Tai Chi vs. Wellness Education for Osteoarthritis

Overseen By Elise Coash, BS

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Tufts Medical Center

Must not be taking: Antibiotics, Probiotics

Disqualifiers: Dementia, Cancer, Cardiovascular, others

Compensation: Varies

Number of Visits: Unknown

Duration: 12 weeks

73 Participants Needed

Trial Summary

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. However, if you have used antibiotics or probiotics in the last 4 weeks, you may not be eligible to participate.

What data supports the effectiveness of the treatment Tai Chi for osteoarthritis?

Research shows that Tai Chi can help reduce pain and improve physical function in people with knee osteoarthritis, although the evidence is not entirely convincing and more studies are needed to confirm these benefits. ^{1 2 3 4 5}

Is Tai Chi safe for humans?

Research shows that Tai Chi is generally safe for humans, with very few reports of adverse events (unwanted side effects) in clinical studies. However, adverse events are often underreported, so it's important to consult with a healthcare provider before starting any new exercise program. ^{3 6 7 8 9}

How is Tai Chi different from other treatments for osteoarthritis?

Tai Chi is a gentle exercise derived from an ancient Chinese martial art that can help relieve knee pain caused by osteoarthritis. Unlike standard treatments, it combines physical movement with mindfulness, making it a unique and cost-effective option, especially for older adults and those with mild cognitive impairment. ^{5 10 11 12 13}

What is the purpose of this trial?

This exploratory study is to compares mechanisms of mind-body exercise with wellness education program on gut microbiota for osteoarthritis as a basis for a future large-scale trial.

Research Team

Chenchen Wang, MD, MSc

Principal Investigator

Tufts Medical Center

Eligibility Criteria

This trial is for individuals over 55 with symptomatic osteoarthritis and a pain score of ≥40 on the WOMAC scale. Participants should meet the American College of Rheumatology criteria for OA but can't join if they've used antibiotics or probiotics recently, have certain gut diseases, infections like hepatitis B or C, dementia, cancer, heart disease, kidney or liver problems.

Inclusion Criteria

Baseline (Month 0) WOMAC pain subscale score ≥ 40

Fulfills the American College of Rheumatology Criteria for symptomatic OA

I am 55 years old or older.

Exclusion Criteria

I haven't used antibiotics or probiotics in the last 4 weeks and don't have significant gut issues or infections.

I do not have any serious health conditions that would prevent me from participating.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants are randomized into Tai Chi or wellness education interventions for 12 weeks

12 weeks

Weekly sessions

Follow-up

Participants are monitored for changes in gut microbiota and clinical outcomes

4 weeks

Treatment Details

Interventions

• Tai Chi
• Wellness Education

Trial Overview The study compares Tai Chi's effects on gut bacteria to those from a wellness education program in people with osteoarthritis. It aims to lay groundwork for future large-scale research by exploring how these interventions might work.

Participant Groups

Group I: Tai Chi Active Control 1 Intervention

12 weeks of Tai Chi classes

Group II: Wellnes Education Placebo Group 1 Intervention

12 weeks of Wellness Education classes

Who Is Running the Clinical Trial?

Tufts Medical Center

Lead Sponsor

Trials

264

Recruited

264,000+

Findings from Research

In a study of 40 individuals with knee osteoarthritis, Tai Chi significantly reduced pain and improved physical function compared to a control group, with notable improvements in WOMAC pain and function scores after 12 weeks.

Participants practicing Tai Chi also experienced enhancements in self-efficacy, depression levels, and overall quality of life, with no severe adverse events reported, indicating it is a safe and effective intervention for managing knee OA symptoms.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Tai Chi is effective in treating knee osteoarthritis: a randomized controlled trial. Wang, C., Schmid, CH., Hibberd, PL., et al.[2022]

Tai chi may help reduce pain in patients with knee osteoarthritis, as indicated by two out of five randomized clinical trials showing significant pain reduction compared to routine treatment.

However, the overall evidence for tai chi's effectiveness in improving physical function and pain reduction is not strong, highlighting the need for larger and longer-term studies with better controls.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Tai chi for osteoarthritis: a systematic review. Lee, MS., Pittler, MH., Ernst, E.[2022]

Tai Chi (TC) has been shown to effectively improve symptoms of knee osteoarthritis (KOA), including pain, stiffness, physical function, and mental quality of life, based on a review of seven systematic reviews and meta-analyses.

Despite these positive findings, the overall methodological quality of the studies was low, with only one deemed high quality, indicating that the results should be interpreted cautiously and highlighting the need for more rigorous research in this area.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of Tai chi in knee osteoarthritis patients: An overview of systematic reviews and meta-analyses. Zhang, N., Cui, H., Li, H., et al.[2023]

Tai chi (TC) is generally safe, with no serious adverse events reported in a review of 153 randomized controlled trials, primarily involving older adults, although minor musculoskeletal issues like knee and back pain were noted.

Only 33% of the trials reported adverse events, and just 12% had a clear protocol for monitoring them, indicating that the inconsistent reporting limits our understanding of TC's safety profile.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

What do we really know about the safety of tai chi?: A systematic review of adverse event reports in randomized trials. Wayne, PM., Berkowitz, DL., Litrownik, DE., et al.[2022]

A significant increase in clinical studies on Tai Chi was observed from 2010 to 2020, with 987 studies identified, primarily randomized controlled trials, indicating growing interest in its health benefits, especially for older adults and conditions like hypertension and depression.

Most studies showed positive outcomes for Tai Chi, with 93.8% reporting at least one favorable result, although adverse events were underreported, highlighting the need for better reporting standards in Tai Chi research.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Tai Chi for health and well-being: A bibliometric analysis of published clinical studies between 2010 and 2020. Yang, GY., Sabag, A., Hao, WL., et al.[2021]

A review of 256 randomized controlled trials involving tai chi (TC) found that it does not lead to a higher frequency of adverse events (AEs) compared to both active and inactive control groups, indicating its safety as an intervention.

In studies involving participants with heart failure, tai chi was associated with fewer serious adverse events compared to inactive interventions, suggesting it may be a safer option for this population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The safety of tai chi: A meta-analysis of adverse events in randomized controlled trials. Cui, H., Wang, Q., Pedersen, M., et al.[2020]

Teaching the 12-form Sun-style Tai Chi to mildly cognitively impaired elders can effectively relieve knee pain caused by osteoarthritis, making it a beneficial exercise option for this population.

The program highlights the need for tailored teaching strategies that accommodate the physical and cognitive challenges faced by older adults, ensuring safety and efficacy in their practice.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Teaching Tai Chi to elders with osteoarthritis pain and mild cognitive impairment. Chang, JY., Tsai, PF., Woods, S., et al.[2021]

Teaching Tai Chi, specifically the 12-form Sun-style, to elders with mild cognitive impairment can effectively relieve knee pain caused by osteoarthritis.

The program demonstrates that with tailored teaching strategies, Tai Chi can be a unique and cost-effective intervention for improving the quality of life in this population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Teaching Tai Chi to elders with osteoarthritis pain and mild cognitive impairment. Chang, JY., Tsai, PF., Woods, S., et al.[2021]

Tai Chi is supported by high and moderate quality evidence from 27 meta-analyses, showing significant improvements in balance, cardiorespiratory fitness, cognition, mobility, sleep, and strength in older adults.

Practicing Tai Chi can also reduce the incidence of falls and nonfatal strokes, making it a valuable exercise for promoting overall health and well-being in older populations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effectiveness of Tai Chi for Health Promotion of Older Adults: A Scoping Review of Meta-Analyses. Yang, FC., Desai, AB., Esfahani, P., et al.[2022]

References

1. United States pubmed.ncbi.nlm.nih.gov

Tai Chi is effective in treating knee osteoarthritis: a randomized controlled trial. [2022]

2. United States pubmed.ncbi.nlm.nih.gov

Effects of Tai Chi exercise on improving walking function and posture control in elderly patients with knee osteoarthritis: A systematic review and meta-analysis. [2023]

3. Germany pubmed.ncbi.nlm.nih.gov

Tai chi for osteoarthritis: a systematic review. [2022]

4. United States pubmed.ncbi.nlm.nih.gov

Efficacy of Tai Chi on pain, stiffness and function in patients with osteoarthritis: a meta-analysis. [2022]

5. Scotland pubmed.ncbi.nlm.nih.gov

Effects of Tai chi in knee osteoarthritis patients: An overview of systematic reviews and meta-analyses. [2023]

6. United States pubmed.ncbi.nlm.nih.gov

What do we really know about the safety of tai chi?: A systematic review of adverse event reports in randomized trials. [2022]

7. Scotland pubmed.ncbi.nlm.nih.gov

Tai Chi for health and well-being: A bibliometric analysis of published clinical studies between 2010 and 2020. [2021]

8. United States pubmed.ncbi.nlm.nih.gov

The safety of tai chi: A meta-analysis of adverse events in randomized controlled trials. [2020]

9. United States pubmed.ncbi.nlm.nih.gov

Evidence base of clinical studies on Tai Chi: a bibliometric analysis. [2018]

10. England pubmed.ncbi.nlm.nih.gov

A community-centric multi-disciplinary education program with the 8-section brocade Tai Chi therapy for patients with osteoarthritis of the knee - a pilot study. [2021]

11. United States pubmed.ncbi.nlm.nih.gov

Teaching Tai Chi to elders with osteoarthritis pain and mild cognitive impairment. [2021]

12. United States pubmed.ncbi.nlm.nih.gov

Teaching Tai Chi to elders with osteoarthritis pain and mild cognitive impairment. [2021]

13. United States pubmed.ncbi.nlm.nih.gov

Effectiveness of Tai Chi for Health Promotion of Older Adults: A Scoping Review of Meta-Analyses. [2022]