Home-based hybrid multicomponent exercise training in adults with diabesity and knee osteoarthritis

Yuni Astuti; Sameer Badri Al-Mhanna; Karrar Jasim Hamzah; Eldawaty; Erianti; Norsuhana Omar; Haripah Lawanis; Ain’ Sabreena Mohd Noh; Marilyn Gilyana; Mingyue Yin; Abubakar Ibrahim; Alexios Batrakoulis

doi:10.58524/jcss.v5i3.1527

Authors

Yuni Astuti Universitas Negeri Padang, Indonesia https://orcid.org/0000-0001-6430-2938
Sameer Badri Al-Mhanna Saveetha Institute of Medical and Technical Sciences, India & Al-Qasim Green University, Iraq https://orcid.org/0000-0001-9063-0185
Karrar Jasim Hamzah Al-Qasim Green University, Iraq https://orcid.org/0000-0003-2411-7871
Eldawaty Universitas Negeri Padang, Indonesia https://orcid.org/0009-0005-4205-4423
Erianti Universitas Negeri Padang, Indonesia https://orcid.org/0009-0003-6966-3603
Norsuhana Omar Universiti Sains Malaysia, Malaysia https://orcid.org/0000-0002-1975-6487
Haripah Lawanis Universitas Negeri Padang, Indonesia https://orcid.org/0009-0009-7102-5196
Ain’ Sabreena Mohd Noh Universiti Sains Malaysia, Malaysia https://orcid.org/0000-0001-7466-9290
Marilyn Gilyana University of Kalba, United Arab Emirates https://orcid.org/0000-0002-4246-5581
Mingyue Yin Shanghai University of Sport, China https://orcid.org/0009-0009-3129-9029
Abubakar Ibrahim Universiti Sains Malaysia, Malaysia https://orcid.org/0000-0001-6471-481X
Alexios Batrakoulis European University Cyprus, Cyprus & Democritus University of Thrace, Greece https://orcid.org/0000-0003-0844-1284

DOI:

https://doi.org/10.58524/jcss.v5i3.1527

Keywords:

Blood pressure, Diabesity, Fasting blood glucose, Hybrid multicomponent exercise, Knee osteoarthritis

Abstract

Background: Adults with type 2 diabetes mellitus (T2DM), excess adiposity, and knee osteoarthritis (OA) require exercise prescriptions that address cardiometabolic risk without unnecessarily increasing joint symptoms.
Aims: This randomized controlled trial evaluated whether 12 weeks of home-based hybrid multicomponent exercise training (HMET) altered metabolic (FBG), hemodynamic (SBP/DBP), anthropometric (BMI), and walking-capacity (6MWD) outcomes in adults with diabesity and radiographic knee OA.
Methods: Forty-two adults aged >50 years with T2DM, BMI ≥23 kg/m², and Kellgren-Lawrence grade 2–3 knee OA were randomized 1:1 to HMET (n = 21) or control (n = 21). HMET was performed three times weekly. Prespecified co-outcomes were BMI, fasting blood glucose (FBG), systolic and diastolic blood pressure (SBP/DBP), and 6-minute walk distance (6MWD). Group × time effects were evaluated using repeated-measures ANOVA; Holm-adjusted p-values were used as a multiplicity sensitivity analysis.

Results: The group × time interaction was strongest for FBG [F(1,40) = 8.83, nominal p = .005, Holm p = .025, partial η² = .18], with an HMET-versus-control difference in change of −82.0 mg/dL (95% CI −137.7 to −26.2). DBP showed a nominal interaction [F(1,40) = 4.31, p = .044, Holm p = .176, partial η² = .10; difference in change −4.9 mmHg, 95% CI −9.7 to −0.1], but did not remain statistically significant after multiplicity adjustment. Interactions for BMI, SBP, and 6MWD were not statistically significant. All 42 participants completed follow-up; HMET adherence was ≥90%, and no adverse events were recorded.
Conclusion: Twelve-week home-based HMET produced a statistically significant FBG group × time effect after Holm adjustment and a more tentative DBP signal, without statistically significant evidence of parallel change in BMI, SBP, or 6MWD. These findings support further confirmatory trials with a prespecified primary endpoint and longer follow-up.

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