Feasibility and safety of a walking football program in middle-aged and older men with type 2 diabetes

Aims: This study aimed to analyze the feasibility and safety of a community-based walking football program in middle-aged and older men with type 2 diabetes (T2D). Methods: Thirty-one male (age, 64.4 ± 4.5 years old; glycated hemoglobin, 6.7 ± 1.0%; body mass index: 28.8 ± 3.3 kg/m²) patients with T2D were recruited from primary health care units in Porto, Portugal. The participants engaged in a 12-wk walking football program (three sessions per week of 60 min; consisting of strength and conditioning exercises, technical skills drills, and small-sided walking football games). Exercise intensity was planned to be gradual throughout the program in three 4-wk phases (phase I, light-intensity; phase II, moderate-intensity; phase III, vigorous-intensity) through the manipulation of game constraints, and monitored by OMNI scale and heart rate reserve (HRR). Sessions' enjoyment level, and exercise-related injuries and adverse events were recorded in all sessions. Results: The median (P25–P75) adherence to the program was 86.1% (77.8–97.2%). The median enjoyment levels reported by participants was 5 (4–5) points in phase I, 5 (5–5) points in phase II and 5 (5–5) points in phase III. Sessions' average subjective exercise intensity was 3.0 ± 0.6 points in OMNI scale in phase I, 3.5 ± 0.4 points in phase II, and 3.8 ± 0.4 points in phase III. Sessions' average HRR was 35.8 ± 6.7% in phase I, 41.6 ± 4.2% in phase II, and 37.3 ± 4.3% in phase III. Most participants attained vigorous-intensity peaks in all phases. Falls (n = 25) and musculoskeletal injuries (n = 8) were the most frequent adverse events. 31% of these events interfered with exercise participation, but no harm has resulted from it. Conclusion: A community-based walking football program for T2D patients revealed high levels of adherence and enjoyment, and light-to-vigorous exercise intensity. The adverse events were according to the expected for the population and activity. Therefore, walking football seems to be a feasible and safe exercise strategy, and has the potential for large scale implementation for T2D control. Trial registration: NCT03810846.