# Assessing the impact of supervised interval training on cardiovascular autonomic neuropathy in type 2 diabetes patients

**Authors:** Laura Stirane, Karlis Stirans, Leonora Pahirko, Janis Mednieks, Karina Ostrovska, Aija Kļavina, Leo Selavo, Jelizaveta Sokolovska

PMC · DOI: 10.14814/phy2.70476 · 2025-08-13

## TL;DR

This study found that supervised interval walking training and physical activity education both reduce cardiovascular autonomic neuropathy in type 2 diabetes patients.

## Contribution

The study demonstrates that both interval training and physical activity education can reduce CAN severity in T2D patients.

## Key findings

- Both interval training and control groups showed significant reductions in Ewing scores.
- Cardiovascular autonomic neuropathy was detected in 66% of the T2D patients at baseline.
- The IT group showed a greater reduction in Ewing scores compared to the control group.

## Abstract

This post hoc analysis of the “Healthy walk” study evaluated the effect of interval walking training on cardiovascular autonomic neuropathy (CAN) in type 2 diabetes (T2D) patients. At baseline, 64 T2D patients underwent tilt table testing with autonomic reflex tests: heart rate responses to the Valsalva maneuver, deep breathing, and standing, and blood pressure responses to standing and sustained handgrip, using the Ewing score. Fifty‐six participants were allocated to an interval training (IT) group and control group. The IT group completed supervised interval walking training three times weekly for 60 min over 4 months, while the control group received physical activity education. Twenty‐four participants in the IT group and 30 in the control group completed the study. The primary endpoint of this post hoc analysis was the change in Ewing score. CAN was detected in 42 patients (66%), mean Ewing score of 2.7 ± 0.72. Those with CAN, 16 were in the IT group and 19 in the control group. Both groups showed a significant reduction in Ewing scores (IT: from 2.5 to 1.77, p = 0.003; control: from 2.72 to 1.91, p = 0.001). Interval walking training and physical activity education both reduce CAN severity in T2D patients.

## Linked entities

- **Diseases:** type 2 diabetes (MONDO:0005148)

## Full-text entities

- **Diseases:** T2D (MESH:D003924), CAN (MESH:D002318)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Figures

8 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12344275/full.md

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Source: https://tomesphere.com/paper/PMC12344275