The Effects of Routine Physiotherapy Alone and in Combination with Either Tai Chi or Closed Kinetic Chain Exercises on Knee Osteoarthritis: A Comparative Clinical Trial Study

Background: Osteoarthritis is a common chronic degenerative disorder. Exercise is regarded as a common practice for the elderly, especially those with knee osteoarthritis. Objectives: This study aimed to examine and compare the effects of Tai Chi and closed kinetic chain exercises on patients with knee osteoarthritis. Methods: Forty-eight patients with knee osteoarthritis participated in this clinical trial study, which was carried out in a private clinic (2016) in district thirteen of Tehran, Iran. They were randomly assigned equally to closed kinetic chain exercise (CKCE) group, Tai Chi Exercise (TCE) group, and no exercise group. All three groups were equally treated using a standard physical therapy protocol. The CKCE group performed static stretching and CKCE, and the TCE group performed Tai Chi warm-up and cool-down and the form 6 of Yang style of Tai Chi exercises. All three groups were evaluated at baseline, sixth, and twelfth sessions of treatment and one- month post- treatment using a six-minute walk test and the knee injury and osteoarthritis outcome score (KOOS) questionnaire. Results: According to KOOS subscale, the TCE improved the symptoms (68.94 ± 9.24) (P < 0.001), pain (75.13 ± 12.33) (P < 0.001), ADL (76.50 ± 12.03) (P = 0.01), and the total score (72.12 ± 8.63) (P < 0.001) significantly more than the CKCE (55.50 ± 13.61, 64.75 ± 10.58, 67.25 ± 9.96, 67.25 ± 7.82, respectively) and routine physiotherapy (34.62 ± 11.34, 53.06 ± 9.36, 61.69 ± 10.32, 51.50 ± 7.24, respectively) in patients with knee OA. Both the TCE (376.43 ± 88.18) (P < 0.001) and CKCE (353.50 ± 78.15) (P < 0.001) groups showed improved walking distance significantly more than the no exercise group (315.35 ± 66.33) in patients with knee OA. Conclusions: In patients with knee OA, Tai Chi exercise relieved pain and symptom even in a short time, and improved QOL, sport, and recreational activities, and ADL. The effects of both TCE and CKCE on the improvement of QOL were similar.