Efficacy of exercise and electromagnetic field therapy on cardiovascular disease risk in patients with type 2 diabetes mellitus. Randomized controlled trial

A.A.M. Abdelaal, A.A. Khushhal, A.A. Ebid, A.R. Ibrahim
American Journal of Cardiovascular Disease, 15(6):509–521, 2025

Type 2 diabetes mellitus predisposes patients to abnormally increased atherosclerotic cardiovascular disease risk and deteriorated lower extremity functional status.

Objective: To evaluate the effect of combined application of moderate to high intensity interval training and low frequency pulsed electromagnetic therapy on atherosclerotic cardiovascular disease risk and lower extremity function in older adults with type 2 diabetes mellitus. 

Fifty-four patients (age 45-60 years) with type 2 diabetes mellitus were randomly allocated into four groups: group A underwent moderate to high intensity interval training plus low frequency pulsed electromagnetic therapy for 8 weeks (n=13), group B received low frequency pulsed electromagnetic therapy (n=14), group C underwent moderate to high intensity interval training (n=13), and group D were the controls (n=14).

The 10-year atherosclerotic cardiovascular disease risk was evaluated using the Atherosclerotic Cardiovascular Disease Risk Estimator Plus tool, while lower extremity function was assessed using the Short Physical Performance Battery. Statistical comparisons were conducted within and between groups using SPSS 20. A P-value <0.05 was considered statistically significant.

After 8 weeks, the atherosclerotic cardiovascular disease risk significantly decreased by -10.91% (P<0.001) and -6.66% (P<0.001) in groups A and C, respectively, non-significantly decreased by -0.16% (P=0.43) in group B, and non-significantly increased by 1.35% (P=0.24) in group D. The lower extremity function significantly increased by 64.62% (P<0.001), 27.48% (P=0.001), and 48.49% (P<0.001) in groups A, B, and C, respectively. There was a non-significant increase of 0.5% (P=0.73) in group D.

In conclusion, the combined application of moderate-to-high-intensity interval training and low-frequency pulsed electromagnetic therapy programmes was effective in improving atherosclerotic cardiovascular disease risk and lower extremity function in older adults with type 2 diabetes mellitus. Furthermore, the moderate-to-high-intensity interval training programme is more effective than low-frequency pulsed electromagnetic therapy in improving atherosclerotic cardiovascular disease risk and lower extremity function in patients with type 2 diabetes mellitus.