Diabetes mellitus (DM) continues as a global alarming epidemic, with an increasingly growing health burden and complications across all socioeconomic levels. Type 2 diabetes mellitus (T2DM) is associated with wide peripheral vascular complications, manifested in deteriorated lower limb blood pressure and vascular endothelial dysfunction. Prevalence of peripheral vascular disorder varies with T2DM duration, ranging from 1.2% in newly discovered T2DM cases, to about 12.5% (after 18 years of T2DM affection), and reaches 20-30% in some reports.
The abnormally increased cardiovascular disease CVD (either through traditional risk factors or direct diabetes effects) is expected to continue rising alongside DM. Adequate management for DM and associated CVD risk factors is essential to ameliorate the progression of DM and CVD.
Being active is beneficial in alleviating the peripheral vascular disease burden in patients with disturbed peripheral vascular function. Supervised treadmill exercise training can improve functional performance in patients with peripheral arterial disorders. Increasing patients' activity level is a cornerstone item in patients with T2DM rehabilitation programs.
Patients may be challenged by the disease-related pathophysiological changes and treatment requirements. The hallmark of inactivity status that dominates in patients with T2DM negatively impacts their performance during weight-bearing activities. The existence of pain, peripheral vascular disturbances, abnormally increased and unequally distributed plantar stress, all limit patients' participation and compliance with the full weight-bearing training programs.
Introducing the well-controlled partial weight-bearing through the lower body positive pressure technology during exercise training programs augments patients' active participation, minimizes weight-bearing related musculoskeletal limitations, while maintaining normal locomotion dynamics and training-related physiological responses.
Conflicts arise regarding the benefits of full and partial weight-bearing exercise training for patients with T2DM. Previous studies investigated the effects of modulating the weight-bearing status during aerobic exercise training on different health aspects and concluded conflicting results. Quite recently published studies reported the safety and efficacy of the partial weight-bearing AET training in improving the T2DM-related musculoskeletal constraints.
To our knowledge, this study is the first to investigate the effects of partial weight bearing during AET on cardiovascular variables in patients with T2DM. The objectives of this study were to evaluate the effectiveness of partial weight off-loading during aerobic exercise training, using the antigravity treadmill, on the cardiovascular disease risk and the peripheral vascular health (presented by the ankle-brachial pressure index) in patients with T2DM.
