Brismee JM, Paige RL, Chyu MC, et al.. Group and home-based Tai Chi in elderly subjects with knee osteoarthritis: a randomized controlled trial. Clin Rehabil. 21: 99-111

Department of Rehabilitation Sciences, School of Allied Health Sciences, Texas Tech University Health Sciences Center, Texas 79430, USA.
Clinical Rehabilitation (Impact Factor: 2.24). 03/2007; 21(2):99-111. DOI: 10.1177/0269215506070505
Source: PubMed


To evaluate the effects of tai chi consisting of group and home-based sessions in elderly subjects with knee osteoarthritis.
A randomized, controlled, single-blinded 12-week trial with stratification by age and sex, and six weeks of follow-up.
General community.
Forty-one adults (70 +/- 9.2 years) with knee osteoarthritis.
The tai chi programme featured six weeks of group tai chi sessions, 40 min/session, three times a week, followed by another six weeks (weeks 7 -12) of home-based tai chi training. Subjects were requested to discontinue tai chi training during a six-week follow-up detraining period (weeks 13-18). Subjects in the attention control group attended six weeks of health lectures following the same schedule as the group-based tai chi intervention (weeks 0 -6), followed by 12 weeks of no activity (weeks 7-18).
Knee pain measured by visual analogue scale, knee range of motion and physical function measured by Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) were recorded at baseline and every three weeks throughout the 18-week study period. Data were analysed using a mixed model ANOVA.
The six weeks of group tai chi followed by another six weeks of home tai chi training showed significant improvements in mean overall knee pain (P = 0.0078), maximum knee pain (P = 0.0035) and the WOMAC subscales of physical function (P = 0.0075) and stiffness (P = 0.0206) compared to the baseline. No significant change of any outcome measure was noted in the attention control group throughout the study. The tai chi group reported lower overall pain and better WOMAC physical function than the attention control group at weeks 9 and 12. All improvements disappeared after detraining.

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    • "In recent years, motion therapy has been applied extensively for OA treatment. Clinical and animal experiments have shown that regular motion therapy can relieve the symptoms of knee OA and improve knee function (2–4). However, research into motion therapy for the treatment of OA is limited, and there are a number of limitations associated, including whether exercise is effective in all types of OA or only to a particular type of OA. "
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    ABSTRACT: The aim of the present study was to investigate the effect of moderate passive motion on articular cartilage in osteoarthritis (OA) caused by knee fracture. Sprague-Dawley rats (age, 8 weeks) with knee fractures were used to construct rat knee early- and middle-stage OA models. The stages were fixed for three and six weeks, with 20 rats analyzed at each stage. The experimental groups were exercised daily for 15 m/min with a specified duration. Following the completion of exercise, the effects of proper passive motion on cartilage thickness, the Mankin rating, cartilage collagen matrix, proteoglycan content and the morphological structure of the cartilage in the rat OA models were measured at the various degenerative stages caused by knee fracture. The proteoglycan content of the cartilage matrix, type II collagen fibers and the number of cartilage cells undergoing apoptosis were semiquantified. For early- and middle-stage OA, the cartilage layers in the three- or six-week experimental groups were significantly thicker and the levels of proteoglycans and type II collagen fibers in the weight-bearing area of the cartilage were significantly higher when compared with the control groups (P<0.05). In addition, the Mankin ratings were lower and ligament tension was increased when compared with the control group (P<0.05). In the early-stage OA group, significantly decreased apoptotic rates (P<0.05) were observed in the three- and six-week experimental groups, however, no significant decrease was observed in the middle-stage OA group. In the early-stage OA rats, the thickness of the cartilage layer, as well as the levels of proteoglycans and type II collagen fibers, in the six-week experimental group, were significantly higher compared with the control and three-week subgroups, and a decreased apoptotic rate was observed (P<0.05). In the six-week experimental middle-stage OA group, significant differences were observed in the content of proteoglycans and type II collagen fibers when compared with the control group, but not when compared with the three-week experimental group. Therefore, proper passive motion can repair and improve the metabolism of chondrocytes and delay the degenerative progress of articular cartilage in OA caused by knee fracture. However, for middle-stage OA, passive motion exhibits no significant repairing effect on the articular cartilage. This therapy increases the levels of proteoglycans and collagen fibers by reducing their decomposition, thereby improving the strength of the articular ligament and the stability of articulation.
    Experimental and therapeutic medicine 08/2014; 8(2):377-383. DOI:10.3892/etm.2014.1746 · 1.27 Impact Factor
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    • "The intervention groups were provided individualized educational sessions, under supervision of researchers which included isometric exercise for one group (Study 1) and acupressure for the other group (Study 2). Each session was 15 min long, three times per week, for 3 months [27] [28]. The researchers educated the patients in the isometric exercise intervention group (Study 1), to do active exercises, introduce different types of exercise gradually (Table 1) [12]. "
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    ABSTRACT: Osteoarthritis (OA) is the most common form of arthritis and a leading cause of disability in older adults. Conservative non-pharmacological strategies, particularly exercise, are recommended by clinical guidelines for its management. The aim of this study was to assess the effectiveness of acupressure versus isometric exercise on pain, stiffness, and physical function in knee OA female patients. This quasi experimental study was conducted at the inpatient and outpatient sections at Al-kasr Al-Aini hospital, Cairo University. It involved three groups of 30 patients each: isometric exercise, acupressure, and control. Data were collected by an interview form and the Western Ontario and McMaster Universities Osteoarthritis index (WOMAC) scale. The study revealed high initial scores of pain, stiffness, and impaired physical functioning. After the intervention, pain decreased in the two intervention groups compared to the control group (p < 0.001), while the scores of stiffness and impaired physical function were significantly lower in the isometric group (p < 0.001) compared to the other two groups. The decrease in the total WOMAC score was sharper in the two study groups compared to the control group. In multiple linear regression, the duration of illness was a positive predictor of WOMAC score, whereas the intervention is associated with a reduction in the score. In conclusion, isometric exercise and acupressure provide an improvement of pain, stiffness, and physical function in patients with knee OA. Since isometric exercise leads to more improvement of stiffness and physical function, while acupressure acts better on pain, a combination of both is recommended. The findings need further confirmation through a randomized clinical trial.
    Journal of Advanced Research 03/2014; 5(2):193–200. DOI:10.1016/j.jare.2013.02.003
    • "There are several studies testing the effects of Tai Chi in knee OA, but interpretation of results is limited because of low levels of adherence, short follow-up and deployment of varying Tai Chi styles (Brismee et al., 2007). Nevertheless, data show some positive effects on improvements in pain and function (Brismee et al., 2007). Tai Chi may enhance cardiovascular bene?ts, muscular strength, balance, coordination, and physical function, contributing to the reduction of joint pain (Wang et al., 2004). "
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    ABSTRACT: Knee osteoarthritis (OA) represents one of the most common causes of disability in the world. It leads to social, psychological and economic costs with financial consequences, also because a further increase is expected. Different knee OA treatments are usually considered in relation to the stage of the disease, such as surgical management and pharmacologic and non-pharmacologic treatments. Treatment should begin with the safest and least invasive one, before proceeding to more invasive, expensive ones. Non-pharmacologic, behavioral treatments of knee OA are recommended not only in rehabilitation but also in prevention because many risk factors, such as excess weight, obesity and joint tissue inflammation, can be monitored and thus prevented. In the present review, we analyze data from the most recent literature in relation to the effects of physical exercise on prevention, therapy and rehabilitation in knee OA. All data suggest that physical exercise is an effective, economical and accessible tool to everyone, in the treatment and prevention of knee OA. The literature search was conducted on PubMed, Scopus and Google Scholar using appropriate keywords in relation to knee osteoarthritis.
    Histology and histopathology 01/2014; 29(6). · 2.10 Impact Factor
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