The Effectiveness of Tai Chi for Knee Osteoarthritis: An Overview of Systematic Reviews

Yuntian Ye,1,2 Aifeng Liu1,2 1Department of Orthopaedic Surgery, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, 300381, People’s Republic of China; 2National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, 300381, People’s Republic of ChinaCorrespondence: Aifeng Liu, Department of Orthopaedic Surgery, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, No. 88 Changling Road, Xiqing District, Tianjin, 300381, People’s Republic of China, Tel +86-13803091533, Email draifeng@163.comBackground: Knee Osteoarthritis (KOA) has become a serious health issue for elderly patients. Several systematic reviews (SRs) have reported Tai Chi has widely been used in the treatment of KOA. However, the methodology and conclusions of these SRs are controversial. This overview aims to summarize and evaluate the available evidence for the efficacy and safety of Tai Chi for KOA.Methods: Two independent researchers searched eight databases from the inception to April 30, 2022. The included SRs were assessed respectively by A Measurement Tool to Assess Systematic Reviews (AMSTAR) 2, the Risk of Bias in Systematic Reviews (ROBIS) tool, and the Preferred Reporting Item for Systematic Review and Meta-analysis (PRISMA) statement. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) tool was used to assess the quality of the included SRs in terms of outcome indicators.Results: Six SRs were finally included in this overview. The results of methodological quality, reporting quality, and risk of bias of the included SRs were generally unsatisfactory. The limitations were a lack of explaining the reasons for selection, a list of excluded literature, reporting bias assessment, and reporting the potential sources of conflict of interest. In addition, only 1 item was assessed as moderate quality by using the GRADE tool. Limitations were the most common downgraded factors.Conclusion: Tai Chi is effective as a non-pharmacological intervention in the integrative treatment of KOA. However, the quality of evidence and methodological quality of SRs is generally unsatisfactory, suggesting that these results must be interpreted with caution.Trial Registration/Protocol Registration: PROSPERO registration number: CRD42022315146.Keywords: Tai Chi, knee osteoarthritis, integrative treatment, systematic review, methodological quality