DELIVERING GROUP-BASED TELE-EXERCISE SESSIONS FOR PEOPLE WITH TYPE 2 DIABETES: RESULTS AND EXPERIENTIAL INSIGHTS OF A PILOT STUDY

Abstract

Delivery of group-based tele-exercise is an emerging treatment option for people with type 2 diabetes (T2D), but best practice is not yet understood. We evaluated the results and experiential insights of a pilot study investigating this model of care. Sixteen people with T2D (age 58.7±12.6, 63% male, duration of T2D 10.0±8.4years) underwent an 8-week tele-exercise intervention. Participants were assessed at baseline (in-person and via telehealth; results compared using intra-class correlations coefficients) and post-intervention (in-person only). The program was delivered in groups of 3-5, by an Accredited Exercise Physiologist using Zoom. Sessions were held once weekly and incorporated whole-body aerobic and resistance exercise (45min) and health behaviour change education (15min), reflecting the structure of Medicare-subsidised group exercise physiology sessions. Semi-structured interviews were conducted to gain participant and clinician feedback. Adverse events were monitored throughout. The intervention demonstrated efficacy, with improvements in HbA1c (mean change -0.3±0.5%), fasting glucose (-0.8±0.8mmol/L), systolic blood pressure (-6.4±8.4mmHg), waist circumference (-0.8±4.2cm), muscular strength (30sec sit-to-stand score 1.6±2.9; 30sec bicep curl score 5.6±3.0) and fitness (2min step test score 24.5±11.9). Clients could reliably self-assess outcomes such as waist circumference (ICC 0.98, 95%CI 0.95-0.99), 30sec sit-to-stand (0.94, 0.82-0.98), and 2min step test (0.96, 0.87-0.99) when supervised by the clinician via telehealth, negating the need for in-person consults. No serious adverse events were reported. Key experiential insights include 1) Technological issues were minimised by providing clients with a guide for using Zoom, and conducting individual Zoom familiarisation sessions, prior to program start. 2) Client confidentiality could be managed by using breakout rooms for private conversations. 3) Creative exercise selection (e.g., TheraBand anchor points, non-traditional equipment) allowed participants to envision exercising in their home, which assisted in self-management. This study contributes practical insights to optimise the delivery of group-based tele-exercise interventions to people with T2