Author(s): FIELD, A., PINTO, H., LEIFSSON, E., SJÚRÐARSON, T., NIKONTOVIC, A., FISCHER, A., HARPER, L., POVOAS, S., NIKOLEIZIG, L., JOHANNESEN, H., KRUSTRUP, P., MOHR, M., SKORADAL, M., Institution: MANCHESTER METROPOLITAN UNIVERSITY, Country: UNITED KINGDOM, Abstract-ID: 2433

INTRODUCTION:
Recreational football (RF) is an effective model for delivering structured physical activity and inducing meaningful cardiometabolic and fitness adaptations. However, its high-intensity demands, including sustained running and frequent changes of direction, may limit its suitability for older adults and individuals living with lifestyle-related conditions. Walking football (WF) has emerged as a modified, lower-intensity format that removes running to enhance accessibility while aiming to preserve the social and motivational elements central to football’s appeal. For populations managing conditions such as type 2 diabetes mellitus (T2DM), exercise must provide sufficient physiological stimulus while remaining tolerable and enjoyable to support sustained engagement and positive long-term health outcomes. Despite the growing popularity of WF, it remains unclear whether it elicits comparable acute glycaemic and physiological responses to RF in adults with T2DM, and direct comparisons of physical and perceptual demands between formats in this population are lacking. Therefore, the present study compared the acute glycaemic, physiological, physical, perceptual, and enjoyment responses to WF and RF in older adults with T2DM.
METHODS:
Forty-five adults with T2DM (60 ± 5 years, 23 women) completed two 40-min small-sided game sessions (WF and RF) in a randomised, counterbalanced crossover design. Heart rate (HR), distances, and speeds were recorded continuously during sessions. Differential ratings of perceived exertion (RPE) were collected for whole-body, muscular, and respiratory domains. Psychological flow was assessed post-session. Interstitial glucose was monitored continuously for 24 h post-session. Paired t-tests were conducted, significance was set at p < 0.05, and Cohen’s d effect sizes were calculated.
RESULTS:
Mean 24-h interstitial glucose did not differ (WF: 7.11 ± 1.70 vs. RF: 7.06 ± 1.74 mmol·L⁻¹, p = 0.60), nor did glucose area under the curve values (WF: 169 ± 31 vs. RF: 172 ± 34 mmol·L⁻¹·h, p = 0.54). Average and peak HR were higher in RF (138 ± 12 vs. 125 ± 17 bpm, p = 0.051; 179 ± 31 vs. 173 ± 31 bpm, p < 0.05), though time spent >70% maximum HR was similar (29 vs. 27 min, p > 0.05). RF had greater physical loads, including total distance (1,844 ± 598 vs. 1,611 ± 542 m, p < 0.05), maximum speed (15.2 ± 4.0 vs. 13.5 ± 2.8 km·h⁻¹, p < 0.05), and moderate-speed distance (255 ± 152 vs. 196 ± 126 m, p < 0.05). RPE was higher for RF across whole-body, muscular, and respiratory domains (all p < 0.05). Psychological flow was similar between formats (RF: 5.8 ± 0.9 vs. WF: 5.5 ± 1.0, p = 0.28).
CONCLUSION:
While RF imposed greater physical and perceptual demands, WF produced comparable glycaemic responses and psychological engagement. This suggests that WF reduces mechanical and cardiovascular load while maintaining motivational and cardiometabolic benefits, making it a safe, enjoyable, and feasible exercise option for older adults with T2DM.