recomendaciones de ejercicio en dt2

8/13/2019 Recomendaciones de Ejercicio en DT2

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Universidad Autnoma de Chihuahua

Facultad de Educacin Fsica y Ciencias del DeporteLaboratorio para la Actividad Fsica y la Salud

Exercise Training Diabetes type 2

Recommendation (ACSM, 2010)


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Aerobic Exercise Training Recommendation

Frequency

Aerobic exercise should beperformed at least 3 d/wk.

Most clinical trials

evaluating exerciseinterventions in T2DM haveused a frequency of threetimes per week, but currentguidelines for adultsgenerally recommend fivesessions of moderateactivity.


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Intensity

Aerobic exercise should be at least at moderate intensity,corresponding approximately to 40%60% of VO2max (maximalaerobic capacity).

For most people with T2DM, brisk walking is a moderate-intensityexercise. Additional benefits may be gained from vigorous exercise(>60% of VO2max).

A meta analysis showed that exercise intensity predicts

improvements in overall BG control to a greater extent thanexercise volume, suggesting that those already exercising at amoderate intensity should consider undertaking some vigorous PAto obtain additional BG (and likely CV) benefits.


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Duration.

Individuals with T2DM should engage in a minimum of 150 min/wkof exercise undertaken at moderate intensity or greater.

Aerobic activity should be performed in bouts of at least 10 min andbe spread throughout the week.

Around 150 min/wk of moderate-intensity exercise is associatedwith reduced morbidity and mortality in observational studies in allpopulations.

The average weekly duration in meta-analyses of exerciseinterventions in T2DM, including higher-intensity aerobic exercise,has been in a similar range.


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Mode

Any form of aerobicexercise (including brisk

walking) that uses largemuscle groups andcauses sustainedincreases in HR is likelyto be beneficial, andundertaking a variety ofmodes of PA isrecommended.


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Rate of progression.

At present, no study onindividuals with T2DM hascompared rates of

progression in exerciseintensity or volume.

Gradual progression of bothis advisable to minimize therisk of injury, particularly ifhealth complications arepresent, and to enhancecompliance.


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Body weight loss andmaintenance.

The most successfulweight control programs

involve combinations ofexercise, diet, andbehavior modification.People who successfully

maintain a large weightloss report exercisingabout 7 h/wk.


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Resistance Exercise Training Recommendation

Frequency

Resistance exercise should

be undertaken at least twice

weekly on nonconsecutive

days

Ideally three times a week

as part of a PA program for

individuals with T2DM,

along with regular aerobic

activities.


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Intensity

Training should be moderate(50% of 1-repetitionmaximum, or 1-RM) orvigorous (75%80% of 1-RM)

for optimal gains in strengthand insulin action.

Home-based resistancetraining following supervised,gym-based training may beless effective for maintaining

BG control but adequate formaintaining muscle mass andstrength.


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Duration

Each training session shouldminimally include 510 exercisesinvolving the major musclegroups (in the upper body, lowerbody, and core) and involve

completion of 1015 repetitionsto near fatigue per set early intraining, progressing over time toheavier weights (or resistance)that can be lifted only 810times.

A minimum of one set ofrepetitions to near fatigue, but asmany as three to four sets, isrecommended for optimalstrength gains.

Mode

Resistance machines and freeweights (e.g.,dumbbells andbarbells) can result in fairlyequivalent gains in strength andmass of targeted muscles.

Heavier weights or resistancemay be needed for optimizationof insulin action and BG control.


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Rate of progression

To progression of intensity, frequency, and duration oftraining sessions should occur slowly.

In most progressive training, increases in weight or

resistance are undertaken first and only once when thetarget number of repetitions per set can consistently beexceeded, followed by a greater number of sets andlastly by increased training frequency.

Progression for 6 months to thrice-weekly sessions of

three sets of 810 repetitions done at 75% to 80% of 1-RM on 810 exercises may be an optimal goal.


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Flexibility Training recommendation

Flexibility training may be included as part of a PA program, although itshould not substitute for other training.

Older adults are advised to undertake exercises that maintain or improvebalance, which may include some flexibility training, particularly for manyolder individuals with T2DM with a higher risk of falling.

Although flexibility exercise (stretching) has frequently beenrecommended as a means of increasing joint range of motion (ROM) andreducing risk of injury, two systematic reviews found that flexibilityexercise does not reduce risk of exercise induced injury.

Flexibility exercise combined with resistance training can increase ROM inindividuals with T2DM and allow individuals to more easily engage inactivities that require greater ROM around joints.


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Flexibility Training recommendation

Frecuencia: ( 2-3 das por semana) incluir en elentrenamiento diario.

Intensidad: Debe sentirse el esfuerzo y un ligero dolor

Tiempo: Flexibilidad esttica (10-30segundos), propioceptiva

de 3-6 segundos. Tipo: grandes y pequeos grupos musculares (esttica,

dinmica o propioceptiva)

Volumen: de 10 hasta 60 segundos

Patrn de progresin: de 2 a 4 veces por ejercicio

Se recomienda hacer ejercicio aerobio ligero/moderado antesde realizar ejercicios de flexibilidad, saunas o baos calientes.


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Escala de Percepcin de Esfuerzo


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Escala de Percepcin de Esfuerzo


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Clasificacin de la intensidad del ejercicio en FCR, Fcmaxma, VO2

Max y EPE (ACSM, 2011)


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Programacin del ejercicio

recomendaciones de ejercicio en dt2

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