Health Studies
Tai Chi Shows Substantial Benefits for Osteoarthritic Knee Pain in Elders With Cognative Impairment

The prevalence of OA in elders with cognitive impairment is comparable to that in elders without cognitive impairment. The knee is particularly affected because it is a major weight-bearing joint. Pharmacological interventions for OA knee pain have shown limited efficacy, and in elders they can produce side effects such as impaired concentration, agitation, increased risk of hypertension and hip fracture, and decreased renal function. 
Because of the pain, elders with knee OA tend to avoid activity, including land-based exercise such as walking and running. This was the first study to explore TC's effects on pain in elders with cognitive impairment and knee OA. Scores on the VDS and observed pain behaviors were significantly better with the TC group than the control group at post-test. Further, the beneficial effects of TC were not associated with cognitive ability. These group comparisons suggest that 20 weeks of TC practice led to significant reductions in OA knee pain in cognitively impaired elders.


Abstract:
Objectives:
This was a secondary data analysis of a cluster-randomized clinical trial that tested the efficacy of a 20-week Sun-style Tai Chi (TC) program in reducing pain in community-dwelling elders with cognitive impairment and knee osteoarthritis (OA). The study also examined whether elders' level of cognitive function was related to the outcomes of the TC program. 
Design:
Elders (N=55) were recruited from 8 study sites. Each site was randomly assigned to participate in either a 20-week TC or an education program. Verbal report of pain was measured by a Verbal Descriptor Scale (VDS) at weeks 1, 5, 9, 13, 17 and 21 (designated as times 1-6). Pain behaviors and analgesic intake were also recorded at times 1-6. 
Results:
At post-test, scores on the VDS and observed pain behaviors were significantly better in the TC group than in the control group (p=0.008-0.048). The beneficial effects of TC were not associated with cognitive ability. 
Conclusion:
These results suggest that TC can be used as an adjunct to pharmacological intervention to relieve OA pain in elders with cognitive impairment. 
Link:
Tsai, Pao-Feng et al. “A supplemental report to a randomized cluster trial of a 20-week Sun-style Tai Chi for osteoarthritic knee pain in elders with cognitive impairment.” Complementary therapies in medicine vol. 23,4 (2015): 570-6. doi:10.1016/j.ctim.2015.06.001
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