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Learning Objective 1: The learner will be able to know the methodology for conducting an RCT in this population with cognitive impairment and osteoarthritic knee.
Learning Objective 2: The learner will be able to know the potential health benefits for teaching Tai Chi to this frail population.
Methods: This was a cluster-randomized clinical trial. Eight sites (55 participants total) were randomly assigned to a TC group (4 sites, 28 participants) or an attention control (education) group (4 sites, 27 participants). Outcome measures included the Western Ontario and McMaster (WOMAC) OA pain scale, physical function and stiffness subscales, the “Get up and Go” test, the “Sit and Stand” test and the Mini Mental State Exam. All outcome measures were administered at baseline and the end of the 4th, 8th, 12th, 16th and 20th weeks. Bivariate statistics (t tests and chi-square) and general linear mixed models were used to analyze the data.
Results: The trajectories of the WOMAC pain score (p=.033) and the WOMAC stiffness score (p=.000) significantly differed between the two groups over the 5-month study period. Secondary analyses for within group differences showed that after adjusting for the site effect, outcomes did not significantly change over time for participants in the attention control group. However, all outcomes did significantly change for participants in the TC group (p=.000-.046).
Conclusion: The results indicate that practicing TC can be efficacious in reducing pain and stiffness in elders with knee OA and CI. TC may have the potential to improve other health outcomes but this requires further verification with sufficient statistical power and better outcome measurement tools tailored to this frail population.