Impact of at-home circuit training on cardiovascular risk, functional capacity and quality of life in older adults with knee osteoarthritis and diabesity: a randomized controlled trial

Sameer Badri Al-Mhanna; Zahid Nori Kamaluddin; Georgian Badicu; Wan Syaheedah Wan Ghazali; Mahaneem Mohamed; Ayu Suzailiana Muhamad; Monira I. Aldhahi; Shaifuzain Ab Rahman; Hafeez Abiola Afolabi; Ab Hamid Siti-Azrin; Maha H. Alhussain; Fatma Hilal Yagin; Mehmet Gülü; Abubakar Ibrahim; Clemens Drenowatz; Alexios Batrakoulis; Sameer Badri Al-Mhanna; Zahid Nori Kamaluddin; Georgian Badicu; Wan Syaheedah Wan Ghazali; Mahaneem Mohamed; Ayu Suzailiana Muhamad; Monira I. Aldhahi; Shaifuzain Ab Rahman; Hafeez Abiola Afolabi; Ab Hamid Siti-Azrin; Maha H. Alhussain; Fatma Hilal Yagin; Mehmet Gülü; Abubakar Ibrahim; Clemens Drenowatz; Alexios Batrakoulis

doi:10.3934/publichealth.2026018

AIMS Public Health

2026, Volume 13, Issue 1: 327-352. doi: 10.3934/publichealth.2026018

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Research article

Impact of at-home circuit training on cardiovascular risk, functional capacity and quality of life in older adults with knee osteoarthritis and diabesity: a randomized controlled trial

1.
Department of Physiology, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu, India
2.
Department of Higher Studies, Al-Qasim Green University, Babylon, Iraq
3.
Department of Physical Education and Special Motricity, Transilvania University of Braşov, Braşov, Romania
4.
Department of Physiology, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
5.
Exercise and Sports Science Program, School of Health Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
6.
Department of Rehabilitation Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh 11671, Saudi Arabia
7.
Department of Orthopedic, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
8.
Department of General Surgery, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
9.
Biostatistics and Research Methodology Unit, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
10.
Department of Food Science and Nutrition, College of Food and Agricultural Science, King Saud University, Riyadh 11451, Saudi Arabia
11.
Department of Biostatistics, Faculty of Medicine, Malatya Turgut Ozal University, Malatya 44210, Turkey
12.
Department of Sports Management, Faculty of Sport Sciences, Kirikkale University, Kirikkale, Turkey
13.
School of Medical Sciences University Sains Malaysia, Department of Obstetrics and Gynecology
14.
Division of Sport, Physical Activity and Health, University of Education Upper Austria, Austria
15.
Department of Life Sciences, School of Sciences, European University Cyprus, Nicosia 2404, Cyprus
16.
Department of Physical Education and Sport Science, School of Physical Education, Sport Science and Occupational Therapy, Komotini 69100, Greece

Received: 22 October 2025 Revised: 26 December 2025 Accepted: 29 January 2026 Published: 09 March 2026

Background
The present study was designed to investigate the effectiveness of a 12-week home-based circuit training (HBCT) protocol on numerous indices associated with knee osteoarthritis (KOA) and cardiometabolic health among older adult patients with KOA and the metabolic overlap between obesity and type 2 diabetes, also known as diabesity.
Methods
This randomized controlled trial was registered at the Clinical Trials Registry (Date: March 7, 2024; ID: NCT06309654). Seventy overweight or obese participants (56% male) with a mean age of 62.2 ± 6.1 years were randomly allocated to the exercise group (n = 35, HBCT) or the non-exercising control group (n = 35, CON). HBCT performed a progressive protocol, lasting 20–60 min, three times per week. Each exercise session comprised seven exercises, with 15–30 repetitions, a 1-min passive rest between exercises, and 2–4 rounds per session. The assessment of outcomes included knee injury and osteoarthritis outcome score, cardiometabolic risk factors, cardiorespiratory fitness, and renal function at pre- and post-training.
Results
The results demonstrate that HBCT led to a notable enhancement in the majority of cardiometabolic health indicators (e.g., anthropometrics, blood pressure, and glucose metabolism), KOA parameters related to quality of life and functionality, and cardiorespiratory fitness when compared with CON (p < 0.05). No significant changes were observed in total bilirubin, sodium, urea, and resting heart rate between HBCT and CON.
Conclusion
The present results suggest that an injury-free HBCT program may improve numerous cardiometabolic health- and KOA-related indicators in older adult patients with KOA and diabesity.
- aerobic exercise,
- strength training,
- glycemic control,
- blood pressure,
- oxidative stress,
- metabolic syndrome
Citation: Sameer Badri Al-Mhanna, Zahid Nori Kamaluddin, Georgian Badicu, Wan Syaheedah Wan Ghazali, Mahaneem Mohamed, Ayu Suzailiana Muhamad, Monira I. Aldhahi, Shaifuzain Ab Rahman, Hafeez Abiola Afolabi, Ab Hamid Siti-Azrin, Maha H. Alhussain, Fatma Hilal Yagin, Mehmet Gülü, Abubakar Ibrahim, Clemens Drenowatz, Alexios Batrakoulis. Impact of at-home circuit training on cardiovascular risk, functional capacity and quality of life in older adults with knee osteoarthritis and diabesity: a randomized controlled trial[J]. AIMS Public Health, 2026, 13(1): 327-352. doi: 10.3934/publichealth.2026018

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Abstract

Background

The present study was designed to investigate the effectiveness of a 12-week home-based circuit training (HBCT) protocol on numerous indices associated with knee osteoarthritis (KOA) and cardiometabolic health among older adult patients with KOA and the metabolic overlap between obesity and type 2 diabetes, also known as diabesity.

Methods

This randomized controlled trial was registered at the Clinical Trials Registry (Date: March 7, 2024; ID: NCT06309654). Seventy overweight or obese participants (56% male) with a mean age of 62.2 ± 6.1 years were randomly allocated to the exercise group (n = 35, HBCT) or the non-exercising control group (n = 35, CON). HBCT performed a progressive protocol, lasting 20–60 min, three times per week. Each exercise session comprised seven exercises, with 15–30 repetitions, a 1-min passive rest between exercises, and 2–4 rounds per session. The assessment of outcomes included knee injury and osteoarthritis outcome score, cardiometabolic risk factors, cardiorespiratory fitness, and renal function at pre- and post-training.

Results

The results demonstrate that HBCT led to a notable enhancement in the majority of cardiometabolic health indicators (e.g., anthropometrics, blood pressure, and glucose metabolism), KOA parameters related to quality of life and functionality, and cardiorespiratory fitness when compared with CON (p < 0.05). No significant changes were observed in total bilirubin, sodium, urea, and resting heart rate between HBCT and CON.

Conclusion

The present results suggest that an injury-free HBCT program may improve numerous cardiometabolic health- and KOA-related indicators in older adult patients with KOA and diabesity.

Acknowledgments

The authors gratefully acknowledge Universiti Sains Malaysia for supporting this study under Grant No. 304.PPSP.6315639. The authors would like to express their gratitude to the participants for their commitment and dedication throughout the experiment.

Data availability

All data generated or analyzed during this study are included in this published article and its supplementary information files.

Authors' contributions

All authors contributed equally to this work.

Conflict of interest

Clemens Drenowatz is the guest editors for special issue of AIMS Public Health and was not involved in the editorial review or the decision to publish this article. All authors declare that there are no competing interests.

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