Tai Chi and Microbiota in Osteoarthritis

 

Inclusion Criteria

• Fulfills the American College of Rheumatology Criteria for symptomatic and radiographic OA of the knee⁶⁶
• Body mass index > 30.0 kg/m2
• Baseline (Month 0) WOMAC pain subscale score ≥ 40 (visual analog version) on at least 1 of 5 questions (range 0 to 100 each)

Exclusion Criteria

• Dementia, neurological disease, cancer, cardiovascular disease, renal disease, liver disease, or other serious medical conditions limiting ability to participate in the programs.
• Factors known or likely to impact the intestinal microbiota or known to be associated with microbial translocation: antibiotic or probiotic use within the previous 4 weeks, gastrointestinal morbidity (irritable bowel syndrome, inflammatory bowel disease, history of gastrointestinal cancer or surgical resection, or acute, severe gastrointestinal symptoms requiring medical attention), opportunistic infection, and evidence of hepatitis B or C virus infection

Study Requirements

The proposed study is a randomized, clinical trial that compares mechanisms of Tai Chi on gut microbiota, with a wellness education program in 80 patients with metabolicOAas a basis for a future large-scale trial. Patients randomized to either Tai Chi or attention control classes will attend 2 sessions per week, over 3 months. The study procedure will be repeated twice over the 2-year study period(20 patients per cycle). Participants will also be instructed to maintain their normal medications and lifestyles. Outcome measurements will be obtained at baseline, and on completion of the 3-month program and 6 month follow-up. We will measure changes in microbiota profiles (composition, relative abundance, alpha and beta diversity) and quantity of Streptococcus species as well as pain, function, psychological health and quality of life. The team conducting assessments will be blinded to treatment allocation. Changes in these parameters will be compared in the 2 study groups.