Comparative Effectiveness of Tai Chi Versus Physical Therapy for Knee Osteoarthritis: A Randomized Trial
Open accessAbstract
BACKGROUND: Few remedies effectively treat long-term pain and disability from knee osteoarthritis. Studies suggest that Tai Chi alleviates symptoms, but no trials have directly compared Tai Chi with standard therapies for osteoarthritis. OBJECTIVE: To compare Tai Chi with standard physical therapy for patients with knee osteoarthritis. DESIGN: Randomized, 52-week, single-blind comparative effectiveness trial. (ClinicalTrials.gov: NCT01258985). SETTING: An urban tertiary care academic hospital. PATIENTS: 204 participants with symptomatic knee osteoarthritis (mean age, 60 years; 70% women; 53% white). INTERVENTION: Tai Chi (2 times per week for 12 weeks) or standard physical therapy (2 times per week for 6 weeks, followed by 6 weeks of monitored home exercise). MEASUREMENTS: The primary outcome was Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score at 12 weeks. Secondary outcomes included physical function, depression, medication use, and quality of life. RESULTS: At 12 weeks, the WOMAC score was substantially reduced in both groups (Tai Chi, 167 points [95% CI, 145 to 190 points]; physical therapy, 143 points [CI, 119 to 167 points]). The between-group difference was not significant (24 points [CI, -10 to 58 points]). Both groups also showed similar clinically significant improvement in most secondary outcomes, and the benefits were maintained up to 52 weeks. Of note, the Tai Chi group had significantly greater improvements in depression and the physical component of quality of life. The benefit of Tai Chi was consistent across instructors. No serious adverse events occurred. LIMITATION: Patients were aware of their treatment group assignment, and the generalizability of the findings to other settings remains undetermined. CONCLUSION: Tai Chi produced beneficial effects similar to those of a standard course of physical therapy in the treatment of knee osteoarthritis. PRIMARY FUNDING SOURCE: National Center for Complementary and Integrative Health of the National Institutes of Health.
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There is sufficient evidence to recommend deployment of Tai Chi, yoga, and exercise therapies including coordination/stabilization, strengthening/resistance, and aerobic/cardiorespiratory activities within the VHA.
“The workgroup found there is sufficient evidence to recommend deployment of three types of exercise within the VHA: Tai Chi, 15 -17 yoga, 18 -20 and exercise therapies including coordination/ stabilization, strengthening/resistance, and aerobic/ cardiorespiratory activities. 17 , 21 -25”
From A Research Agenda for Advancing Non-pharmacological Management of Chronic Musculoskeletal Pain: Findings from a VHA State-of-the-art Conference (2018) · cites this paper as [16]
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- Authors
- Wang, C., Schmid, C. H., Iversen, M. D., Harvey, W. F., Fielding, R. A., Driban, J. B., Price, L. L., Wong, J. B., Reid, K. F., Rones, R., & McAlindon, T.
- Affiliations
- Tufts University (US)
- ORCID
- Venue
- Annals of Internal Medicine
- Publisher
- American College of Physicians
- Published
- 2016-07-19
- Volume
- 165
- Issue
- 2
- Pages
- 77-86
- ISSN
- 0003-4819 (ISSN-L)
- 1539-3704
- PMC
- PMC4960454
- OpenAlex
- W2397437154
- Cited by
- 206
- References
- 41
- Citations by year
- 2026: 24 · 2025: 27 · 2024: 34 · 2023: 22 · 2022: 23 · 2021: 12 · 2020: 17 · 2019: 10 · 2018: 20 · 2017: 10 · 2016: 7
- FWCI
- 16.67
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Annals of Internal Medicine (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Annals of Internal Medicine
- Funders
- U.S. Department of Agriculture (58-1950-4-003, 1P30AG031679)
- Pfizer
- Rheumatology Research Foundation
- Brown University
- Regeneron Pharmaceuticals
- Astellas Pharma
- European League Against Rheumatism
- Fidia Farmaceutici
- National Institutes of Health (UL1TR000073, UL1TR001064, 1P30AG031679, 5p30ag031679-15)
- National Institute on Aging (P30-AG031679)
- National Center for Research Resources (UL1RR025752)
- National Center for Advancing Translational Sciences (RR025752)
- National Center for Complementary and Integrative Health (K24AT007323, R01AT005521)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (R24HD065688)
- Topics
- Health Sciences › Medicine › Rheumatology › Osteoarthritis Treatment and Mechanisms
- Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
- Health Sciences › Medicine › Physiology › Physical Activity and Health
- Keywords
- Tai Chi, knee osteoarthritis, physiotherapy, comparative effectiveness, exercise therapy, WOMAC, depression, quality of life, physical function, home-based exercise, complementary and integrative health
- MeSH terms
- Depression, Female, Follow-Up Studies, Humans, Male, Middle Aged, Quality of Life, Single-Blind Method, Treatment Outcome, Osteoarthritis, Knee, Tai Ji, Physical Therapy Modalities, Comparative Effectiveness Research
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