SAN FRANCISCO, California—Tai chi may help treat pain and physical impairment among patients with severe knee osteoarthritis (OA), according to research presented at the American College of Rheumatology Annual Scientific Meeting in San Francisco, California.¹

"Tai chi mind-body exercise appears to provide an important approach for self-care and self-management for knee OA; however, these results should be confirmed by future large studies," said lead researcher Chenchen Wang MD, MSc, at Tufts Medical Center in Boston.

In the new study of 40 patients with severe knee OA, those patients in the tai chi arm showed significantly greater improvements in pain, physical function, depression, self-efficacy and health status, compared with their counterparts who were randomized to stretching and wellness education. Patients participated in either tai chi or stretching and wellness education interventions for 60 minutes, twice a week for 12 weeks.

Moreover, patients who continued tai chi practice reported after 12 weeks durable benefits in the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) pain and function indices.  

Overall, attendance for the 12-week assessment was 85% in the tai chi group and 89% in the stretching and wellness arm. On average, patients were 65 years old and moderately overweight, and had knee OA for ~10 years.

“Further studies should be performed to replicate these results and deepen our understanding of this therapeutic modality,” the researchers conclude.

Changes in Primary Outcomes

Variables	Groups*	Baseline	At 12 week change (95% CI)	P-Value for Δ between group†
WOMAC-Pain	Tai Chi	209.3 (58.5)	-157.3 (-198.5, -116)	.0004
VAS, 0-500 mm	Control	220.4 (101)	-38.5 (-87.2, 10.3)

*N=20 for each group. †Significant improvement of tai chi versus attention control at week 12

Adapted from: Wang C, et al. Presented at:  American College of Rheumatology 2008 Annual Scientific Meeting; October 24-29, 2008; San Francisco, Calif. Presentation No. 636.¹

Translating research into practice

“Tai chi has quite an important role for management of several types of musculoskeletal  conditions,” said Eric Matteson, MD, professor of medicine at the Mayo Clinic in Rochester, Minnesota. “The main beneficial aspect is that tai chi is gentle, really emphasizes the mind/body dynamic, and emphasizes the function of the musculoskeletal system.”

At the Mayo Clinic, patients with OA, fibromyalgia, and other forms of inflammatory arthritis use tai chi.  “In patients with RA who have the inflammatory component under control, but are still suffering from joint pain and limitation in mobility, this is very effective,” Dr. Matteson said.

Still, “not everybody is capable of doing tai chi. It requires some coordination and balance,” he said. “Patients interested in tai chi should work with instructors who are tuned in to arthritis issues.”

Reference

1. Wang C, Schmid CH, Hibberd P, et al. Tai chi is effective in treating knee osteoarthritis: a randomized controlled trial. Presented at:  American College of Rheumatology 2008 Annual Scientific Meeting; October 24-29, 2008; San Franciso, Calif. Presentation No. 636.