Effects of Tai Chi Rehabilitation Program on Walking Ability in Elderly Women with Knee Osteoarthritis

Abstract

PURPOSE: To investigate the effect Innovative Tai Chi Rehabilitation (ITCR) Program on gait kinematics, physical function and pain in patients with knee osteoarthritis (KOA). An Innovative Tai Chi Rehabilitation Program was developed for patients with knee OA. METHODS: 60 female KOA patients (according to the American College of Rheumatology criteria) aged 60-70 years old from three communities in Shanghai participated in the ITCR Program. Subjects were divided into two groups: Tai Chi (TC) group (n=21, 64.20 ± 3.05 yr.) and control (CON) group (n=19, 64.53 ± 3.51 yr.). Participants in TC group performed a 60-min exercise training three times a week throughout a time-period of 24 weeks. Health education was provided for CON group. Gait kinematics was measured before and after the 24-week intervention. The primary outcomes included gait velocity, step length, initial contact angle and maximal angle of knee. Secondary outcomes included Western Ontario and McMaster osteoarthritis index (WOMAC). Two-way ANOVA were executed to determine significant differences. RESULTS: 40 subjects (66.67%) were retained after the 24-week treatment. After intervention, TC group demonstrated a significant increase in gait velocity, step length, initial contact angle and maximal angle of knee compared to CON group. Mean (±SD) of gait velocity (cm/s) before and after the 24-week intervention were as follows: 135.08±13.19 and 140.28±12.00 for TC group, and 128.43±10.09 and 130.36±10.49 for CON group. TC group also showed a significant improvement in WOMAC scores of knee pain relief, alleviation of stiffness and physical function compared to CON group (P<0.05). Significant differences were found in improvements of gait velocity (P=0.011), the period of gait cycle (P=0.002) and right single support time percentage (P=0.031) between TC and CON groups. CONCLUSIONS: The ITCR Program showed a significant effect on reducing pain, stiffness, and activity limitations in KOA patients. ITCR Program may be beneficial to the walking ability in older women with KOA through kinematic gait compensations.