Lee CD, Chen SC, Kuo SH. Effects of One-Year Swimming Training on Blood Pressure and Insulin Sensitivity in Mild Hypertensive Young Patients. Chinese Journal of Physiology 2011; 33(3): 185-9.

Andreazzi AE, Scomparin DX, Mesquita FP, Balbo SL, Gravena C, De Oliveira JC, et al. Swimming exercise at weaning improves glycemic control and inhibits the onset of onosodium L-glutamate-obesity in mice. J Endocrinol 2009; 201(3): 351-9.

Mahmoud Sh, Kader AE, Abdullah Gari M. Metabolic Control Response to Weight Reduction in Obese Non-Insulin Dependent Diabetic Patients. World Journal of Medical Sciences 2009; 4(2): 98-103.

Hashemi M, Bayat M, Azizi Saraji AR, Entezari M. The Effect of Swimming Exercise on Experimental Diabetic Myopathy in Rats. World Journal of Zoology 2009; 4(3): 216-22.

Taguchi T, Kishikawa H, Motoshima H, Sakai K, Nishiyama T, Yoshizato K, et al. Involvement of bradykinin in acute exercise-induced increase of glucose uptake and GLUT-4 translocation in skeletal muscle: studies in normal and diabetic humans and rats. Metabolism 2000; 49(7): 920-30.

Zhang QJ, Li QX, Zhang HF, Zhang KR, Guo WY, Wang HC, et al. Swim training sensitizes myocardial response to insulin: role of Akt-dependent eNOS activation. Cardiovasc Res 2007; 75(2): 369-80.

Ersoy C, Imamoglu S, Budak F, Tuncel E, Erturk E, Oral B. Effect of amlodipine on insulin resistance & tumor necrosis factor-alpha levels in hypertensive obese type 2 diabetic patients. Indian J Med Res 2004; 120(5): 481-8.

Shenoy S, Arora E, Jaspal S. Effects of progressive resistance training and aerobic exercise on type 2 diabetics in Indian population. Int J Diabetes & Metabolism 2009; 17: 27-30.




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