Tai Chi for rheumatoid arthritis

Area of Science:

• Rheumatology
• Complementary and Alternative Medicine
• Systematic Review and Meta-Analysis

Background:

• Rheumatoid arthritis (RA) is a chronic, systemic inflammatory autoimmune disease leading to joint deformity and reduced mobility.
• Treatment goals for RA include pain relief, reduced inflammation, prevention of joint damage and disability, and improved well-being.
• Tai Chi, an ancient Chinese health-promoting practice, has been historically recognized as an effective therapy for arthritis.

Purpose of the Study:

• To evaluate the benefits and harms of Tai Chi as a therapeutic intervention for individuals diagnosed with rheumatoid arthritis (RA).
• To update previous systematic reviews by incorporating recent research on Tai Chi for RA treatment.

Main Methods:

• Updated systematic search of CENTRAL, MEDLINE, Embase, and clinical trial registries from 2002 to September 2018.
• Included randomized controlled trials (RCTs) and controlled clinical trials assessing benefits (e.g., pain, function, disease activity) and harms (adverse events, withdrawals).
• Studies involved Tai Chi interventions compared to no therapy or alternative therapies; standard Cochrane methodological procedures were applied.

Main Results:

• Seven trials with 345 participants (mostly women with RA) were included; most trials had a high risk of bias due to lack of blinding.
• Evidence quality for pain, disease activity, and function was very low, making it uncertain if Tai Chi provides clinically important improvements.
• Participants in Tai Chi groups showed significantly fewer withdrawals from studies compared to control groups (low-quality evidence).

Conclusions:

• The current evidence is insufficient to determine the effect of Tai Chi on clinical outcomes like pain, activity limitation, and function in RA.
• While Tai Chi may reduce study attrition, its benefits and harms remain uncertain due to very low-quality evidence and reporting limitations.
• Further high-quality research is necessary to definitively assess the efficacy and safety of Tai Chi for rheumatoid arthritis management.