Tai Chi Stands Out in Studies of Non-pharmacologic Management of Osteoarthritis in 2010
February 27, 2011
At the 2010 annual meeting of
Osteoarthritis Research Society International, held
in Brussels, Belgium in September of
several researchers from
University of Toronto presented their systematic review of studies
non-pharmacologic management of
osteoarthritis (OA) published from September 2009 to September 2010.
Their search identified 117 unique articles.
Of these, four studies were chosen to highlight. A nested two-stage trial found
that traditional Chinese acupuncture (TCA) was not superior to sham acupuncture,
but that the providers' style affected both pain reduction and satisfaction with
treatment, suggesting that the analgesic benefits of acupuncture may be
partially mediated by the acupuncturists' behavior. A systematic review found
little evidence of a significant effect for electrostimulation vs sham or no
intervention on pain in knee OA. A single-blinded trial of Tai Chi vs attention
controls found that 12 weeks of Tai Chi was associated with improvements in
symptoms and disability in patients with knee OA. A randomized trial of early
ACL reconstructive surgery and rehabilitation vs structured rehabilitation alone
in subjects with acute anterior cruciate ligament tears found that, at 24 months
following randomization, all study participants had improved, suggesting that a
strategy of structured rehabilitation followed acute ACL injury may preclude the
need for surgical reconstruction.
High quality studies of the safety and
efficacy of non-pharmacologic agents in the management of OA remain challenging
due to difficulties with adequate blinding and appropriate selection of
attention controls. High quality studies suggest modest, if any, benefit of many
non-pharmacologic therapies over attention control or placebo, but a significant
impact of both over no intervention at all.