# The DiaActive study: feasibility, safety and acceptability of a fall-preventive rhythm- and ADL-based exercise protocol for older adults with type 2 diabetes

## TL;DR

This study tested a new exercise program to prevent falls in older adults with type 2 diabetes, finding it safe, feasible, and well-accepted.

## Contribution

A novel fall-preventive exercise protocol combining rhythm-based movement, ADL exercises, and social interaction for older adults with T2D.

## Key findings

- High adherence (median 88%) and no adverse events were observed during the four-week program.
- Participants reported increasing satisfaction and perceived the difficulty level as appropriately challenging over time.
- Positive group atmosphere and structured social elements were key motivators for adherence and engagement.

## Abstract

Older adults with type 2 diabetes (T2D) face an elevated risk of falls due to combined physical and cognitive impairments. The DiaActive feasibility study evaluated the safety, feasibility, and acceptability of a novel fall-prevention exercise program integrating multitask rhythm-based movement, activities of daily living (ADL) exercises, and a structured social component.

Eight community-dwelling adults (≥ 65 years) with T2D participated in two 60-minute physiotherapist-led sessions per week for four weeks (total 480 min). The program combined rhythm-based (Rythma) and ADL exercises with structured social interaction. Feasibility outcomes included adherence, safety, satisfaction, and overall acceptability.

Adherence was high, with a median attendance of 88% (range 75–100%) and 100% questionnaire completion. No injuries or adverse events occurred, indicating good safety and tolerability. Participants reported that session difficulty progressed appropriately, shifting from “too easy” early on to “appropriately challenging” by week four. Satisfaction increased over time, with most rating sessions as “satisfactory” or “very satisfactory.” Qualitative feedback evolved from exercise-focused comments to broader reflections on body awareness and social connectedness. The positive group atmosphere and structured social elements were key motivators supporting adherence and engagement.

The DiaActive protocol—combining rhythm-based, ADL-focused, and social components—was safe, feasible, and well accepted by older adults with T2D. High adherence, absence of adverse events, and increasing satisfaction support progression to a fully powered randomized controlled trial to assess clinical efficacy and long-term adherence.

The online version contains supplementary material available at 10.1007/s40520-026-03328-0.