Effects of Tai Chi versus Physical Therapy on Mindfulness in Knee Osteoarthritis.

Author: Lee AC1, Harvey WF1, Wong JB2,3,4, Price LL2,3, Han X5, Chung M5, Driban JB1, Morgan LPK6, Morgan NL1,7, Wang C1
Affiliation:
1Center for Complementary and Integrative Medicine, Division of Rheumatology, Tufts Medical Center, Boston, MA, USA.
2Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA.
3Tufts Clinical and Translational Science Institute, Tufts University, Boston, MA, USA.
4Division of Clinical Decision Making, Department of Medicine, Tufts Medical Center, Boston, MA, USA.
5Department of Public Health and Community Medicine, Tufts University, Boston, MA, USA.
6I Ola Lahui Rural Hawai'i Behavioral Health, Honolulu, HI, USA.
7Department of Medicine, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, USA.
Conference/Journal: Mindfulness (N Y).
Date published: 2017 Oct
Other: Volume ID: 8 , Issue ID: 5 , Pages: 1195-1205 , Special Notes: doi: 10.1007/s12671-017-0692-3. Epub 2017 Feb 23. , Word Count: 252


Tai Chi mind-body exercise is widely believed to improve mindfulness through incorporating meditative states into physical movements. A growing number of studies indicate that Tai Chi may improve health in knee osteoarthritis (OA), a chronic pain disease and a primary cause of global disability. However, little is known about the contribution of mindfulness to treatment effect of Tai Chi practice. Therefore, our purpose was to investigate the effect of Tai Chi mind-body practice compared to physical therapy (PT) on mindfulness in knee OA. Adults with radiographic-confirmed, symptomatic knee OA were randomized to either 12 weeks (twice weekly) of Tai Chi or PT. Participants completed the Five Facet Mindfulness Questionnaire (FFMQ) before and after intervention along with commonly-used patient-reported outcomes for pain, physical function, and other health-related outcomes. Among 86 participants (74% female, 48% white, mean age 60 years, 85% at least college educated), mean total FFMQ was 142±17. Despite substantial improvements in pain, function, and other health-related outcomes, each treatment group's total FFMQ did not significantly change from baseline (Tai Chi= 0.76, 95% CI: -2.93, 4.45; PT= 1.80, 95% CI: -2.33, 5.93). The difference in total FFMQ between Tai Chi and PT was not significant (-1.04 points, 95% CI: -6.48, 4.39). Mindfulness did not change after Tai Chi or PT intervention in knee OA, which suggests that Tai Chi may not improve health in knee OA through cultivating mindfulness. Further study is needed to identify underlying mechanisms of effective mind-body interventions among people with knee OA.

KEYWORDS: Chronic Pain; Mechanism; Mind-body; Mindfulness; Osteoarthritis; Tai Chi

PMID: 28959369 PMCID: PMC5612617 [Available on 2018-10-01] DOI: 10.1007/s12671-017-0692-3

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