User Engagement and Experiences With an Online Unsupervised Tai Chi Program for People With Knee Osteoarthritis: Mixed Methods Process Evaluation Nested in a Randomized Controlled Trial

Abstract

Background: Knee osteoarthritis is a major global health burden, and exercise is a core recommended treatment. Tai Chi is an evidence-based exercise shown to improve symptoms in people with knee osteoarthritis. However, traditional in-person delivery can limit accessibility. To address this, we developed a 12-week unsupervised online Tai Chi intervention and demonstrated its clinical effectiveness in a randomized controlled trial (RCT). This RCT compared the Tai Chi program plus educational information and an exercise adherence support app (intervention) with online education alone (control) for people with knee osteoarthritis. While the intervention improved pain and function, participants’..