Effect of Isometric and Dynamic Resistance Exercises on Functional Performance and Glycoprotein-bound Haemoglobin of Type 2 Diabetes Mellitus Patients with Knee Osteoarthritis: An Interventional Study

Abstract

Introduction: Osteoarthritis (OA) is the most prevalent articular and rheumatologic condition, impacting over 80% of individuals aged 55 and above. There exists a significant correlation between Type 2 Diabetes Mellitus (T2DM) and OA. Both Diabetes Mellitus (DM) and OA are common afflictions. Physiotherapy plays a crucial role in alleviating pain and mitigating issues linked to the early stages of knee OA and DM. The rationale of this study is to determine whether isometric resistance exercise can achieve comparable or superior outcomes to dynamic resistance exercise in terms of long-term glycaemic control and physical function, while also being more tolerable for individuals with knee OA. Aim: To compare the efficacy of resistance exercises in diabetic patients with knee OA and specifically to examine how two resistance exercise protocols influence glycated haemoglobin (HbA1c) levels and functional performance. Materials and Methods: An interventional study was conducted using a convenience sampling technique. Approximately, 30 subjects were selected from the primary physiotherapy outpatient department in Chennai, Tamil Nadu, India. The study lasted for 12 weeks, from July 2022 to September 2022. The total population was split into two groups: Group-A received dynamic resistance exercises, whereas Group-B underwent isometric resistance exercises. Both pre- and post-treatment evaluations were performed using the Western Ontario and McMaster Universities OA Index questionnaire (WOMAC), alongside measuring HbA1c levels in all participants. Care instructions emphasised weight reduction, maintaining a balanced diet, and avoiding prolonged periods of standing. Paired t test was used to compare the pre and post test WOMAC scores and p<0.05 was considered statistically significant. Results: Significant changes were observed in WOMAC scores and HbA1c pre-post comparison. The study revealed a statistically significant difference in reducing pain, enhancing functional performance, and lowering HbA1c levels among both groups (p≤0.001). Conclusion: The results indicate that both groups experienced effective pain relief and reduced HbA1c levels after the treatment period. However, subjects treated with dynamic resistance exercises demonstrated greater enhancements in functional performance and reductions in HbA1c levels compared to the isometric resistance exercises.

Keywords

• mcmaster universities osteoarthritis index
• quality of life
• resistance exercises
• western ontario