The Research On Ttm-based Exercise Intervention In Community Elderly Diabetic Patients With Sarcopenia

Objective The study investigated the sarcopenia,mental and social conditions of elderly diabetic patients who lived in community,analyzed its influencing factors,and verified the efficacy of exercise intervention based on the Transtheroetical Model on sarcopenia symptoms,muscle indexes,blood sugar,depression,quality of life and behavioral stages,taking the results as a reference for slowing down the speed of muscle decreasing,and the prevention of outcomes of sarcopenia.Methods(1)264 diabetic patients were select as the survey subjects by the two-stage sampling method,and the basic data questionnaire,SARC-F scale,GDS-15 sacle and SF-12 sacle were used as means to investigate the current situation,mental and social conditions and influencing factors of sarcopenia in elderly diabetic patients in the community.(2)These patients with sarcopenia who were qualified were assigned to the control group and the intervention group with 30 cases each according to the random number table method.The control group was provided general diabetes care,mainly instructing patients to take medication on time,monitoring blood glucose and so on.The intervention group implements exercise intervention taken TTM as the framework.The general information questionnaire,SARC-F scale,muscle measurement indexes,SF-12 Scale,GDS-15 Scale,and Stages of Change-Continuous Measure Scale were used before and after 6-month intervention respectively,to assess the sarcopenia status,muscle function,depression,quality of life and behavior changes of the two groups of patients.We entered all the acquired data into SPSS23.0 software,and then used frequency,composition ratio,mean and standard deviation to describe the data;and used t test,x2 test,rank sum test,analysis of variance,multiple stepwise regression and Spearman rank correlation to analyze the data.Results(1)The quantity of sarcopenia in elderly diabetic patients in the community was 63,and the incidence of sarcopenia was 23.9%.Depression in elderly diabetic patients in the community was positively correlated with sarcopenia(r=0.735,p<0.01),and quality of life was negatively correlated with sarcopenia(r=-0.685,p<0.01).(2)Analysis of variance showed that the incidence of sarcopenia in elderly diabetic patients in community was significantly different between age,gender,fasting blood glucose,falling,and sedentary time in everyday(p<0.05).(3)After performing logistic regression,age,gender,fasting blood glucose,falling,and long sedentary time in everyday were the main factors of the occurence of sarcopenia.(4)We take comparison of the two groups of community elderly diabetes patients with sarcopenia before making intervention,discovering that they are comparable among baseline data,and statistical difference was not significant among the incidence of sarcopenia,muscle measurement indexes,blood glucose,depression,quality of life,and behavioral stages(p>0.05).(5)Taking comparison after intervention based on TTM,the control group was worse than the intervention group in the incidence of sarcopenia,grip strength,4-meter pace,fasting blood glucose,2-hour postprandial blood glucose,the incidence of depression,quality of life score,and behavioral stage(p<0.05);while calf circumference of the two groups did not have statistical difference(p>0.05).(6)Fasting blood glucose,two-hour postprandial blood glucose,sarcopenia scores,grip strength,4m pace,depression,quality of life and behavioral stage of intervention group after intervention were better than those before intervention(p<0.05),while calf circumference did not have statistical difference(p>0.05).Conclusion(1)The incidence of sarcopenia in community-living elderly patients with diabetes is much higher.Logistic analysis showed that age,gender,fasting blood glucose,falling,and sedentary time were the main factors about he incidence of sarcopenia,moreover which was positively correlated with depression,and was negatively correlated with quality of life.(2)TTM-based exercise intervention could effectively relieve the symptom of sarcopenia,enhance muscle strength and physical performance in patients who have had diabetes and sarcopenia.Meanwhile,it can also make blood glucose stable,change depression mood and improve the quality of life,as well as urgent patients to exercise.