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Cardiac autonomic recovery in response to aerobic versus resistance exercise in type 2 diabetes mellitus patients

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International Journal of Diabetes in Developing Countries Aims and scope Submit manuscript

Abstract

Purpose

To investigate the effect of aerobic exercise (AE) versus resistance exercise (RE) on outcomes of cardiac autonomic recovery in type 2 diabetes mellitus (T2DM) patients with cardiac autonomic neuropathy (CAN).

Methods

Fifty T2DM patients with CAN (age: 52.2 ± 6.8 years) were recruited for the present study. They were randomly allocated into two groups: AE (n = 25) and RE (n = 25). The AE group performed graded maximal exercise test using Balke protocol while the RE group performed 5 sets of leg press exercise at 10 repetition maximum (RM) intensity. Heart rate variability (HRV) was assessed for 10 min after both exercise bouts while heart rate recovery (HRR) was recorded for the first 3 min after completion of the exercise bouts. Key outcome measures for the study were standard time and frequency domain parameters of HRV and HRR1min, HRR2min, and HRR3min. Standard statistical analysis which included independent t-test and repeated measures analysis of variance was performed in order to test the study hypothesis.

Results

Significant impairment was observed in both HRV and HRR after both AE and RE (p < 0.05). However, alterations in both HRV and HRR responses were found to be more after AE as compared to RE (p < 0.05) in T2DM patients with CAN.

Conclusion

Findings of the present study suggest significant blunting of autonomic responses after both AE and RE in T2DM patients with CAN. However, deterioration in them was found to be more after AE as compared to the RE indicating that AE may pose greater stress on the cardiovascular system of T2DM patients with CAN.

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Abbreviations

30:15 ratio:

Ratio of the longest R-R interval during 30 s and the shortest R-R interval during 15th second of the head-up tilt test

AE:

Aerobic exercise

ANCOVA:

Analysis of covariance

ANS:

Autonomic nervous system

BP:

Blood pressure

BRS:

Baroreflex sensitivity

CAN:

Cardiac autonomic neuropathy

CARTs:

Cardiovascular autonomic reflex tests

CVD:

Cardiovascular disease

DBP:

Diastolic blood pressure

DBT:

Deep breathing test

E:I ratio:

Ratio of the average of longest R-R interval during expiration and the shortest R-R interval during inspiration of the deep breathing test

ECG:

Electrocardiogram

HF:

High frequency

HGT:

Hand grip test

HR:

Heart rate

HRR:

Heart rate recovery

HRV:

Heart rate variability

HUT:

Head-up tilt

LF/HF ratio:

Ratio of low- and high-frequency power

LF:

Low frequency

Mean NN:

Average of N–N intervals

MHR:

Maximal heart rate

pNN50:

Proportion of differences in consecutive N–N intervals that are longer than 50 ms

PNS:

Parasympathetic nervous system

RE:

Resistance exercise

RM:

Repetition maximum

RMSSD:

Root mean square of successive differences between adjacent R-R intervals

SBP:

Systolic blood pressure

SDNN:

Standard deviation of N–N intervals

SNS:

Sympathetic nervous system

T2DM:

Type 2 diabetes mellitus

TP:

Total power

VM:

Valsalva maneuver

VR:

Valsalva ratio

ΔHR:

Change in R-R intervals during six consecutive cycles of deep inspiration and expiration

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Acknowledgements

A sincere thanks to Jamia Millia Islamia (A Central University) for providing logistic help during this study. We would also like to extend our gratitude to the University Grants Commission, India, for providing fellowship to author P. B. during this study.

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Authors and Affiliations

  1. Faculty of Physiotherapy, Shree Guru Gobind Singh Tricentenary University, Gurugram, Haryana-122505, India

    Pooja Bhati

  2. Faculty of Allied Health Sciences, Shree Guru Gobind Singh Tricentenary University, Gurugram, Haryana-122505, India

    M. Ejaz Hussain

Authors
  1. Pooja Bhati
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  2. M. Ejaz Hussain
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Corresponding author

Correspondence to M. Ejaz Hussain.

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Ethics approval and consent to participate

The present trial was ethically approved by the Institutional Ethics Committee, Jamia Millia Islamia (A Central University), New Delhi, India. A written informed consent was obtained from each participant for their participation in the study.

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Not applicable.

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The authors declare no competing interests.

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Bhati, P., Hussain, M.E. Cardiac autonomic recovery in response to aerobic versus resistance exercise in type 2 diabetes mellitus patients. Int J Diabetes Dev Ctries 42, 552–559 (2022). https://doi.org/10.1007/s13410-021-01013-8

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