Multiform-based Yi Jin Jing exercise against osteoarthritis of the knee: study protocol for a randomised controlled trial.

Introduction: Knee osteoarthritis (KOA) is a chronic osteoarticular disease characterized by degenerative lesions of articular cartilage, with clinical manifestations of knee pain, stiffness, and limited mobility. Patients with KOA often experience lower limb muscle strength decline and weakened joint stability due to pain, further exacerbating functional disabilities. Yijinjing, a traditional Chinese fitness qigong, features stretching and gentle movements, emphasizing the coordination of limb movements and breathing. This study innovatively combined traditional Yijinjing with Baduanjin and Wuqinxi to design a modified Yijinjing training program including three postures: upright, sitting, and recumbent. The program adopts a stepped training model, adjusting training postures according to patients' knee joint mobility, and designs targeted movements for common symptoms of KOA, aiming to provide personalized rehabilitation options for KOA patients with different severities.

Methods/design: In this study, a single-blind randomised controlled trial was used and a randomised list was generated using a computerised random number generator and opaque sealed envelopes for group allocation were prepared.Strict blinding was followed and outcome evaluators were blinded until the end of the experiment, when participants would not know which group they were included in.The study was conducted on patients aged between 40 and 75 years, with stable medical conditions, who had not practised Yi Jin Jing regularly in the past.These patients were randomly divided into the following 3 groups: (1) Conventional medication group (CG); (2) Traditional Yi Jin Jing exercise group (TG); (3) Modified Yi Jin Jing exercise group (MG); the control group received only conventional medication, whereas the TG and IG groups exercised for 1 h per day on top of the conventional medication for 3 months. One day per week was taken and all groups, except the control group, underwent 1 day of volitional supervised training. WOMAC was the primary outcome variables; the HSS knee score, Time Up and Go Test Active and passive knee mobility and the SF-36 scale served as secondary outcome indicators.

Discussion: The present study may result in a new and widely accepted, easy-to-use, targeted and adaptable exercise prescription for Yi Jin Jing.The prescription encompasses three forms: upright, seated, and recumbent positions, along with stepped exercise patterns and targeted movements. This comprehensive approach is designed to accommodate the varying stages of KOA and the individual conditions of patients, and it is anticipated to address the shortcomings of conventional knee rehabilitation and traditional Yi Jin Jing practices.

Trial registration: International Traditional Medicine Clinical Registry Platform, ITMCTR2024000234. Registered on 30 July 2024.