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

Abstract Purpose 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. Methods 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. Results 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. Conclusion 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.