Background: One of the effects of diabetes mellitus (DM), peripheral neuropathy, affects feet sensation and can increase the chance of falling. The purpose of the study was to investigate the effect of 8 weeks of Tai Chi (TC) training combined with mental imagery (MI) on improving balance in people with diabetes and an age matched control group. Methods: Seventeen healthy subjects and 12 diabetic sedentary subjects ranging from 50-80 years of age were recruited. All subjects in both groups attended a Yang style of TC class, two sessions per week for 8 weeks. Each session was one hour long. Measures were taken using a balance platform test, an Activities-specific Balance Confidence (ABC) Scale, a one leg standing test (OLS), and a functional reach test (FRT). These measures were taken twice, pre and post-study, for both groups. Additional measurements for the DM group were hemoglobin A1C (HbA1C), H-reflex and nerve conduction velocity test. Results: This study showed that both groups experienced significant improvements in ABC, OLS, FRT (P < 0 .01) after completing 8 weeks of TC exercise, with no significant difference improvement between groups. Subjects using the balance platform test demonstrated improvement in balance in all different tasks with no significant difference between groups. There was no significant change in HbA1C among people with diabetes. For the H-reflex, there was a significant increase in amplitude (μV) after completing 8 weeks of TC exercise (1226.9±320.8 vs. 1815.6±478.8, p=0.02). There were significant improvements in the sural nerve in terms of velocity (m/sec) (30.9±3.6 vs. 33.8±3.9, p=0.01), amplitude (μV) (18.2±4.1 vs. 7.6±1.2, p=0.01), and latency (ms) (3.7±0.4 vs. 3.4±0.4, p=0.01). In the superficial peroneal nerve, significant improvements were observed in velocity (m/sec) (p=0.02) and latency (ms) (p=0.01) but not in amplitude (μV) (p>0.05). Conclusion: Combining TC with MI for 8 weeks resulted in an improvement in balance in the diabetic and the control groups; however, no significant difference between the groups was observed. Keywords: Tai Chi exercise, balance, aging, diabetes, H-reflex and nerve conduction velocity test.

LLU Discipline

Physical Therapy


Physical Therapy


School of Allied Health Professions

First Advisor

Petrofsky, Jerrold S.

Second Advisor

Balbas, Edward

Third Advisor

Daher, Noha S.

Fourth Advisor

Laymon, Michael S.

Fifth Advisor

Lohmann, Everett, III

Degree Name

Doctor of Science (DSc)

Degree Level


Year Degree Awarded


Date (Title Page)




Library of Congress/MESH Subject Headings

Tai Ji - Methods; Exercise Therapy; Exercise Movement Techniques; Mind-Body Therapies; Postural Balance

Subject - Local

Tai Chi; Diabetes Mellitus; Peripheral Neuropathy; Mental Imagery; Balance; Activities-specific Balance Confidence Scale



Page Count


Digital Format


Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.


Loma Linda University Electronic Theses and Dissertations

Collection Website



Loma Linda University. Del E. Webb Memorial Library. University Archives