Knee Osteoarthritis Can Benefit from Tai Chi

Every day, people in parks, community centers, YMCAs, gyms, churches, and living rooms across the country are performing tai chi, a centuries-old Chinese martial art—not because of their interest in martial training, but for its purported physical and mental health benefits. Tai chi’s slow, repetitive movements provide a low-impact method for strengthening the body’s muscular, skeletal, and organ systems while the emphasis on breathing and inner stillness relieves stress and anxiety. And as an added bonus, it burns more calories than surfing and nearly as many as downhill skiing. Studies have shown tai chi may help lower cholesterol, improve cardiovascular and respiratory function, reduce the symptoms of Attention Deficit and Hyperactivity Disorder (ADHD), reduce the severity of diabetes, and improve people’s overall health. And recently, researchers found that regular tai chi exercise can also help reduce pain and improve knee function among seniors with osteoarthritis.

Osteoarthritis of the knee is very common among older adults, affecting about 4.3 million Americans over the age of 60, according to the Centers for Disease Control and Prevention (CDC). This joint disease can lead to stiffness, limited movement, increase the risk of falls and fractures, contribute to feelings of depression, and decrease a person’s overall quality of life. Many people rely on painkillers to cope with the pain of osteoarthritis or undergo knee replacement reduce pain and restore mobility to the affected joint. Some people can achieve modest improvements with exercise and physiotherapy. But Dr. Chenchen Wang and colleagues at Tufts University School of Medicine in Boston thought one exercise might be particularly helpful.

To test their theory, they recruited 40 people, average age 65, with knee osteoarthritis. Half were randomly chosen to take part in hour-long tai chi classes, twice-weekly for three months. These classes included 10 minutes of self-message and review, a half hour of tai chi movements, 10 minutes of breathing techniques and 10 minutes of relaxing. Participants were also asked to practice tai chi for at least 20 minutes a day at home while maintaining their usual physical routine.

The other 20 participants acted as a control group, attending two hour-long classes on osteoarthritis each week for the three months, which included information on diet and nutrition, treatments for osteoarthritis and on how to handle stress. They also did full-body stretching exercises and were encouraged to stretch for 20 minutes at home, while following their regular fitness regimen.

At the end of the study period, those in the tai chi group had a 75 percent reduction in knee pain, on average, and a 72 percent improvement in their ability to perform everyday tasks, such as using stairs. The tai chi group also reported less depression and better overall health status. The control group also reported improvements, but they were much lower than in the tai chi group. “Tai chi is a mind-body approach that appears to be an applicable treatment for older adults with knee osteoarthritis,” Dr. Wang said in a news release. “Our observations emphasize a need to further evaluate the biologic mechanisms and approaches of tai chi to extend its benefits to a broader population.”

Dr. Paul Lam, a Sydney-based family practitioner and tai chi master who designed the Australian arthritis program, says tai chi is an exercise almost anyone who can walk can do safely. Dr. Lam, now 52, began tai chi in his 20s when he developed osteoarthritis in his neck, back and hands. “There’s no doubt that tai chi, done properly, can be a beneficial exercise for people with arthritis,” he said.

Other experts agree. “Given its low impact and evidence that it tends to increase muscle strength and balance and give general pain relief, we think it’s a worthwhile option for arthritis patients,” says Dr. William L. Haskell, deputy director of the Stanford University Center for Research in Disease Prevention in California.

The study appears in the November issue of the journal Arthritis Care and Research.