Journal List > J Korean Acad Nurs > v.38(1) > 1063700

Lee and Lee: Effects of Tai Chi Exercise in Elderly with Knee Osteoarthritis



This study was to determine whether the Sun-style 24 forms of Tai Chi exercise improve pain, stiffness, disability, knee joint motion, mobility, balance or falling.


Forty-six community-dwelling elderly subjects (mean age, 75.46±6.28) voluntarily participated in an intervention group of either 24 forms of Sun-style Tai Chi for 60 min, 2 times per week for 12 weeks or a control group. A on-equivalent pretest-posttest design was used. Independent t-test and ANCOVA were used to examine group differences by using SPSS12.0.


The experimental group had significantly less pain (F=7.60, p=.008) and stiffness (t=-3.19, p=.003) than the control group. Also there were significant improvements in knee joint motion on the right knee (t=2.44, p=.019), left knee (t=2.30, p=.026), rising time (F=8.03, p=.07), balance on the left single leg test (t=2.20, p=.033), and fear of falling (t=-2.33, p=.024) in the Tai Chi exercise group. No significant group differences were found in disability and falls efficacy.


The Sun-style 24 forms Tai Chi exercise is effective in decreasing pain, stiffness, fear of falling and it improves balance, rising time, and knee joint motion. We suggest a continuing long term intervention to decrease disability and increase efficacy concerning falls.

Figures and Tables

Table 1
Demographic Characteristics of Subjects
Table 2
Homogeneity Test of the Outcome Variables
Table 3
Mean differences of Physical function, Knee Joint of Motion, Mobility, and Balance between Pre-test and Post-test

*F value of ANCOVA.

Table 4
Mean differences of Fear of Falling and Falls Efficacy between Pre-test and Post-test


1. Allegrante JO, Kovar PA, Mackenzie CR, Peterson MGE, Gutin B. A walking education program for patients with osteoarthritis of the knee: theory and intervention strategies. Health Educ Q. 1993. 20:63–81.
2. Arnold CM, Faulkner RA. The history of falls and the association of the timed up and go test to falls and near-falls in older adults with hip osteoarthritis. BMC Geriatr. 2007. 7:17.
3. Bae SC, Lee HS, Yun HR, Kim TH, Yoo DH, Kim SY. Cross-cultural adaptation and validation of Korean Western Ontario and McMaster Universities (WOMAC) and Lequesne osteoarthritis indices for clinical research. Osteoarthritis Cartilage. 2001. 9:746–750.
4. Bellamy N. Musculoskeletal clinical metrology. 1993. London: Kluwer Academic Publishers.
5. Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt LW. Validation study of WOMAC: a health status instrument for measure clinically important patient relevant outcomes to antirheumatic drug therapy in patient with osteoarthritis of the hip or knee. J Rheumatol. 1988. 15:1833–1840.
6. Campbell AJ, Robertson MC, Gardner MM, Norton RN, Buchner DM. Falls prevention over 2 years: A randomized controlled trial in women 80 years and older. Age Ageing. 1999. 28:513–518.
7. Fuller GF. Falls in the elderly. Am Fam Physician. 2000. 61:2159–2168.
8. Hoffman DF. Arthritis and exercise. Prim Care. 1993. 20:895–910.
9. Jordan KM, Arden NK, Doherty M, Bannwarth B, Bijlsma JW, Dieppe P, et al. EULAR recommendations 2003: an evidence based approach to the management of kneeosteoarthritis: Report of a task force of the standing committee for international clinical studies including therapeutic trials (ESCISIT). Ann Rheum Dis. 2003. 62:1145–1155.
10. Korea Institute for Health and Social Affairs. 2005 national health and nutrition survey. 2006.
11. Lam P. New horizons. Developing tai chi for health care. Aust Fam Physician. 1998. 27:100–101.
12. Lam P. How does Tai-Chi improve health and arthritis? 2000. form http://www.
13. Lee HY, Kim HI. Effects of sun style tai chi program on muscle strength and physical function in osteoarthritis patients. J Korean Nurses Association for Complementary Alternative Therapy. 2004. 1:43–52.
14. Lee HY, Suh MJ, Lee EO, Eun Y, Choi JH. Analysis of the effectiveness of Tai Chi exercise for improving balance. J Korean Acad Adult Nurs. 2004. 16:409–420.
15. Li F, Harmer P, Fisher KJ, McAuley E, Chaumeton N, Eckstrom E, et al. Tai Chi and fall reductions in older adults: a randomized controlled trial. J Gerontol A Biol Sci Med Sci. 2005. 60:187–194.
16. Mathias S, Nayak USL, Isaacs B. Balance in the elderly patient: The "Get-up and Go" test. Physical Medicine Rehabilitation. 1986. 67:587–591.
17. McAlindon TE, Wilson PW, Aliabadi P, Weissman B, Felson DT. Level of physical activity and the risk of radiographic and symptomatic knee osteoarthritis in the elderly: the Framinghamstudy. Am J Med. 1999. 106:151–157.
18. McCarberg BH, Herr KA. American Academy of Pain Medicine. Osteoarthritis. How to manage pain and improve patient function. Geriatri. 2001. 56:14–24.
19. Pandya NK, Draganich LF, Mauer A, Piotrowski GA, Pottenger L. Osteoarthritis of the knees increases the propensity to trip on an obstacle. Clin Orthop Relat Res. 2005. 431:150–156.
20. Ross C, Bohannon S, Davis C, Gurchiek L. The effects of a short-term exercise program on movement, pain, and mood in the elderly. Results of a pilot study. J Holist Nurs. 1999. 17:139–147.
21. Schoenfelder DP. A fall prevention program for elderly individuals. Exercise in long-term care settings. J Gerontol Nurs. 2000. 26:43–51.
22. Song RY, Lee EO, Lam P, Bae SC. Effects of Tai Chi exercise on pain, balance, muscle strength, and perceived difficulties in physical functioning in older women with osteoarthritis: A randomized clinical trial. J Rheumatol. 2003. 30:2039–2044.
23. Taggart HM. Effects of Tai Chi exercise on balance, functional mobility, and fear of falling among older women. Appl Nurs Res. 2002. 15:235–242.
24. Tideiksaar R. Falling in old age. Prevention and management. 1997. 2nd ed.New York: Springer publishing Co..
25. Tinetti ME, Baker DI, McAvay G, Claus EB, Garrett P, Gottschalk M, et al. A multifactorial intervention to reduce the risk of falling among elderly people living in the community. N Engl J Med. 1994. 331:821–827.
26. Tinetti ME, Speechley M. The effect of falls and fall injuries on functioning in community-dwelling older persons. J Gerontol. 1998. 53:112–119.
27. Tinetti ME, Richman D, Powell L. Falls efficacy as a measure of fear of falling. J Gerontol. 1990. 45:239–243.
28. van Baar ME, Dekker J, Lemmens JA, Oostendorp RA, Bijlsma JW. Pain and disability in patients with osteoarthritis of hip or knee: The relationship with articular, kinesiological, and psychological characteristics. J Rheumatol. 1998. 25:125–133.
29. Wang TJ, Belza B, Thompson FE, Whitney JD, Bennett K. Effects of aquatic exercise on flexibility, strength and aerobic fitness in adults with osteoarthritis of the hip or knee. J Adv Nurs. 2006. 57:141–152.
30. Wolf SL, Barnhart HX, Kutner NG, McNeely E, Coogler C, Xu T, et al. Reducing frailty and falls in older persons: an investigation of Tai Chi and computerized balance training. J Am Geriatr Soc. 1996. 44:489–497.
Similar articles