Research Information System
PHYSIOTHERAPY THEORY AND PRACTICE, 2026 (SCI-Expanded, Scopus)
Background: Physical activity (PA) has a protective effect on impaired glucose and pilates effectively supports patients with high plasma glucose levels. Objective: This study aimed to evaluate the effects of ACSM (American College of Sports Medicine) person-centered PA counseling using the 5A model (Assess, Advise, Agree, Assist, And Arrange), combined with Pilates exercises, on metabolic control variables in patients with prediabetes (PD) and type 2 diabetes (T2D). Methods: Ninety women with T2D and PD were randomly assigned to three groups: Group 1 (Pilates + PA counseling), Group 2 (PA counseling), and Group 3 (standard treatment). Both intervention groups also received standard treatment. Primary outcomes were metabolic measures (blood glucose and lipid parameters). Secondary outcomes included body composition (body fat %, visceral fat, muscle mass) and physical performance (functional capacity, PA level, balance). Measurements were taken at baseline and after 12 weeks. Results: No significant between-group differences were found in metabolic or body composition outcomes. However, Group 1 showed higher PA levels (p = .002, eta 2 = 0.13) and step counts (p = .003, eta 2 = 0.12) compared with the control group. Both intervention groups improved functional capacity (p = .001, eta 2 = 0.15) and balance (p < .001, eta 2 = 0.26). In T2D participants, functional capacity improved in Group 1 and 2 (both p < .001, eta 2 = 0.25). In PD participants, steps counts increased in Group 1 (p = .003, eta 2 = 0.24) compared with Group 3, while PA levels and balance scores (p < .001, both, eta 2 = 0.31, eta 2 = 0.43, respectively) improved in Groups 1 and 2. The remaining parameters showed no differences (p > .05). Conclusion: Physical activity counseling using the 5A model plus Pilates exercises may improve functional capacity, PA level, number of steps, and balance. In Type 2 diabetes, PA counseling alone may prevent declines in functional capacity. In PD, PA counseling improves PA levels and balance, and adding Pilates may further boost daily steps.