Osteopathy and Low Back Pain, Acupuncture and in Vitro Fertilization, Tai Chi and Osteoarthritis, Andrographis Paniculata and Ulcerative Colitis, and Acupressure and Vertigo.

PMID: 24439098

article: http://www.explorejournal.com/article/S1550-8307(13)00317-0/fulltext

Tai Chi May Be Beneficial for Osteoarthritis of the Knee in Older Adults
Level 2 (mid-level) evidence

Reference: Complement Ther Med 2013;21(4):396–406

Osteoarthritis (OA) of the knee is a painful and disabling degenerative joint disorder characterized by articular cartilage loss, bone remodeling, and periarticular muscle weakness. Risk factors include obesity, prior trauma, and repetitive articular stress.19 The Framingham Osteoarthritis (FOA) cohort study found that 27.7% of men and 32.9% of women ≥70 years old suffer from osteoarthritic knee pain.20 The American College of Rheumatology recommends Tai Chi as one possible adjunctive therapy.21 Tai Chi is a Chinese martial art that combines a meditative state with slow, fluid movements. While the results of a previous meta-analysis suggested that Tai Chi may be beneficial for pain and function in OA patients over the short-term,22 long-term benefits have not been similarly evaluated.

In the most recent meta-analysis (n = 252), short-term outcomes were assessed at the completion of the Tai Chi program (lasting eight to 20 weeks) in all five trials.23 Long-term outcomes were also assessed 18–24 weeks later in two trials. Participants’ median age was 69.3 years, and most were female (86.5%). All participants practiced Tai Chi two to three times per week (for at least eight weeks), and at varying intervals after adopting a recommended home practice. While three different styles of Tai Chi were used in the trials, all included the typical slow, smooth, and flowing movements. Tai Chi was positively associated with short-term pain reduction (five trials; standard mean difference [SMD] = −0.72; 95% CI: −1.00 to −0.44; P < .00001), improved physical function (five trials; SMD = −0.72; 95% CI: −1.01 to −0.44; P < .00001), decreased stiffness (five trials; SMD = −0.59; 95% CI: −0.99 to −0.19; P = .004), and enhanced physical quality of life (two trials; SMD = 0.88; 95% CI: 0.42–1.34; P < .0001). Tai Chi was not associated with significant changes in mental quality of life (two trials). No long-term effects were documented for any outcomes measured. In a subgroup analysis, the two trials using wait-list controls showed a statistically significant short-term effect for pain, function, and stiffness. Similar outcomes were observed in the three trials using attention controls, with the exception of stiffness. No serious adverse events were reported in any of the trials.

Based on these results, participating in a Tai Chi program for at least eight weeks may be a safe and effective strategy for patients suffering from osteoarthritis of the knee as measured by multiple short-term outcomes. The favorable findings from the two trials using wait-list controls, however, cannot be distinguished from attention bias. Long-term benefits have yet to be established.