Functional outcomes of Tai Chi exercise prescription in women with knee osteoarthritis

Abstract

Knee Osteoarthritis (KOA) is the most common type of knee joint injury and also a risk factor for multiple health consequences and is prevalent among older women. The updated clinical guidelines for KOA treatment by the American Rheumatism Association recommend Tai Chi exercise. However, a literature review outlined limitations in Tai Chi intervention implementations. This study aimed to address some of the gaps. This study selected thirty female patients to participate in Tai Chi exercises and undergo relevant tests. The subjects were randomly assigned to Tai Chi or education groups. Independent sample t-tests were conducted to compare the difference in health indicators between the two groups after the intervention. The difference-in-differences (DID) regression was performed to assess the difference in the health outcomes between the two groups at baseline and follow-up and the difference in the differences. After the completion of the intervention, the Tai Chi group reported significantly improved KOA symptoms, physical fitness, and health status indicators than the control group. Specifically, the group differences were significantly larger at the baseline than at the follow-up. Our findings provide compelling evidence of the effects of the innovative Tai Chi exercise prescription specifically designed for KOA patients. The empirical evidence on its effectiveness in alleviating KOA symptoms and improving the overall health of middle-aged and elderly women with KOA suggested that Tai Chi intervention exercise has huge prospects for integration in KOA rehabilitation therapy.

Keywords

Tai Chi / KOA / Intervention / Exercise prescription

References

[[1]] A Emrani, H Bagheri, MR Hadian, M Jabal-Ameli, GR Olyaei, S Talebian. Isokinetic strength and functional status in knee osteoarthritis. J Phys Ther Sci, 18 (2) ( 2006), pp. 107-114, DOI: 10.1589/jpts.18.107

[[2]] C Wang, MD Iversen, T McAlindon, et al.. Assessing the comparative effectiveness of Tai Chi versus physical therapy for knee osteoarthritis: design and rationale for a randomized trial. BMC Compl Alternative Med, 14 ( 2014), p. 333, DOI: 10.1186/1472-6882-14-333

[[3]] JM Jordan, G Luta, JB Renner, A Dragomir, MC Hochberg, JG Fryer. Ethnic differences in self-reported functional status in the rural south: the Johnston County Osteoarthritis Project. Arthritis Care Res Off J Arthritis Health Prof Assoc, 9 (6) ( 1996), pp. 483-491, DOI: 10.1002/art.1790090610

[[4]] DS Logerstedt, J Zeni Jr., L Snyder-Mackler. Sex differences in patients with different stages of knee osteoarthritis. Arch Phys Med Rehabil, 95 (12) ( 2014), pp. 2376-2381, DOI: 10.1016/j.apmr.2014.07.414

[[5]] AE Nelson, KD Allen, YM Golightly, AP Goode, JM Jordan.A systematic review of recommendations and guidelines for the management of osteoarthritis: the chronic osteoarthritis management initiative of the U.S. bone and joint initiative. Semin Arthritis Rheum, 43 (6) ( 2014), pp. 701-712, DOI: 10.1016/j.semarthrit.2013.11.012

[[6]] RM Ferreira, JA Duarte, RS Gonçalves. Non-pharmacological and non-surgical interventions to manage patients with knee osteoarthritis: an umbrella review. Acta Reumatol Port, 43 (3) ( 2018), pp. 182-200

[[7]] CL Shen, CR James, MC Chyu, et al.. Effects of Tai Chi on gait kinematics, physical function, and pain in elderly with knee osteoarthritis--a pilot study. Am J Chin Med, 36 (2) ( 2008), pp. 219-232, DOI: 10.1142/S0192415X08005734

[[8]] E Ghandali, ST Moghadam, MR Hadian, G Olyaei, S Jalaie, E Sajjadi. The effect of Tai Chi exercises on postural stability and control in older patients with knee osteoarthritis. J Bodyw Mov Ther, 21 (3) ( 2017), pp. 594-598, DOI: 10.1016/j.jbmt.2016.09.001

[[9]] M Zhou, N Peng, Q Dai, HW Li, RG Shi, W Huang. Effect of Tai Chi on muscle strength of the lower extremities in the elderly. Chin J Integr Med, 22 (11) ( 2016), pp. 861-866, DOI: 10.1007/s11655-015-2104-7

[[10]] Z Zhang, L Huang, Y Liu, L Wang.Effect of tai chi training on plantar loads during walking in individuals with knee osteoarthritis. BioMed Res Int, 2020 ( 2020), p. 3096237, DOI: 10.1155/2020/3096237

[[11]] R Lomas-Vega, E Obrero-Gaitán, FJ Molina-Ortega, R Del-Pino-Casado. Tai chi for risk of falls. A meta-analysis. J Am Geriatr Soc, 65 (9) ( 2017), pp. 2037-2043, DOI: 10.1111/jgs.15008

[[12]] Y Li, CN Devault, S Van Oteghen. Effects of extended Tai Chi intervention on balance and selected motor functions of the elderly. Am J Chin Med, 35 (3) ( 2007), pp. 383-391, DOI: 10.1142/S0192415X07004904

[[13]] MP Gallant, M Tartaglia, S Hardman, K Burke. Using tai chi to reduce fall risk factors among older adults: an evaluation of a community-based implementation. J Appl Gerontol Off J South Gerontol Soc, 38 (7) ( 2019), pp. 983-998, DOI: 10.1177/0733464817703004

[[14]] T Field. Knee osteoarthritis pain in the elderly can be reduced by massage therapy, yoga and tai chi: a review. Compl Ther Clin Pract, 22 ( 2016), pp. 87-92, DOI: 10.1016/j.ctcp.2016.01.001

[[15]] C Wang, JP Collet, J Lau. The effect of tai chi on health outcomes in patients with chronic conditions: a systematic review. Arch Intern Med, 164 (5) ( 2004), pp. 493-501, DOI: 10.1001/archinte.164.5.493

[[16]] C Wang, CH Schmid, PL Hibberd, et al.. Tai Chi is effective in treating knee osteoarthritis: a randomized controlled trial. Arthritis Rheum, 61 (11) ( 2009), pp. 1545-1553, DOI: 10.1002/art.24832

[[17]] JE Ware Jr., CD Sherbourne.The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care, 30 (6) ( 1992), pp. 473-483

[[18]] JR Wingert, CE Corle, DF Saccone, J Lee, AE Rote. Effects of a community-based tai chi program on balance, functional outcomes, and sensorimotor function in older adults. Phys Occup Ther Geriatr, 38 (2) ( 2020), pp. 129-150, DOI: 10.1080/02703181.2019.1709600

[[19]] R Ren, G Tang, C Tang, J Zhang, X Xiao, Q Zhang.The Tai Chi training for middle-aged and elderly patients with knee osteoarthritis: a protocol for systematic review and meta analysis. Medicine (Baltim), 99 (20) ( 2020), p. e20242, DOI: 10.1097/MD.0000000000020242

[[20]] J Ye, Q Zheng, L Zou, et al.. Mindful exercise (baduanjin) as an adjuvant treatment for older adults (60 Years old and over) of knee osteoarthritis: a randomized controlled trial. Evid Based Complement Alternat Med, 2020 ( 2020), p. 9869161, DOI: 10.1155/2020/9869161

[[21]] R Song, EO Lee, P Lam, SC Bae. Effects of a Sun-style Tai Chi exercise on arthritic symptoms, motivation and the performance of health behaviors in women with osteoarthritis. Taehan Kanho Hakhoe Chi, 37 (2) ( 2007), pp. 249-256, DOI: 10.4040/jkan.2007.37.2.249

[[22]] T Xiao, L Yang, L Smith, et al.. Correlation between cognition and balance among middle-aged and older adults observed through a tai chi intervention program. Front Psychol, 11 ( 2020), p. 668, DOI: 10.3389/fpsyg.2020.00668

[[23]] C Wang, CH Schmid, PL Hibberd.Tai Chi for treating knee osteoarthritis: designing a long-term follow up randomized controlled trial. BMC Muscoskel Disord, 9 ( 2008), p. 108, DOI: 10.1186/1471-2474-9-108

[[24]] J Ye, MW Simpson, Y Liu, et al.. The effects of baduanjin qigong on postural stability, proprioception, and symptoms of patients with knee osteoarthritis: a randomized controlled trial. Front Med, 6 ( 2019), p. 307, DOI: 10.3389/fmed.2019.00307