Improving the neuromuscular fitness of patients with type 2 diabetes by aquatic exercise trainingThe Diabetes and Aquatic Training Study (DATS 3) a randomized controlled trial

BACKGROUND: To compare the effects of aquatic aerobic and combined training on neuromuscular outcomes in patients with type 2 diabetes. METHODS: Patients with type 2 diabetes were randomized to an aerobic aquatic training (AERO), a combined aquatic training (COMBI) or a procedure control (CON) three weekly for 15 weeks. The sessions were 50 minutes long. Maximal strength and muscle endurance were assessed by the 1RM and maximum repetitions at 60% 1RM tests, respectively, in knee extension and elbow flexion exercises. Timed up and go test, testosterone, cortisol and testosterone:cortisol ratio also were evaluated. RESULTS: Participants had 59.0 +/- 8.2 years, 51% women. All groups increased (P<0.001) the maximal knee extension strength (Mean Difference: AERO: 21.1 kg; COMBI: 14.6 kg; CON: 4.4 kg), while only COMBI group increased (P<0.001) the maximal elbow flexion strength (Mean Difference: 2.6 kg). Muscle endurance in both exercises were increased in all groups. The Timed Up and Go test at the usual and maximal speed decreased in all groups. Testosterone were not modified in present study, while cortisol and testosterone:cortisol were improved in COMBI group. CONCLUSIONS: Aquatic training, especially combined aquatic training, improve the neuromuscular fitness of patients with type 2 diabetes.