Osteoarthritis (OA) is a leading cause of musculoskeletal pain and disability. OA is one of the most frequent causes of pain, loss of function, and disability in adults in Western countries, occurring in the majority of people over 65 years of age and in roughly 80% of those over 75 years of age. No cure is currently available for OA and treatment options include primarily pharmacological or surgical treatment. Taking into account the increasing prevalence of OA and associated disability, social, and economic costs, the American College of Rheumatology has developed guidelines for non-pharmacological therapy including exercise, education, physical therapy, and relatively low costs for OA. However, despite the potential benefits of exercise, very few OA patients participate in regular physical activity.

Some published clinical trials of Tai Chi (TC) in patients with OA have shown inconsistent results for pain, stiffness, and physical function. To the best of their knowledge, the previous systematic review (SR) suggested that the evidence is insufficient to support TC reduction of pain or improvement of physical function, and the latest SR suggested that TC may be effective for controlling pain and improving physical function in patients with knee OA.

A computerized search of PubMed and Embase (up to Sept 2012) was performed to identify relevant studies. The quality of the included studies was assessed by the Jadad score. Standard mean differences (SMDs) and 95% confidence intervals (CIs) were calculated and pooled using a random effects model.

The outcome measures were pain, stiffness, and physical function.

A total of seven randomized controlled trials involving 348 patients with osteoarthritis met the inclusion criteria. The mean Jadad score was 3.6. The pooled SMD was -0.45 (95% CI -0.70--0.20, P = 0.0005) for pain, -0.31 (95% CI -0.60--0.02, P = 0.04) for stiffness, and -0.61 (95% CI -0.85--0.37, P<0.00001) for physical function. A change of 32.2-36.4% in the outcomes was greater than the minimum clinically important difference.

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