A recent study concerning the use of Tai Chi in the treatment of fibromyalgia:
Fibromyalgia: Chronic widespread pain (CWP), the hallmark symptom of fibromyalgia, is defined by the American College of Rheumatology (ACR) as pain present in at least 2 contralateral body quadrants and the axial skeleton and persisting for at least 3 months. Approximately 10% of the general population of developed countries report CWP. The majority of these individuals have no structural musculoskeletal disease that would result in this condition and are likely to experience higher rates of psychological distress than the average population.
The ACR classification criteria for fibromyalgia, met by approximately 50% of individuals with CWP, include the presence of CWP in combination with tenderness at 11 or more of the 18 predefined tender points upon digital palpation. Tender points are a measure of hyperalgesia and do not correlate with any tissue abnormality. The greater the number of tender points, the more an individual will fall on the most severe end of the CWP scale.
Fibromyalgia: Chronic widespread pain (CWP), the hallmark symptom of fibromyalgia, is defined by the American College of Rheumatology (ACR) as pain present in at least 2 contralateral body quadrants and the axial skeleton and persisting for at least 3 months. Approximately 10% of the general population of developed countries report CWP. The majority of these individuals have no structural musculoskeletal disease that would result in this condition and are likely to experience higher rates of psychological distress than the average population.
The ACR classification criteria for fibromyalgia, met by approximately 50% of individuals with CWP, include the presence of CWP in combination with tenderness at 11 or more of the 18 predefined tender points upon digital palpation. Tender points are a measure of hyperalgesia and do not correlate with any tissue abnormality. The greater the number of tender points, the more an individual will fall on the most severe end of the CWP scale.
Fibromyalgia can be a difficult illness to treat, but previous research suggests that effective treatment can begin with increasing patients' physical activity. In a systematic review of exercise therapy for fibromyalgia by Busch and colleagues, which was published in the June 2008 issue of the Journal of Rheumatology, the researchers found that aerobic exercise improved overall well-being and physical function among patients with fibromyalgia. Strength training was also associated with improved outcomes for fibromyalgia, although these results were not as robust vs those for aerobic exercise.
Tai chi can improve both physical function and mindfulness, and those properties make tai chi a potentially effective treatment of fibromyalgia. The current randomized trial examines the efficacy of tai chi for fibromyalgia.
* Study participants were at least 21 years old and fulfilled standard criteria for fibromyalgia by the American College of Rheumatology. Patients with other serious medical conditions were excluded from study analysis.
* Patients were permitted to continue routine medications during the trial.
* Study participants were randomly assigned to attend tai chi classes or a wellness education and stretching program (control group). Both groups met twice weekly for 12 weeks. Tai chi was practiced in the Yang style and was led by a tai chi master. Both the tai chi group and the control group were instructed to practice exercise at home for 20 minutes per day.
* The main study outcome was the change in the FIQ from baseline to 12 weeks. Secondary outcomes included measures of pain, sleep, depression, and quality of life, as well as a 6-minute walk test. Outcomes were assessed by investigators blinded to the randomly assigned treatment.
* 66 individuals underwent randomization to the tai chi group and to the control group. Baseline data were generally similar between the 2 groups, except that the tai chi group had slightly lower depression scores. The mean age of participants was 50 years, and 86% were women. The average duration of fibromyalgia was 11 years.
* The rates of attendance during the 12-week program were 77% for the tai chi group and 70% for the control group.
* At 12 weeks, the tai chi group experienced a mean decrease in the FIQ score of 27.8 points vs an average decline of 9.4 points in the control group (P < .001). The superiority of the tai chi group in this outcome persisted at 24 weeks.
* Sleep and participants' global assessment were also superior in the tai chi group vs the control group. Tai chi improved both physical and mental components of quality of life to a greater degree than the control intervention, and depression scores improved more in the tai chi group vs the control group.
* All of these superior outcomes for tai chi therapy vs control therapy were maintained at 24 weeks.
* Compared with subjects in the control group, participants in the tai chi group were able to walk an average of 44 yards longer in the 6-minute walk test at 12 weeks.
* There was a nonsignificant trend toward less medication use among participants in the tai chi group vs those in the control group.
* No adverse events were associated with the study interventions.
Clinical Implications
* Previous research suggests that aerobic exercise improves overall well-being and physical function among patients with fibromyalgia. Strength training was also associated with improved outcomes for fibromyalgia, although these results were not as robust vs those for aerobic exercise.
* The current study suggests that tai chi can improve multiple outcomes of fibromyalgia, including global symptoms, sleep, depression, and quality of life.
Tai chi can improve both physical function and mindfulness, and those properties make tai chi a potentially effective treatment of fibromyalgia. The current randomized trial examines the efficacy of tai chi for fibromyalgia.
* Study participants were at least 21 years old and fulfilled standard criteria for fibromyalgia by the American College of Rheumatology. Patients with other serious medical conditions were excluded from study analysis.
* Patients were permitted to continue routine medications during the trial.
* Study participants were randomly assigned to attend tai chi classes or a wellness education and stretching program (control group). Both groups met twice weekly for 12 weeks. Tai chi was practiced in the Yang style and was led by a tai chi master. Both the tai chi group and the control group were instructed to practice exercise at home for 20 minutes per day.
* The main study outcome was the change in the FIQ from baseline to 12 weeks. Secondary outcomes included measures of pain, sleep, depression, and quality of life, as well as a 6-minute walk test. Outcomes were assessed by investigators blinded to the randomly assigned treatment.
* 66 individuals underwent randomization to the tai chi group and to the control group. Baseline data were generally similar between the 2 groups, except that the tai chi group had slightly lower depression scores. The mean age of participants was 50 years, and 86% were women. The average duration of fibromyalgia was 11 years.
* The rates of attendance during the 12-week program were 77% for the tai chi group and 70% for the control group.
* At 12 weeks, the tai chi group experienced a mean decrease in the FIQ score of 27.8 points vs an average decline of 9.4 points in the control group (P < .001). The superiority of the tai chi group in this outcome persisted at 24 weeks.
* Sleep and participants' global assessment were also superior in the tai chi group vs the control group. Tai chi improved both physical and mental components of quality of life to a greater degree than the control intervention, and depression scores improved more in the tai chi group vs the control group.
* All of these superior outcomes for tai chi therapy vs control therapy were maintained at 24 weeks.
* Compared with subjects in the control group, participants in the tai chi group were able to walk an average of 44 yards longer in the 6-minute walk test at 12 weeks.
* There was a nonsignificant trend toward less medication use among participants in the tai chi group vs those in the control group.
* No adverse events were associated with the study interventions.
Clinical Implications
* Previous research suggests that aerobic exercise improves overall well-being and physical function among patients with fibromyalgia. Strength training was also associated with improved outcomes for fibromyalgia, although these results were not as robust vs those for aerobic exercise.
* The current study suggests that tai chi can improve multiple outcomes of fibromyalgia, including global symptoms, sleep, depression, and quality of life.
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