Effect of exercise-based rehabilitation on functional capacity and renal function in type 2 diabetes mellitus with nephropathy: a randomized controlled trial

Introduction: Diabetic nephropathy is a growing public health challenge with implications on health. Renal function decline impacts the functional ability and overall health and well-being of individuals with diabetic nephropathy due to development of several renal manifestations. The objective of the study was to determine the effect of an exercise-based rehabilitation program on functional capacity and renal function among individuals with type 2 diabetic nephropathy. Methods: A total of 283 individuals were screened and 60 eligible participants aged 45–70 years with diabetic nephropathy were randomly allocated (n = 30 each) to the intervention group (IG) and control group (CG), respectively. The study outcome measures comprised of functional capacity (6-min walk test) and renal function assessed at baseline, 12th week and 24th week. Participants allocated to IG received 12 weeks of exercise based rehabilitation (comprising of supervised + home-based exercises) along with standard care and followed-up till 24th week. Results: The repeated measures ANOVA with Greenhouse–Geisser correction indicated significant timepoint*group interaction effect for 6-min walk distance F _{(1.71, 90.59)} = 619, p < 0.001, serum creatinine F _{(1.23, 65.14)} = 174.8, p < 0.001, estimated glomerular filtration rate F_{(1.15, 60.88)} = 105.2, p < 0.001, serum urea F_{(1.48, 78.45)} = 261.4, p < 0.001 and urine protein F _{(1.13, 59.82)} = 4.58, p < 0.328. Conclusion: The study found that exercise based rehabilitation improved both functional capacity and renal function among individuals with type 2 diabetic nephropathy.