The effect of Tai Chi on knee osteoarthritis: A systematic review and meta-analyses of 13 randomized controlled trials

Background and purposeOsteoarthritis is a public health issue in an aging society with no radical cure. Complementary therapies such as Tai Chi might be beneficial for patients with osteoarthritis.MethodsThe present meta-analysis summarized current evidence on the effectiveness of Tai Chi in patients with osteoarthritis. PubMed, Embase, and Cochrane Library databases were systematically searched for RCTs published from inception up to March 2020. The primary outcome was the pain score on the Western Ontario and McMaster Universities Arthritis Index (WOMAC). For pooled outcomes, standardized mean differences (SMDs) and 95% confidence intervals (CIs) were calculated.ResultsWe identified 13 trials with data from 817 patients. The results indicated that patients who practiced Tai Chi exercise showed more significant improvements in pain (SMD, -1.40; 95% CI, -2.17 to -0.63; P < 0.001), physical function (SMD, -1.54; 95% CI, -2.28 to -0.81; P < 0.001), and stiffness (SMD, -1.19; 95% CI, -1.94 to -0.44; P < 0.001) than the control group. Subgroup analysis data were consistent with the overall findings. Meta-regression showed that Tai Chi sessions, publication year, sample size, and Jadad score did not affect the therapeutic effects of Tai Chi. Tai Chi had a significant impact on the physiological and psychological health of patients with knee osteoarthritis.ConclusionsThis meta-analysis provides moderate-to-high quality evidence that Tai Chi has a clinically significant beneficial impact on knee osteoarthritis, with effect sizes exceeding minimal clinically important differences for pain and function.