Effect of Tai Chi Exercise on Mechanical Joint Loading in Knee Osteoarthritis

NCT ID: NCT03621631

Last Updated: 2025-09-15

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 15 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2018-08-27
• Study Completion Date: 2024-07-31

Brief Summary

This project is designed to identify the biomechanical mechanisms of Tai Chi (TC) exercise and test a novel optimized TC intervention by modifying newly identified mechanisms for those with knee osteoarthritis (OA) and to assess the changes in mechanical load with the intervention. It combines unique real time torque biofeedback approach, and uses external knee adduction moment (EKAM) as modulation target tailored to TC intervention in this population. The potential benefit from this project is to provide biomechanical insights of TC and this novel TC approach may produce meaningful changes of mechanical load in these patients who can learn and practice safely during this intervention.

Detailed Description

Disabilities that arise from typical impairments of knee osteoarthritis (OA) include decreased muscle strength, reduced range of motion, and decreased aerobic cardiovascular function. A large number of individuals with knee OA experience disability and require rehabilitation. Traditional TC intervention has been a promising therapeutic intervention in knee OA, but the efficacy of TC as a knee OA intervention has proven inconclusive presumably because individuals with knee OA perform different TC components (steps) with widely varying mechanical knee joint loads. This variation could be a confounding factor in the way in which TC affects knee OA. Therefore, a feasibility study is proposed here to quantify external knee adduction moment (EKAM) response to the different TC steps, and then determine if it is feasible to use biofeedback of torque acting on the knee to modify some TC steps so as to reduce the EKAM they produce. Those TC steps whose EKAM can be easily reduced below mean EKAM during walking and those already below that level will constitute an optimized form of TC for knee OA; the remainder will be discarded. A phase 1 randomized controlled trial will be conducted to compare the optimized TC intervention to traditional TC training in reducing EKAM. The proposed research represents the first study to identify the biomechanical mechanisms of TC and to target EKAM by using a real-time biofeedback approach to manipulate EKAM during TC performance.

Conditions

Knee Osteoarthritis

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: DOUBLE

Study Groups

optimized Tai Chi intervention

optimized Tai Chi intervention

Group Type: EXPERIMENTAL

Optimized Tai Chi intervention

Intervention Type: BEHAVIORAL

Optimized Tai Chi intervention

traditional Tai Chi intervention

traditional Tai Chi intervention

Group Type: ACTIVE_COMPARATOR

Traditional Tai Chi intervention

Intervention Type: BEHAVIORAL

Traditional Tai Chi intervention

Interventions

Optimized Tai Chi intervention

Optimized Tai Chi intervention

Intervention Type: BEHAVIORAL

Traditional Tai Chi intervention

Traditional Tai Chi intervention

Intervention Type: BEHAVIORAL

Other Intervention Names

OTC; TTC

Eligibility Criteria

Inclusion Criteria

• OA participants will be diagnosed based on the American College of Rheumatology classification criteria.
• Knee pain average level > 3 cm on a 10 cm visual analog scale,
• Kellgren / Lawrence scale of 2-3 on radiographs.
• Pain/tenderness over the medial region or lateral region of the knee on physical examination.
• The participants will have 40 years of age or older and have no TCC experience prior this study.

Exclusion Criteria

• a history of lower extremity joint replacement
• intra-articular knee injection (steroid, hyaluronic acid) within the previous 6 months
• systemic rheumatoid arthritic condition affecting the knee clinically or radiographically,
• report of any of the following health problems (heart condition, chest pain during periods of activity or rest)
• currently seeking or receiving physical therapy for knee OA,
• having a medical condition precluding the participant from undergoing physical activity or biomechanical gait analysis.

• Minimum Eligible Age: 40 Years
• Maximum Eligible Age: 80 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

National Center for Complementary and Integrative Health (NCCIH)

NIH

Sponsor Role: collaborator

The University of Texas Health Science Center at San Antonio

OTHER

Sponsor Role: collaborator

Edward Via Virginia College of Osteopathic Medicine

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Locations

UT Health San Antonio, Rehabilitation Biomechanics Lab

San Antonio, Texas, United States

Countries

United States

References

Yang F, Markides K, Reistetter TA, Moore AA, Liu W. Effects of Optimal Tai Chi forms in alleviating knee pain among Hispanic people with knee osteoarthritis: A case series. Complement Ther Clin Pract. 2025 May;59:101961. doi: 10.1016/j.ctcp.2025.101961. Epub 2025 Feb 12.

Reference Type: DERIVED

PMID: 39961273 (View on PubMed)

Other Identifiers

1K23AT009568-01A1

Identifier Type: NIH

Identifier Source: secondary_id

View Link

2016-050

Identifier Type: -

Identifier Source: org_study_id