Trial Summary

Symptomatic osteoarthritis affects more than 32.5 million people in the United States and is a leading cause of disability and increasing medical costs. Toxicities associated with drug therapies for knee osteoarthritis pain have reduced the number of recommended treatments. There is now a critical shortage of treatment options for people with knee osteoarthritis, especially because the comorbid conditions that complicate treatment selection are highly prevalent in this older adult population. Tai chi, a multidimensional practice that integrates physical, psychosocial, and behavioral components, can provide clinically significant improvements in chronic knee osteoarthritis pain. American College of Rheumatology clinical practice guidelines strongly recommend tai chi as an intervention for knee osteoarthritis. Recent studies conducted during the COVID-19 pandemic suggest that remotely delivered tai chi is a promising and scalable strategy for knee osteoarthritis pain. However, critical knowledge gaps remain as to the real-world effectiveness of remote tai chi for knee osteoarthritis and its implementation across multiple healthcare systems. The TAICHIKNEE NIH Collaboratory Trials will compare the effects of a 3-month, twice-weekly, remotely delivered, web-based tai chi intervention vs routine care in 20 to 25 clinics across 4 healthcare systems in 4 geographic regions. The study will enroll a diverse sample of 600 patients with a clinical diagnosis of knee osteoarthritis. Participants will be evaluated at baseline and 3 months, with additional follow-up at 6 and 12 months. The hypothesis of the study is that implementation of remotely delivered tai chi is feasible across 4 healthcare systems and that tai chi, compared with routine care, will improve physical health (including knee-related pain and function), mental health, and healthcare utilization. TAICHIKNEE will be the first rigorous multisite, embedded, pragmatic trial of a remote tai chi mind-body program in the outpatient practices of multiple healthcare systems and using web-based technology designed to improve patient-centered outcomes of knee osteoarthritis. The results will enable widespread adoption of mind-body approaches for knee osteoarthritis across healthcare systems and lay the groundwork for future trials comparing the effectiveness of different implementation strategies.

NIH Project Information