Table 29Osteoarthritis knee pain: mind-body therapies

Author, Year, Followup, Pain Duration, Study QualityInterventionPopulationFunction and Pain OutcomesOther Outcomes

Brismee, 2007

1.5 months

Duration of pain:

Poor

A. Tai chi (n=18): group tai chi classes for 6 weeks followed by 6 weeks of home video tai chi practice; 40 minute sessions, 3x/week for 12 weeks (36 total)

B. Attention Control (n=13): group lectures and discussions covering health-related topics, no further activity past 6 week group period; 40 minutes sessions, 3x/week for 6 weeks (18 total)

A vs. B

Age: 71 vs. 69

Female: 86.4% vs. 78.9%

Race:

WOMAC Total (26−13)]: 64.6 vs. 59.6

WOMAC Physical Function (17-85): 42.7 vs. 37.6

WOMAC Pain (7−35): 16.5 vs. 16.9

Pain (0−10): 4.7 vs. 4.2

WOMAC Stiffness (2−10): 5.6 vs. 5.1

A vs. B

1.5 months

WOMAC Total: 60.3 vs. 57.7, p=

WOMAC Physical Function: 38.6 vs. 37.6, p=

WOMAC Pain: 16.4 vs. 16, p=

Pain: 3.5 vs. 3.2, p=

WOMAC Stiffness: 5.3 vs. 4.5, p=

Wang, 2009

3 and 9 months

Duration of pain: 9.7 years

Fair

A. Tai chi (n=20): group tai chi classes, 10 forms from the classic Yang style tai chi; home tai chi practice at least 20 minutes per day with a DVD. Home practice continued after group sessions ended until the 48 week followup.

B. Attention Control (n=20): group classes on nutritional and medical information paired with 20 minutes of stretching. Instruction to practice at least 20 minutes of stretching exercises per day at home.

In both groups, treatments were 2x/week for 12 weeks (24 total), 60 minute sessions

A vs. B

Age: 63 vs. 68

Female: 80% vs. 70%

Race:

Baseline WOMAC Physical Function (0−1,700): 707.6 vs. 827

Baseline WOMAC Pain (0-500): 209.3 vs. 220.4

Baseline Patient-Assessed Pain (0−10): 4.2 vs. 4.8

Baseline Physician-Assessed Pain (0−10): 4.8 vs. 5.8

Baseline WOMAC Stiffness (0-200): 105.7 vs. 120.7

A vs. B

3 months

(mean change from baseline)

WOMAC Physical Function: −440.5 (95% −574.4 to −306.6) vs. −257.3 (95% CI −391.2 to −123.4); difference −183.2 (95% CI −372.6 to 6.2)

WOMAC Pain: −131.6 (95% −177.4 to −85.7) vs. −64.6 (95% CI −110.5 to −18.7); difference −70.0 (95% CI −131.8 to −2.1)

Patient Assessed Pain: −2.4 (95% −3.5 to −1.2) vs. −1.7 (−2.9 to −0.5); difference −0.7 (−2.3 to 1.0)

Physician Assessed Pain: −2.6 (95% −3.3 to −1.9) vs. −2.1 (95% CI −2.8 to −1.3); difference −0.5 (95% CI −1.6 to 0.5)

WOMAC Stiffness: −65.0 (95% −86.3 to −43.7) vs. −50.2 (95% CI −71.5 to −28.9); difference −14.8 (95% CI −44.9 to 15.3)

9 months

WOMAC Physical Function: −405.9 (95% −539.8 to −271.9) vs. −300.6 (95% CI −434.5 to −166.6); difference −105.3 (95% CI −294.7 to −84.1)

WOMAC Pain: −115.4 (95% −161.2 to −69.5) vs. −69.2 (95% CI −115.1 to −23.3); difference −46.2 (95% CI −111.0 to 18.7)

Patient Assessed Pain: −1.7 (95% −2.8 to −0.5) vs. −1.7 (95% CI −2.9 to −0.5); difference 0.04 (95% CI −1.6 to 1.7)

Physician-Assessed Pain: −2.5 (95% −3.3 to −1.8) vs. −1.5 (−2.3 to −0.8); difference −1.0 (95% CI −2.1 to 0.02) WOMAC Stiffness: −64.2 (95% CI −85.5 to −42.8) vs. −60.5 (95% CI −81.8 to −39.2); difference −3.7 (95% CI −33.8 to 26.5)

A vs. B

3 months

(mean change from baseline)

SF-36 PCS (0−100): 10.8 (95% 7.3 to 14.3) vs. 6.3 (95% CI 2.8 to 9.8); difference 4.5 (95% CI −0.4 to 9.5)

SF-36 MCS (0−100): 4.4 (95% −0.11 to 8.9) vs. 4.5 (95% CI 0.0 to 9.0); difference −0.1 (95% CI −6.5 to 6.3)

(0-60): −6.4 (95% −9.9 to −2.9) vs. −1.1 (95% CI −4.6 to 2.4); difference −5.3 (95% CI −10.2 to −0.4)

9 months

SF-36 PCS: 10.4 (95% 6.9 to 13.9) vs. 4.1 (95% CI 0.6 to 7.6); difference 6.3 (95% CI 1.4 to 11.3)

SF-36 MCS: 5.8 (95% 1.3 to 10.3) vs. 1.0 (95% CI −3.5 to 5.5); difference 4.8 (95% CI −1.6, 11.1)

: −7.3 (95% −10.7 to −3.8) vs. 1.7 (95% CI −1.8 to 5.1); difference −8.9 (95% CI −13.8 to −4.0)

= Center for Epidemiologic Studies Depression Scale; = confidence interval; MCS = Mental Component Score; = not reported; = not statistically significant; SF-36 MCS = Short-Form 36 Questionaire Mental Component Score; SF-36 PCS = Short-Form 36 Questionnaire Physical Component Score; = Visual Analog Scale; WOMAC = Western Ontario and McMaster Universities Osteoarthritis index

a

Unless otherwise noted, followup time is calculated from the end of the treatment period

From: Results

Cover of Noninvasive Nonpharmacological Treatment for Chronic Pain: A Systematic Review Update
Noninvasive Nonpharmacological Treatment for Chronic Pain: A Systematic Review Update [Internet].
Comparative Effectiveness Review, No. 227.
Skelly AC, Chou R, Dettori JR, et al.

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