Effectiveness of tele‐guidance for physiotherapy in older patients with type 2 diabetes: A randomized controlled trial

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AIMS/INTRODUCTION: Whether regular intervention via modern communication tools is effective in older patients with type 2 diabetes is unclear. We aimed to determine the effects of tele-guidance for physiotherapy on muscle strength in such patients. MATERIALS AND METHODS: This randomized controlled trial was conducted at seven hospitals across Japan. The study participants were 74 older patients with type 2 diabetes randomly assigned to either the tele-guidance for physiotherapy group, which received weekly telephone interventions, or the non-intervention group. Both groups performed a combined aerobic and resistance exercise program. The intervention period was 6 months, during which the tele-guidance for physiotherapy and non-intervention groups received remote physiotherapy instruction once weekly and at the 3-month mark, respectively. RESULTS: Knee extension force was significantly increased in the tele-guidance for physiotherapy group (from 1.25 ± 0.52 to 1.34 ± 0.54 Nm/kg) but significantly decreased in the non-intervention group (from 1.28 ± 0.46 to 1.22 ± 0.43 Nm/kg). Hemoglobin A1c levels improved significantly in the tele-guidance for physiotherapy and non-intervention groups (from 9.5 ± 2.6 to 7.4 ± 1.6% and from 10.2 ± 2.5 to 7.6 ± 2.0%, respectively). Adherence to the physiotherapy program was significantly higher in the tele-guidance for physiotherapy group than in the non-intervention group (71.8% vs 48.6%). CONCLUSIONS: Weekly tele-guidance for physiotherapy proved effective in improving knee extension force and increasing physiotherapy adherence in older patients with type 2 diabetes. Tele-guidance may be a valuable intervention to improve muscle strength in such patients, offering a cost-effective, accessible solution for healthcare management.