| Objective: To investigate the decline of muscle strength and its influencing factors in elderly inpatients with type 2 diabetes mellitus in the Hospital.To explore the effects of aerobic combined resistance exercise based on the King’s Theory of Goal Attainment on muscle strength in elderly patients with type 2 diabetes mellitus.Methods: 1.This study was carried out in two stages.In the first stage,420 elderly patients with type 2 diabetes mellitus who were hospitalized in a Classⅲ Grade A hospital in Nanning from January to June 2022 were selected as the research objects by convenience sampling method.In the second phase,elderly patients with type 2 diabetes mellitus and decreased muscle strength who met the inclusion and exclusion criteria of the second phase of the study and volunteered to participate in the second phase of the study were selected from the first phase.The subjects were randomly divided into a control group and three experimental groups by using SPSS26.0 software package,32 cases in each group,a total of 128 cases.The control group carried out routine health education and follow-up.On the basis of that in the control group,the experimental group implemented aerobic exercise,resistance exercise and aerobic combined resistance exercise based on the King’s Theory of Goal Attainment.The results of muscle strength,skeletal muscle mass,body fat rate,body mass index,Short Physical Performance Battery scores,Morse Fall Scale scores,blood glucose of patients were collected before intervention and8 and 12 weeks after intervention to evaluate the intervention effect.2.SPSS26.0 software was used for data analysis.Statistical methods used included descriptive statistics,non-parametric test,chi-square test,Fisher’s exact test,binary logistic regression analysis,one-way analysis of variance,repeated measures analysis of variance,etc.P < 0.05 was considered statistically significant.Results: 1.A total of 382 elderly patients with Type 2 Diabetes Mellitus were included in the first phase,including 148 cases(38.7%)with normal muscle strength,234 cases(61.3%)with decreased muscle strength.2.Binary logistic regression analysis showed that age [OR=2.671,95%CI(1.754,4.067)],education level [OR=0.644,95%CI(0.426,0.975)],exercise habit [OR=0.627,95%CI(0.450,0.874)],smoking history [OR=1.847,95%CI(1.049,3.252)],body mass index [OR=0.914,95%CI(0.843,0.991)],duration of diabetes[OR=1.729,95%CI(1.024,2.921)] and peripheral neuropathy [OR=2.158,95%CI(1.173,3.971)] were the influencing factors of muscle strength decline(P < 0.05).3.A total of 127 patients were included in the second stage.Non-parametric analysis showed that the compliance rates of exercise frequency and exercise time of patients in each experimental group were higher than those in the control group at the 4th,8th and 12 th weeks of intervention,and the differences were statistically significant(P < 0.05).At the 8th week of intervention,the Short Physical Performance Battery scores of the resistance exercise group and the aerobic combined resistance exercise group were higher than those of the control group,and the differences were statistically significant(P < 0.05).At the 12 th week,the Short Physical Performance Battery scores of each experimental group were higher than those of the control group,and the resistance exercise group and the aerobic combined resistance exercise group had a lower Morse Fall Scale score than the control group,and the difference was statistically significant(P < 0.05).Repeated measures analysis of variance showed that there were time and group interaction effects on grip strength,appendicular skeletal mass index,body fat rate,body mass index,fasting plasma glucose,2 hour plasma glucose and other indicators(P < 0.05).Further analysis of individual effects showed that at the 8th week of intervention,the grip strength of the resistance exercise group and the aerobic combined resistance exercise group was higher than that of the aerobic exercise group and the control group.The body fat rate and2 hour plasma glucose of each experimental group were lower than those of the control group,and the differences were statistically significant(P < 0.05).At the 12 th week,the grip strength and appendicular skeletal mass index of the resistance exercise group and the aerobic combined resistance exercise group were higher than those of the aerobic exercise group and the control group,and the body fat rate,body mass index,fasting plasma glucose,2 hour plasma glucose of the experimental groups were lower than those of the control group,and the differences were statistically significant(P < 0.05).One-way analysis of variance showed that the Hemoglobin A1 c of each experimental group after 12 weeks of intervention was lower than that of the control group and before intervention,and the differences were statistically significant(P < 0.05).Conclusion: 1.The incidence of muscle strength decline is high in elderly patients with Type 2 Diabetes Mellitus.2.The muscle strength of elderly patients with Type 2 Diabetes Mellitus is related to age,gender,education level,body mass index,exercise habit,smoking history,duration of diabetes,and whether combined with peripheral neuropathy.3.The aerobic combined resistance exercise program based on the King’s Theory of Goal Attainment is practical and safe,which can improve the exercise compliance,muscle strength and related function of elderly patients with type 2 diabetes. |
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