The Effectiveness of Tai Chi for Knee Osteoarthritis: An Overview of Systematic Reviews

Abstract

Background

Knee Osteoarthritis (KOA) has become a serious health issue for elderly patients. Several systematic reviews (SRs) have reported Tai Chi has widely been used in the treatment of KOA. However, the methodology and conclusions of these SRs are controversial. This overview aims to summarize and evaluate the available evidence for the efficacy and safety of Tai Chi for KOA.

Methods

Two independent researchers searched eight databases from the inception to April 30, 2022. The included SRs were assessed respectively by A Measurement Tool to Assess Systematic Reviews (AMSTAR) 2, the Risk of Bias in Systematic Reviews (ROBIS) tool, and the Preferred Reporting Item for Systematic Review and Meta-analysis (PRISMA) statement. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) tool was used to assess the quality of the included SRs in terms of outcome indicators.

Results

Six SRs were finally included in this overview. The results of methodological quality, reporting quality, and risk of bias of the included SRs were generally unsatisfactory. The limitations were a lack of explaining the reasons for selection, a list of excluded literature, reporting bias assessment, and reporting the potential sources of conflict of interest. In addition, only 1 item was assessed as moderate quality by using the GRADE tool. Limitations were the most common downgraded factors.

Conclusion

Tai Chi is effective as a non-pharmacological intervention in the integrative treatment of KOA. However, the quality of evidence and methodological quality of SRs is generally unsatisfactory, suggesting that these results must be interpreted with caution.

Trial Registration/Protocol Registration

PROSPERO registration number: CRD42022315146.

Keywords:

• Tai Chi
• knee osteoarthritis
• integrative treatment
• systematic review
• methodological quality

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

The authors have no conflicts of interest to declare for this work.

Additional information

Funding

This work was supported by grants from the National Natural Science Foundation of China (NO. 81873316), Tianjin Administration of Traditional Chinese Medicine rehabilitation appropriate technology project (The application and popularization of sports prescription based on traditional work method in the treatment of spondyloarthropathy) and the Non-profit Central Research Institute Fund of Chinese Academy of Medical Sciences (2022-JKCS-07).