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Published on: July 22, 2019
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User Engagement and Experiences With an Online Unsupervised Tai Chi Program for People With Knee Osteoarthritis:
Shiyi Julia Zhu1, Rana S Hinman1, Rachel K Nelligan1
1Department of Physiotherapy, Centre for Health, Exercise and Sports Medicine, University of Melbourne, Melbourne, Australia.
JMIR Rehabilitation and Assistive Technologies
|November 14, 2025
Summary
Most participants found the online Tai Chi program engaging and beneficial for knee osteoarthritis, reporting high satisfaction. Some encountered delivery challenges, but the program shows potential for improving access to recommended exercise.
Area of Science:
- Gerontology
- Rehabilitation Medicine
- Digital Health
Background:
- Knee osteoarthritis (OA) presents a significant global health challenge, with exercise therapy being a cornerstone of management.
- Tai Chi (TC) is an evidence-based exercise effective for improving knee OA symptoms, but traditional delivery methods face accessibility limitations.
- An unsupervised 12-week online TC intervention was developed and validated for clinical effectiveness in a randomized controlled trial (RCT).
Purpose of the Study:
- To investigate user engagement and experiences with a novel online, unsupervised Tai Chi program for individuals with knee osteoarthritis.
- To identify factors influencing adherence and satisfaction within a digital exercise intervention for knee OA.
Main Methods:
- A mixed-methods approach was employed, collecting quantitative and qualitative data from 89 participants in the intervention arm of an RCT.
- User engagement was measured by TC session frequency, app usage, and adherence scores.
- User experience was evaluated through satisfaction, recommendation likelihood, credibility, usability, and acceptability ratings, supplemented by qualitative content analysis of open-text feedback.
Main Results:
- 73% of participants met the adherence criteria (≥ 2 days/week) for the online Tai Chi program.
- High levels of satisfaction (median 9/10) and likelihood to recommend (median 9/10) were reported.
- While most users reported positive experiences and perceived benefits, some noted issues with session length, pacing, technical difficulties, and dissatisfaction with outcomes.
Conclusions:
- The online unsupervised Tai Chi program demonstrated high engagement and positive user experiences for most participants with knee OA.
- Despite some challenges, the intervention holds promise for increasing access to guideline-recommended exercise for knee osteoarthritis.
- Further refinement of digital delivery is warranted to optimize user experience and outcomes for all participants.
