Clinical Rheumatology

, Volume 27, Issue 2, pp 211–218 | Cite as

Tai chi for osteoarthritis: a systematic review

Original Article

Abstract

The aim of this study was to evaluate data from controlled clinical trials testing the effectiveness of tai chi for treating osteoarthritis. Systematic searches were conducted on MEDLINE, AMED, British Nursing Index, CINAHL, EMBASE, PsycInfo, The Cochrane Library 2007, Issue 2, the UK National Research Register and ClinicalTrials.gov, Korean medical databases, the Qigong and Energy database and Chinese medical databases (until June 2007). Hand searches included conference proceedings and our own files. There were no restrictions regarding the language of publication. All controlled trials of tai chi for patients with osteoarthritis were considered for inclusion. Methodological quality was assessed using the Jadad score. Five randomised clinical trials (RCTs) and seven non-randomised controlled clinical trials (CCTs) met all inclusion criteria. Five RCTs assessed the effectiveness of tai chi on pain of osteoarthritis (OA). Two RCTs suggested significant pain reduction on visual analog scale or Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) compared to routine treatment and an attention control program in knee OA. Three RCTs did not report significant pain reduction on multiple sites pain. Four RCTs tested tai chi for physical functions. Two of these RCTs suggested improvement of physical function on activity of daily living or WOMAC compared to routine treatment or wait-list control, whilst two other RCTs failed to do so. In conclusion, there is some encouraging evidence suggesting that tai chi may be effective for pain control in patients with knee OA. However, the evidence is not convincing for pain reduction or improvement of physical function. Future RCTs should assess larger patient samples for longer treatment periods and use appropriate controls.

Keywords

Osteoarthritis Pain Systematic review Tai chi 

References

  1. 1.
    World Health Organization. Chronic rheumatic conditions (available at: http://www.who.int/ chp/topics/rheumatic/en/print.html). Accessibility was verified June 22, 2007
  2. 2.
    Burks K (2005) Osteoarthritis in older adults: current treatments. J Gerontol Nurs 31:11–19; quiz 59–60PubMedGoogle Scholar
  3. 3.
    Pendleton A, Arden N, Dougados M et al (2000) EULAR recommendations for the management of knee osteoarthritis: report of a task force of the Standing Committee for International Clinical Studies Including Therapeutic Trials (ESCISIT). Ann Rheum Dis 59:936–944PubMedCrossRefGoogle Scholar
  4. 4.
    American College of Rheumatology Subcommittee on Osteoarthritis Guidelines (2000) Recommendations for the medical management of osteoarthritis of the hip and knee: 2000 update. Arthritis Rheum 43:1905–1915CrossRefGoogle Scholar
  5. 5.
    Jordan KM, Arden NK, Doherty M et al (2003) EULAR Recommendations 2003: an evidence based approach to the management of knee osteoarthritis: Report of a Task Force of the Standing Committee for International Clinical Studies Including Therapeutic Trials (ESCISIT). Ann Rheum Dis 62:1145–1155PubMedCrossRefGoogle Scholar
  6. 6.
    Scott DL, Shipley M, Dawson A et al (1998) The clinical management of rheumatoid arthritis and osteoarthritis: strategies for improving clinical effectiveness. Br J Rheumatol 37:546–554PubMedCrossRefGoogle Scholar
  7. 7.
    Roddy E, Zhang W, Doherty M (2005) Aerobic walking or strengthening exercise for osteoarthritis of the knee? A systematic review. Ann Rheum Dis 64:544–548PubMedCrossRefGoogle Scholar
  8. 8.
    Roddy E, Zhang W, Doherty M et al (2005) Evidence-based recommendations for the role of exercise in the management of osteoarthritis of the hip or knee—the MOVE consensus. Rheumatol 44:67–73CrossRefGoogle Scholar
  9. 9.
    National Center for Complementary and Alternative Medicine. Tai chi for health purposes (available at http://nccam.nih.gov/health/taichi/). Accessibility is verified June 22, 2007
  10. 10.
    Adler PA, Roberts BL (2006) The use of tai chi to improve health in older adults. Orthop Nurs 25:122–126PubMedCrossRefGoogle Scholar
  11. 11.
    Taylor SK (2003) Tai chi for chronic pain and arthritis. Tech Orthop 18:110–114CrossRefGoogle Scholar
  12. 12.
    Verhagen AP, Immink M, van der Meulen A et al (2004) The efficacy of tai chi chuan in older adults: a systematic review. Fam Pract 21:107–113PubMedCrossRefGoogle Scholar
  13. 13.
    Wang C, Collet JP, Lau J (2004) The effect of Tai Chi on health outcomes in patients with chronic conditions: a systematic review. Arch Intern Med 164:493–501PubMedCrossRefGoogle Scholar
  14. 14.
    Jadad AR, Moore RA, Carroll D et al (1996) Assessing the quality of reports of randomized clinical trials: is blinding necessary? Control Clin Trials 17:1–12PubMedCrossRefGoogle Scholar
  15. 15.
    Adler P, Good M, Roberts B et al (2000) The effects of tai chi on older adults with chronic arthritis pain. J Nurs Scholars 32:377CrossRefGoogle Scholar
  16. 16.
    Song R, Lee EO, Lam P et al (2007) Effects of a Sun-style tai chi exercise on arthritic symptoms, motivation and the performance of health behaviors in women with osteoarthritis. J Korea Acad Nurs 37:249–256Google Scholar
  17. 17.
    Adler PA (2007) The effects of tai chi on pain and function in older adults with osteoarthritis. PhD dissertation. Frances Payne Bolton School of Nursing, Case Western Reserve University, OhioGoogle Scholar
  18. 18.
    Brismee JM, Paige RL, Chyu MC et al (2007) Group and home-based tai chi in elderly subjects with knee osteoarthritis: a randomized controlled trial. Clin Rehabil 21:99–111PubMedCrossRefGoogle Scholar
  19. 19.
    Fransen M, Nairn L, Winstanley J et al (2007) Physical activity for osteoarthritis management: a randomized controlled clinical trial evaluating hydrotherapy or tai chi classes. Arthritis Care Res 57:407–414CrossRefGoogle Scholar
  20. 20.
    Hartman CA, Manos TM, Winter C et al (2000) Effects of T’ai chi training on function and quality of life indicators in older adults with osteoarthritis. J Am Geriatr Soc 48:1553–1559PubMedGoogle Scholar
  21. 21.
    Song R, Lee EO, Lam P et al (2003) Effects of tai chi exercise on pain, balance, muscle strength, and perceived difficulties in physical functioning in older women with osteoarthritis: a randomized clinical trial. J Rheumatol 30:2039–2044PubMedGoogle Scholar
  22. 22.
    Baek MH (2005) A study on effects of tai-chi exercise program on pain, flexibility, perceived health status and instrumental activities of daily living for osteoarthritis patients. J Rheumatol Health 12:119–131 (in Korean)Google Scholar
  23. 23.
    Cho KS, Kang HS, Kim JI et al (2007) Comparing effects of tai chi exercise, tai chi self-help program, and self-help management program for osteoarthritis patients. J Muscle Joint Health 14:75–83 (in Korean)Google Scholar
  24. 24.
    Lee EN, Yu YW (2004) Effects of 8 weeks tai chi exercise program on the risk factors for falls in the elderly with osteoarthritis. J Rheumatol Health 11:61–73 (in Korean)Google Scholar
  25. 25.
    Lee HY (2006) Comparison of effects among tai-chi exercise, aquatic exercise, and a self-help program for patients with knee osteoarthritis. Taehan Kanho Hakhoe Chi 36:571–580 (in Korean)PubMedGoogle Scholar
  26. 26.
    Park YJ (2004) Effect of tai chi exercise program on self-efficacy, pain, and physical function in patients with osteoarthritis. PhD dissertation. Department of Nursing, Chonnam National University, Gwang-Ju, Korea (in Korean)Google Scholar
  27. 27.
    Lee HY, Lee KJ (2006) The effects of tai chi exercise on physical function and fall in elderly with osteoarthritis. Proceeding of the 1st International Conference of Tai Chi for Health Seoul, Korea:203 (abstract)Google Scholar
  28. 28.
    Yen M, Chen CH (2003) Influence of tai chi exercise on health status for older patients with osteoarthritis. Geriatr Gerontol Int 3:S167 (abstract)Google Scholar
  29. 29.
    Andrews G, Simonella L, Lapsley H et al (2006) Evidence-based medicine is affordable: the cost-effectiveness of current compared with optimal treatment in rheumatoid and osteoarthritis. J Rheumatol 33:671–680PubMedGoogle Scholar
  30. 30.
    Gabriel SE, Crowson CS, Campion ME et al (1997) Direct medical costs unique to people with arthritis. J Rheumatol 24:719–725PubMedGoogle Scholar
  31. 31.
    Rabenda V, Manette C, Lemmens R et al (2006) Direct and indirect costs attributable to osteoarthritis in active subjects. J Rheumatol 33:1152–1158PubMedGoogle Scholar
  32. 32.
    Gupta S, Hawker GA, Laporte A et al (2005) The economic burden of disabling hip and knee osteoarthritis (OA) from the perspective of individuals living with this condition. Rheumatology (Oxford) 44:1531–1537CrossRefGoogle Scholar
  33. 33.
    Maetzel A, Li LC, Pencharz J et al (2004) The economic burden associated with osteoarthritis, rheumatoid arthritis, and hypertension: a comparative study. Ann Rheum Dis 63:395–401PubMedCrossRefGoogle Scholar
  34. 34.
    Dickersin K (1990) The existence of publication bias and risk factors for its occurrence. JAMA 263:1385–1389PubMedCrossRefGoogle Scholar
  35. 35.
    Egger M, Smith GD (1998) Bias in location and selection of studies. BMJ 316:61–66PubMedGoogle Scholar
  36. 36.
    Ernst E, Pittler MH (1997) Alternative therapy bias. Nature 385:480PubMedCrossRefGoogle Scholar
  37. 37.
    Pittler MH, Abbot NC, Harkness EF et al (2000) Location bias in controlled clinical trials of complementary/alternative therapies. J Clin Epidemiol 53:485–489PubMedCrossRefGoogle Scholar

Copyright information

© Clinical Rheumatology 2007

Authors and Affiliations

  • Myeong Soo Lee
    • 1
  • Max H. Pittler
    • 1
  • Edzard Ernst
    • 1
  1. 1.Complementary Medicine, Peninsula Medical SchoolUniversities of Exeter & PlymouthExeterUK

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