# Real time biofeedback Tai Chi training for knee osteoarthritis: A feasibility study

> **NIH NIH K23** · VIRGINIA COLLEGE OF OSTEOPATHIC MEDICINE · 2020 · $164,840

## Abstract

Program Director/Principal Investigator (Liu, Wei):
Abstract
The overall goal of this mentored career development award (K23) is to support Wei Liu, PhD to become an
independent investigator in the field of complementary and alternative medicine (CAM) and chronic pain, with a
focus on biofeedback Tai Chi intervention development and testing. Disabilities that arise from typical
impairments of knee osteoarthritis (OA) include decreased muscle strength, reduced range of motion, and
decreased aerobic cardiovascular function. A large number of individuals with knee OA experience disability
and require rehabilitation. Traditional Tai Chi intervention (TC) has been promising therapeutic intervention for
pain reduction in knee OA, but the efficacy of TC as a knee OA intervention have proven inconclusive because
individual with knee OA performed TC with widely varying mechanical knee joint loads, this variation could be a
confounding factor in any study of TC. Therefore, Dr. Liu proposes a feasibility study in Aim 1 to quantify
external knee adduction moment (EKAM), a strong predictor of OA disease severity and progression during TC
practice, and in Aim 2, he will introduce real time biofeedback Tai Chi training (BTC) and see if it is feasible to
use biofeedback of torque acting on the knee to modify some TC forms by reducing EKAM. In Aim 3, he will
conduct a pilot study to determine the feasibility of using optimized BTC training for OA knee pain reduction.
The proposed research represents the first study to identify the biomechanical mechanisms of TC exercise
(Aim 1 and 2) and target EKAM by using real-time biofeedback approach and manipulate EKAM independently
for TC intervention (Aim 3). We can alter medial knee joint loading response of TC. EKAM would be a
biomechanical marker for TC intervention associated with clinical outcomes in knee OA. At the completion of
the pilot trial in Aim 3, the optimized BTC intervention will be ready to be tested in an R33 to evaluate its
efficacy. This proposal represents a 5-year comprehensive mentoring, training and research plan to transition
the candidate, Dr. Liu, to a career as a successful independent investigator. By end of the award period, Dr.
Liu will have contributed substantially to the field of CAM research. Already an expert on biomechanical
approaches to Tai Chi, he will be positioned to become a leader in developing and testing novel CAM
interventions in this area, including conducting behavioural clinical trials.
OMB No. 0925-0001/0002 (Rev. 03/16 Approved Through 10/31/2018) Page Continuation Format Page

## Key facts

- **NIH application ID:** 9976459
- **Project number:** 5K23AT009568-03
- **Recipient organization:** VIRGINIA COLLEGE OF OSTEOPATHIC MEDICINE
- **Principal Investigator:** Wei Liu
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $164,840
- **Award type:** 5
- **Project period:** 2018-08-15 → 2020-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9976459

## Citation

> US National Institutes of Health, RePORTER application 9976459, Real time biofeedback Tai Chi training for knee osteoarthritis: A feasibility study (5K23AT009568-03). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9976459. Licensed CC0.

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