Document Type : Original Article


1 Research Center for Health Sciences and Department of Health, School of Public Health, Hamadan University of Medical Sciences, Hamadan

2 Department of Health Education and Promotion, Faculty of Health, Isfahan University of Medical Science

3 Department of Health Services, Faculty of Health, Tehran University of Medical Sciences, Tehran, Iran


Background: Regular physical activity has an important role in reducing cardiovascular risk factors
and improving metabolic control in patients with type 2 diabetes. This study aims to investigate the
effect of physical activity stage-matched intervention on metabolic control in type 2 diabetes patients.
Materials and Methods: An 8-week physical activity program conducted with 50 type 2 diabetes
females who were physically inactive and in precontemplation, contemplation, and preparation
stages of change. Participants were divided into intervention and control groups (each group, n =
25). Data were collected by physical activity stage of change questionnaire and metabolic factors
were measured by laboratory tests before initiation program. Subsequently, stage-matched physical
activity program was conducted for the interventional group. Control group received routine education
from the diabetes center. After 8 weeks, physical activity questionnaire filled out by participants and
metabolic factors were evaluated by a laboratory test. Results: Findings showed patients in the
intervention group and compared with control group significantly moved through stages of change
after physical activity program (P-value < 0.05). Evaluation of physical activity after educational
program demonstrated that the intervention group adopted regular physical activity more than
the control group and also the difference between groups was significant (P-value < 0.05). Our
findings indicate a significant relationship between physical activity level and moving in stages of
change in the intervention group (P-value < 0.05). Comparison of metabolism factors after physical
activity program showed significant decrease in glycosilated hemoglobin in the intervention group
than the control group (P-value < 0.05). However, significant differences between groups were not
observed in other metabolism factors. Conclusion: Designing and implementing physical activity
stage-matched intervention can improve metabolic control and management of type 2 diabetes.


1. Kirk AF, Mutrie N, Macintyre PD, Fisher MB. Promoting and
maintaining physical activity in people with type 2 diabetes. Am J
Prev Med 2004;27:289-96.
2. Kim Y, Cardinal BJ, Lee J. Undrestanding exercise behavior among
Korean adults: A test of transtheoretical model. Int J Behav Med
3. Maiorana A, O’Driscoll G, Goodman C, Taylor R, Green D. Combined
aerobic and resistance exercise improves glycemic control and
fitness in type 2 diabetes. Diabetes Res Clin Pract 2002;56:115-23.
4. Jeon CY, Lokken RP, Hu FB, van Dam RM. Physical activity of
moderate intensity and risk of type 2 diabetes. Diabetes Care
5. Zanuso S, Jimenez A, Pugliese G, Corigliano G, Balducci S. Exercise
for the management of type 2 diabetes: A review of the evidence.
Acta Diabetol 2010;47:15-22.
6. Kirk A, MacMillan F, Webster N. Application of the Transtheoretical
model to physical activity in older adults with type 2 diabetes and/
or cardiovascular disease. Psychol Sport Exerc 2010;11:320-4.
7. Prochaska JO, Redding CA, Evers KE. The trans theoretical model
and stages of change. Health behavior and health education: Theory,
research, and practice. San Francisco: Jossey–Bass; 2002. p. 99-120.
8. US National Cancer Institute (2005). Theory at a Glance: A Guide
for Health Promotion Practice (second edition). U.S. Department
of Health and Human Services, National Institutes of Health. www. 9. Pekmezi D, Barbera B, Marcus BH. Using
the transtheoretical model to promote physical activity. ACSM
Health Fit J 2010;14.
10. Shirazi KK, Wallace LM, Niknami S, Hidarnia A, Torkaman G,
Gilchrist M, et al. A home-based, transtheoretical change model
designed strength training intervention to increaseexercise to
prevent osteoporosis in Iranian women aged 40-65 years: A
randomized controlled trial. Health Educ Res 2007;22:305-17.
11. Sigal RJ, Kenny GP, Boulé NG, Wells GA, Prud’homme D, Fortier M,
et al. Effects of aerobic training, resistance training, or both on
glycemic control in type 2 diabetes. Ann Intern Med 2007;147:357-69.
12. Kevin A, Hughes M. Readiness to change and clinical success in a
diabetes educational program. J Am Board Fam Pract 2002;15:266-71.
13. Allen NA, Fain JA, Braun B, Chipkin SR. Continuous glucose
monitoring counseling improves physical activity behaviors of
individuals with type 2 diabetes: A randomized clinical trial. Diabetes
Res Clin Pract 2008;80:371-9.
14. Kim YH. Application of the transtheoretical model to identify
psychological constructs influencing exercise behavior:
A questionnaire survey. Int J Nurs Stud 2007;44:936-44.
15. Findorff MJ, Stock HH, Gross CR, Wyman JF. Does the
Transtheoretical Model (TTM) explain exercise behavior in a
community-based sample of older women? J Aging Health
16. Molison EF, Yadric MK. Stages of change and fluid intake in dialysis
patients. Patient Edu Couns 2003;49:5-12.