Chinese exercise Tai chi relieves knee pain

Tai chi is effective in the treatment of pain and physical impairment in people with severe knee osteoarthritis, according to research presented this week at the American College of Rheumatology Annual Scientific Meeting in San Francisco, Calif.

Osteoarthritis, or OA as it is commonly called, is the most common joint disease affecting middle-age and older people. It is characterized by progressive damage to the joint cartilage-the slippery material at the end of long bones-and causes changes in the structures around the joint.

These changes can include fluid accumulation, bony overgrowth, and loosening and weakness of muscles and tendons, all of which may limit movement and cause pain and swelling.

Osteoarthritis in the knee and hip areas can generate chronic pain or discomfort during standing or walking. According to the Centers for Disease Control, knee OA affects 240 people out of every 100,000 people per year.

Tai chi is an ancient Chinese exercise that uses an integrated mind-body approach to enhance muscle function, balance, and flexibility and has been known to reduce pain, depression and anxiety in those who practice the exercise.

Researchers set out to determine if tai chi could successfully treat the physical and mental effects of severe knee OA. A total of 40 patients were randomly chosen to participate in the study. On average they were 65 years old and moderately overweight, and had knee OA for approximately 10 years; 75 percent of the patients were female and 70 percent were Caucasian.

Participants were introduced to either tai chi (10 modified forms from the classical Yang style) or to conventional stretching and wellness education. Each group received the intervention twice-weekly for 60 minutes over the course of 12 weeks. Patients were evaluated with a self assessment questionnaire (WOMAC) that evaluates pain, stiffness and physical function in hips and knees at the beginning and end of the study.

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Additionally, researchers studied WOMAC function, patient and physician global assessments, timed chair stand, balance tests, knee proprioception, depression, self-efficacy, and health-related quality of life. These assessments were also done at weeks 24 and 48 to determine how lasting each intervention was for the participants.

Attendance for the 12-week interventions was 85 percent in the tai chi group and 89 percent in the stretching and wellness group. Participants who took part in tai chi exhibited significantly greater improvements in pain, physical function, depression, self-effectiveness and health status. Patients who continued participating in tai chi after the 12-week intervention also reported long-lasting benefits in WOMAC pain and function.

These results lead investigators to believe that tai chi is effective in the treatment of the pain and physical impairments in people with severe knee OA. Chenchen Wang MD, MSc; Tufts Medical Center, Division of Rheumatology, and lead investigator in the study explains, “Tai chi mind-body exercise appears to provide an important approach for self-care and self-management for knee OA; however, these results should be confirmed by future large studies.”

Patients should consult their rheumatologists before beginning this, or any, exercise program.

Source: American College of Rheumatology, USA

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