Effects Of Tai Chi Exercise For Symptoms Of Knee Osteoarthritis: A Systematic Review And Meta-analysis

PURPOSE: To systematically review and meta-analyze the effects of Tai Chi Exercise for symptoms of knee osteoarthritis (KOA). METHODS: We performed systematic searches in five electronic databases: PubMed, Web of Science, Cochrane Library, EBSCO and EMBASE from the time of their inception to August 2021. All eligible Randomized Controlled Trials (RCTs) were included in which Tai Chi was utilized to treat KOA compared to a control group. Three reviewers independently extracted the data and evaluated the risk of bias following the Cochrane Risk of Bias Tool for RCTs. The symptom of KOA evaluated by the Western Ontario and McMaster Universities Arthritis Index (WOMAC) was regarded as the primary outcomes in this study. Outcomes measures included pain, joint stiffness and physical function. Each outcome measure was pooled by a standardized mean difference (SMD) with 95% confidence intervals (CI). A meta-analysis was applied with a random effect model for the collected data to calculate the summary SMD with 95% CI based on different statistical heterogeneity. RESULTS: A total of 11 RCTs with 709 patients with KOA met the established inclusion criteria. The systematic review illustrated the efficacy of Tai Chi in treating and managing KOA. Patients' outcomes practising Tai Chi were improved significantly. Compared with a control group, the synthesized data of Tai Chi showed a significant reduction in WOMAC pain score (SMD = −0.64; 95% CI: −0.90 to −0.36; p < 0.001), stiffness score (SMD = −0.52; 95% CI: −0.84 to −0.21; p = 0.001), and physical function score (SMD = −0.77; 95% CI: −1.05 to −0.48; p < 0.001). No adverse events associated with Tai Chi were reported. CONCLUSIONS: Our study suggested that Tai Chi may effectively alleviate pain, relieve stiffness and improve the patients' physical function with KOA. Tai Chi was beneficial for alleviating the OA of patients and could be used as a rehabilitation exercise.