Effects Of Outpatient Exercise Prescription Intervention In A Combined Physical Medicine Model On Quality Of Life And Physical Fitness In Elderly Patients With T2DM

Objective:This study was conducted through a combination of medical instrument monitoring and scientifically guided exercise rehabilitation mode after outpatient prescription of exercise for elderly T2 DM patients in a professional medical institution（hospital）,aiming to investigate the effectiveness and sustainability of hospital-based exercise prescription intervention on physical morphology,glucose homeostasis,quality of life and physical fitness of elderly T2 DM patients under the combined model of physical medicine.The aim of this study was to investigate the effectiveness and sustainability of the hospital-based exercise prescription intervention on the physical morphology,glucose homeostasis,quality of life and physical fitness of elderly patients with T2 DM,to promote the change of patients’ behavior and lifestyle,and to provide a reference basis for the practical promotion of exercise prescription.Methods:In this study,a total of 334 exercise prescription questionnaires were distributed to urban residents in Xi’an after the reliability test was developed and conducted in the pre-experimental stage,so as to analyze the residents’ attitudes towards the perception of exercise prescription and the treatment of diseases.A total of 30 elderly T2 DM patients（15 of each sex）were screened by the questionnaire survey,who met the diagnostic criteria for T2 DM and had no contraindications to exercise.Before the intervention,the patients were tested for blood glucose and lipid levels,screened for exercise risk,and assessed for body shape,quality of life,and fitness indicators through routine outpatient clinics to understand the patients’ disease management needs,develop exercise prescriptions,and conduct effective supervision.Among the exercise prescriptions included exercise modality: combined resistance-aerobic training,exercise intensity:40%-45% VO2 max for aerobic,40%-50% 1RM for resistance,exercise duration: 5 minutes of warm-up（dynamic stretching plus static stretching）,50 minutes of main exercise（20min equipment resistance exercise 3 groups/8-12 times,3min rest between groups + 30 min fast aerobic exercise in place）,5 minutes of finishing exercise（static stretching）,exercise frequency: 3 times a week,60 minutes each time;after 9 weeks of intervention,the indexes were measured again through the regular clinic,and statistical analysis was performed according to the two index tests before and after the intervention.Results:（1）The results of the questionnaire survey on the development status of exercise prescription and the feasibility of promoting it show that half or more people know about exercise prescription,67.1% of the residents think it is meaningful to open exercise prescription clinics in general hospitals or rehabilitation institutions,and the demand for knowledge about the choice of hospitals and exercise prescription varies according to the degree of individual awareness.（2）After the 9-week outpatient exercise prescription intervention,there were significant differences in weight and BMI between male and female patients（p<0.05）,including a high significant difference in waist circumference（p<0.01）.（3）After the 9-week outpatient exercise prescription intervention,there was improvement but no statistical significance（p>0.05）in total cholesterol and triglycerides,a significant difference in glycosylated hemoglobin（p<0.05）and a high significant difference in fasting glucose（p<0.01）in both male and female patients compared to the pre-intervention period.（4）After the 9-week outpatient exercise prescription intervention,male patients had significant differences in mental health and energy（p<0.05）,including high significant differences in somatic pain and physiological function（p<0.01）;female patients had significant differences in mental health and somatic pain（p<0.05）,including high significant differences in physiological function and energy（p< 0.01）,and a slight increase in physiological function,social function,and emotional function in both male and female patients compared to pre-intervention,but not statistically significant（p>0.05）.（5）After the 9-week outpatient exercise prescription intervention,male patients showed significant differences in the dumbbell straight arm raise test（p<0.05）,with high significant differences in the maximal oxygen uptake,6-minute walk,and 30-second chair sit-stand tests（p<0.01）,and no statistically significant differences in the seated forward bend test;female patients showed significant differences in the maximal oxygen uptake,6-minute walk,30-second chair sit-stand,and seated forward bend tests（p<0.01）.There were significant differences（p<0.05）in maximal oxygen uptake,6-minute walk,30-second chair sit-to-stand,and seated forward bend tests in female patients,with no statistically significant.（6）Patients with average fasting glucose level control had higher physiological function scores and lower limb muscle strength than those with poorer control,and the difference was statistically significant（p<0.05）;by one-dimensional linear regression analysis,it was found that poorer fasting glucose level control was a risk factor for decreased physiological function and lower limb muscle strength in patients（p<0.05）.Conclusions:（1）The study found that outpatient exercise prescription is one of the effective and important cognitive ways to help residents form the correct concept of chronic disease treatment,and the implementation of exercise prescription intervention through outpatient clinics can dynamically adjust the exercise prescription,more targeted,and effectively avoid the occurrence of exercise risks;and patient compliance is high,which is an innovative chronic disease health management model-exercise prescription outpatient.（2）The study found that the outpatient exercise prescription had a significant effect on the body shape of elderly T2 DM patients in terms of weight,BMI and waist circumference,effectively preventing the occurrence of obesity and metabolic disorders;lowering fasting blood glucose and glycated hemoglobin,and promoting the improvement of blood glucose levels.（3）The study found that outpatient exercise prescription significantly improved the quality of life and increased the well-being index of elderly patients with T2DM;enhanced the physical fitness capacity and cardiorespiratory endurance of patients.（4）The study also found that fasting blood glucose levels in elderly T2 DM patients were associated with physiological functions and lower limb muscle strength,and that poorer control of fasting blood glucose levels was one of the risk factors for decreased quality of life and physical fitness in patients.