Effects of Tai Chi Exercises on Patients Functional Status With Knee Osteoarthritis

Assessment of the Effects of Tai Chi Exercises on Balance and Functional Status in Patients With Knee Osteoarthritis

Brief summary

The goal of this clinical trial is to evaluate whether Tai Chi exercise, used as an adjunct to standard physiotherapy, can improve balance, functional status, pain, and knee joint mobility in older adults (65-75 years) diagnosed with knee osteoarthritis (gonarthrosis), compared with standard physiotherapy alone and physiotherapy combined with virtual reality-based training.

The main questions it aims to answer are:

Does adding Tai Chi to standard physiotherapy lead to greater improvements in static and dynamic balance (Berg Balance Scale, Timed Up and Go test) in patients with knee osteoarthritis?

Does Tai Chi result in superior improvements in pain intensity (VAS), functional status (WOMAC), and knee joint range of motion compared with standard physiotherapy and VR-based training?

Researchers will compare three intervention arms-standard physiotherapy, standard physiotherapy plus virtual reality (Kinect-based biofeedback training), and standard physiotherapy plus Tai Chi-to determine whether Tai Chi provides greater clinical and functional benefits than the other rehabilitation approaches.

Participants will:

Receive standard inpatient physiotherapy for knee osteoarthritis

Additionally perform one of the following interventions for 30 minutes daily over 4 weeks:

Tai Chi exercises led by a qualified therapist, focusing on balance, controlled movement, and pain-free execution

Virtual reality-based balance training using a Kinect system

Undergo assessments before and after the intervention period, including pain, balance, functional performance, and knee joint mobility measures

Study Overview

• Status: Completed
• Conditions: OA Knee
• Intervention / Treatment: Other: Tai Chi training; Other: Comprehensive Inpatient Physiotherapy with other standard therapies; Other: Kinect-Based Virtual Reality Balance Training with Biofeedback

• Study Type: Interventional
• Enrollment (Actual): 96
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Poland
  • Krakow, Poland, 31-066
    • Department of Biomechanics and Kinesiology, Institute of Physiotherapy, Faculty of Health Sciences, Jagiellonian University Medical College

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Diagnosed knee osteoarthritis
• Age between 60 and 80 years

Exclusion Criteria:

• Patients with significant knee joint effusion and excessive valgus or varus deformity of the knee joint
• Post-surgical status
• Patients with a body mass index (BMI) ≥ 34
• Patients after knee joint surgery
• Patients with severe clinically significant comorbidities that could interfere with study outcomes
• Lack of patient consent to participate in the study, as well as non-compliance or diagnosed psychiatric disorders
• History of stroke and other neurological disorders

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Double

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Standard Physiotherapy Combined with Tai Chi Balance Training	Other: Tai Chi training; In addition to standard therapy, instead of balance training, the participant performed Tai Chi exercises daily for 30 minutes under the supervision of a qualified therapist. The Tai Chi sessions emphasized balance in a variety of positions engaging the knee joint; the exercises were performed in smooth sequences combined with deep breathing. During the sessions, particular attention was paid to movement quality and the absence of pain during movement.
Active Comparator: Inpatient Physiotherapy with Manual Therapy, Physical Modalities, and Conventional Balance Training	Other: Comprehensive Inpatient Physiotherapy with other standard therapies; who, as part of inpatient physiotherapy, underwent a comprehensive treatment program consisting of: manual therapy-20 minutes daily, including soft tissue techniques and mobilization of the knee joint-and physical therapy modalities including electrotherapy, laser therapy, magnetotherapy, and ultrasound therapy. The patients also performed balance-supporting exercises in the form of balance training, which included: balancing on sensorimotor cushions for 10 minutes in various directions, resistance exercises-leg press on a machine for 3 sets of 15-20 repetitions, semi-squats on sensorimotor cushions for 3 sets of 20 repetitions, and core stability exercises in the supine position for 10 minutes.
Active Comparator: Standard Physiotherapy Combined with Kinect-Based Virtual Reality Balance Training	Other: Kinect-Based Virtual Reality Balance Training with Biofeedback; where, in addition to standard therapy, instead of conventional balance training, the group additionally received exercises using a Kinect-based system on the iStander device (Alreh Medical, Łódź, Poland), which enables safe and engaging therapy in a controlled virtual environment with the use of biofeedback. The exercises were delivered in the form of game-based activities for 30 minutes daily at a moderate level of difficulty.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Total score on the Berg Balance Scale.	Assessment of static and dynamic balance using a 14-item scale. The unit of measurement is points (range 0-56), where a higher score indicates better balance.	Baseline; Day 1 (09 May 2025) Final assessment: after 4 weeks (06 June 2025)
Score on the WOMAC questionnaire (Western Ontario and McMaster Universities Osteoarthritis Index).	Assessment of the severity of osteoarthritis symptoms (pain, stiffness, and physical function). The unit of measurement is points (sum of 24 items), where a higher score indicates poorer functional status and greater pain.	Baseline; Day 1 (09 May 2025) Final assessment: after 4 weeks (06 June 2025)
Time to complete the Timed Up and Go (TUG) test.	Assessment of functional mobility and fall risk. The unit of measurement is time in seconds required to stand up from a chair, walk 3 meters, turn around, return, and sit down again.	Baseline; Day 1 (09 May 2025) Final assessment: after 4 weeks (06 June 2025)

Collaborators and Investigators

• Sponsor: Grzegorz Mańko
• Investigators: Principal Investigator: Grzegorz Mańko, PhD, Department of Biomechanics and Kinesiology, Institute of Physiotherapy, Faculty of Health Sciences, Jagiellonian University Medical College, Cracow, Poland

Study record dates

Study Major Dates

• Study Start (Actual): May 9, 2025
• Primary Completion (Actual): June 13, 2025
• Study Completion (Actual): June 13, 2025

Study Registration Dates

• First Submitted: February 4, 2026
• First Submitted That Met QC Criteria: February 19, 2026
• First Posted (Actual): February 23, 2026

Study Record Updates

• Last Update Posted (Actual): February 23, 2026
• Last Update Submitted That Met QC Criteria: February 19, 2026
• Last Verified: February 1, 2026

More Information

Terms related to this study

• Keywords: Osteoarthritis; older adults; tai chi; fall risk; functional indicators
• Additional Relevant MeSH Terms: Musculoskeletal Diseases; Arthritis; Joint Diseases; Rheumatic Diseases; Osteoarthritis; Osteoarthritis, Knee; Therapeutics; Mind-Body Therapies; Complementary Therapies; Behavior Therapy; Psychotherapy; Behavioral Disciplines and Activities; Feedback, Psychological; Biofeedback, Psychology
• Other Study ID Numbers: 118.0043.1.208.2025

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL; SAP; ICF

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No