Tai Chi for sufferers of knee osteoarthritis

Osteoarthritis is a degenerative joint disease that affects about half of all people over the age of 60. Knee joint involvement is very common and can cause significant walking limitations.

The main causes of this condition are trauma, abnormal joint development, overweight and high joint stress. Over time, the cartilages of the knee wear down and bone surfaces are exposed to each other.

In recent years, numerous therapeutic options have been developed, ranging from simple drug therapy to local injection of cortisone or hyaluronic acid, up to joint replacement with artificial prostheses.

Physiotherapy, which aims to increase the mobility and flexibility of the joint as well as strengthen the leg muscles, is also part of a treatment plan. Physical therapy, as well as exercise, are often effective in reducing pain and improving joint function.

A new perspective on physical therapy for osteoarthritis comes from a recent paper published in Annals of Internal Medicine, which compares the results of physiotherapy with those obtained through the practice of Tai Chi.

The 204 patients included in the study were randomised to a series of Tai Chi sessions, twice a day, for twelve weeks, or physiotherapy treatment twice a week, for six weeks, followed by six weeks of monitored exercise at home. Tai Chi sessions were carried out under the guidance of experienced instructors.

The main endpoint was the presence of joint pain, assessed with the WOMAC scale. Secondary endpoints, assessed at 12, 24 and 52 weeks, included joint function and stiffness, the presence of depression and the results of the 6-minute and 20-metre walk test, among others. Participants were allowed to continue using their usual medication, such as NSAIDs and paracetamol.

The results showed that both groups had improved pain and similar improvements in most endpoints assessed at 12 weeks and in all endpoints assessed at 24 and 52 weeks.

Browsing through the study data, one can see that Tai Chi actually induced a greater improvement than physiotherapy in most of the endpoints considered, but without reaching statistical significance. Except in the assessment of depression, where the Chinese discipline proved superior.

This research therefore seems to highlight how Tai Chi can be recommended to patients with osteoarthritis, for the improvement of pain symptoms and overall well-being. The mental and socialisation component of Tai Chi could add specific additional benefits to simple physical exercise.



Chenchen Wang, et al. Comparative Effectiveness of Tai Chi Versus Physical Therapy for Knee Osteoarthritis. Ann Intern Med. 2016;165:77-86.

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