Last updated September 3, 2026
Key finding
Knee extension force significantly increased from 1.25 ± 0.52 to 1.34 ± 0.54 Nm/kg.
Weekly tele-guidance for physiotherapy improved muscle strength in older patients with type 2 diabetes.
Quick read
The essential study design details in one scan.
EvidenceScore™
Moderate
Study type
RCTs
Follow-up
Medium-Term (3–12 mo)
Risk of bias
Some Concerns
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Plain-language summary
A plain-language read of the study’s main message and where it applies.
Study focus
Weekly tele-guidance for physiotherapy improved muscle strength in older patients with type 2 diabetes.
Improving muscle strength and adherence to physiotherapy in older adults with type 2 diabetes can lead to better overall health, reduced complications, and enhanced quality of life. This study suggests that tele-guidance may be a valuable tool for managing diabetes and promoting physical activity in this population.
Limited sample size may affect generalizability. Short duration of the intervention may not capture long-term effects. Potential selection bias in participant recruitment.
Published in
Publication details and source links for this paper.
Hiroaki K, Takuo N, Hiroyuki O, Yukio I. Weekly tele-guidance for physiotherapy improves muscle strength in older patients with type 2 diabetes. Journal of Diabetes Investigation. 2025;16(7):1284-1291. doi:10.1111/jdi.70047
Knee extension force increased by 0.09 Nm/kg in the tele-guidance group (p=0.021).
Knee extension force decreased by 0.06 Nm/kg in the non-intervention group (p=0.044).
Hemoglobin A1c levels improved by 2.1% in one group (p=0.001) and by 2.6% in another (p=0.001).
Adherence to the physiotherapy program was 71.8% in the tele-guidance group compared to 48.6% in the non-intervention group.
Evidence network
Understand where this research contributes within the broader evidence network.
This study contributes evidence to Group B: Adapted intervention with 2-3 monthly messages, Tele-guidance for physiotherapy and Adherence to physiotherapy program, Knee extension force, Reduction in Hemoglobin A1C levels.
This study contributes evidence to
Primary intervention
Group B: Adapted intervention with 2-3 monthly messages
Primary outcomes
Evidence topics
Primary intervention
Intervention and outcome relationships this study adds to the evidence network.
Editorial context
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Evidence network role
This section describes how the study fits into the current evidence network. It does not determine whether an intervention works on its own.
1
Related topics
6
Evidence pairs
603
Related studies
Evidence topic
Contributes evidence
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Primary evidence
Evidence topic
matched_outcome
Core evidence
The primary outcomes reported in this study.
Group B: Adapted intervention with 2-3 monthly messages → Adherence to physiotherapy program
Group B: Adapted intervention with 2-3 monthly messages → Adherence to physiotherapy program
Group B: Adapted intervention with 2-3 monthly messages → Knee extension force
Group B: Adapted intervention with 2-3 monthly messages → Knee extension force
Group B: Adapted intervention with 2-3 monthly messages → Reduction in Hemoglobin A1C levels
Group B: Adapted intervention with 2-3 monthly messages → Reduction in Hemoglobin A1C levels
Tele-guidance for physiotherapy → Adherence to physiotherapy program
Tele-guidance for physiotherapy → Adherence to physiotherapy program
Tele-guidance for physiotherapy → Knee extension force
Tele-guidance for physiotherapy → Knee extension force
Tele-guidance for physiotherapy → Reduction in Hemoglobin A1C levels
Tele-guidance for physiotherapy → Reduction in Hemoglobin A1C levels
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Relationships organized using the Dediabetes Evidence Intelligence™ framework.
This study contributes to evidence on Group B: Adapted intervention with 2-3 monthly messages and Adherence to physiotherapy program, Group B: Adapted intervention with 2-3 monthly messages and HbA1c.
This study contributes to the evidence on the following intervention-outcome relationships.
Behavioral & Lifestyle
Behavioral & Lifestyle
Curated evidence collections and hubs this study is part of.
All studies measuring Adherence to physiotherapy program
Measures Adherence to physiotherapy program as a key outcome.
All studies on Group B: Adapted intervention with 2-3 monthly messages
Contributes to Group B: Adapted intervention with 2-3 monthly messages evidence base.
All studies measuring HbA1c
Measures HbA1c as a key outcome.
Latest published studies
Published within the last 2 years.
Jump to pre-filtered views in Evidence Explorer.
1 results
1 results
1 results
1 results
1 results
Generated from the study's connected evidence using Evidence Intelligence™.
Group B: Adapted intervention with 2-3 monthly messages appears to reduce reduction in hemoglobin a1c levels.
ConsistencyScore™: Consistency cannot yet be determined from the available evidence.
Ranked evidence signals
Reduction in Hemoglobin A1C levels
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | strong positive | ConsistencyScore™ Unclear | 1 study
Why this answer: This answer is based on a single supporting study.
Limitations
Tele-guidance for physiotherapy appears to improve adherence to physiotherapy program.
ConsistencyScore™: Consistency cannot yet be determined from the available evidence.
Ranked evidence signals
Adherence to physiotherapy program
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | strong positive | ConsistencyScore™ Unclear | 1 study
Why this answer: This answer is based on a single supporting study.
Limitations
Tele-guidance for physiotherapy appears to improve knee extension force.
ConsistencyScore™: Consistency cannot yet be determined from the available evidence.
Ranked evidence signals
Knee extension force
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | strong positive | ConsistencyScore™ Unclear | 1 study
Why this answer: This answer is based on a single supporting study.
Limitations
Tele-guidance for physiotherapy appears to reduce reduction in hemoglobin a1c levels.
ConsistencyScore™: Consistency cannot yet be determined from the available evidence.
Ranked evidence signals
Reduction in Hemoglobin A1C levels
EvidenceScore™ Emerging | EvidenceScore™ 59.0 | strong positive | ConsistencyScore™ Unclear | 1 study
Why this answer: This answer is based on a single supporting study.
Limitations
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