Effect of Tai Chi and Multimodal Exercise in Overweight and Obese Women

The test used a chair approximately 45 cm high. Participants were asked to stand up from the chair, walk 3 meters at a comfortable pace, pass and turn around a marker on the floor, walk back to the chair, and sit down. A time taken to complete the test of ≥13.5 seconds indicates individuals at high risk of falling. A shorter time indicates better functional performance. The test was administered twice.

For the test, the person is asked to balance on one leg, and the time they maintain their balance is recorded in seconds.The test involved standing on one leg for 60 seconds; the test was terminated if there was any swaying from side to side, loss of balance, or the foot touching the ground. The test was repeated twice for each extremity.

The test area was created by attaching a measuring tape to a flat surface. Participants were asked to stand on one leg at the midpoint of the test setup (the setup created with the measuring tape), with their hands placed on their iliac crests, without shoes. They were instructed to maintain balance and touch the tip of their toe to the maximum distance without lifting the heel of their foot from the ground, moving anteriorly, posteromedially, and posterolaterally with the other leg. If the hands left the iliac crests or balance was lost during the test, the test was terminated and repeated. To eliminate the learning effect, participants were allowed to try the test four times in each direction before evaluation. The test was repeated three times in each direction and applied to both lower extremities. The distance reached with the toes was recorded in centimeters using the measuring tape.

The 5-repetition sit-up test is used to assess fall risk, endurance, and functional strength. Participants were instructed to cross their arms over their chest and stand up fully and then sit down fully again as quickly as possible, five times. The test was administered twice. The test result was recorded in seconds (s).

This functional task and cognitive function test assesses dynamic balance ability. Four squares are created on a flat surface using tape. The squares are numbered 1-2-3-4. Before the test begins, the participant is instructed to lift their foot as quickly as possible, step without touching the tape, and ensure both feet touch the ground in each square. The participant is given one attempt to remember the sequence. The test is repeated if the participant fails to complete the sequence successfully, loses balance, or touches the tape. The test time starts when the participant's first foot touches the second square and ends when the last foot touches the first square. The test result is recorded in seconds (s).

Body mass index calculated as body weight in kilograms divided by height in meters squared.

Waist circumference was measured at the level of the superior iliac crest using a tape measure. A waist circumference of >80 cm in women and >94 cm in men is associated with an increased risk of metabolic complications.

Leg length was measured and recorded from the anterior superior iliac joint to the distal part of the medial malleolus. Leg length was measured to normalize the Y-Balance Test results.

Post-training perceived difficulty was assessed using a 15-point (6-20) Borg scale. The Borg scale identifies somatic symptoms and requires participants to express the degree to which their bodies were strained after exercise. The effort level on the scale is rated as follows; 6 (no exertion/rest), 7 (very, very light), 9 (very light), 11 (light), 13 (somewhat hard), 15 (hard), 17 (very hard), 19 (extremely hard), and 20 (maximal exertion). The effort level felt by participants after each session was recorded using the Borg scale.

Participants' adherence to the exercise program was evaluated using an exercise diary. The exercise diary recorded whether participants attended the exercise session, the reason for absence if absent, the degree of exertion felt using the Borg scale, and any complaints after the exercise session. The date of the exercise session and the week of the exercise program were also recorded in the exercise diary.