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T'ai chi for the treatment of osteoarthritis: a systematic review and meta-analysis
  1. Jung Won Kang1,
  2. Myeong Soo Lee2,3,
  3. Paul Posadzki3,
  4. Edzard Ernst3
  1. 1Department of Acupuncture & Moxibustion, College of Korean Medicine, Kyung Hee University, Seoul, Republic of Korea
  2. 2Brain Disease Research Centre, Korea Institute of Oriental Medicine, Daejeon, South Korea
  3. 3Complementary Medicine, Peninsula Medical School, University of Exeter, Exeter, UK
  1. Correspondence to Dr Myeong Soo Lee; drmslee{at}gmail.com

Abstract

Objectives To summarise and critically evaluate the evidence from randomised clinical trials (RCTs) of t'ai chi as a treatment for patients with osteoarthritis (OA).

Design Eleven databases were searched from their inception to July 2010. RCTs testing t'ai chi against any type of controls in human patients with OA localised in any joints that assessed any type of clinical outcome measures were considered. Two reviewers independently performed the selection of the studies, data abstraction and validations. The risk of bias was assessed using Cochrane criteria.

Results Nine RCTs met the inclusion criteria, and most of them had significant methodological weaknesses. Six RCTs tested the effects of t'ai chi compared with that of an attention-control programme, a waiting list and routine care or self-help programmes in patients with OA in the knee. The meta-analysis suggested that t'ai chi has favourable effects on pain (n=256; standard mean difference (SMD), −0.79; 95% CI −1.19 to −0.39; p=0.0001; I2=55%), physical function (n=256; SMD, −0.86; 95% CI −1.20 to −0.52; p<0.00001; I2=38%) and joint stiffness (n=256; SMD, −0.53; 95% CI −0.99 to −0.08; p=0.02; I2=67%).

Conclusion The results are encouraging and suggest that t'ai chi may be effective in controlling pain and improving physical function in patients with OA in the knee. However, owing to the small number of RCTs with a low risk of bias, the evidence that t'ai chi is effective in patients with OA is limited.

  • T'ai chi
  • osteoarthritis
  • systematic review
  • meta-analysis
  • complementary medicine
  • clinical trials
  • complementary medicine
  • rheumatology
  • rehabilitation medicine

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/2.0/ and http://creativecommons.org/licenses/by-nc/2.0/legalcode.

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Footnotes

  • To cite: Kang JW, Lee MS, Posadzki P, et al. T'ai chi for the treatment of osteoarthritis: a systematic review and meta-analysis. BMJ Open 2011;1:e000035. doi:10.1136/bmjopen-2010-000035

  • Funding MSL was supported by Korea Institute of Oriental Medicine (K10251 and K11111).

  • Competing interests None.

  • Contributors JWK and MSL designed the review, performed searches, appraised and selected trials, abstracted data, contacted authors for additional data, carried out the analysis and interpretation of the data, and drafted this report. PP and EE reviewed and critiqued the review protocol and this report, and assisted in designing the review. All authors read and approved the final version of the manuscript.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement No additional data available.

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