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Brief summary
The goal of this clinical trial is to evaluate whether Tai Chi exercise, used as an adjunct to standard physiotherapy, can improve balance, functional status, pain, and knee joint mobility in older adults (65-75 years) diagnosed with knee osteoarthritis (gonarthrosis), compared with standard physiotherapy alone and physiotherapy combined with virtual reality-based training.
The main questions it aims to answer are:
Does adding Tai Chi to standard physiotherapy lead to greater improvements in static and dynamic balance (Berg Balance Scale, Timed Up and Go test) in patients with knee osteoarthritis?
Does Tai Chi result in superior improvements in pain intensity (VAS), functional status (WOMAC), and knee joint range of motion compared with standard physiotherapy and VR-based training?
Researchers will compare three intervention arms-standard physiotherapy, standard physiotherapy plus virtual reality (Kinect-based biofeedback training), and standard physiotherapy plus Tai Chi-to determine whether Tai Chi provides greater clinical and functional benefits than the other rehabilitation approaches.
Participants will:
Receive standard inpatient physiotherapy for knee osteoarthritis
Additionally perform one of the following interventions for 30 minutes daily over 4 weeks:
Tai Chi exercises led by a qualified therapist, focusing on balance, controlled movement, and pain-free execution
Virtual reality-based balance training using a Kinect system
Undergo assessments before and after the intervention period, including pain, balance, functional performance, and knee joint mobility measures
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Standard Physiotherapy Combined with Tai Chi Balance Training | Experimental |
| |
| Inpatient Physiotherapy with Manual Therapy, Physical Modalities, and Conventional Balance Training | Active Comparator |
| |
| Standard Physiotherapy Combined with Kinect-Based Virtual Reality Balance Training | Active Comparator |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Tai Chi training | Other | In addition to standard therapy, instead of balance training, the participant performed Tai Chi exercises daily for 30 minutes under the supervision of a qualified therapist. The Tai Chi sessions emphasized balance in a variety of positions engaging the knee joint; the exercises were performed in smooth sequences combined with deep breathing. During the sessions, particular attention was paid to movement quality and the absence of pain during movement. |
| Measure | Description | Time Frame |
|---|---|---|
| Total score on the Berg Balance Scale. | Assessment of static and dynamic balance using a 14-item scale. The unit of measurement is points (range 0-56), where a higher score indicates better balance. | Baseline; Day 1 (09 May 2025) Final assessment: after 4 weeks (06 June 2025) |
| Score on the WOMAC questionnaire (Western Ontario and McMaster Universities Osteoarthritis Index). | Assessment of the severity of osteoarthritis symptoms (pain, stiffness, and physical function). The unit of measurement is points (sum of 24 items), where a higher score indicates poorer functional status and greater pain. | Baseline; Day 1 (09 May 2025) Final assessment: after 4 weeks (06 June 2025) |
| Time to complete the Timed Up and Go (TUG) test. | Assessment of functional mobility and fall risk. The unit of measurement is time in seconds required to stand up from a chair, walk 3 meters, turn around, return, and sit down again. | Baseline; Day 1 (09 May 2025) Final assessment: after 4 weeks (06 June 2025) |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Grzegorz Mańko, PhD | Department of Biomechanics and Kinesiology, Institute of Physiotherapy, Faculty of Health Sciences, Jagiellonian University Medical College, Cracow, Poland | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Department of Biomechanics and Kinesiology, Institute of Physiotherapy, Faculty of Health Sciences, Jagiellonian University Medical College | Krakow | 31-066 | Poland |
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| Type | Includes Protocol | Includes SAP | Includes ICF | Document Label | Document Date | Document Uploaded Date | Document File Name |
|---|---|---|---|---|---|---|---|
| Prot_SAP | Yes | Yes | No | Study Protocol and Statistical Analysis Plan | Dec 10, 2025 | Feb 13, 2026 | Prot_SAP_000.pdf |
| ICF | No | No | Yes | Informed Consent Form | Apr 15, 2025 | Feb 13, 2026 | ICF_001.pdf |
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| ID | Term |
|---|---|
| D020370 | Osteoarthritis, Knee |
| D010003 | Osteoarthritis |
| ID | Term |
|---|---|
| D001168 | Arthritis |
| D007592 | Joint Diseases |
| D009140 | Musculoskeletal Diseases |
| D012216 | Rheumatic Diseases |
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| ID | Term |
|---|---|
| D001676 | Biofeedback, Psychology |
| ID | Term |
|---|---|
| D026441 | Mind-Body Therapies |
| D000529 | Complementary Therapies |
| D013812 | Therapeutics |
| D001521 | Behavior Therapy |
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|
| Comprehensive Inpatient Physiotherapy with other standard therapies | Other | who, as part of inpatient physiotherapy, underwent a comprehensive treatment program consisting of: manual therapy-20 minutes daily, including soft tissue techniques and mobilization of the knee joint-and physical therapy modalities including electrotherapy, laser therapy, magnetotherapy, and ultrasound therapy. The patients also performed balance-supporting exercises in the form of balance training, which included: balancing on sensorimotor cushions for 10 minutes in various directions, resistance exercises-leg press on a machine for 3 sets of 15-20 repetitions, semi-squats on sensorimotor cushions for 3 sets of 20 repetitions, and core stability exercises in the supine position for 10 minutes. |
|
| Kinect-Based Virtual Reality Balance Training with Biofeedback | Other | where, in addition to standard therapy, instead of conventional balance training, the group additionally received exercises using a Kinect-based system on the iStander device (Alreh Medical, Łódź, Poland), which enables safe and engaging therapy in a controlled virtual environment with the use of biofeedback. The exercises were delivered in the form of game-based activities for 30 minutes daily at a moderate level of difficulty. |
|
| D011613 |
| Psychotherapy |
| D004191 | Behavioral Disciplines and Activities |
| D030141 | Feedback, Psychological |