Effects of Tai Chi and resistance exercise on fatigue in patients with ulcerative colitis: A randomized clinical trial

• This study compared Tai Chi and resistance training for ulcerative colitis fatigue. • Both interventions helped reduce fatigue and improve overall well-being. • As a traditional Chinese practice, Tai Chi can ease anxiety and depression. • Resistance training enhanced physical strength and increased muscle mass. • Both exercises show potential for inclusion in long-term ulcerative colitis care. Fatigue is common and burdensome in patients with ulcerative colitis (UC), yet pharmacological treatments offer limited relief. Exercise is gaining attention as a non-pharmacological strategy, and resistance training is increasingly recommended. However, Tai Chi—a traditional Chinese exercise—has not yet been evaluated in this population. This study compared the effects of Tai Chi and resistance training on multiple outcomes in patients with UC. This single-center, evaluator-blind, three-arm randomized clinical trial block-randomized 75 patients with UC to 12 weeks of Tai Chi or resistance training and a control group involving standard treatment and care with general exercise advice. Eligible participants had fatigue (Multidimensional Fatigue Inventory score ≥ 40) and were in remission or had mild-to-moderate disease activity (Modified Mayo score ≤ 10). The primary outcome was fatigue, secondary outcomes included handgrip strength (HGS), skeletal muscle mass index (SMI), sleep quality, anxiety, depression, and health-related quality of life, all strongly associated with fatigue. The three groups showed significant differences in total fatigue and in general, physical, and mental fatigue subdimensions. Compared with the control group, fatigue improved in both the Tai Chi group (mean difference: -8.90 [95% confidence interval [CI], -15.11 to -2.69]) and the resistance training group (mean difference: -7.00 [95% CI, -13.16 to -0.84]), with no significant differences between them. However, between the two interventions, Tai Chi showed numerically greater improvements in anxiety, depression, and emotional function, while resistance training led to greater improvements in HGS (mean difference: 7.50 [95% CI, 2.37 to 12.63]) and SMI (mean difference: 0.54 [95% CI, 0.01 to 1.08]). No adverse events occurred, except for one case of mild abdominal discomfort in the resistance training group, which resolved with rest. Both Tai Chi and resistance training effectively reduced fatigue and improved related outcomes in UC patients. Tai Chi may be more beneficial for psychological symptoms, while resistance training showed greater improvements in physical strength. Given their complementary advantages and safety, both may serve as valuable non-pharmacological options in UC management. Future studies should explore their integration into long-term, multimodal treatment strategies. ChiCTR2300071289. None.