| Objectives1.To construct a multicomponent exercise training program for elderly diabetic patients with frailty in the community.2.To explore the effects of multicomponent exercise training on frailty status,blood glucose,physical function and quality of life among elderly diabetic patients with frailty in the community.Methods1.The content analysis was used to construct the first draft of multicomponent exerxise training program;Fifteen experts were invited to demonstrate and revise the first draft of the intervention program using two rounds of expert letter consultation;Eight elderly diabetic patients with frailty in the community who met the inclusion and exclusion criteria were selected for the preliminary test,and the test draft of the multicomponent exercise training program was further modified and perfected.2.Taking the opportunity of community annual health examination,free community clinic and resident health records,94 patients were recruited from four community health service stations affiliated to East Hanghai Road Community Health Service Center in Zhengzhou.We adopted the residence grouping method,bounded by Weilai Road in Zhengzhou,and divided patients into intervention group(47 cases)and control group(47 cases).The control group received routine community care,on this basis,the intervention group implemented 12 weeks(three times a week)of multicomponent exercise training and 3 times(once a month)of group exercise health education.To evaluate the effects of multicomponent exercise training on elderly diabetic patients with frailty in the community,the indicators of the Chinese version of Tilburg Frailty Indicator,Short Physical Performance Battery,handgrip strength,walking speed,fasting blood glucose and Diabetes Specific Quality of Life Scale were assessed at baseline,at 1 month,at 3 months.The methods of descriptive statistics,chi-square test,Mann-Whiteney U rank sum test,t test,repeated measurement of variance analysis and generalized estimation equation analysis were mainly used for statistical analysis.Results1.Construction of intervention program(1)In the literature study,11 literatures were finally included and the first draft of the intervention program was extracted,including 2 primary indicators,7 secondary indicators and 17 tertiary indicators.(2)The two rounds of Delphi response rate were 100%and the expert group authority coefficient was 0.87.The Kendall’W was 0.122 and 0.127 respectively.After the first round of Delphi expert consultation,5 indicators were modified,11 indicators were added.After the second round of Delphi,There was no indicators were modified.The multicomponent exercise training program include 2 primary indicators,9 secondary indicators and 26 tertiary indicators.(3)Through the preliminary test of 8 elderly diabetic patients with frailty in the community,the final test draft of the multicomponent exercise training program was formed,including three parts:regular health education,group exercise health education and multicomponent exercise training.2.Quasi-experimental studyAmong the 94 patients,3 patients of the intervention group and 2 patients of the control group were lost to follow-up.Finally,a total of 89 patients were fully involved in the study,including 45 cases in the control group and 44 cases in the intervention group.(1)The total score of the Chinese version of Tilburg Frailty Indicator,physical frailty score and psychological frailty score between the two groups were statistically significant in group effect,time effect and interaction effect at each time point(P<0.05).The time effect of social frailty score was statistically significant(P<0.05),but there was no statistically significant difference in the group effect and interaction effect(P>0.05).(2)There were statistically significant differences between the two groups in the total score of Short Physical Performance Battery and the score of each dimension,handgrip strength,walking speed,fasting blood glucose,the total score of Diabetes Specific Quality of Life Scale and the score of each dimension in the group effect,time effect and interaction effect(P<0.05).(3)At 1 month and 3 months of intervention compared with the baseline,at 3 months of intervention compared with 1 month of intervention,the total score of the Chinese version of Tilburg Frailty Indicator,physical frailty score and psychological frailty score were decreased significantly(P<0.001).The score of social frailty at 3 months was lower than that at baseline(P<0.05),but at 1 month of intervention compared with the baseline,at 3 months of intervention compared with 1 month of intervention,the difference was not statistically significant(P>0.05).(4)At 1 month and 3 months of intervention compared with the baseline,at 3 months of intervention compared with 1 month of intervention,the total score of Short Physical Performance Battery and the score of each dimension,handgrip strength,walking speed were increased(P<0.01).Fasting blood glucose,the total score of Diabetes Specific Quality of Life Scale and scores in all dimensions were decreased(P<0.05).Conclusion1.Multicomponent exercise training is simple,easy to perform and highly operable,which can improve the frailty state of elderly diabetes patients,especially physical and psychological frailty,and has certain positive significance in reducing fasting blood glucose and improving physical function and quality of life.2.As a diversified exercise method,multicomponent exercise training is economical and effective,and ensures the safety,interest,feasibility and scientific nature of patients’ exercise,which is worthy of further promotion and application in the community. |
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