JMIR Publications

ABSTRACT

Background:

Age-associated declines in metabolic, cardiovascular, and physical functions substantially diminish the quality of life in older adults. While structured exercise is crucial for promoting healthy aging, the most effective modality remains uncertain. In China, various forms of exercise, including the 12-form Chen-style Tai Chi (CTC12), 24-form Tai Chi (TC24), square dance (SD), and walking, differ in complexity and physiological impact. However, their comparative effects on cardiometabolic, physical, and psychological health have not been comprehensively established. Additionally, the differences in dose–response efficiency and cardiovascular safety among these exercise modalities have not been systematically examined.

Objective:

This study aimed to compare the effects of four common community-based exercise modalities on cardiometabolic health, physical function, and quality of life in middle-aged and older adults, and to evaluate their relative dose–response efficiency and safety.

Methods:

This study was designed as a single-blind randomized controlled trial involving a cohort of 113 middle-aged and older adults (mean age = 63 years) was allocated into five distinct groups: CTC12, TC24, SD, walking, and a controlgroup. The intervention spanned 12 weeks and comprised two supervised sessions per week, each lasting 90 minutes. Assessments conducted before and after the intervention included measurements of blood pressure, lipid profiles, fasting glucose levels, interleukin-6 (IL-6) concentrations, performance on the Short Physical Performance Battery (SPPB), activities of daily living (ADL), and the World Health Organization Quality of Life (WHOQOL) index. Intra-group changes were analyzed using paired t-tests, while inter-group differences were evaluated using one-way ANOVA followed by Tukey’s post hoc tests.

Results:

CTC12 and SD demonstrated significant enhancements in lipid profiles, fasting glucose levels, physical function as measured by the Short Physical Performance Battery (SPPB), and overall quality of life as assessed by the World Health Organization Quality of Life (WHOQOL) instrument (all p < 0.05). Specifically, CTC12 was associated with an increase in high-density lipoprotein cholesterol (HDL-C) and a reduction in interleukin-6 (IL-6) levels. Additionally, SD was found to improve psychological health and metabolic activity. In contrast, TC24 and walking interventions resulted in only modest improvements. No significant changes were observed in the control group. Importantly, all interventions were deemed safe and well tolerated.

Conclusions:

Both CTC12 and SD significantly enhanced cardiometabolic, physical, and psychological health outcomes in older adults. CTC12 provided a wider range of multidimensional benefits, potentially attributable to its incorporation of physical, respiratory, and cognitive components. Both interventions are safe, scalable, and suitable for promoting healthy aging within community settings. Notably, CTC12 resulted in comparable metabolic improvements while exerting reduced cardiovascular stress, indicating enhanced dose–response efficiency and safety in aging populations. Clinical Trial: This trial was registered at the Chinese Clinical Trial Registry (Registration No.: ChiCTR2400092473).