TAI CHI FOR PAIN MANAGEMENT IN PATIENTS WITH OSTEOARTHRITIS: UN UMBRELLA REVIEW

Abstract

Background: Osteoarthritis (OA) is a chronic joint disease characterized by constant pain, stiffness, and impaired physical function, which significantly affects the well-being of the patients. Tai chi (TC) is a Chinese traditional exercise with a holistic approach to promote mind-body balance. TC is increasingly recognized as a non-drug alternative for treating OArelated pain, however, the efficacy, comparative efficacy and safety of this intervention require further investigation. Objectives: This systematic review aimed to evaluate the effectiveness of Tai Chi for reducing chronic pain associated with osteoarthritis, compare its effectiveness with other physical treatments, evaluate secondary outcomes including stiffness, physical function and quality of life, and identify appropriate patient profiles for tai chi recommendation. Methods: A systematic review was conducted in accordance with the recommendations of PRISMA. Databases (PubMed, Cochrane Library, Medline Complete, Web of Science) searched for randomized controlled trials, systematic reviews, and meta-analyses examining the effects of Taijiquan on adult OA pain. The inclusion criteria were based on the PICO system: adults diagnosed with OA; the use of tai chi by itself or in comparison with other physical treatments; results related to pain, stiffness, physical function and quality of life. Initially, 181 studies were selected, 15 of them met all the inclusion criteria. Results: An analysis of the selected studies showed that tai chi significantly reduces pain in osteoarthritis , 14 out of 15 studies reported a statistically significant reduction in pain. The standardized mean difference (SMD) for pain was -0.81, indicating moderate efficacy. Tai chi significantly improved physical function (SMD -0.77) and moderately reduced joint stiffness 2(SMD -0.60). Comparative analysis has shown that Tai chi is as effective as standard physical therapy and comparable to yoga, massage, and water exercises, although it is less effective than strength training, aerobic exercise, cycling, and dietary measures in terms of pain, stiffness, functionality and quality of life. This intervention was considered safe, especially during short-term courses (8-24 weeks, 2-3 sessions per week). The improvement in quality of life was moderate. Conclusions: Tai chi is a moderately effective, safe, cost-effective non-drug treatment for chronic pain in OA, especially suitable for the elderly, patients with low physical activity, impaired health, psychological problems or balance disorders. Despite the positive results, there are limitations like a small sample size, variability in intervention protocols and insufficient long-term data. Future research should focus on standardized protocols, longer follow-up periods and high-quality comparative efficacy studies.