Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
BMC Complementary Medicine and Therapies
Published in: BMC Complementary Medicine and Therapies 1/2023

Open Access 01-12-2023 | Knee Osteoarthritis | Study Protocol

Effect of Tai Chi on knee pain and muscle strength in middle-aged and older adults with knee osteoarthritis: a randomized controlled trial protocol

Authors: Hongyu Yue, Yang Li, Jianwen Ma, Chaoqun Xie, Fangfang Xie, Junhao Cai, Min Fang, Fei Yao

Published in: BMC Complementary Medicine and Therapies | Issue 1/2023

Login to get access

Abstract

Background

Knee osteoarthritis (KOA) is a common public health problem and a leading cause of long-term pain, decreased muscle strength, and even disability. Tai Chi has been proved effective and highly recommended for KOA management worldwide. However, little is known about its benefits on quadriceps strength which is closely associated with relieving knee pain. 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.

Methods

A total of 100 participants will be randomly divided into a Tai Chi group (TC group) (1x/week for 12 weeks) and a control group with a health education and stretching program (1x/week for 12 weeks) with a follow-up period of 6 weeks. The primary outcome is the change of Western Ontario and McMaster Universities (WOMAC) pain subscale at week 12 compared with baseline. Secondary outcomes include WOMAC stiffness and function subscales, data from isokinetic dynamometry, gait analysis with electromyography (EMG), and a 36-item short form health survey (SF-36). The daily dose of pain-relieving medication will also be recorded. All adverse effects will be assessed by the Treatment Emergent Symptom Scale (TESS).

Discussion

We expect this randomized trial to evaluate the effectiveness of Tai Chi on relieving pain and increasing quadriceps strength in KOA patients. This protocol, if proven effective, will contribute to providing a promising alternative intervention for middle-aged and older adults with KOA.

Trials registration number

This trial has been registered in the China Clinical Trials Registry (registration number: ChiCTR2300069339).
Literature
1.
Ringdahl E, Pandit S. Treatment of knee osteoarthritis. Am Fam Physician. 2011;83(11):1287–92.PubMed
2.
Chen H, Wu J, Wang Z et al. Trends and patterns of knee osteoarthritis in China: a longitudinal study of 17.7 million adults from 2008 to 2017. Int J Environ Res Public Health 2021, 18(16).
3.
Carlesso LC, Neogi T. Identifying pain susceptibility phenotypes in knee osteoarthritis. Clin Exp Rheumatol. 2019;37(5):96–9.PubMedCentralPubMed
4.
de Rooij M, van der Leeden M, Heymans M, et al. Prognosis of pain and physical functioning in patients with knee osteoarthritis: a systematic review and meta-analysis. Ann Behav Med. 2016;50:317–S317.
5.
Focht BC. Effectiveness of Exercise Interventions in reducing Pain symptoms among older adults with knee osteoarthritis: a review. J Aging Phys Act. 2006;14(2):212–35.CrossRefPubMed
6.
Tanaka R, Hirohama K, Ozawa J. Can muscle weakness and disability influence the relationship between pain catastrophizing and pain worsening in patients with knee osteoarthritis? A cross-sectional study. Braz J Phys Ther. 2019;23(3):266–72.CrossRefPubMed
7.
Heiden TL, Lloyd DG, Ackland TR. Knee extension and flexion weakness in people with knee osteoarthritis: is antagonist Cocontraction a factor? J Orthop Sports Phys Ther. 2009;39(11):807–15.CrossRefPubMed
8.
de Zwart AH, van der Esch M, Pijnappels MAGM, et al. Falls Associated with muscle strength in patients with knee osteoarthritis and self-reported knee instability. J Rheumatol. 2015;42(7):1218–23.CrossRefPubMed
9.
Alkhawajah HA, Alshami AM. The effect of mobilization with movement on pain and function in patients with knee osteoarthritis: a randomized double-blind controlled trial. BMC Musculoskelet Disord 2019, 20(1).
10.
Muraki S, Akune T, Teraguchi M et al. Quadriceps muscle strength, radiographic knee osteoarthritis and knee pain: the ROAD study. BMC Musculoskelet Disord 2015, 16.
11.
12.
Segal NA, Findlay C, Wang K, et al. The longitudinal relationship between thigh muscle mass and the development of knee osteoarthritis. Osteoarthritis Cartilage. 2012;20(12):1534–40.CrossRefPubMedCentralPubMed
13.
Lauche R, Langhorst J, Dobos G, et al. A systematic review and meta-analysis of Tai Chi for osteoarthritis of the knee. Complement Ther Med. 2013;21(4):396–406.CrossRefPubMed
14.
Braun J, Baraliakos X, Westhoff T. Nonsteroidal anti-inflammatory drugs and cardiovascular risk - a matter of indication. Semin Arthritis Rheum. 2020;50(2):285–8.CrossRefPubMed
15.
16.
da Costa BR, Reichenbach S, Keller N, et al. Effectiveness of non-steroidal anti-inflammatory drugs for the treatment of pain in knee and hip osteoarthritis: a network meta-analysis. Lancet. 2016;387(10033):2093–105.CrossRefPubMed
17.
Michael JWP, Schlueter-Brust KU, Eysel P. The epidemiology, etiology, diagnosis, and treatment of Osteoarthritis of the knee. Deutsches Arzteblatt International. 2010;107(9):152–U139.PubMedCentralPubMed
18.
Sanders JO, Heggeness MH, Murray J, et al. The American Academy of Orthopaedic Surgeons Appropriate Use Criteria on the Non-Arthroplasty treatment of Osteoarthritis of the knee. J Bone Joint Surgery-American Volume. 2014;96A(14):1220–1.
19.
Brosseau L, Taki J, Desjardins B, et al. The Ottawa panel clinical practice guidelines for the management of knee osteoarthritis. Part two: strengthening exercise programs. Clin Rehabil. 2017;31(5):596–611.CrossRefPubMed
20.
Weber KL, Jevsevar DS, McGrory BJ. AAOS Clinical Practice Guideline: Surgical Management of Osteoarthritis of the knee: evidence-based Guideline. J Am Acad Orthop Surg. 2016;24(8):E94–6.CrossRefPubMed
21.
Bennell KL, Egerton T, Martin J, et al. Effect of Physical Therapy on Pain and function in patients with hip osteoarthritis a Randomized Clinical Trial. Jama-Journal of the American Medical Association. 2014;311(19):1987–97.CrossRef
22.
Messier SP, Mihalko SL, Beavers DP, et al. Effect of high-intensity strength training on knee Pain and knee joint compressive forces among adults with knee osteoarthritis: the START Randomized Clinical Trial. Jama-Journal of the American Medical Association. 2021;325(7):646–57.CrossRef
23.
Yu AP, Tam BT, Lai CW, et al. Revealing the neural Mechanisms underlying the Beneficial Effects of Tai Chi: a neuroimaging perspective. Am J Chin Med. 2018;46(2):231–59.CrossRefPubMed
24.
Kolasinski SL, Neogi T, Hochberg MC, et al. 2019 American College of Rheumatology/Arthritis Foundation Guideline for the management of Osteoarthritis of the Hand, hip, and knee. Arthritis & Rheumatology. 2020;72(2):220–33.CrossRef
25.
Wang C, Schmid CH, Iversen MD, et al. Comparative effectiveness of Tai Chi Versus physical therapy for knee osteoarthritis. Ann Intern Med. 2016;165(2):77–.CrossRefPubMedCentralPubMed
26.
Wang C, Schmid CH, Hibberd PL, et al. Tai Chi is effective in treating knee osteoarthritis: a Randomized Controlled Trial. Arthritis & Rheumatism-Arthritis Care & Research. 2009;61(11):1545–53.CrossRef
27.
Hu X, Lai Z, Wang L. Effects of Taichi exercise on knee and ankle proprioception among individuals with knee osteoarthritis. Res Sports Med. 2020;28(2):268–78.CrossRefPubMed
28.
Hu L, Wang Y, Liu X, et al. Tai Chi exercise can ameliorate physical and mental health of patients with knee osteoarthritis: systematic review and meta-analysis. Clin Rehabil. 2021;35(1):64–79.CrossRefPubMed
29.
Zhu Q, Huang L, Wu X, et al. Effects of Tai Ji Quan training on gait kinematics in older chinese women with knee osteoarthritis: a randomized controlled trial. J Sport Health Sci. 2016;5(3):297–303.CrossRefPubMedCentralPubMed
30.
Chan A-W, Tetzlaff JM, Altman DG, et al. SPIRIT 2013 Statement: defining standard protocol items for clinical trials. Ann Intern Med. 2013;158(3):200–.CrossRefPubMedCentralPubMed
31.
Bellamy N, Buchanan WW, Goldsmith CH, et al. Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol. 1988;15(12):1833–40.PubMed
32.
Moskowitz RW. The burden of osteoarthritis: clinical and quality-of-life issues. Am J Manag Care. 2009;15(8 Suppl):223–9.
33.
Kersten P, White PJ, Tennant A. The visual Analogue WOMAC 3.0 scale - internal validity and responsiveness of the VAS version. BMC Musculoskelet Disord 2010, 11.
34.
Symonds T, Hughes B, Liao S, et al. Validation of the Chinese Western Ontario and McMaster Universities Osteoarthritis Index in Patients from Mainland China with Osteoarthritis of the knee. Arthritis Care Res (Hoboken). 2015;67(11):1553–60.CrossRefPubMed
35.
Wageck B, Nunes GS, Bohlen NB, et al. Kinesio Taping does not improve the symptoms or function of older people with knee osteoarthritis: a randomised trial. J Physiother. 2016;62(3):153–8.CrossRefPubMed
36.
Brazier JE, Harper R, Jones NM, et al. Validating the SF-36 health survey questionnaire: new outcome measure for primary care. Bmj-British Med J. 1992;305(6846):160–4.CrossRef
37.
Li L, Wang HM, Shen Y. Chinese SF-36 Health Survey: translation, cultural adaptation, validation, and normalisation. J Epidemiol Community Health. 2003;57(4):259–63.CrossRefPubMedCentralPubMed
38.
39.
Roos EM, Herzog W, Block JA, et al. Muscle weakness, afferent sensory dysfunction and exercise in knee osteoarthritis. Nat Rev Rheumatol. 2011;7(1):57–63.CrossRefPubMed
40.
Wang C, Roubenoff R, Lau J, et al. Effect of Tai Chi in adults with rheumatoid arthritis. Rheumatology. 2005;44(5):685–7.CrossRefPubMed
41.
Morgan N, Irwin MR, Chung M et al. The Effects of mind-body therapies on the Immune System: Meta-Analysis. PLoS ONE 2014, 9(7).
42.
Metadata
Title
Effect of Tai Chi on knee pain and muscle strength in middle-aged and older adults with knee osteoarthritis: a randomized controlled trial protocol
Authors
Hongyu Yue
Yang Li
Jianwen Ma
Chaoqun Xie
Fangfang Xie
Junhao Cai
Min Fang
Fei Yao
Publication date
01-12-2023
Publisher
BioMed Central
Published in
BMC Complementary Medicine and Therapies / Issue 1/2023
Electronic ISSN: 2662-7671
DOI
https://doi.org/10.1186/s12906-023-04070-0

Other articles of this Issue 1/2023

BMC Complementary Medicine and Therapies 1/2023 Go to the issue

Research

Prediction and validation of common targets in atherosclerosis and non-small cell lung cancer influenced by atorvastatin

Research

Oxymatrine ameliorates myocardial injury by inhibiting oxidative stress and apoptosis via the Nrf2/HO-1 and JAK/STAT pathways in type 2 diabetic rats

Research

Screening of major hepatotoxic components of Tripterygium wilfordii based on hepatotoxic injury patterns

Research

Indigenous medicinal plants used in folk medicine for malaria treatment in Kwara State, Nigeria: an ethnobotanical study

Research

Descriptions of sham acupuncture in randomised controlled trials: a critical review of the literature

Research

Antibacterial activity of oregano essential oils against Streptococcus mutans in vitro and analysis of active components