Clinical Question: Can a specifically designed tai chi exercise program improve symptoms and physical function in women with osteoarthritis?
Setting: Outpatient (specialty)
Study Design: Randomized controlled trial (nonblinded)
Synopsis: Tai chi is a martial art that involves slow, continuous, gentle motions, including isometric exercise, relaxation, stretching, and correct body posturing. A series of 12 Sun-style tai chi exercises has been developed to meet the specific needs of patients with arthritis. Patients in this study were older women in South Korea with radiologic and clinical evidence of osteoarthritis who were not already involved in an exercise program.
Of the 72 women who started the study, only 43 completed the entire 12 weeks. Approximately one half of the patients who completed the study considered themselves to be in poor or very poor health. The average body mass index of the women was 25 kg per m2 . They were assigned randomly (using concealed allocation) to regular care without exercise or tai chi training. Members of the tai chi group participated in classes three times a week for the first two weeks, followed by weekly classes supplemented with twice-weekly home exercise for 20 minutes during the next 10 weeks. The analysis included only the 43 women who completed all 12 weeks of the study.
Using the Korean version of the Western Ontario and McMaster Universities Osteoarthritis Index, joint pain, stiffness, and physical function were significantly different in the exercise group. Balance on one foot was significantly increased (by seven seconds in the exercise group versus one second worse; P < .05), as was abdominal muscle strength (an increase of two sit-ups versus none in the regular-care group; P < .05). Muscle strength and endurance, flexibility, and weight were not affected. Of concern, the investigators evaluating the outcomes may not have been blinded to the treatment the patients received.
Bottom Line: A specifically designed tai chi program for older women with osteoarthritis decreases pain and joint stiffness, and improves physical function, balance, and abdominal muscle strength in women who continue the exercises. The results may be a bit inflated because the researchers evaluating the outcomes may have known which patients had received treatment. (Level of Evidence: 1c)