Long-term pain is a major issue affecting large portions of the population, as evidenced by the current Opioid crisis in the United States. For some conditions, the only feasible treatment option is physical therapy. One study examined whether Tai Chi could serve as an effective alternative to physical therapy in knee osteoarthritis (Wang et al., 2016). This article will briefly review that study.
Methods
The population in this study consisted of 204 people over 40 years old who had knee osteoarthritis. None of these people had participated in either Tai Chi or physical therapy for the year prior. In addition, all participants scored 40 or higher on at least one of the five questions in the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain subscale at baseline.
The study considered nine “cycles” of participants, each totaling about 20 participants. In each cycle, the participants were randomly assigned to either a Tai Chi group or a physical therapy group:
- Participants in the Tai Chi group practiced Tai Chi two times a week for 12 weeks.
- These sessions were 60 minutes each.
- Participants were also encouraged to practice Tai Chi at home for 20 minutes a day.
- Upon completion of these 12 weeks, participants were encouraged to continue practicing Tai Chi at home for 52 weeks.
- Participants in the physical therapy group engaged in physical therapy two times a week for six weeks in a clinical setting, then conducted rigorously monitored exercise at home four times a week for a further six weeks.
- The outpatient settings were 30 minutes each.
- The home sessions were also 30 minutes each.
- All participants were discouraged from engaging in new exercises outside of their normal routine.
The following outcome measures were assessed to assess the effects of the two treatments:
- Knee osteoarthritis outcomes, as measured using “the core set recommended by the Osteoarthritis Research Society International (OARSI) and focused on pain, physical function, and patients’ overall assessment of their disease severity”
- WOMAC pain subscale score
- WOMAC physical function and stiffness scores
- Patient Global Assessment score
- Beck Depression Inventory-II score
- Physical and mental components of the 36-item Short Form Health Survey (SF-36)
- Arthritis Self-Efficacy Scale score
- 6-minute walk test and 20-meter walk test results
- Outcome Expectations for Exercise Scale
Results
The following results were obtained:
- Participants in both groups showed improved WOMAC pain scores at 12 weeks, with no significant differences in improvements between the two groups.
- Both groups showed improvements in most secondary outcomes at 12 weeks, and in all outcomes at 24 and 52 weeks.
- Participants in the Tai Chi group showed a significantly greater improvement in Beck Depression Inventory-II scores than those in the physical therapy group.
Altogether, the results suggest that the Tai Chi intervention was at least as effective as the physical therapy intervention.
Wrapping up
The results of this study show that a Tai Chi program can be as effective as traditional physical therapy for knee osteoarthritis. In addition, the Tai Chi program may have even had additional benefits in alleviating depressive symptoms. This is promising, because the more treatment options that there are available for a certain issue, the more likely it is that someone can find relief themselves. Future research should continue searching for alternatives to physical therapy, and further studies should aim to validate these results.
References
Wang, C., Schmid, C.H., Iversen, M.D., Harvey, W.F., Fielding, R.A., Driban, J.F., Price, L.L., Wong, J.B., Reid, K.F., Rones, R., McAlindon, T. (2016). Comparative Effectiveness of Tai Chi Versus Physical Therapy for Knee Osteoarthritis: A Randomized Trial. Annals of Internal Medicine, 165(2), 77-86. doi: 10.7326/M15-2143.
