JMIR Publications

ABSTRACT

Background:

Telemedicine is an effective and promising strategy, especially for the initial stages of a home-based therapeutic exercise program. We designed a randomized controlled trial (RCT) to investigate the effects of Tai Chi and walking on cognitive function in older adults with Type 2 Diabetes Mellitus (T2DM) using wearable devices in a mobile healthcare model.

Objective:

We designed a randomized controlled trial (RCT) to investigate the effects of Tai Chi and walking on cognitive function in older adults with Type 2 Diabetes Mellitus (T2DM) using wearable devices in a mobile healthcare model.

Methods:

The study was a randomized controlled trial in which participants were randomized (1:1:1) to receive usual care, fitness walking, or Tai Chi exercise. All indicators were assessed at baseline and 12-week follow-up. The usual care includes traditional diabetes education. Participants in the fitness walking group performed walking exercises on a treadmill under the supervision of a researcher three times a week for 12 weeks. Participants in the Tai Chi group practiced 24-style Simplified Tai Chi through live video streaming under the guidance of professors and professionals. In this 12-week program, participants underwent continuous glucose monitoring (CGM) using Guardian Sensors 3, CGM sensors attached to the upper arm. All participants will carry bracelets to record their heart rate, sleep parameters, and steps. The primary outcome was the Montreal Cognitive Assessment (MoCA) at 12 weeks. Secondary outcomes included other cognitive subdomain tests, and blood metabolic indices.

Results:

After 12 weeks of intervention, the Tai Chi exercise group showed a significant improvement in MoCA scores from baseline (23.83 [17.79, 25.66] vs. 21.42 [17.11, 24.74], P=0.027). The fitness walking exercise group showed an improvement in MoCA scores (22.94 [18.05, 23.98] vs. 21.58 [17.35, 24.12], P=0.083), but did not reach statistical significance.

Conclusions:

In summary, this study showed that web-based exercise therapy for patients may help improve exercise therapy's effectiveness in cognitive function among older T2DM. Tai Chi has significant advantages in improving cognitive function and sleep quality, while fitness walking, although also beneficial, is relatively weak in these areas. Clinical Trial: All participants signed an informed consent form, and the Institutional Review Boards of all participating institutions approved the study (2024-013-01). The study was registered on the Chinese Clinical Trial Register, ChiCTR2200057863(19/03/2022).