Effectiveness of Osteopathic Manipulative Treatment versus Tai Chi on Mobility, Balance, and Pain Alleviation in Elderly Patients with Knee Osteoarthritis

Main Article Content

Ayyaz Ahmad
Dr. Ghazi Mustafa
Shahid Khan
Adeen Naeem
Kashmala Khan
Khaula Munir
Dr. Afifa Sarwar
Huma Asif

Abstract

Background: Knee osteoarthritis is a common degenerative joint disorder in older adults, frequently associated with chronic pain, stiffness, impaired mobility, poor balance, reduced gait performance, and functional limitation. Non-pharmacological rehabilitation strategies such as Osteopathic Manipulative Treatment and Tai Chi may offer clinically useful benefits by targeting different mechanisms of impairment. Objective: To compare the effectiveness of Osteopathic Manipulative Treatment and Tai Chi on pain, physical function, mobility, balance, and gait speed in elderly patients with knee osteoarthritis. Methods: A single-blind randomized controlled trial included 60 elderly participants aged 60–80 years with clinically and radiographically confirmed knee osteoarthritis. Participants were allocated equally into Osteopathic Manipulative Treatment, Tai Chi, and standard-care control groups. The intervention groups received 45-minute sessions twice weekly for 12 weeks. Outcomes were assessed at baseline and post-intervention using the Western Ontario and McMaster Universities Osteoarthritis Index, Timed Up and Go test, Berg Balance Scale, Numeric Pain Rating Scale, and 10-meter walk test. Results: Both Osteopathic Manipulative Treatment and Tai Chi produced greater improvements than standard care. Osteopathic Manipulative Treatment showed larger descriptive reductions in WOMAC pain, WOMAC function, and Numeric Pain Rating Scale scores, while Tai Chi showed greater descriptive improvements in Timed Up and Go performance, Berg Balance Scale score, and gait speed. Conclusion: Both interventions were effective non-pharmacological approaches for elderly patients with knee osteoarthritis. Osteopathic Manipulative Treatment may be more beneficial for pain and stiffness reduction, whereas Tai Chi may be preferable for improving balance, gait, and functional mobility.

Article Details

Section

Articles

How to Cite

1.
Ayyaz Ahmad, Dr. Ghazi Mustafa, Shahid Khan, Adeen Naeem, Kashmala Khan, Khaula Munir, et al. Effectiveness of Osteopathic Manipulative Treatment versus Tai Chi on Mobility, Balance, and Pain Alleviation in Elderly Patients with Knee Osteoarthritis. JHWCR [Internet]. 2026 Jun. 2 [cited 2026 Jun. 2];4(11):1-11. Available from: https://jhwcr.com/index.php/jhwcr/article/view/1668

References

1. Urits I, Schwartz RH, Orhurhu V, Maganty NV, Reilly BT, Patel PM, et al. A comprehensive review of alternative therapies for the management of chronic pain patients: acupuncture, tai chi, osteopathic manipulative medicine, and chiropractic care. Adv Ther. 2021;38(1):76-89.

2. Khan A, Ahmad A, Ibrar SS, Awan SK, Hashmat A, Berkhamova A, et al. Opioid stewardship and gastrointestinal-sparing alternatives in primary care pain management. Cureus. 2025;17(6).

3. Molinari L, Mingrone L, Novelli E. Effectiveness of osteopathic manual treatment in the elderly population: a scoping review of clinical evidence. J Osteopath Med. 2025;125(10):497-505.

4. Yue H, Li Y, Ma J, Xie C, Xie F, Cai J, et al. Effect of Tai Chi on knee pain and muscle strength in middle-aged and older adults with knee osteoarthritis: a randomized controlled trial protocol. BMC Complement Med Ther. 2023;23(1):256.

5. Song J, Wei L, Cheng K, Lin Q, Xia P, Wang X, et al. The effect of modified Tai Chi exercises on the physical function and quality of life in elderly women with knee osteoarthritis. Front Aging Neurosci. 2022;14:860762.

6. Ye Y, Liu A. The effectiveness of Tai Chi for knee osteoarthritis: an overview of systematic reviews. Int J Gen Med. 2023;16:4499-4514.

7. You Y, Liu J, Tang M, Wang D, Ma X. Effects of Tai Chi exercise on improving walking function and posture control in elderly patients with knee osteoarthritis: a systematic review and meta-analysis. Medicine. 2021;100(16):e25655.

8. You Y, Min L, Tang M, Chen Y, Ma X. Bibliometric evaluation of global Tai Chi research from 1980–2020. Int J Environ Res Public Health. 2021;18(11):6150.

9. Feng T, Wang X, Jin Z, Qin X, Sun C, Qi B, et al. Effectiveness and safety of manual therapy for knee osteoarthritis: an overview of systematic reviews and meta-analyses. Front Public Health. 2023;11:1081238.

10. Bagagiolo D, Persiani M, Cicchitti L, Vismara L, Bruini I, Mauro A, et al. Efficacy and safety of musculoskeletal manipulations in elderly population with musculoskeletal disorders: a systematic review. BMJ Open. 2025;15(6):e088655.

11. Trivedi H, Avrit TA, Chan L, Burchette DM, Rathore R. The benefits of integrative medicine in the management of chronic pain: a review. Cureus. 2022;14(10).

12. Bhoi D, Jain D, Garg R, Iyengar KP, Hoda W, Vaishya R, et al. Complementary and alternative modalities for pain management in musculoskeletal diseases. J Clin Orthop Trauma. 2021;18:171-180.

13. Kaye AD, Granier AL, Garcia AJ, Carlson SF, Fuller MC, Haroldson AR, et al. Non-opioid perioperative pain strategies for the clinician: a narrative review. Pain Ther. 2020;9(1):25-39.

14. Yanuck SB, Fox SK, Harting BR, Motyka TM. Effect of manual manipulation on mechanical gait parameters. J Osteopath Med. 2024;124(10):437-446.

15. Zhang F, Zhang B, Wang X, Huang C, Hu B. Effects of Tai Chi on insomnia in elderly people with chronic non-specific low back pain: a study protocol for a randomized controlled trial. Front Psychol. 2023;14:1105359.

16. Zhong W, Chen J, Li Y, Liu M, Yang S. Efficacy and safety of traditional Chinese medicine rehabilitation program in the treatment of knee osteoarthritis: a randomized controlled trial protocol. Ann Palliat Med. 2021;10(6):6909-6918.

17. Ihns K, Starr K, Marchand C, Jaimon J, Singer A, Hassoun L, et al. Evidence of commonly used integrative approaches with pharmacotherapy for chronic pain management. J Pain Palliat Care Pharmacother. 2024;38(3):302-317.