Discontinuously supervised aerobic training vs. physical activity promotion in the self-management of type 2 diabetes in older Italian patients: design and methods of the 'TRIPL-A' randomized controlled trial

• Published in: BMC geriatrics Vol. 19; no. 1; p. 11
• Main Authors: Lucertini, Francesco, Ferri Marini, Carlo, Sisti, Davide, Stocchi, Vilberto, Federici, Ario, Gregorio, Franco, Piangerelli, Donata, Chiatti, Carlos, Cherubini, Antonio, Boemi, Massimo, Romagnoli, Fabio, Cucchi, Michela, D'Angelo, Federica, Luconi, Maria Paola, Bonfigli, Anna Rita
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 11.01.2019; BioMed Central; BMC
• Subjects: Aerobics; Aged; Analysis; Baby boomers; Care and treatment; Chronic illnesses; Clinical trials; Diabetes; Diabetes mellitus; Diabetes mellitus (non-insulin dependent); Diabetes mellitus type 2; Diabetes Mellitus, Type 2 - epidemiology; Diabetes Mellitus, Type 2 - psychology; Diabetes Mellitus, Type 2 - therapy; Diabetes therapy; Disease management; Elderly patients; Evidence-based medicine; Exercise; Exercise - physiology; Exercise therapy; Exercise training; Female; Fitness training programs; General practitioners; Geriatrics; Habits; Health care industry; Health promotion; Healthy Lifestyle - physiology; Humans; Intervention; Italy - epidemiology; Lifestyles; Male; Medical care utilization; Medical referrals; Metabolism; Methods; Older; Older people; Patient compliance; Patient monitoring equipment; Patients; Physical activity; Physical fitness; Physical training; Physicians; Primary care; Primary Health Care - methods; Public health; Quality of life; Quality of Life - psychology; Questionnaires; Retirement benefits; Retrospective Studies; Sedentary Behavior; Sedentary lifestyle; Self-Management - methods; Self-Management - psychology; Smartphones; Study Protocol; Technology; Training; Type 2 diabetes; Validity; Italy; Sedentary lifestyle; Computer-based intervention; Exercise training; Patient compliance; Randomized controlled trial; Diabetes mellitus type 2; Exercise referral scheme; Habits; Older; Quality of life
• ISSN: 1471-2318; 1471-2318
• DOI: 10.1186/s12877-018-1022-x

Physical activity (PA) has health benefits for people with type 2 diabetes (T2D). Indeed, regular PA is considered an important part of any T2D management plan, yet most patients adopt a sedentary lifestyle. Exercise referral schemes (ERS) have the potential to effectively promote physical activity among T2D patients, and their effectiveness may be enhanced when they are supported by computer-based technologies. The 'TRIPL-A' study (i.e., a TRIal to promote PhysicaL Activity among patients in the young-old age affected by T2D) aims to assess if realizing an innovative ERS, based on a strong partnership among general practitioners, specialist physicians, exercise specialists, and patients, and supported by a web-based application (WBA), can effectively lead sedentary older T2D patients to adopt an active lifestyle. A randomized controlled design will be used, and an ERS, supported by a WBA, will be implemented. 300 physically inactive T2D patients (aged 65-74 years) will be assigned to either an intervention or control arm. Control arm patients will only receive behavioral counseling on physical activity and diet, while intervention arm patients will also undergo an 18-month (3 day/week), discontinuously supervised aerobic exercise training program. The trial will be divided into six three-month periods: during first, third and fifth period, an exercise specialist will supervise the training sessions and, using the WBA, prescribe exercise progression and monitor exercise adherence. Patients will exercise on their own in the other periods. Patients' sedentary behaviors (primary outcome), PA level, fitness status, metabolic profile, psychological well-being, quality of life, and use of health care services (secondary outcomes) will be assessed at baseline and at 6, 12, and 18 months from baseline. Repeated measure ANCOVAs will be used to compare the intervention and control arm with respect to each study outcome measure. Primary and secondary outcome results will allow us to evaluate the effectiveness of an ERS, specifically designed for the management of T2D clinical conditions and supported by a WBA, in promoting PA within Italian primary care settings. This trial is retrospectively registered under the Australian New Zealand Clinical Trials Registry (reference number: ACTRN12618001164280 ; registered 13 July 2018).