#2-41E. Digital Tai Chi: A Scalable Solution for Knee OA Pain and Function (JAMA Intern Med, 2025)

Knee osteoarthritis (OA) is a leading cause of chronic pain, and while exercise is the cornerstone of guideline-recommended management, limited access to in-person classes often presents a barrier. How can we leverage digital tools to provide effective, guideline-recommended exercise to a wider patient population? The RETREAT randomized clinical trial addressed this by examining a 12-week unsupervised multimodal online Yang-style tai chi intervention—the My Joint Tai Chi program, which included video instruction and an adherence support app—against an online OA education control group in 178 Australian adults with clinically diagnosed knee OA. The key finding is that the online tai chi group achieved significantly greater and clinically relevant improvements in both knee pain (NRS) and physical function (WOMAC) compared to the control group at 12 weeks (P < .001 for both outcomes). This intervention proved safe, with no serious related adverse events reported. However, as a pragmatic trial, participants were unblinded, meaning we must consider the potential for contextual or expectation bias when interpreting the magnitude of these effects. This study offers clinicians an effective, free, and highly scalable web-based resource that supports evidence-based care delivery and improves access to a critical treatment modality for patients with knee OA.

Citation: Zhu, Shiyi Julia et al. Online Unsupervised Tai Chi Intervention for Knee Pain and Function in People With Knee Osteoarthritis. JAMA Internal Medicine. 2025. DOI: 10.1001/jamainternmed.2025.5723

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