Impact of a community-based exercise programme on physical fitness in middle-aged and older patients with type 2 diabetes

Objectives: Physical fitness is related to all-cause mortality, quality of life and risk of falls in patients with type 2 diabetes. This study aimed to analyse the impact of a long-term community-based combined exercise program (aerobic + resistance + agility/balance + flexibility) developed with minimum and low-cost material resources on physical fitness in middle-aged and older patients with type 2 diabetes. Methods: This was a non-experimental pre-post evaluation study. Participants (N = 43; 62.92 ± 5.92 years old) were engaged in a community-based supervised exercise programme (consisting of combined aerobic, resistance, agility/balance and flexibility exercises; three sessions per week; 70 min per session) of 9 months' duration. Aerobic fitness (6-Minute Walk Test), muscle strength (30-Second Chair Stand Test), agility/balance (Timed Up and Go Test) and flexibility (Chair Sit and Reach Test) were assessed before (baseline) and after the exercise intervention. Results: Significant improvements in the performance of the 6-Minute Walk Test (Δ = 8.20%, p < 0.001), 30-Second Chair Stand Test (Δ = 28.84%, p < 0.001), Timed Up and Go Test (Δ = 14.31%, p < 0.001), and Chair Sit and Reach Test (Δ = 102.90%, p < 0.001) were identified between baseline and end-exercise intervention time points. Conclusions: A long-term community-based combined exercise programme, developed with low-cost exercise strategies, produced significant benefits in physical fitness in middle-aged and older patients with type 2 diabetes. This supervised group exercise programme significantly improved aerobic fitness, muscle strength, agility/balance and flexibility, assessed with field tests in community settings.

"Learning together, growing with family": the implementation and evaluation of a family support programme

The "Learning together, growing with family" programme is targeted to at-risk parents and children from 6 to 11 years old, with a preventive focus on promoting positive parent-child relationships. In this study, we examined the quality of the programme implementation and its influence on the programme results in a sample of 425 parents and 138 facilitators drawn from the first trial. Mixed methods were used, consisting of: parental self-reports on parenting dimensions, professionals' records on parental attendance and appraisals on six topics of the implementation process, and focus group discussions in which facilitators reported on the initial steps of the implementation. Results showed a high quality of implementation with respect to the group facilitator and the programme organization factors, followed by the coordination with services and the support facilities offered to participants and, finally, by the factors of fidelity and prior organization steps. Results of the focus groups confirmed that the prior steps were challenging and offered the more effective strategies. Better quality in the implementation factors predicted better parenting styles and parental competencies after the programme, as well as a higher attendance rate. In sum, this study demonstrates the importance of good implementation in at-risk contexts and provides some clues as to the key elements that moderate programme effectiveness.