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

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores the impact of Tai Chi and wellness education on gut health in people with osteoarthritis, aiming to guide future studies. Participants will either take Tai Chi classes or attend wellness education sessions for 12 weeks. This study is ideal for individuals aged 55 or older who have osteoarthritis symptoms and experience significant joint pain. As an unphased trial, it offers a unique opportunity to contribute to innovative research that could improve osteoarthritis management.

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.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research has shown that Tai Chi is generally safe for people with knee osteoarthritis. Some studies suggest it can relieve pain and improve joint function. A few studies noted that some participants initially experienced more knee pain, but this subsided with improved posture. No serious side effects were found. Over time, Tai Chi can enhance quality of life.

The Wellness Education program presents no specific safety concerns, as it focuses on learning to manage overall health, making it a low-risk option. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about Tai Chi for osteoarthritis because it offers a unique, gentle approach to managing symptoms, unlike traditional treatments like pain relievers and physical therapy. Tai Chi combines slow, flowing movements with deep breathing and mindfulness, which may improve joint flexibility and reduce pain without the side effects of medication. Meanwhile, Wellness Education empowers individuals with knowledge about osteoarthritis, potentially enhancing self-management of the condition. Both approaches focus on holistic well-being, offering alternatives that could complement or even reduce reliance on conventional medical treatments.

What evidence suggests that this trial's treatments could be effective for osteoarthritis?

Research has shown that Tai Chi, one of the treatments in this trial, can help treat knee osteoarthritis. Studies have found that practicing Tai Chi for 12 weeks greatly reduces pain and improves mobility. It also boosts confidence in managing symptoms and enhances overall health. Additionally, Tai Chi increases exercise capacity and reduces stiffness. These benefits make Tai Chi a promising method for managing osteoarthritis symptoms. Participants in this trial will be assigned to either Tai Chi classes or Wellness Education classes to compare their effects on osteoarthritis. ^{6 7 8 9 10}

Who Is on the Research Team?

Chenchen Wang, MD, MSc

Principal Investigator

Tufts Medical Center

Are You a Good Fit for This Trial?

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 for a Trial Participant

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

What Are the Treatments Tested in This Trial?

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.

How Is the Trial Designed?

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+

Published Research Related to This Trial

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]

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]

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]

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]

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]

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]

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]

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 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]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC10560483/

The Effectiveness of Tai Chi for Knee Osteoarthritis Tai chi exercises are effective in improving pain, function, stiffness and enhancing exercise capacity in KOA patients. Future research should ...

2. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC3023169/

Tai Chi is Effective in Treating Knee Osteoarthritis In conclusion, 12-week Tai Chi appears to reduce pain and improve physical function, self-efficacy, depression and health status for knee OA. These observations ...

3. mdpi.com mdpi.com/2227-9032/13/13/1615

The Effectiveness and Safety of Tai Chi on Knee Pain Tai Chi consistently demonstrated significant improvements in knee pain and function compared to health education and no intervention, as evidenced by ...

4. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/27183035/

Comparative Effectiveness of Tai Chi Versus Physical ... Studies suggest that Tai Chi alleviates symptoms, but no trials have directly compared Tai Chi with standard therapies for osteoarthritis.

5. bmccomplementmedtherapies.biomedcentral.com bmccomplementmedtherapies.biomedcentral.com/articles/10.1186/s12906-023-04070-0

Effect of Tai Chi on knee pain and muscle strength in middle ... This trial is designed to evaluate the efficacy and safety of Tai Chi on knee pain and muscle strength in middle-aged and older adults with KOA.

6. jamanetwork.com jamanetwork.com/journals/jamainternalmedicine/fullarticle/10.1001/jamainternmed.2025.5723

Tai Chi Intervention for Knee Pain and Function in People ... Systematic reviews of in-person group tai chi classes have demonstrated benefits for pain, function, stiffness, mobility, and mental health in ...

7. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC12249842/

The Effectiveness and Safety of Tai Chi on Knee Pain Two studies reported increased knee pain during initial Tai Chi sessions, but no adverse events occurred after postural corrections. Conclusions ...

8. sciencedirect.com sciencedirect.com/science/article/pii/S2665913124001031

An unsupervised online Tai Chi program for people with ... The results showed greater improvement in physical function, but not knee pain, at 12 weeks with benefits for some secondary outcomes [32]. The program has now ...

9. rethinkingclinicaltrials.org rethinkingclinicaltrials.org/demonstration-projects/remote-tai-chi-for-knee-osteoarthritis-an-embedded-pragmatic-trial-remote-tai-chi/

UH3 Project: Remote Tai Chi for Knee Osteoarthritis American College of Rheumatology clinical practice guidelines strongly recommend tai chi as an intervention for knee osteoarthritis. Moreover, studies conducted ...

10. frontiersin.org frontiersin.org/journals/aging-neuroscience/articles/10.3389/fnagi.2022.860762/full

The Effect of Modified Tai Chi Exercises on the Physical ... The results showed that 12-week Tai Chi exercises could significantly reduce pain, improve physical function and quality of life compared to the control group.