Exercise is important for controlling hemoglobin A1c, and maintaining proper glycemic control in people with diabetes. Exercise also increases the diabetics overall insulin sensitivity, and decreases their dependency on diabetes medication. However, people with diabetes are faced with metabolic and endothelial impairment, which could result in a prolonged sensation of muscle soreness following exercise. This would make it difficult for these people to sustain exercise regimes. Delayed-onset muscle soreness (DOMS) is a common problem in healthy individuals and in people who have diabetes. DOMS is a painful sensation experienced by individuals who have been recently inactive and then over-exercise. Yet, because people with diabetes usually have neuropathies, they may not feel this soreness appropriately, leading to premature return to exercise and causing further injuries. Therefore, this investigation assessed the differences in DOMS between people with diabetes, and healthy individuals, at 2 different body regions. However, DOMS is mainly measured with subjective scales, but we wanted to establish a new objective measure. Infra-red (IR) thermal imaging was used as one of the biomarkers in this assessment, and after expanding on this technique, it was considered a valid and relaible tool for detecting and quantifying delayed onset muscle soreness after an intense exercise session. Once muscle soreness in people with diabetes was determined, and a new novel biomarker was established, another focus of this dissertation was to examine whether DOMS could be attenuated by ingesting a nutritional supplement. Branched Chain Amino Acids (BCAA) have been shown to be effective in promoting muscle recovery following exercise; however, the effects of this supplement have not been investigated amongst diabetic individuals. The results of this experiment showed that people with diabetes get sorer than healthy individuals. It was also found that IR thermal imaging may be a valuable technique for identifying which muscles are sore after exercising. Thus, thermal imaging would be an efficient and painless way of quantifying DOMS in both healthy individuals and in people with diabetes. Furthermore, this investigation showed that BCAA significantly reduced muscle soreness and enhanced healing in subjects with diabetes. However, in the healthy control group this supplement had minimal effects.

LLU Discipline

Rehabilitation Sciences


Rehabilitation Sciences


School of Allied Health Professions

First Advisor

Petrofsky, Jerrold S.

Second Advisor

Berk, Lee S.

Third Advisor

Hubbard, Richard

Fourth Advisor

Laymon, Michael S.

Fifth Advisor

Zimmerman, Grennith

Degree Name

Doctor of Philosophy (PhD)

Degree Level


Year Degree Awarded

January 2011

Date (Title Page)




Library of Congress/MESH Subject Headings

Muscle, Skeletal -- Metabolism; Insulin - Pysiology; Exercise - Physiology; Diabetes Mellitus - Physiopathology; Diabetes Mellitus, Type 2 - Therapy; Muscles - Physiology; Muscle Fatigue; Pain Measurement; Dietary Supplements - Therapeutic Use; Amino Acids, Branched-Chain - Metabolism; Analysis of Variance

Subject - Local

Muscle Soreness; Diabetes; Nutritional Supplementation; Glycemic Control; Exercise; Insulin Sensitivity; Delayed-Onset Muscle Soreness; Branched Chain Amino Acids



Page Count

127 p.

Digital Format


Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.


Loma Linda University Electronic Theses & Dissertations

Collection Website



Loma Linda University. Del E. Webb Memorial Library. University Archives