Calisthenics and Passive Stretching Exercises for Patients with Type 2 Diabetes Mellitus: A Study Protocol

  • Norazila NordinEmail author
  • Zainal Abidin Zainuddin
Conference paper


Resistance training using one’s own body weight has a pivotal role in lessen the risk factors associated with type 2 diabetes mellitus (T2DM). One of the typical resistance training exercises is traditional calisthenics, frequently included in rehabilitation or physical therapy program. Likewise, passive stretching is beneficial in improving glycemic control and physical fitness. To date, however, the effect of calisthenics exercises and passive stretching that could improve the risk factors in the population are not well understood. The propose study therefore, sets out to assess the effectiveness of the supervised calisthenics exercise and passive stretching on glycemic controls, body composition, risk factors that associate with cardiovascular disease, and some fitness parameters. Adult patients who are registered in the Health Centre, UTM, Skudai and meet some inclusion criterion will be randomly chosen for this study. A total of 66 type 2 diabetics will be randomised into three experimental groups (i.e. calisthenics (CS) and passive stretching (PS) and also combined exercise (CP) and will receive treatment for 12 weeks of study duration. All parameters will be measured at baseline and post measurement. We are aiming for an improvement in physical measurement and blood biomarkers in subjects, besides investigating the effectiveness of intervention exercises on fitness parameters thereby improving their quality of life.


Calisthenics exercises Passive stretching Type 2 diabetes mellitus 



This work was supported by the health practitioners of the UTM Health Clinic, with the cooperation of the Rehabilitation Centre, Sultan Ismail Hospital Johore Bahru, Malaysia.


  1. 1.
    Holt, R. I. G., & Hanley, N. A. (2012). Endocrinology and Diabetes (6th ed.). Oxford. UK: Wiley Blackwell.Google Scholar
  2. 2.
    International Diabetes Federation. (2009). IDF Diabetes Atlas, 4th Edn. Retrieved from
  3. 3.
    Letchuman, G. R., Wan Nazaimoon, W. M., Wan Mohamad, W. B., Chandran, L. R., Tee, G. H., Jamaiyah, H., et al. (2006). Prevalence of Diabetes in the Malaysian National Health Mobidity Survey III. Medical Journal Malaysia, 65(3).Google Scholar
  4. 4.
    National Health and Morbidity Survey. (2011). The Fact Sheet. Retrieved from
  5. 5.
    Holt, R. I. G., & Hanley, N. A. (2012). Endocrinology and Diabetes (6th ed.). Wiley Blackwell: Oxford. UK.Google Scholar
  6. 6.
    WHO. (2011). Global Recommendation on Physical Activity For Health. Retrieved from
  7. 7.
    Mendes, R., Sousa, N., Almeida, A., Subtil, P., & Guedes-Marques, Fdo. (2015). Victor Machado Reis, José Luís Themudo-Barata. Exercise prescription for patients with type 2 diabetes—a synthesis of international recommendations: Narrative review. British Journal Sports Medicine, 1, 1–4.Google Scholar
  8. 8.
    Colberg, S. R., Sigal, R. J., Fernhall, B., Regensteiner, J. G., Blissmer, J. G., Rubin, R. R., et al. (2010). Exercise and Type 2 Diabetes. The American College of Sports Medicine and American Diabetes Association: Joint Position Statement. Diabetes Care, 33(12), e147–e167.CrossRefGoogle Scholar
  9. 9.
    Howley, E. T., & Thompson, D. L. (2012). Fitness Professional’s Handbook (6th ed.). USA: Human Kinetics.Google Scholar
  10. 10.
    American College Of Sports Medicine. (2010). ACSM’s guidelines for exercise testing and prescription (8th ed.). Baltimore: William and Wilkins.Google Scholar
  11. 11.
    Fleck, S. J., & Kraemer, W. J. (1997). Designing resistance training program (2nd ed.). Champaign, IL, US: Human Kinetics.Google Scholar
  12. 12.
    Tsuzuku, S., Kajioka, T., Endo, H., Abbott, Robert D., Curb, J. D., & Yano, K. (2007). Favorable effects of non-instrumental resistance training on fat distribution and metabolic profiles in healthy elderly people. Original Article European Journal of Applied Physiology, 99, 549–555.CrossRefGoogle Scholar
  13. 13.
    Guzel, N. A., Pinar, L., Colakoglu, F., Karacan, S. & Ozer, C. (2012). Long-Term Callisthenics Exercise Related Changes in Blood Lipids, Homocysteine, Nitric Oxide Level, and Body Composition in Middle-aged Healthy Sedentary Women. Chinese Journal of Physiology. 55.xx.Google Scholar
  14. 14.
    Ajayi-Vincent, O. B., & Adesina, M. O. (2013). Effects of resistance training on the blood lipid variables of young adults. European Scientific Journal, 9 (12).Google Scholar
  15. 15.
    Teramoto, M., & Golding, L. A. (2013). Regular Exercise and Plasma Lipid Levels Associated With the Risk of Coronary Heart Disease. Research Quarterly For Exercise and Sports., 80(2), 138–145.CrossRefGoogle Scholar
  16. 16.
    Sarvan, S. (2013). The Effect eight-week Core Exercises on Blood Lipid Profiles In Females. Australian Journal of Basic and Applied Sciences, 7(10), 209–214.Google Scholar
  17. 17.
    Ayan Perez, C., Martin Sanchez, V., Teixeira, De Souza, & De Paz Fernandez, J. A. (2007). Effects of a Resistance Training Program in Multiple Sclerosis Spanish Patients: A Pilot Study. Journal of Sports Rehabilitation, 16, 143–153.CrossRefGoogle Scholar
  18. 18.
    Ozer Kaya, D., Duzgun, I., Baltaci, G., Karacan, S., & Colakoglu, F. (2012). Effects of Calisthenics and Pilates Exercise on Coordination and Proprioception in Adult Women: Randomized Controlled Trial. Journal of Sports Rehabilitation., 21, 235–243.CrossRefGoogle Scholar
  19. 19.
    Farinatti, P. T. V., Rubini, E. C., Silva, E. B., & Vanfraechem, J. H. (2014). Flexibility of the Elderly After One-Year Practice of Yoga and Calisthenics. International Journal of Yoga Therapy, 24, 71–77.Google Scholar
  20. 20.
    Hamasaki, H., Kawashima, Y., Tamada, Y., Furuta, M., Katsuyama, H., Sako, A., et al. (2015). Associations of Low-intensity resistance training with body composition and lipid profiles in obese patients with Type 2 Diabetes. PLoS ONE, 10(7), e0132959.CrossRefGoogle Scholar
  21. 21.
    Nelson, A. G., & Kokkonen, J. (2014). Stretching Anatomy (2nd ed.). United States: Human Kinetics.Google Scholar
  22. 22.
    Nelson, A. G., Kokkonen, J. & Arnall, D. A. (2011). Twenty minutes of passive stretching lowers glucose levels in an at-risk population: An experimental study. Journal of Physiotherapy, 57.CrossRefGoogle Scholar
  23. 23.
    Putri Thanaya, S. A., Indrayani, A. W., & Andayani, N. L. N. (2015). Passive Stretching Menurunkan Kadar Glukosa Darah Pada Penderita Diabetes Melitus Tipe 2 Di Kota Denpasar. Majalah Ilmiah Fisioterapi Indonesia, 3(1).Google Scholar
  24. 24.
    Park, S. H. (2015). Effects of Passive Static Stretching on Blood Glucose Levels in Patients with Type 2 Diabetes Mellitus. Journal of Physical Therapy Science., 27, 1463–1465.CrossRefGoogle Scholar
  25. 25.
    Solomen, S., Syakya, R., Agarwal, K., Aaron, P., & Pradeep, S. (2015). Passive Stretching Versus Active Stretching on Immediate Blood Glucose in Subjects With Type II Diabetes Mellitus—A Pilot Study. International Journal of Physical Education, Sports and Health., 2(1), 146–149.Google Scholar
  26. 26.
    Alter, M. J. (1996). Science of Flexibility (2nd ed.). Champaign, IL, US: Human Kinetics.Google Scholar
  27. 27.
    Hayashino, Y., Jackson, J. L., Fukumori, N., Nakamura, F., & Fukuhara, S. (2012). Effects of Supervised Exercise on Lipid Profiles and Blood Pressure Control in People with Type 2 Diabetes Mellitus: A Meta-analysis of Randomized Controlled Trials. Diabetes Research and Clinical Practice, 98, 349–360.CrossRefGoogle Scholar
  28. 28.
    Gordon, B. A., Benson, A. C., Bird, S. R., & Fraser, S. F. (2009). Resistance Training Improves Metabolic Health In Type 2 Diabetes Mellitus: A Systemic Review. Diabetes Research and Clinical Practice, 83, 157–175.CrossRefGoogle Scholar
  29. 29.
    Honkola, A., Forsen, T., & Ericksson, J. (1997). Resistance Training improves the metabolic profile in individuals with type 2 diabetes. Acta Diabetologica, 34, 245–248.CrossRefGoogle Scholar
  30. 30.
    Castaneda, C., Layne, J. E., Munoz-Orians, L., Gordon, P. L., Walsmith, J., Foldvari, M., et al. (2002). A Randomized Controlled Trial of Resistance Exercise Training to Improve Glycemic Control in Older Adults With Type 2 Diabetes. Diabetes Care, 25(12), 2335–2341.CrossRefGoogle Scholar
  31. 31.
    Bweir, S., Al-Jarrah, M., Almalty, A. M., Maayah, M., Smirnova, I. V., Novikova, L., et al. (2009). Resistance Exercise Training Lowers HbA1c More Than Aerobic Training in Adults with Type 2 Diabetes. Diabetology & Metabolic Syndrome., 1, 27.CrossRefGoogle Scholar
  32. 32.
    Ghalavand, A., Shakeriyan, S., Monazamnezhad, A., & Delaramnasab, M. (2014). The Effect of Resistance Training on Cardio-Metabolic factors in Males with Type 2 Diabetes Jundishapur. Journal Chronic Disease Care, 3(4), e23346.Google Scholar
  33. 33.
    Dadgostar, H., Firouzinezhad, S., Ansari, M., Shima Younespour, S., Azam Mahmoudpour, A., & Khamseh, M. E. (2016). Supervised group-exercise theraphy versus home-based exercise therapy: Their effects on quality of life and cardiovascular risk factors in women with type 2 diabetes. Diabetes & Metabolic Syndrome: Clinical Research & Reviews., 2016, 1871–4021.Google Scholar
  34. 34.
    Plotnikoff, R. C., Eves, N., Jung, M., Sigal, R. J., Padwal, R., & Karunamuni, N. (2010). Multicomponent, Home-based Resistance Training for Obese Adults with Type 2 Diabetes: A Randomized Controlled Trial. International Journal of Obesity, 34, 1733–1741.CrossRefGoogle Scholar
  35. 35.
    Hazley, L., Ingle, L., Tsakirides, C., Carroll, S., & Nagi, D. K. (2010). Impact of a short-term, moderate intensity, lower volume circuit resistance training programme on metabolic risk factors in overweight/obese Type 2 Diabetics. Research In Sports Medicine., 18, 251–262.CrossRefGoogle Scholar
  36. 36.
    Arimi Fitri, M. L. (2013). Effects of a 16-week, home-based, high-intensity, progressive-resistance training program on glucose homeostasis, cardiovascular disease risk factors, and functional capacity of older Malaysians with type 2 Diabetes Mellitus. Doctor Philosophy. Serdang: Universiti Putra Malaysia.Google Scholar
  37. 37.
    Ibaneze, J., Izquierdo, M., Arguelles, I., Larrion, J. L., Garcia-Unciti, M., Idoate, M., et al. (2005). Twice-weekly Progressive Resistance Training (PRT) Decreases Abdominal Fat & Improves Insulin Sensitivity in Older Men With Type 2 Diabetes. Diabetes Care, 28(3), 662–667.CrossRefGoogle Scholar
  38. 38.
    Declaration of Helsinki. (2008). World Medical Association. Retrieved on 27 March 2016 from:
  39. 39.
    American Diabetes Association. (2014). Standard of Medical Care in Diabetes. Diabetes Care, 37(1), S14–S80.CrossRefGoogle Scholar
  40. 40.
    Simpson, K. A., Mavros, Y., Kay, S., Meiklejohn, J., Vos, N. D., Wang, Y., Guo, Q., et al. (2015). Graded Resistance Exercise And Type 2 Diabetes in Older adults (The GREAT2DO study): methods and baseline cohort characteristics of a randomized controlled trial. Simpson et al. Trials.Google Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2019

Authors and Affiliations

  1. 1.School of Education, Faculty of Social Sciences and HumanitiesUniversiti Teknologi MalaysiaSkudaiMalaysia

Personalised recommendations