Feasibility, safety and preliminary efficacy of telehealth-delivered group exercise for people with type 2 diabetes: A pilot trial

Emily R Cox; Myles D Young; Shelley E Keating; Ryan J Drew; Matthew Kolasinski; Ronald C Plotnikoff

doi:10.1177/1357633X241287966

Feasibility, safety and preliminary efficacy of telehealth-delivered group exercise for people with type 2 diabetes: A pilot trial

J Telemed Telecare. 2024 Nov 13:1357633X241287966. doi: 10.1177/1357633X241287966. Online ahead of print.

Authors

Emily R Cox^{1

2

3}, Myles D Young^{1

2

4}, Shelley E Keating⁵, Ryan J Drew^{1

2

3}, Matthew Kolasinski³, Ronald C Plotnikoff^{1

2

6}

Affiliations

¹ Centre for Active Living and Learning, University of Newcastle, Callaghan, NSW, Australia.
² Active Living and Learning Research Program, Hunter Medical Research Institute, New Lambton, NSW, Australia.
³ School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, NSW, Australia.
⁴ School of Psychological Sciences, University of Newcastle, Callaghan, NSW, Australia.
⁵ Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, The University of Queensland, St Lucia, QLD, Australia.
⁶ School of Education, University of Newcastle, Callaghan, NSW, Australia.

PMID: 39533924
DOI: 10.1177/1357633X241287966

Abstract

Introduction: Several barriers can preclude people with type 2 diabetes (T2D) from in-person exercise session participation. Telehealth may be an alternative mode of service delivery to increase uptake. We evaluated the feasibility, safety and preliminary efficacy of delivering group exercise via telehealth for people with T2D.

Methods: Sixteen people with T2D (age 59.9 ± 12.7 years, 63% male, duration of T2D 11.5 ± 11.1 years) underwent an 8-week telehealth-delivered group exercise intervention. Weekly supervised sessions incorporated whole-body aerobic and resistance exercises, followed by education. Feasibility was evaluated by recruitment, enrolment, attendance and attrition rates, the practicality of telehealth delivery, and participant feedback. Adverse events were monitored throughout (safety). Preliminary efficacy was determined from changes in glycaemic control, body composition, blood pressure, exercise capacity, neuromuscular strength/fitness, quality of life and physical activity levels. The agreement/reliability of in-person clinician-measured versus telehealth-supervised participant-self-measured assessments was also evaluated.

Results: Feasibility was supported by high attendance (97.1%) and low attrition (81%). All (100%) participants reported they would participate in telehealth-delivered exercise interventions in the future and would recommend them to other people with T2D. No serious adverse events were reported. There were improvements in hip circumference (Cohen's d -0.50), diastolic blood pressure (-0.75), exercise capacity (1.72), upper body strength (1.14), grip strength (0.58), health-related quality of life (0.76-0.81) and self-reported physical activity (1.14). Participant-self-measured assessment of body weight, 2-min step test and 30-sec sit-to-stand test were deemed acceptable.

Discussion: Telehealth-delivered group exercise appears feasible, safe and efficacious for people with T2D. These findings warrant further exploration in a powered trial.

Trial registration: Australian New Zealand Clinical Trials Registry (ACTRN12622000379718).

Keywords: Diabetes mellitus, type 2; exercise; technology; telemedicine.