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Group and home-based tai chi in elderly subjects with knee osteoarthritis: a randomized controlled trial

Department of Rehabilitation Sciences, School of Allied Health Sciences, Texas Tech University Health Sciences Center, Texas, USA

Robert L Paige

Department of Mathematics and Statistics, Texas Tech University, Lubbock, Texas, USA

Ming-Chien Chyu

Department of Health, Exercise, and Sport Sciences, Texas Tech University, Lubbock, Texas, USA

Julie D Boatright

Department of Rehabilitation Sciences, School of Allied Health Sciences, Texas Tech University Health Sciences Center, Texas, USA

James M Hagar

Department of Rehabilitation Sciences, School of Allied Health Sciences, Texas Tech University Health Sciences Center, Texas, USA

Joseph A McCaleb

Department of Rehabilitation Sciences, School of Allied Health Sciences, Texas Tech University Health Sciences Center, Texas, USA

Mauricio M Quintela

Department of Rehabilitation Sciences, School of Allied Health Sciences, Texas Tech University Health Sciences Center, Texas, USA

Du Feng

Department of Human Development and Family Studies, Texas Tech University, Lubbock, Texas, USA

Ke T Xu

Department of Family and Community Medicine, Texas Tech University Health Sciences Center, Texas, USA

Chwan-Li Shen

Department of Pathology, School of Medicine, Texas Tech University Health Sciences Center, Texas, USA, leslie.shen{at}ttuhsc.edu

Objective: To evaluate the effects of tai chi consisting of group and home-based sessions in elderly subjects with knee osteoarthritis.

Design: A randomized, controlled, single-blinded 12-week trial with stratification by age and sex, and six weeks of follow-up.

Setting: General community.

Participants: Forty-one adults (709 ^/ 9.2 years) with knee osteoarthritis.

Interventions: The tai chi programme featured six weeks of group tai chi sessions, 40 min/session, three times a week, followed by another six weeks (weeks 7 -12) of home-based tai chi training. Subjects were requested to discontinue tai chi training during a six-week follow-up detraining period (weeks 13-18). Subjects in the attention control group attended six weeks of health lectures following the same schedule as the group-based tai chi intervention (weeks 0 -6), followed by 12 weeks of no activity (weeks 7-18).

Main outcome measures: Knee pain measured by visual analogue scale, knee range of motion and physical function measured by Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) were recorded at baseline and every three weeks throughout the 18-week study period. Data were analysed using a mixed model ANOVA.

Results: The six weeks of group tai chi followed by another six weeks of home tai chi training showed significant improvements in mean overall knee pain (P = 0.0078), maximum knee pain (P = 0.0035) and the WOMAC subscales of physical function (P = 0.0075) and stiffness (P = 0.0206) compared to the baseline. No significant change of any outcome measure was noted in the attention control group throughout the study. The tai chi group reported lower overall pain and better WOMAC physical function than the attention control group at weeks 9 and 12. All improvements disappeared after detraining.

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