Abstract
BackgroundWhether Tai Chi benefits patients with osteoarthritis remains controversial. We performed a meta-analysis to assess the effectiveness of Tai Chi exercise for pain, stiffness, and physical function in patients with osteoarthritis.MethodsA computerized search of PubMed and Embase (up to Sept 2012) was performed to identify relevant studies. The outcome measures were pain, stiffness, and physical function. Two investigators identified eligible studies and extracted data independently. The quality of the included studies was assessed by the Jadad score. Standard mean differences (SMDs) and 95% confidence intervals (CIs) were calculated and pooled using a random effects model. The change in outcomes from baseline was compared to the minimum clinically important difference.ResultsA total of seven randomized controlled trials involving 348 patients with osteoarthritis met the inclusion criteria. The mean Jadad score was 3.6. The pooled SMD was −0.45 (95% CI −0.70–−0.20, P = 0.0005) for pain, −0.31 (95% CI −0.60–−0.02, P = 0.04) for stiffness, and −0.61 (95% CI −0.85–−0.37, P<0.00001) for physical function. A change of 32.2–36.4% in the outcomes was greater than the minimum clinically important difference.ConclusionsTwelve-week Tai Chi is beneficial for improving arthritic symptoms and physical function in patients with osteoarthritis and should be included in rehabilitation programs. However, the evidence may be limited by potential biases; thus, larger scale randomized controlled trials are needed to confirm the current findings and investigate the long-term effects of Tai Chi.
Highlights
Osteoarthritis (OA) is a leading cause of musculoskeletal pain and disability [1,2]
The following selection criteria were applied: (i) population, patients diagnosed with OA localized in any joints according to American College of Rheumatology criteria; (ii) intervention, Tai Chi, TaiJi Chuan, or Tai Chi Qigong with or without other treatment; (iii) comparison intervention, any type of control; (iv) outcome measures, pain, stiffness, and function assessed by Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC); and (v) study design, randomized controlled trial (RCT)
Twelve potentially relevant studies were identified for full-text analysis, but one RCT was excluded because of designing type and two RCTs were excluded because it included subjects with rheumatoid arthritis
Summary
Osteoarthritis (OA) is a leading cause of musculoskeletal pain and disability [1,2]. OA is one of the most frequent causes of pain, loss of function, and disability in adults in Western countries, occurring in the majority of people over 65 years of age and in roughly 80% of those over 75 years of age [3]. Taking into account the increasing prevalence of OA and associated disability, social, and economic costs, the American College of Rheumatology has developed guidelines for non-pharmacological therapy including exercise, education, physical therapy, and relatively low costs for OA [5,6]. TC is a low-impact physical activity with slow and gentle movements associated with health benefits, including increased flexibility and lower extremity muscle strength, improved fitness and cardiovascular health, better gait, balance, functional performance, and arthritic symptoms, for a variety of conditions, including OA [8,9,10,11]. Whether Tai Chi benefits patients with osteoarthritis remains controversial. We performed a meta-analysis to assess the effectiveness of Tai Chi exercise for pain, stiffness, and physical function in patients with osteoarthritis
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