Enhancing Exercise Prescription and Adherence for Type 2 Diabetes Management for Adults with Long-COVID

Potential participants will initially make contact via email or phone if they are willing to volunteer to take part in the study. Potential participants will initially be screened to ensure they meet all eligibility criteria. After providing written informed consent, the participants will undergo one in-person assessment at the Hunter Medical Research Institute (~3 hours). The intervention group will undergo an 8-week exercise program, delivered in groups of 2-6 by an Accredited Exercise Physiologist. Participants will complete one 1-hour session per week, which will include 45 minutes of exercise and 15 minutes of education. Participants will be provided with an individualised home program to complete twice weekly, outside of the supervised sessions. The exercise sessions will include aerobic and resistance training, targeting all major muscle groups using body weight (e.g., wall push-ups), free weight (e.g., dumbbell bicep curl), and machine-based exercise (e.g., leg press). The exercise intensity will be prescribed based on long-COVID symptoms. The aim will be to achieve a Borg 0-10 category ratio dyspnoea or fatigue score of 4 to 6 (somewhat severe to severe). Exercise will be modified based on symptom responses to enable participants to exercise for high enough volumes and intensities to achieve physiological adaptations, without exacerbating unpleasant long-COVID symptoms. Exercises will be progressed on as as-needed basis. Adherence will be monitored through attendance checklists. In addition to the structured exercise component, the program will also include 15 minutes of education to help participants transition to self-management. These will be delivered by electronic slide presentations at the end of each session, and will cover such topics as safe intensity of movement, how to self-monitor symptoms and prevent activity-related symptom exacerbations, health behaviour change, exercise guidelines for T2D, goal setting, medications, and dietary guidelines. To enhance the likelihood of long-term behaviour change, the education sessions will target key constructs from Bandura’s Social Cognitive Theory (i.e., self-efficacy, goals, beliefs, and social support). The education has been specifically designed for this program. After the 8-week program, participants will attend the Hunter Medical Research Institute for their follow-up assessment (~3 hours).