BACKGROUND: Exercise-based interventions prevent or delay symptoms and complications of type 2 diabetes (T2D) and are highly recommended for T2D patients; though with very low participation rates. Τelerehabilitation (TR) could act as an alternative to overcome the barriers preventing the promotion of T2D patients' well-being. AIM: Determine the effects of a six-week TR program on glycemic control, functional capacity, muscle strength, PA, quality of life and body composition in patients with T2D. DESIGN: A multicenter randomized, single-blind, parallel-group clinical study. SETTING: Clinical trial. POPULATION: Patients with T2D. METHODS: Thirty T2D patients (75% male, 60.1±10.9 years) were randomly allocated to an intervention group (IG) and a control group (CG) with no exercise intervention. IG enrolled in a supervised, individualized exercise program (combination of aerobic and resistance exercises), 3 times/week for 6 weeks at home via a TR platform. Glycated hemoglobin (HbA1c), six-minute walk test (6MWT), muscle strength (Hand Grip Strength Test [HGS], 30-Second Chair Stand test [30CST] physical activity [IPAQ-SF]), quality of life (SF-36) and anthropometric variables were assessed. RESULTS: Two-way repeated-ANOVA showed a statistically significant interaction between group, time and test differences (6MWT, muscle strength) (V=0.33, F [2.17]=4.14, P=0.03, partial η2=0.22). Paired samples t-test showed a statistically significant improvement in HbA1c (Z=-2.7), 6MWT (Μean ∆=-36.9±27.2 m, t=-4.5), muscle strength (Μean ∆=-1.5±1.4 kg, t=-2.22). Similarly, SF-36 (mental health [Μean ∆=-13.3±21.3%], general health [Μean ∆=-11.4±16.90%]) were statistically improved only in IG. CONCLUSIONS: The findings of this study indicate that a 6-week supervised home-based TR exercise program induced significant benefits in patients with T2D, thus enabling telehealth implementation in rehabilitation practice as an alternative approach. CLINICAL REHABILITATION IMPACT: Home-based exercise via the TR platform is a feasible and effective alternative approach that can help patients with T2D eliminate barriers and increase overall rehabilitation utilization.

Clinical Exercise Physiology and Rehabilitation Laboratory Department of Physiotherapy Faculty of Health Sciences University of Thessaly Lamia Greece

Department of Internal Medicine General Hospital of Lamia Lamia Greece

Department of Public Health Faculty of Medicine Masaryk University Brno Czech Republic

Department of Rehabilitation University Hospital of Brno Brno Czech Republic

Medical Diabetology Practice Lamia Greece

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American Diabetes Association . 2. Classification and Diagnosis of Diabetes: Standards of Medical Care in Diabetes-2020. Diabetes Care 2020;43(Suppl 1):S14–31. https://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=31862745&dopt=Abstract10.2337/dc20-S002 PubMed DOI

Sun H, Saeedi P, Karuranga S, Pinkepank M, Ogurtsova K, Duncan BB, et al. IDF Diabetes Atlas: Global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045. Diabetes Res Clin Pract 2022;183:109119. https://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=34879977&dopt=Abstract10.1016/j.diabres.2021.109119 PubMed DOI PMC

Kahn SE, Cooper ME, Del Prato S. Pathophysiology and treatment of type 2 diabetes: perspectives on the past, present, and future. Lancet 2014;383:1068–83. https://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=24315620&dopt=Abstract10.1016/S0140-6736(13)62154-6 PubMed DOI PMC

American Diabetes Association . (2) Classification and diagnosis of diabetes. Diabetes Care 2015;38(Suppl):S8–16. https://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=25537714&dopt=Abstract10.2337/dc15-S005 PubMed DOI

Amanat S, Ghahri S, Dianatinasab A, Fararouei M, Dianatinasab M. Exercise and Type 2 Diabetes. Adv Exp Med Biol 2020;1228:91–105. https://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=32342452&dopt=Abstract10.1007/978-981-15-1792-1_6 PubMed DOI

Sgrò P, Emerenziani GP, Antinozzi C, Sacchetti M, Di Luigi L. Exercise as a drug for glucose management and prevention in type 2 diabetes mellitus. Curr Opin Pharmacol 2021;59:95–102. https://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=34182427&dopt=Abstract10.1016/j.coph.2021.05.006 PubMed DOI

Colberg SR, Sigal RJ, Fernhall B, Regensteiner JG, Blissmer BJ, Rubin RR, et al. Exercise and type 2 diabetes: the American College of Sports Medicine and the American Diabetes Association: joint position statement. Diabetes Care 2010;33:147–67. 10.2337/dc10-9990 PubMed DOI PMC

Duclos M, Dejager S, Postel-Vinay N, di Nicola S, Quéré S, Fiquet B. Physical activity in patients with type 2 diabetes and hypertension—insights into motivations and barriers from the MOBILE study. Vasc Health Risk Manag 2015;11:361–71. https://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=26170686&dopt=Abstract PubMed PMC

Patterson R, McNamara E, Tainio M, de Sá TH, Smith AD, Sharp SJ, et al. Sedentary behaviour and risk of all-cause, cardiovascular and cancer mortality, and incident type 2 diabetes: a systematic review and dose response meta-analysis. Eur J Epidemiol 2018;33:811–29. https://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=29589226&dopt=Abstract10.1007/s10654-018-0380-1 PubMed DOI PMC

Martin CG, Pomares ML, Muratore CM, Avila PJ, Apoloni SB, Rodríguez M, et al. Level of physical activity and barriers to exercise in adults with type 2 diabetes. AIMS Public Health 2021;8:229–39. https://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=34017888&dopt=Abstract10.3934/publichealth.2021018 PubMed DOI PMC

Pepera G, Tribali MS, Batalik L, Petrov I, Papathanasiou J. Epidemiology, risk factors and prognosis of cardiovascular disease in the Coronavirus Disease 2019 (COVID-19) pandemic era: a systematic review. Rev Cardiovasc Med 2022;23:28. https://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=35092220&dopt=Abstract10.31083/j.rcm2301028 PubMed DOI

Winnige P, Filakova K, Hnatiak J, Dosbaba F, Bocek O, Pepera G, et al. Validity and Reliability of the Cardiac Rehabilitation Barriers Scale in the Czech Republic (CRBS-CZE): Determination of Key Barriers in East-Central Europe. Int J Environ Res Public Health 2021;18:13113. https://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=34948722&dopt=Abstract10.3390/ijerph182413113 PubMed DOI PMC

Antoniou V, Pasias K, Loukidis N, Exarchou-Kouveli KK, Panagiotakos DB, Grace SL, et al. Translation, Cross-Cultural Adaptation and Psychometric Validation of the Greek Version of the Cardiac Rehabilitation Barriers Scale (CRBS-GR): What Are the Barriers in South-East Europe? Int J Environ Res Public Health 2023;20:4064. https://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=36901075&dopt=Abstract10.3390/ijerph20054064 PubMed DOI PMC

Batalik L, Filakova K, Sladeckova M, Dosbaba F, Su J, Pepera G. The cost-effectiveness of exercise-based cardiac telerehabilitation intervention: a systematic review. Eur J Phys Rehabil Med 2023;59:248–58. https://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=36692413&dopt=Abstract10.23736/S1973-9087.23.07773-0 PubMed DOI PMC

Antoniou V, Davos CH, Kapreli E, Batalik L, Panagiotakos DB, Pepera G. Effectiveness of Home-Based Cardiac Rehabilitation, Using Wearable Sensors, as a Multicomponent, Cutting-Edge Intervention: A Systematic Review and Meta-Analysis. J Clin Med 2022;11:3772. https://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=35807055&dopt=Abstract10.3390/jcm11133772 PubMed DOI PMC

Milani R, Chava P, Wilt J, Entwisle J, Karam S, Burton J, et al. Improving Management of Type 2 Diabetes Using Home-Based Telemonitoring: cohort Study. JMIR Diabetes 2021;6:e24687. https://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=34110298&dopt=Abstract10.2196/24687 PubMed DOI PMC

Kitsiou S, Paré G, Jaana M, Gerber B. Effectiveness of mHealth interventions for patients with diabetes: an overview of systematic reviews. PLoS One 2017;12:e0173160. https://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=28249025&dopt=Abstract10.1371/journal.pone.0173160 PubMed DOI PMC

He Q, Zhao X, Wang Y, Xie Q, Cheng L. Effectiveness of smartphone application-based self-management interventions in patients with type 2 diabetes: A systematic review and meta-analysis of randomized controlled trials. J Adv Nurs 2022;78:348–62. https://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=34324218&dopt=Abstract10.1111/jan.14993 PubMed DOI

Pepera G, Karanasiou E, Blioumpa C, Antoniou V, Kalatzis K, Lanaras L, et al. Tele-Assessment of Functional Capacity through the Six-Minute Walk Test in Patients with Diabetes Mellitus Type 2: Validity and Reliability of Repeated Measurements. Sensors (Basel) 2023;23:1354. https://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=36772396&dopt=Abstract10.3390/s23031354 PubMed DOI PMC

Tan SY, Mei Wong JL, Sim YJ, Wong SS, Mohamed Elhassan SA, Tan SH, et al. Type 1 and 2 diabetes mellitus: A review on current treatment approach and gene therapy as potential intervention. Diabetes Metab Syndr 2019;1:364–72. PubMed

Antoniou V, Xanthopoulos A, Giamouzis G, Davos C, Batalik L, Stavrou V, et al. Efficacy, efficiency and safety of a cardiac telerehabilitation programme using wearable sensors in patients with coronary heart disease: the TELEWEAR-CR study protocol. BMJ Open 2022;12:e059945. https://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=35738643&dopt=Abstract10.1136/bmjopen-2021-059945 PubMed DOI PMC

Duruturk N, Özköslü MA. Effect of tele-rehabilitation on glucose control, exercise capacity, physical fitness, muscle strength and psychosocial status in patients with type 2 diabetes: A double blind randomized controlled trial. Prim Care Diabetes 2019;13:542–8. https://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=31014938&dopt=Abstract10.1016/j.pcd.2019.03.007 PubMed DOI

Dadgostar H, Firouzinezhad S, Ansari M, Younespour S, Mahmoudpour A, Khamseh ME. Supervised group-exercise therapy versus home-based exercise therapy: their effects on Quality of Life and cardiovascular risk factors in women with type 2 diabetes. Diabetes Metab Syndr 2016;10(Suppl 1):S30–6. https://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=26822461&dopt=Abstract10.1016/j.dsx.2016.01.016 PubMed DOI

Batalik L, Pepera G, Papathanasiou J, Rutkowski S, Líška D, Batalikova K, et al. Is the Training Intensity in Phase Two Cardiovascular Rehabilitation Different in Telehealth versus Outpatient Rehabilitation? J Clin Med 2021;10:4069. https://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=34575185&dopt=Abstract10.3390/jcm10184069 PubMed DOI PMC

Brawner CA, Ehrman JK, Schairer JR, Cao JJ, Keteyian SJ. Predicting maximum heart rate among patients with coronary heart disease receiving beta-adrenergic blockade therapy. Am Heart J 2004;148:910–4. https://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=15523326&dopt=Abstract10.1016/j.ahj.2004.04.035 PubMed DOI

Pepera G, Xanthos E, Lilios A, Xanthos T. Knowledge of cardiopulmonary resuscitation among Greek physiotherapists. Monaldi Arch Chest Dis 2019;89. https://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=31711281&dopt=Abstract 10.4081/monaldi.2019.1124 PubMed DOI

Stefanakis M, Batalik L, Antoniou V, Pepera G. Safety of home-based cardiac rehabilitation: A systematic review. Heart Lung 2022;55:117–26. https://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=35533492&dopt=Abstract10.1016/j.hrtlng.2022.04.016 PubMed DOI

ATS Committee on Proficiency Standards for Clinical Pulmonary Function Laboratories . ATS statement: guidelines for the six-minute walk test. Am J Respir Crit Care Med 2002;166:111–7. https://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12091180&dopt=Abstract10.1164/ajrccm.166.1.at1102 PubMed DOI

Alfonso-Rosa RM, Del Pozo-Cruz B, Del Pozo-Cruz J, Sañudo B, Rogers ME. Test-retest reliability and minimal detectable change scores for fitness assessment in older adults with type 2 diabetes. Rehabil Nurs 2014;39:260–8. https://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=23780835&dopt=Abstract10.1002/rnj.111 PubMed DOI

Spencer LM, Alison JA, McKeough ZJ. Six-minute walk test as an outcome measure: are two six-minute walk tests necessary immediately after pulmonary rehabilitation and at three-month follow-up? Am J Phys Med Rehabil 2008;87:224–8. https://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=17912139&dopt=Abstract10.1097/PHM.0b013e3181583e66 PubMed DOI

Borg GA. Psychophysical bases of perceived exertion. Med Sci Sports Exerc 1982;14:377–81. https://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7154893&dopt=Abstract10.1249/00005768-198205000-00012 PubMed DOI

Pepera GK, Sandercock GR, Sloan R, Cleland JJ, Ingle L, Clark AL. Influence of step length on 6-minute walk test performance in patients with chronic heart failure. Physiotherapy 2012;98:325–9. https://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=23122439&dopt=Abstract10.1016/j.physio.2011.08.005 PubMed DOI

MacDermid J, Solomon G. Therapists ASoH. Clinical assessment recommendations 3rd edition: Impairment-based conditions. Third edition ed: Mount Laurel, NJ: American Society of Hand Therapists; 2015.

Pepera G, Christina M, Katerina K, Argirios P, Varsamo A. Effects of multicomponent exercise training intervention on hemodynamic and physical function in older residents of long-term care facilities: A multicenter randomized clinical controlled trial. J Bodyw Mov Ther 2021;28:231–7. https://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=34776146&dopt=Abstract10.1016/j.jbmt.2021.07.009 PubMed DOI

Papathanasiou G, Georgoudis G, Georgakopoulos D, Katsouras C, Kalfakakou V, Evangelou A. Criterion-related validity of the short International Physical Activity Questionnaire against exercise capacity in young adults. Eur J Cardiovasc Prev Rehabil 2010;17:380–6. https://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=19940775&dopt=Abstract10.1097/HJR.0b013e328333ede6 PubMed DOI

Pappa E, Kontodimopoulos N, Niakas D. Validating and norming of the Greek SF-36 Health Survey. Qual Life Res 2005;14:1433–8. https://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=16047519&dopt=Abstract10.1007/s11136-004-6014-y PubMed DOI

Moser O, Tschakert G, Mueller A, Groeschl W, Eckstein ML, Koehler G, et al. Different Heart Rate Patterns During Cardio-Pulmonary Exercise (CPX) Testing in Individuals With Type 1 Diabetes. Front Endocrinol (Lausanne) 2018;9:585. https://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=30333794&dopt=Abstract10.3389/fendo.2018.00585 PubMed DOI PMC

Sigal RJ, Purdon C, Bilinski D, Vranic M, Halter JB, Marliss EB. Glucoregulation during and after intense exercise: effects of beta-blockade. J Clin Endocrinol Metab 1994;78:359–66. https://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7906280&dopt=Abstract PubMed

Hansen D, Peeters S, Zwaenepoel B, Verleyen D, Wittebrood C, Timmerman N, et al. Exercise assessment and prescription in patients with type 2 diabetes in the private and home care setting: clinical recommendations from AXXON (Belgian Physical Therapy Association). Phys Ther 2013;93:597–610. https://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=23392184&dopt=Abstract10.2522/ptj.20120400 PubMed DOI

Pepera G, Bromley P, Sandercock G. A pilot study to investigate the safety of exercise training and testing in cardiac rehabilitation patients. Br J Cardiol 2013;20:78.

von Storch K, Graaf E, Wunderlich M, Rietz C, Polidori MC, Woopen C. Telemedicine-Assisted Self-Management Program for Type 2 Diabetes Patients. Diabetes Technol Ther 2019;21:514–21. https://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=31287736&dopt=Abstract10.1089/dia.2019.0056 PubMed DOI

Eberle C, Stichling S. Clinical Improvements by Telemedicine Interventions Managing Type 1 and Type 2 Diabetes: systematic Meta-review. J Med Internet Res 2021;23:e23244. https://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=33605889&dopt=Abstract10.2196/23244 PubMed DOI PMC

Lee PA, Greenfield G, Pappas Y. The impact of telehealth remote patient monitoring on glycemic control in type 2 diabetes: a systematic review and meta-analysis of systematic reviews of randomised controlled trials. BMC Health Serv Res 2018;18:495. https://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=29940936&dopt=Abstract10.1186/s12913-018-3274-8 PubMed DOI PMC

Stratton IM, Adler AI, Neil HA, Matthews DR, Manley SE, Cull CA, et al. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ 2000;321:405–12. https://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=10938048&dopt=Abstract10.1136/bmj.321.7258.405 PubMed DOI PMC

Marios T. A Smart N, Dalton S. The Effect of Tele-Monitoring on Exercise Training Adherence, Functional Capacity, Quality of Life and Glycemic Control in Patients With Type II Diabetes. J Sports Sci Med 2012;11:51–6. https://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=24137063&dopt=Abstract PubMed PMC

Faruque LI, Wiebe N, Ehteshami-Afshar A, Liu Y, Dianati-Maleki N, Hemmelgarn BR, et al. Alberta Kidney Disease Network . Effect of telemedicine on glycated hemoglobin in diabetes: a systematic review and meta-analysis of randomized trials. CMAJ 2017;189:E341–64. https://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=27799615&dopt=Abstract10.1503/cmaj.150885 PubMed DOI PMC

Akinci B, Yeldan I, Satman I, Dirican A, Ozdincler AR. The effects of Internet-based exercise compared with supervised group exercise in people with type 2 diabetes: a randomized controlled study. Clin Rehabil 2018;32:799–810. https://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=29417832&dopt=Abstract10.1177/0269215518757052 PubMed DOI

Kokkinos P, Myers J, Nylen E, Panagiotakos DB, Manolis A, Pittaras A, et al. Exercise capacity and all-cause mortality in African American and Caucasian men with type 2 diabetes. Diabetes Care 2009;32:623–8. https://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=19196898&dopt=Abstract10.2337/dc08-1876 PubMed DOI PMC

Batalik L, Filakova K, Radkovcova I, Dosbaba F, Winnige P, Vlazna D, et al. Cardio-Oncology Rehabilitation and Telehealth: Rationale for Future Integration in Supportive Care of Cancer Survivors. Front Cardiovasc Med 2022;9:858334. https://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=35497988&dopt=Abstract10.3389/fcvm.2022.858334 PubMed DOI PMC

Cancino-López J, Vergara PZ, Dinamarca BL, Contreras PF, Cárcamo LM, Ibarra NC, et al. Telerehabilitation is Effective to Recover Functionality and Increase Skeletal Muscle Mass Index in COVID-19 Survivors. Int J Telerehabil 2021;13:e6415. https://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=35646231&dopt=Abstract10.5195/ijt.2021.6415 PubMed DOI PMC

Johnson-Kozlow M, Sallis JF, Gilpin EA, Rock CL, Pierce JP. Comparative validation of the IPAQ and the 7-Day PAR among women diagnosed with breast cancer. Int J Behav Nutr Phys Act 2006;3:7. https://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=16579852&dopt=Abstract10.1186/1479-5868-3-7 PubMed DOI PMC

Lidegaard LP, Schwennesen N, Willaing I, Faerch K. Barriers to and motivators for physical activity among people with Type 2 diabetes: patients’ perspectives. Diabet Med 2016;33:1677–85. https://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=27279343&dopt=Abstract10.1111/dme.13167 PubMed DOI

Daher AM, AlMashoor SA, Winn T. Glycaemic control and quality of life among ethnically diverse Malaysian diabetic patients. Qual Life Res 2015;24:951–8. https://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=25352036&dopt=Abstract10.1007/s11136-014-0830-5 PubMed DOI

Pan B, Ge L, Xun YQ, Chen YJ, Gao CY, Han X, et al. Exercise training modalities in patients with type 2 diabetes mellitus: a systematic review and network meta-analysis. Int J Behav Nutr Phys Act 2018;15:72. https://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=30045740&dopt=Abstract10.1186/s12966-018-0703-3 PubMed DOI PMC

Okorodudu DO, Jumean MF, Montori VM, Romero-Corral A, Somers VK, Erwin PJ, et al. Diagnostic performance of body mass index to identify obesity as defined by body adiposity: a systematic review and meta-analysis. Int J Obes 2010;34:791–9. https://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=20125098&dopt=Abstract10.1038/ijo.2010.5 PubMed DOI

Li J, Wei D, Liu S, Li M, Chen X, Chen L, et al. Efficiency of an mHealth App and Chest-Wearable Remote Exercise Monitoring Intervention in Patients With Type 2 Diabetes: A Prospective, Multicenter Randomized Controlled Trial. JMIR Mhealth Uhealth 2021;9:e23338. https://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=33560244&dopt=Abstract10.2196/23338 PubMed DOI PMC

Batalik L, Pepera G, Su JJ. Cardiac telerehabilitation improves lipid profile in the long term: insights and implications. Int J Cardiol 2022;367:117–8. https://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=36055472&dopt=Abstract10.1016/j.ijcard.2022.08.055 PubMed DOI

Batalik L, Dosbaba F, Hartman M, Konecny V, Batalikova K, Spinar J. Long-term exercise effects after cardiac telerehabilitation in patients with coronary artery disease: 1-year follow-up results of the randomized study. Eur J Phys Rehabil Med 2021;57:807–14. https://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=33619944&dopt=Abstract10.23736/S1973-9087.21.06653-3 PubMed DOI

Delgado-Lista J, Alcala-Diaz JF, Torres-Peña JD, Quintana-Navarro GM, Fuentes F, Garcia-Rios A, et al. CORDIOPREV Investigators. Long-term secondary prevention of cardiovascular disease with a Mediterranean diet and a low-fat diet (CORDIOPREV): a randomised controlled trial. Lancet 2022;399:1876–85. https://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=35525255&dopt=Abstract10.1016/S0140-6736(22)00122-2 PubMed DOI

Technology-assisted cardiac rehabilitation for coronary heart disease patients with central obesity: a randomized controlled trial

Validity and reliability of automated treadmill six-minute walk test in patients entering exercise-based cardiac rehabilitation