Tai chi improves pain in patients with knee arthritis, trial findsBMJ 2016; 353 doi: https://doi.org/10.1136/bmj.i2726 (Published 18 May 2016) Cite this as: BMJ 2016;353:i2726
Tai chi produced beneficial effects similar to a standard course of physical therapy in the treatment of knee osteoarthritis, a randomised single blind trial has shown.1
Tai chi is a traditional Chinese practice that combines meditation with slow, gentle movements, deep breathing, and relaxation. It has previously been shown to alleviate symptoms of knee osteoarthritis, but no trials directly compared tai chi with standard care.
The new research, published in Annals of Internal Medicine, included 204 patients with symptomatic knee osteoarthritis attending Tufts Medical Center in Boston, Massachusetts, USA. They were randomly assigned to tai chi twice a week for 12 weeks, or to physical therapy in a clinical setting twice a week for six weeks followed by six weeks of rigorously monitored home exercise.
After 12 weeks the patients in both groups showed significant improvements in pain as measured by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). No significant difference was seen between the two groups: patients in the tai chi group scored 167 points (95% confidence interval 145 to 190 points), compared with 143 points in the standard physical therapy group (119 to 167 points). The benefits were maintained up to 52 weeks.
Both groups also showed similar clinically significant improvement in most secondary outcomes including physical function, medication use, and quality of life, but those in the tai chi group showed significantly greater improvements in depression and the physical component of quality of life.
The researchers said that a major strength of the trial was the enrolment of a representative sample of participants with knee arthritis, including older and obese people with comorbidities. The patients had a mean age of 60, 70% were women, 53% were white, and the mean body mass index was 33.
Overall, 79% of tai chi participants and 78% of physical therapy participants attended at least half of the sessions. The study also found that the benefit of tai chi was consistent across instructors.
The authors concluded that tai chi should be considered as an effective therapeutic option in knee osteoarthritis.
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