Research suggests that impaired mobility
and balance among obese older adults with
type 2 diabetes may be related to their low
muscle power, which results from their inability
to quickly contract their muscles.
In a study of older
obese adults with type 2 diabetes, "there
was a strong relationship between muscle power/speed
and poor mobility and balance," study co-author
Rhonda Orr, a lecturer at the University of
Sydney, in Australia stated. "Those individuals
with lower muscle power and slower muscle
speed had greater balance and mobility impairment."
The study also shows that older obese type
2 diabetics can benefit from low-intensity,
low-impact Tai Chi exercises as well as from
regular stretching and calisthenics.
"Our Tai Chi program was just as effective
as gentle stretching/calisthenics in improving
balance and mobility, but not effective in
improving muscle function in our cohort,"
said Orr. She noted that "improving muscle
contraction speed or power may be more appropriate
interventions to gain improvements in balance
and mobility."
In the study, 38 men and women with type
2 diabetes were randomly assigned to Tai Chi
exercises or seated calisthenics and stretching.
The participants, who were about 65 years
old, participated in 55-minute exercise sessions
twice a week for 16 weeks.
At the end of the study period, participants
in both exercise groups experienced improvements
in their balance and walking speed. Men and
women who participated in Tai Chi exercises
showed improved mobility, but their improvements
were no greater than that found among men
and women in the comparison group.
The reason for the lack of greater benefit
among the Tai Chi participants may be because
the high prevalence of obesity and osteoarthritis
among the study participants "may have compromised
an optimal training style," Orr and her co-authors
suggest. Or perhaps the dose and/or movements
incorporated into the Tai Chi program were
not sufficient to elicit a stronger response.
Overall, balance was most improved among
men and women with poorer quality of life
at the start of the study, whereas better
health, muscle function and exercise capacity
at the start of the study, was associated
with increased walking speeds by the end of
the study. In particular, lower levels of
blood glucose and less body fat at the start
of the study was associated with improved
walking speeds over time.
In light of the findings, "we need to further
investigate an optimal modality of exercise(s)
and dose for older, obese and long-term sedentary
adults with type 2 diabetes, so that they
are able to increase their level of physical
activity, enjoy and adhere to an exercise
program in order to retard the decline in
physical function associated with diabetes,"
Orr stated.
The Tai Chi for Diabetes form was created
by study co-author Paul Lam, who is also the
founder of Tai Chi Productions.
SOURCE: Diabetes Care, September 2006.
