Effects of Tai Chi Chuan on balance function in adults 60 years or older with type 2 diabetes and mild cognitive impairment in China: A secondary analysis of a multi-center randomized clinical trial.

Aims: To investigate the effect of Tai Chi Chuan on balance function in adults 60 years or older with type 2 diabetes and mild cognitive impairment (MCI) in China.

Materials And Methods: This was a three-arm, parallel-group, randomized controlled trial with concealed allocation, assessor blinding, intention-to-treat (ITT), and per-protocol (PP) analysis. 328 adults 60 years or older, with a diagnosis of both type 2 diabetes and MCI, were randomly allocated into Tai Chi Chuan group, fitness walking group, and control group. All three groups were provided with a 30-min diabetes self-management education session, once every 4 weeks, for 24 weeks. In addition, the Tai Chi Chuan group received 24-form simplified Tai Chi Chuan. The fitness walking group received fitness walking training. Both Tai Chi Chuan and fitness walking groups took the training for 60 min/session, three times/week, for 24 weeks in a supervised setting. After completing the 24-week interventions, the participants were encouraged to continue exercise until the 36-week follow-up evaluation. The outcomes were time up and go (TUG) assessments, one leg standing test (OLST), functional reach test (FRT), grip strength, 5 time sit to stand test (5STS), modified fall efficacy scale (MFES), and falls data at baseline, 24 weeks, and 36 weeks follow-up.

Results: At 36 weeks, the Tai Chi Chuan group was significantly more effective in decreasing the TUG-cognitive-motor (mean difference, -0.72; 95% CI -1.37 to -0.06), OLST (eyes-closed, right leg) (mean difference, 1.02; 95% CI 0.24-1.80), FRT (mean difference, 2.00; 95% CI 0.57-3.42), 5STS (mean difference, -0.66; 95% CI -1.28 to -0.04), and MFES (mean difference, 0.36; 95% CI 0.15-0.56) compared with the fitness walking group. The Tai Chi Chuan group showed significantly fewer total falls during 36-week experimental period compared with the fitness walking group. PP analysis demonstrated similar results as the ITT analysis.

Conclusions: Among the older adults with type 2 diabetes and MCI, Tai Chi Chuan was more effective than fitness walking and control at improving balance function and reducing fall risk.