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Universidad Autnoma de Chihuahua
Facultad de Educacin Fsica y Ciencias del DeporteLaboratorio para la Actividad Fsica y la Salud
Exercise Training Diabetes type 2
Recommendation (ACSM, 2010)
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Aerobic Exercise Training Recommendation
Frequency
Aerobic exercise should beperformed at least 3 d/wk.
Most clinical trials
evaluating exerciseinterventions in T2DM haveused a frequency of threetimes per week, but currentguidelines for adultsgenerally recommend fivesessions of moderateactivity.
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Aerobic Exercise Training Recommendation
Intensity
Aerobic exercise should be at least at moderate intensity,corresponding approximately to 40%60% of VO2max (maximalaerobic capacity).
For most people with T2DM, brisk walking is a moderate-intensityexercise. Additional benefits may be gained from vigorous exercise(>60% of VO2max).
A meta analysis showed that exercise intensity predicts
improvements in overall BG control to a greater extent thanexercise volume, suggesting that those already exercising at amoderate intensity should consider undertaking some vigorous PAto obtain additional BG (and likely CV) benefits.
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Aerobic Exercise Training Recommendation
Duration.
Individuals with T2DM should engage in a minimum of 150 min/wkof exercise undertaken at moderate intensity or greater.
Aerobic activity should be performed in bouts of at least 10 min andbe spread throughout the week.
Around 150 min/wk of moderate-intensity exercise is associatedwith reduced morbidity and mortality in observational studies in allpopulations.
The average weekly duration in meta-analyses of exerciseinterventions in T2DM, including higher-intensity aerobic exercise,has been in a similar range.
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Aerobic Exercise Training Recommendation
Mode
Any form of aerobicexercise (including brisk
walking) that uses largemuscle groups andcauses sustainedincreases in HR is likelyto be beneficial, andundertaking a variety ofmodes of PA isrecommended.
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Aerobic Exercise Training Recommendation
Rate of progression.
At present, no study onindividuals with T2DM hascompared rates of
progression in exerciseintensity or volume.
Gradual progression of bothis advisable to minimize therisk of injury, particularly ifhealth complications arepresent, and to enhancecompliance.
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Aerobic Exercise Training Recommendation
Body weight loss andmaintenance.
The most successfulweight control programs
involve combinations ofexercise, diet, andbehavior modification.People who successfully
maintain a large weightloss report exercisingabout 7 h/wk.
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Resistance Exercise Training Recommendation
Frequency
Resistance exercise should
be undertaken at least twice
weekly on nonconsecutive
days
Ideally three times a week
as part of a PA program for
individuals with T2DM,
along with regular aerobic
activities.
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Resistance Exercise Training Recommendation
Intensity
Training should be moderate(50% of 1-repetitionmaximum, or 1-RM) orvigorous (75%80% of 1-RM)
for optimal gains in strengthand insulin action.
Home-based resistancetraining following supervised,gym-based training may beless effective for maintaining
BG control but adequate formaintaining muscle mass andstrength.
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Resistance Exercise Training Recommendation
Duration
Each training session shouldminimally include 510 exercisesinvolving the major musclegroups (in the upper body, lowerbody, and core) and involve
completion of 1015 repetitionsto near fatigue per set early intraining, progressing over time toheavier weights (or resistance)that can be lifted only 810times.
A minimum of one set ofrepetitions to near fatigue, but asmany as three to four sets, isrecommended for optimalstrength gains.
Mode
Resistance machines and freeweights (e.g.,dumbbells andbarbells) can result in fairlyequivalent gains in strength andmass of targeted muscles.
Heavier weights or resistancemay be needed for optimizationof insulin action and BG control.
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Resistance Exercise Training Recommendation
Rate of progression
To progression of intensity, frequency, and duration oftraining sessions should occur slowly.
In most progressive training, increases in weight or
resistance are undertaken first and only once when thetarget number of repetitions per set can consistently beexceeded, followed by a greater number of sets andlastly by increased training frequency.
Progression for 6 months to thrice-weekly sessions of
three sets of 810 repetitions done at 75% to 80% of 1-RM on 810 exercises may be an optimal goal.
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Flexibility Training recommendation
Flexibility training may be included as part of a PA program, although itshould not substitute for other training.
Older adults are advised to undertake exercises that maintain or improvebalance, which may include some flexibility training, particularly for manyolder individuals with T2DM with a higher risk of falling.
Although flexibility exercise (stretching) has frequently beenrecommended as a means of increasing joint range of motion (ROM) andreducing risk of injury, two systematic reviews found that flexibilityexercise does not reduce risk of exercise induced injury.
Flexibility exercise combined with resistance training can increase ROM inindividuals with T2DM and allow individuals to more easily engage inactivities that require greater ROM around joints.
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Flexibility Training recommendation
Frecuencia: ( 2-3 das por semana) incluir en elentrenamiento diario.
Intensidad: Debe sentirse el esfuerzo y un ligero dolor
Tiempo: Flexibilidad esttica (10-30segundos), propioceptiva
de 3-6 segundos. Tipo: grandes y pequeos grupos musculares (esttica,
dinmica o propioceptiva)
Volumen: de 10 hasta 60 segundos
Patrn de progresin: de 2 a 4 veces por ejercicio
Se recomienda hacer ejercicio aerobio ligero/moderado antesde realizar ejercicios de flexibilidad, saunas o baos calientes.
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Escala de Percepcin de Esfuerzo
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Escala de Percepcin de Esfuerzo
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Clasificacin de la intensidad del ejercicio en FCR, Fcmaxma, VO2
Max y EPE (ACSM, 2011)
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Programacin del ejercicio
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