ACR Meeting Abstracts

ACR Meeting Abstracts

  • Home
  • Meetings Archive
    • ACR Convergence 2020
    • 2020 ACR/ARP PRSYM
    • 2019 ACR/ARP Annual Meeting
    • 2018 ACR/ARHP Annual Meeting
    • 2017 ACR/ARHP Annual Meeting
    • 2017 ACR/ARHP PRSYM
    • 2016-2009 Meetings
    • Download Abstracts
  • Keyword Index
  • Advanced Search
  • Your Favorites
    • Favorites
    • Login
    • Register
    • View and print all favorites
    • Clear all your favorites
  • Meeting Resource Center

Abstract Number: 951

Comparative Effectiveness of Tai Chi Versus Physical Therapy in Treating Knee Osteoarthritis: A Randomized, Single-Blind Trial

Chenchen Wang1,2, Christopher Schmid3, Maura D. Iversen4, William F. Harvey2, Roger A. Fielding5, Jeffrey B. Driban2, Lori Lyn Price6, John B. Wong7,8, Kieran Reid5, Ramel Rones9 and Timothy E. McAlindon2, 1Rheumatology, Tufts Medical Center, Bosotn, MA, 2Rheumatology, Tufts Medical Center, Boston, MA, 3Brown University School of Public Health, Providence, RI, 4Northeastern University,, Boston, MA, 5Nutrition, Exercise Physiology and Sarcopenia Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, 6Clinical Care Research, Tufts Medical Center, Boston, MA, 7Tufts Medical Center, Boston, MA, 8Clinical Decision Making, Tufts Medical Center, Boston, MA, 9Center for Mind–Body Therapies, Boston, MA

Meeting: 2015 ACR/ARHP Annual Meeting

Date of first publication: September 29, 2015

Keywords: Osteoarthritis, physical therapy, randomized trials and tai chi

  • Tweet
  • Email
  • Print
Save to PDF
Session Information

Date: Sunday, November 8, 2015

Session Title: Osteoarthritis - Clinical Aspects: Treatments and Epidemiology

Session Type: ACR Concurrent Abstract Session

Session Time: 2:30PM-4:00PM

Background/Purpose: Knee osteoarthritis (OA) causes long-term pain and no effective treatments currently exist. Previous trials demonstrated that Tai Chi can improve both physical and mental health among patients with knee OA. However, it has not been compared against a standard of care therapy for knee OA. We designed this novel randomized, single-blind trial to test the superiority of Tai Chi compared to a standard physical therapy (PT) regimen for treatment of symptomatic and radiographic knee OA. The study was also powered to detect differences in outcomes among different Tai Chi instructors as an important secondary objective.

Methods: Adults ≥ 40 years old satisfying ACR criteria for Knee OA were randomized to 12 weeks of classical Yang style Tai Chi (2x/week) or to the standard PT regimen (2x/week for 6 weeks, followed by 6 weeks of rigorously monitored home PT). Clinical outcomes assessments were blinded to treatment allocation. The primary outcome was change in WOMAC pain subscale (0-500) at 12 weeks. Secondary outcomes included change in pain at 24 and 52 weeks as well as change in WOMAC function scores, patient global assessment (VAS, 0-10 cm), depression (Beck II, 0-63), chronic pain self-efficacy (0-10), 20 meter walk test (sec) and 6 min walk test (meters), quality of life (SF-36, 0-100), pain medication usage and comparisons of all outcomes by instructor assignment at 12, 24 and 52 weeks. We used an intent-to-treat analysis.

Results: We randomized 204 participants: 106 to Tai Chi and 98 to PT. The mean age 60 years, disease duration 8 years, BMI 33 kg/m2; 70% were female; and 53% were white. Treatment groups did not differ in baseline characteristics, including participant expectation of treatment benefit. At 12 weeks, WOMAC pain scores improved by 167 points (95% CI: 145, 190) in the Tai Chi group and 143 points (95% CI: 119, 167) in the PT group. There was no significant difference between groups in WOMAC pain improvement (p = 0.16). A significantly greater improvement in the Tai Chi group was found in the SF-36 Physical Component score 3.2 (95% CI: 0.8, 5.5; p=0.01) and the Beck depression score 2.7 (95% CI, 0.7, 4.8, p=0.008). No differences between groups were found for other outcomes at 12 weeks. There were no serious adverse events. Pain medication use was reduced compared to baseline at all follow-up times in both groups, but the reductions did not differ between groups. Changes in WOMAC pain did not differ among the four Tai Chi instructors (p = 0.81), though differences approached significance comparing physical therapists (p=0.05).

Conclusion: Both Tai Chi and PT led to similar improvements in pain and other outcomes for persons with symptomatic knee OA, and the benefits of Tai Chi did not differ by instructor, suggesting that standardizedTai Chi can be used as a viable therapeutic alternative to treat knee OA.

Table. Changes in Primary and Secondary Outcomes

Variables

Groups

Baseline

Mean (SD)

At 12 week

Change (95% CI)

95% CI and P-value

for D between group

WOMAC pain

(0-500)

Tai Chi

PT

254.8 (95.5)

252.9 (101.9)

-167.2 (-190.4,-144.9)

-143.0 (-167.4,-118.6)

-24.2 (-57.9, 9.6)

P=0.16

WOMAC function

(0-1700)

Tai Chi

PT

912.1 (338.5)

884.7 (368.1)

-608.3 (-695.3,-521.4)

-494.2 (-585.3,-403.2)

-114.1 (-240, 118)

P=0.08

Patient Global

(10-cm VAS)

Tai Chi

PT

0.5 (0.2)

0.5 (0.2)

-0.3 (-0.3, -0.2)

-0.2 (-0.3, -0.2)

-0.7 (-0.15, 0.02)

P=0.06

Chronic Pain

Self-Efficacy (10-cm)

Tai Chi

PT

6.1 (2.0)

6.3 (2.2)

1.3 (0.8, 1.8)

0.8 (0.3, 1.4)

0.4 (-0.3, 1.2)

P=0.22

20 meter walk test (sec)

Tai Chi

PT

19.6 (6.3)

18.4 (3.9)

-1.6 (-2.4, -0.8)

-1.1 (-2.0, -0.2)

-0.5 (-1.7, 0.7)

P=0.40

6 min walk test (meters)

Tai Chi

PT

391.2 (91.7)

400.1 (88.7)

28.6 (17.9, 39.2)

26.1 (14.9, 37.4)

2.5 (-13.1, 18.0)

P=0.76

SF-36: PCS

(0-100)

Tai Chi

PT

36.5 (8.3)

36.7 (10.0)

6.3 (4.6, 7.9)

3.1 (1.4, 4.8)

3.2 (0.8, 5.5)

P=0.01

SF-36: MCS

(0-100)

Tai Chi

PT

52.6 (9.3)

52.4 (9.2)

1.6 (-0.1, 3.2)

-0.03 (-1.7, 1.7)

1.6 (-0.8, 3.9)

P=0.18

Beck II Depression

(0-60)

Tai Chi

PT

7.8 (9.0)

7.5 (8.3)

-2.2 (-3.7, -0.9)

0.5 (-1.0, 2.0)

-2.7 (-4.8, -0.7)

P=0.008

Western Ontario and McMaster Universities =WOMAC. VAS= Visual Analogue Scale; SF-36 (PCS) =Short-Form health survey (physical component summary). SF-36 (MCS) = Short-Form health survey (mental component summary) PT= Physical Therapy.


Disclosure: C. Wang, National Institutes of Health, 2; C. Schmid, National Institutes of Health, 2; M. D. Iversen, National Institutes of Health, 2; W. F. Harvey, National Institutes of Health, 2; R. A. Fielding, National Institutes of Health, 2; J. B. Driban, National Institutes of Health, 2; L. L. Price, National Institutes of Health, 2; J. B. Wong, National Institutes of Health, 2; K. Reid, National Institutes of Health, 2; R. Rones, National Institutes of Health, 2; T. E. McAlindon, National Institutes of Health, 2,Tufts MCPO, 3.

To cite this abstract in AMA style:

Wang C, Schmid C, Iversen MD, Harvey WF, Fielding RA, Driban JB, Price LL, Wong JB, Reid K, Rones R, McAlindon TE. Comparative Effectiveness of Tai Chi Versus Physical Therapy in Treating Knee Osteoarthritis: A Randomized, Single-Blind Trial [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/comparative-effectiveness-of-tai-chi-versus-physical-therapy-in-treating-knee-osteoarthritis-a-randomized-single-blind-trial/. Accessed April 13, 2021.
  • Tweet
  • Email
  • Print
Save to PDF

« Back to 2015 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/comparative-effectiveness-of-tai-chi-versus-physical-therapy-in-treating-knee-osteoarthritis-a-randomized-single-blind-trial/

Advanced Search

Your Favorites

You can save and print a list of your favorite abstracts by clicking the “Favorite” button at the bottom of any abstract. View your favorites »

ACR Convergence: Where Rheumatology Meets. All Virtual. November 5-9.

ACR Pediatric Rheumatology Symposium 2020

© COPYRIGHT 2021 AMERICAN COLLEGE OF RHEUMATOLOGY

Wiley

  • Home
  • Meetings Archive
  • Advanced Search
  • Meeting Resource Center
  • Online Journal
  • Privacy Policy
  • Permissions Policies
loading Cancel
Post was not sent - check your email addresses!
Email check failed, please try again
Sorry, your blog cannot share posts by email.
This site uses cookies: Find out more.