Dose-Response Effects of Tai Chi and Physical Therapy Exercise Interventions in Symptomatic Knee Osteoarthritis.
Augustine C Lee, William F Harvey, Lori Lyn Price and 6 others
PMID 29407226WHAT IT FOUND
No significant difference in how quickly Tai Chi and physical therapy worked; both improved knee OA pain and function, with 20% response after 2 weeks and 50% response after 4 to 5 weeks.
Key findings
01Pain and function improved steadily with each attended week: Tai Chi averaged 11.4 points on the 0-500 WOMAC pain scale and 40.6 points on the 0-1700 function scale; physical therapy averaged 9.3 pain points and 32.4 function points.
02There was no significant difference between Tai Chi and physical therapy in time to response for either 20% or 50% improvement in pain or function (p = .10 to .36).
03The median time to reach 20% pain and function improvement was 2 attendance-weeks; about half reached 50% improvement after 4 physical therapy weeks or 5 Tai Chi weeks.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The parent trial had no untreated control group, so improvement cannot be separated from placebo or other non-specific effects. Only 182 of 204 parent-trial participants were analysed because they attended the first week; a completer analysis may slightly overestimate treatment effect. WOMAC was collected once weekly, not at every session, so the timing of response is less precise than session-level data. The analysis was a secondary dose-response study, not a direct test of which treatment is better overall. Participants had to be able to walk without an assistive device and had no severe medical limitations, so findings may not apply to more severely limited patients. The outcome expectation association is not proof that changing expectations causes faster recovery.
Declared interests
The study was funded by NIH, and the authors declared no conflicts of interest.
The easy way to misread this
Do not conclude that Tai Chi and physical therapy are equivalent overall. This secondary analysis found no significant difference in time to response for pain and function (p = .10 to .36), not equivalence, and the parent trial had no untreated control group.