Long-Term Benefits of Eccentric Cycling Exercise in Patients With Type 2 Diabetes Mellitus

NCT07109102 | Not Yet Recruiting

• 1 other identifier: USM/JEPeM/PP/25030323
• Study Type: interventional
• Target: 30
• Locations: 1 country
• Sites: 1

Brief Summary

The goal of this interventional study is to evaluate the long-term benefits of eccentric (ECC) cycling exercise on physiological responses, exercise capacity, and quality of life (QoL) in patients with type 2 diabetes mellitus (T2DM). The main questions it aims to answer are:

• What are the effects of ECC cycling compared to concentric (CON) cycling on physiological responses, exercise capacity, and QoL in patients with T2DM?
• What are the differential effects of moderate- and high-intensity ECC cycling compared to CON cycling on physiological responses, exercise capacity, and QoL in patients with T2DM? Researchers will compare moderate- and high-intensity ECC cycling to CON cycling (conventional cycling) to see if ECC cycling can be a viable alternative or complement to existing exercise protocols for managing T2DM. Participants will:
• Undergo pre-, mid-, and post-intervention assessment
• Perform either moderate- or high-intensity ECC cycling or moderate intensity CON cycling according to group randomisation by the researcher.
• Start with two familiarisation sessions prior to the actual cycling training.
• Perform cycling exercise twice per week for 10 weeks.

Conditions

Type 2 Diabetes Mellitus (T2DM)

Keywords

Eccentric cycling; eccentric exercise; exercise capacity; quality of life; physiological responses; Type 2 diabetes mellitus

Outcome Measures

Primary Outcomes (6)

• Glycated haemoglobin (HbA1C)

  Baseline and post-intervention at 10 weeks

• Lipid profile

  Baseline and post-intervention at 10 weeks

• Maximal voluntary contraction (MVC)

  isometric quadriceps peak torque (QPT) and isokinetic QPT

  Baseline, mid-intervention (6 weeks), and post-intervention (10 weeks).

• Exercise capacity

  6-minute walk test (6-MWT)

  Baseline, mid-intervention (6 weeks), and post-intervention (10 weeks)

• 13-item Revised Version of Diabetes Quality of Life (RV-DQOL13)

  Scores range from 13 to 65, with higher scores reflecting reduced quality of life

  Baseline, mid-intervention (6 weeks), and post-intervention (10 weeks)

• Short Form-12 (SF-12) health survey

  Scoring ranges from 0 to 100, with higher scores indicating better physical and mental health.

  Baseline, mid-intervention (6 weeks), and post-intervention (10 weeks)

Secondary Outcomes (9)

• Electromyography (EMG) for muscle activity assessment

  Baseline, mid-intervention (6 weeks), and post-intervention (10 weeks)

• Blood pressure

  Baseline and up to 10 weeks

• Heart rate

  Baseline and up to 10 weeks

• Borg Category-Ratio scale (Borg CR-10)

  Every cycling training session from week 1 to week 10

• Body weight

  Baseline, mid-intervention (6 weeks), and post-intervention (10 weeks)

Study Arms (3)

Moderate intensity eccentric cycling (MI-ECC)

EXPERIMENTAL

Other: Moderate-intensity eccentric cycling

High intensity eccentric cycling (HI-ECC)

EXPERIMENTAL

Other: High-intensity eccentric cycling

Moderate intensity concentric cycling (MI-CON)

ACTIVE COMPARATOR

Other: Moderate-intensity concentric cycling

Interventions

Moderate-intensity eccentric cycling OTHER

* This group will perform eccentric cycling exercise twice per week for ten weeks using the Cyclus2 standard eccentric ergometer. * The intensity will start at 60% of the peak power output (PPO) of the incremental concentric cycling test. * The intensity will progressively increase by 5% of PPO every 2 weeks (60%-80% PPO).

Also known as: MI-ECC

Moderate intensity eccentric cycling (MI-ECC)

High-intensity eccentric cycling OTHER

* This group will perform eccentric cycling exercise twice per week for ten weeks using the Cyclus2 standard eccentric ergometer. * The intensity will start at 80% of the peak power output (PPO) of the incremental concentric cycling test. * The intensity will progressively increase by 5% of PPO every 2 weeks (80%-100% PPO).

Also known as: HI-ECC

High intensity eccentric cycling (HI-ECC)

Moderate-intensity concentric cycling OTHER

* This group will perform concentric cycling exercise twice per week for ten weeks using the Lode Excalibur sport ergometer. * The intensity will start at 60% of the peak power output (PPO) of the incremental concentric cycling test. * The intensity will progressively increase by 5% of PPO every 2 weeks (60%-80% PPO).

Also known as: MI-CON

Moderate intensity concentric cycling (MI-CON)

Eligibility Criteria

• Age: 30 Years - 60 Years
• Sex: male
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Male diagnosed with T2DM
• Age 30 - 60 years old
• Height ≥155cm (To ensure proper ergonomics, comfort and safety during cycling)
• HbA1C level between 6-8%
• No resistance exercise for ≤ 3 months before participating in the current study.
• Physical inactivity (moderate to vigorous exercise ≤60 minutes weekly based on International Physical Activity Questionnaires-Short Form (IPAQ-SF))

You may not qualify if:

• Acute illness or any foot ulcer, diabetic ulcer, retinopathy, kidney, musculoskeletal, cardiovascular, or neurological disorder that could impair exercise performance or pose a risk to participants during exercise.
• Insulin injection

Sponsors & Collaborators

• Universiti Sains Malaysia: lead

Study Sites (1)

Cardio and Muscle Function Laboratory, Pusat Perubatan USM Bertam

Kepala Batas, Pulau Pinang, 13200, Malaysia

Location

Related Publications (12)

• Ansari M, Hardcastle S, Myers S, Williams AD. The Health and Functional Benefits of Eccentric versus Concentric Exercise Training: A Systematic Review and Meta-Analysis. J Sports Sci Med. 2023 Jun 1;22(2):288-309. doi: 10.52082/jssm.2023.288. eCollection 2023 Jun.

  PMID: 37293426 BACKGROUND

• Borot L, Pageaux B, Laroche D, Vergotte G, Lepers R, Perrey S. Eccentric cycling involves greater mental demand and cortical activation of the frontoparietal network. Scand J Med Sci Sports. 2024 Jan;34(1):e14517. doi: 10.1111/sms.14517. Epub 2023 Oct 9.

  PMID: 37814520 BACKGROUND

• Penailillo L, Blazevich AJ, Nosaka K. Factors contributing to lower metabolic demand of eccentric compared with concentric cycling. J Appl Physiol (1985). 2017 Oct 1;123(4):884-893. doi: 10.1152/japplphysiol.00536.2016. Epub 2017 Jun 29.

  PMID: 28663378 BACKGROUND

• Hoppeler H. Moderate Load Eccentric Exercise; A Distinct Novel Training Modality. Front Physiol. 2016 Nov 16;7:483. doi: 10.3389/fphys.2016.00483. eCollection 2016.

  PMID: 27899894 BACKGROUND

• Marcus RL, Lastayo PC, Dibble LE, Hill L, McClain DA. Increased strength and physical performance with eccentric training in women with impaired glucose tolerance: a pilot study. J Womens Health (Larchmt). 2009 Feb;18(2):253-60. doi: 10.1089/jwh.2007.0669.

  PMID: 19183097 BACKGROUND

• Clos P, Laroche D, Stapley PJ, Lepers R. Neuromuscular and Perceptual Responses to Sub-Maximal Eccentric Cycling. Front Physiol. 2019 Mar 28;10:354. doi: 10.3389/fphys.2019.00354. eCollection 2019.

  PMID: 30984032 BACKGROUND

• Penailillo L, Blazevich A, Numazawa H, Nosaka K. Metabolic and muscle damage profiles of concentric versus repeated eccentric cycling. Med Sci Sports Exerc. 2013 Sep;45(9):1773-81. doi: 10.1249/MSS.0b013e31828f8a73.

  PMID: 23475167 BACKGROUND

• LaStayo P, Marcus R, Dibble L, Frajacomo F, Lindstedt S. Eccentric exercise in rehabilitation: safety, feasibility, and application. J Appl Physiol (1985). 2014 Jun 1;116(11):1426-34. doi: 10.1152/japplphysiol.00008.2013. Epub 2013 Jul 3.

  PMID: 23823152 BACKGROUND

• LaStayo PC, Ewy GA, Pierotti DD, Johns RK, Lindstedt S. The positive effects of negative work: increased muscle strength and decreased fall risk in a frail elderly population. J Gerontol A Biol Sci Med Sci. 2003 May;58(5):M419-24. doi: 10.1093/gerona/58.5.m419.

  PMID: 12730250 BACKGROUND

• Kudiarasu C, Rohadhia W, Katsura Y, Koeda T, Singh F, Nosaka K. Eccentric-only versus concentric-only resistance training effects on biochemical and physiological parameters in patients with type 2 diabetes. BMC Sports Sci Med Rehabil. 2021 Dec 20;13(1):162. doi: 10.1186/s13102-021-00384-z.

  PMID: 34930480 BACKGROUND

• Julian V, Thivel D, Miguet M, Pereira B, Costes F, Coudeyre E, Duclos M, Richard R. Eccentric cycling is more efficient in reducing fat mass than concentric cycling in adolescents with obesity. Scand J Med Sci Sports. 2019 Jan;29(1):4-15. doi: 10.1111/sms.13301. Epub 2018 Oct 4.

  PMID: 30222208 BACKGROUND

• Szucs G, Pipicz M, Szabo MR, Csont T, Torok L, Csonka C. Effect of Eccentric Exercise on Metabolic Health in Diabetes and Obesity. Sports Med Open. 2023 Sep 29;9(1):91. doi: 10.1186/s40798-023-00596-2.

  PMID: 37775653 BACKGROUND

Related Links

• Related Info

MeSH Terms

Conditions

Diabetes Mellitus, Type 2

Condition Hierarchy (Ancestors)

Diabetes Mellitus; Glucose Metabolism Disorders; Metabolic Diseases; Nutritional and Metabolic Diseases; Endocrine System Diseases

Central Study Contacts

Syamimi Shamsuddin

CONTACT

+6045622024; syamimi.s@usm.my

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Model Details: This study is an open-label, single-centre, parallel-group, three-arm, randomised controlled study.

Study Record Dates

• First Submitted: July 29, 2025
• First Posted: August 7, 2025
• Study Start: August 1, 2025
• Primary Completion: May 1, 2026
• Study Completion (Estimated): August 1, 2026
• Last Updated: August 7, 2025

Record last verified: 2025-07

Data Sharing

• IPD Sharing: Will not share

Locations

MY (1)