Peer-Reviewed Research: Effects of Tai Chi Exercise on Glucose Control, Neuropathy Scores, Balance, and Quality of Life in Patients with Type 2 Diabetes and Neuropathy
Peer-Reviewed Research: Effects of Tai Chi Exercise on Glucose Control, Neuropathy Scores, Balance, and Quality of Life in Patients with Type 2 Diabetes and Neuropathy
The study "Effects of Tai Chi Exercise on Glucose Control, Neuropathy Scores, Balance, and Quality of Life in Patients with Type 2 Diabetes and Neuropathy" by Sukhee Ahn and Rhayun Song investigates the impact of Tai Chi (TC) exercise on individuals suffering from Type 2 diabetes mellitus (T2DM) complicated by peripheral neuropathy (DPN). The primary aim of the study was to evaluate whether a 12-week Tai Chi program could improve glucose control, alleviate neuropathic symptoms, enhance balance, and improve the overall quality of life (QoL) in patients with T2DM and DPN. The research addresses the growing need for non-pharmacological interventions in managing chronic complications associated with diabetes, particularly DPN, which significantly impacts patients' morbidity and mortality due to its association with sensory loss, pain, and increased fall risk.
Methodology
The study utilized a quasi-experimental pretest-posttest design with a non-equivalent control group. The participants, 59 T2DM patients with neuropathy recruited from an outpatient clinic at a university hospital in Korea, were divided into a Tai Chi group (n = 30) and a control group (n = 29). The Tai Chi group participated in a standardized 12-week Tai Chi for Diabetes (TCD) program, consisting of bi-weekly, 1-hour sessions, which included Tai Chi movements combined from the Yang and Sun styles, qigong exercises, and warm-up and cool-down routines. The control group received usual care and diabetes education without engaging in the Tai Chi program.
Outcome measures were assessed before and after the intervention and included fasting blood glucose (FBS), glycosylated hemoglobin (HbA1c), neuropathy scores using the Semmes-Weinstein monofilament examination (SWME) and total symptom scores (TSS), balance through a single-leg stance test, and QoL via the Korean version of the SF-36v2 survey. The dropout rate was notable, with 20 participants (34%) not completing the study.
Results
The study found significant improvements in the Tai Chi group compared to the control group across several outcome measures. Specifically, participants in the Tai Chi group exhibited better glucose control, as indicated by a significant reduction in FBS and HbA1c levels. Additionally, the Tai Chi group demonstrated improved balance and reduced neuropathic symptoms, as measured by the TSS, although no significant difference was found in the SWME scores between the groups.
The QoL assessments also revealed substantial benefits for the Tai Chi group, with significant improvements in five out of eight dimensions, including physical functioning, bodily pain, role limitations due to physical and emotional problems, and social functioning. These findings suggest that the Tai Chi exercise program not only contributed to better physiological outcomes but also enhanced the psychosocial well-being of participants.
Discussion
The authors discuss the multifactorial nature of DPN, emphasizing the role of prolonged hyperglycemia in its pathogenesis and the potential of Tai Chi to improve glucose metabolism, thereby mitigating DPN symptoms. The findings align with previous studies demonstrating the positive effects of Tai Chi on microcirculatory function and peripheral nerve health, which are crucial in managing DPN. However, the lack of significant change in SWME scores suggests that the measure may lack sensitivity in detecting subtle changes in peripheral sensory function over a relatively short intervention period.
The study's results are consistent with literature supporting the beneficial effects of Tai Chi on glucose control and QoL in patients with chronic conditions, although the authors acknowledge the conflicting evidence regarding Tai Chi's impact on glucose homeostasis in diabetic patients. The significant improvements in QoL reported by the Tai Chi group highlight the program's potential to address the psychosocial dimensions of chronic illness, which are often overlooked in clinical management.
Limitations
Several limitations of the study are acknowledged. The non-randomized design may have introduced selection bias, and the relatively high dropout rate could have influenced the results, particularly given that participants who dropped out tended to have better initial QoL scores. Additionally, the small sample size and the short duration of the intervention limit the generalizability of the findings. The authors call for further research with larger, randomized samples and longer follow-up periods to validate the effects of Tai Chi on DPN and related outcomes.
Conclusion
This study provides evidence that a 12-week Tai Chi program can effectively improve glucose control, alleviate neuropathic symptoms, enhance balance, and improve the QoL in patients with T2DM and DPN. Tai Chi, as a low-to-moderate intensity exercise, appears to be a safe and beneficial intervention for managing DPN, with the potential to prevent complications such as falls and further deterioration of health. However, further research is necessary to confirm these findings and explore the long-term benefits of Tai Chi in this population.
Reference
Ahn, S., & Song, R. (2012). Effects of Tai Chi exercise on glucose control, neuropathy scores, balance, and quality of life in patients with type 2 diabetes and neuropathy. Journal of Alternative and Complementary Medicine, 18(12), 1172–1178
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