Observation Of Intervention Effect Of Blood Flow Restriction Combined With Limb Linkage Training In Patients With Type 2 Diabetes

Type 2 diabetes is characterized by chronic hyperglycemia,deterioration of musculoskeletal and muscular deterioration.It is a chronic disease based on insulin resistance.Exercise therapy is an essential part of comprehensive management measures for patients with type 2 diabetes.At present,aerobic exercise combined with resistance exercise is the main exercise recommendation for type 2 diabetic patients.However,for those with type 2 diabetes with irregular movement and poor body foundation,the traditional resistance exercise involved in exercise intervention is difficult to complete,resulting in low compliance.Blood flow restriction training has attracted much attention because it can achieve the same effect as medium and highintensity training with low-intensity exercise.However,whether blood flow restriction training combined with aerobic exercise can improve body shape,muscle circumference,muscle function,glycolipid metabolism and cardiorespiratory function of patients with type 2 diabetes mellitus is still inconclusive.It is not clear whether the combination of blood flow restriction and aerobic exercise can produce traditional resistance training combined with aerobic exercise in patients with type 2 diabetes.Objective:Objective to investigate the effects of blood flow restriction and limb joint training on body shape,muscle circumference,muscle function,glycolipid metabolism and cardiorespiratory function in patients with type 2 diabetes.To compare the effects of different training programs on type 2 diabetes patients,and to provide a theoretical basis for formulating a safe,effective and effective training program.Method:This study selected 30 patients with type 2 diabetes who met the inclusion and exclusion criteria in the Chaoyang District South Mill community health service center in Beijing.They were randomly divided into three groups: blood flow restriction combined with limb linkage training group(BFR group),resistance training combined with limb linkage training group(RT group)and simple limb linkage training group(CON group),with 10 people in each group.The arterial occlusive pressure(AOP)of both lower limbs was measured by color Doppler ultrasound.The blood flow limiting pressure of BFR group was set according to 50% of individual AOP.All three groups need to complete limb linkage training,and the intensity of limb linkage training is the level of anaerobic threshold determined by cardiopulmonary exercise load test.Each main training time is 20 min,warm-up 10 min,stretch and relax 10 min.In BFR group,the thigh root was treated with compression training belt(compression pressure of 50% AOP)and combined with limb linkage training,5 times a week for 4 weeks.CON group was given pressure free training belt at the same position,combined with limb linkage training,5times a week for 4 weeks.RT group was given pressure free training belt at the same position,combined with limb linkage training,3 times a week for 4 weeks.In addition,RT group was matched with elastic band resistance exercise twice a week(the interval between two resistance exercises was ? 48h),and each main body training time was20 min,warm-up 10 min,stretching and relaxation 10 min,for a total of 4 weeks.All subjects were evaluated for physical morphology,thigh circumference,muscle function,blood glucose,blood lipid and cardiopulmonary function before training and within 2days after 4 weeks of training intervention.Objective to explore the effect of blood flow restriction combined with limb joint training on patients with type 2 diabetes mellitus,and compare the effects of different training programs on type 2 diabetes patients.Result:1.Changes of body morphological indexes of three groups of subjects before and after exercise interventionIn group comparison,after 4 weeks of training,the body weight and BMI of BFR group and RT group were significantly lower than those before the intervention(P < 0.01),and there was no significant difference in body weight and BMI of CON group(P >0.05).There was no significant difference in body weight and BMI among the three groups before and after training(P > 0.05).2.Changes of thigh muscle circumference of the three groups of subjects before and after exercise interventionIn group comparison,after 4 weeks of training,the muscle circumference of left and right thighs in BFR group increased significantly compared with that before the intervention(P < 0.01,P < 0.05),and there was no significant difference between RT group and con group(P > 0.05).There was no significant difference in muscle circumference of left and right thigh in the three groups before training(P > 0.05).After 4 weeks of training,the muscle circumference of left thigh in BFR group was significantly higher than that in RT group(P < 0.05),but there were no significant differences in the muscle circumference of left thigh between BFR group and CON group,RT group and CON group,and right thigh muscle circumference between the three groups(P > 0.05).3.Changes of muscle function of three groups of subjects before and after exercise intervention(1)Changes of muscle strength of three groups of subjects before and after exercise interventionIn comparison within the group,when the angular velocity was 60°/s,the peak torque of the left knee extensor muscle of the three groups,the right knee extensor muscle peak torque of the BFR group and CON group,the right hip flexor muscle peak torque of the three groups,and the left hip flexor muscle peak torque of the BFR group and RT group were significantly increased after 4 weeks of training compared with before intervention(P < 0.01,P < 0.05).There was no significant difference in the peak torque of right knee extensor muscle and left hip flexor muscle in RT group and CON group compared with before intervention(P > 0.05).When the angular velocity was 60°/s,there was no significant difference in the peak torques of knee extensor muscle and hip flexor muscle between the three groups before training(P > 0.05).After 4 weeks of training,the peak torques of left and right knee extensor muscles in BFR group were significantly higher than those in RT group(P <0.01,P < 0.05),and the peak torques of left knee extensor muscles in BFR group were significantly higher than those in CON group(P < 0.01).There were no significant differences in the peak torques of right knee extensor muscle between BFR group and CON group,the peak torques of left and right knee extensor muscle between RT group and CON group,and the peak torques of left and right hip flexor muscle between the three groups(P > 0.05).(2)Changes of muscle endurance of three groups of subjects before and after exercise interventionIntra-group comparison,after 4 weeks of training at 60°/s,left knee extensor muscle fatigue,left hip flexor muscle fatigue in BFR group,and left hip flexor muscle fatigue in RT group were significantly lower than before(P < 0.01,P < 0.05).There were no significant differences in left and right knee extensor muscle fatigue between RT group and CON group,right hip flexor muscle fatigue in BFR group,and left and right hip flexor fatigue in CON group compared with before intervention(P > 0.05).There was no significant difference in knee extensor muscle fatigue and hip flexor muscle fatigue in the three groups before and after training when the angular velocity was 180°/s(P > 0.05).4.Changes of blood glucose indexes of three groups of subjects before and after exercise interventionAfter 4 weeks of training,fasting blood glucose,postprandial 2h blood glucose and hba1 c in the BFR group,fasting blood glucose and postprandial 2h blood glucose in the RT group,and postprandial 2h blood glucose in the CON group were significantly lower than those before intervention(P < 0.01,P < 0.05).There were no significant differences in Hb A1 c in RT group and fasting blood glucose and Hb A1 c in CON group compared with before intervention(P > 0.05).There were no significant differences in fasting blood glucose,2h postprandial blood glucose and Hb A1 c among the three groups before training(P > 0.05).After 4 weeks of training,fasting blood glucose in BFR group was significantly lower than that in RT group and CON group(P < 0.01,P < 0.05),and there were no significant differences in fasting blood glucose,2h postprandial blood glucose and hba1 c between RT group and CON group(P > 0.05).5.Changes of blood lipid indexes before and after exercise intervention in the three groupsIntra-group comparison,after 4 weeks of training,LDL-C in TC,TG and BFR groups was significantly lower than before intervention(P < 0.01,P < 0.05);There was no significant difference in LDL-C and HDL-C between RT group and CON group compared with before intervention(P > 0.05);HDL-C in BFR group and RT group was significantly higher than before intervention(P < 0.01,P < 0.05).There were no significant differences in TC,TG,LDL-C and HDL-C among the three groups before training(P > 0.05).After 4 weeks of training,TC in BFR group was significantly lower than that in RT group and CON group(P < 0.01,P < 0.05),and there was no significant difference in TC between RT group and CON group and TG among the three groups(P > 0.05).LDL-C in BFR group was significantly lower than that in CON group(P < 0.05),there was no significant difference in LDL-C between BFR group and RT group,RT group and CON group(P > 0.05),HDL-C in BFR group and RT group was significantly higher than that in CON group(P < 0.01).There was no significant difference in HDL-C between BFR group and RT group(P > 0.05).6.Changes of cardiopulmonary function indexes before and after exercise intervention in the three groupsThere was no significant difference in FVC between the three groups after 4 weeks of training compared with before intervention(P > 0.05).FEV1/FVC in BFR group was significantly increased compared with before intervention(P < 0.05);There was no significant difference in FEV1/FVC in RT group and CON group compared with before intervention(P > 0.05).The peak oxygen pulse of BFR group was significantly higher than that before intervention(P < 0.01).There was no significant difference in peak oxygen pulse between RT group and CON group(P > 0.05).Anaerobic threshold oxygen uptake in BFR group and CON group was significantly higher than that before intervention(P < 0.01,P < 0.05);There was no significant difference in anaerobic threshold oxygen uptake in RT group compared with before intervention(P > 0.05).Anaerobic threshold metabolic equivalent and peak oxygen uptake in the three groups were significantly higher than before intervention(P < 0.01,P < 0.05).There were no significant differences in FVC,FEV1/FVC,peak oxygen pulse,anaerobic threshold oxygen uptake,anaerobic threshold metabolic equivalent and peak oxygen uptake among the three groups before training(P > 0.05).After 4 weeks of training,there was no significant difference in FVC and FEV1/FVC between the three groups(P > 0.05).The peak oxygen pulse of BFR group was significantly higher than that of RT group and CON group(P < 0.01,P < 0.05),but there was no significant difference between RT group and CON group(P > 0.05).Anaerobic threshold oxygen uptake in BFR group was significantly higher than that in RT group(P < 0.01),but there was no significant difference between BFR group and CON group,RT group and CON group(P > 0.05).There were no significant differences in anaerobic threshold metabolic equivalent and peak oxygen uptake among three groups(P > 0.05).Conclusion:1.Blood flow restriction combined with limb linkage training and resistance training combined with limb linkage training can improve the body weight and BMI of patients with type 2 diabetes.2.Blood flow restriction combined with limb linkage training can increase the muscle circumference of the pressurized site;All three training programs can significantly improve the muscle strength of type 2 diabetes patients,and the improvement effect of blood flow restriction combined with limb linkage training is better.Blood flow restriction combined with limb linkage training and resistance training combined with limb linkage training significantly improved muscular endurance in patients with type2 diabetes.3.The three training programs can improve the glucose and lipid indexes of patients with type 2 diabetes,and the effect of blood flow restriction combined with limb joint training is more significant.4.All the three training programs can improve the cardiopulmonary function of patients with type 2 diabetes,and the improvement effect of blood flow restriction combined with limb linkage training is more significant.