A randomized controlled trial of 8-form Tai chi improves symptoms and functional mobility in fibromyalgia patients

Abstract

Previous researchers have found that 10-form Tai chi yields symptomatic benefit in patients with fibromyalgia (FM). The purpose of this study was to further investigate earlier findings and add a focus on functional mobility. We conducted a parallel-group randomized controlled trial FMmodified 8-form Yang-style Tai chi program compared to an education control. Participants met in small groups twice weekly for 90 min over 12 weeks. The primary endpoint was symptom reduction and improvement in self-report physical function, as measured by the Fibromyalgia Impact Questionnaire (FIQ), from baseline to 12 weeks. Secondary endpoints included pain severity and interference (Brief Pain Inventory (BPI), sleep (Pittsburg sleep Inventory), selfefficacy, and functional mobility. Of the 101 randomly assigned subjects (mean age 54 years, 93 % female), those in the Tai chi condition compared with the education condition demonstrated clinically and statistically significant improvements in FIQ scores (16.5 vs. 3.1, p=0.0002), BPI pain severity (1.2 vs. 0.4, p=0.0008), BPI pain interference (2.1 vs. 0.6, p=0.0000), sleep (2.0 vs. −0.03, p=0.0003), and self-efficacy for pain control (9.2 vs. −1.5, p=0.0001). Functional mobility Correspondence to: Kim D. Jones. Disclosures: None.Electronic supplementary material The online version of this article (doi:10.1007/s10067-012-1996-2) contains supplementary material, which is available to authorized users. Existent FM literature indicates that higher intensity exercise programs, regardless of mode, result in improved physical fitness, but often worsen pain, induce a symptom flare, reduce self-efficacy, and have little or no effect on sleep [6,7]. Clinicians, therefore, may not wish to encourage FM patients to initiate a conventional exercise program. Recently, exercise that employs a mind/body component has been found to be effective for reducing FM symptoms [8]. Tai chi is a mind/body exercise that differs from conventional exercise programs that focus exclusively on physical fitness (e.g., aerobics training) in that the mind (psychological) and body (physical) are an integrated, unified whole. Tai chi combines slow, graceful, purposeful movements with controlled breathing and relaxation. As a form of ancient Chinese martial arts, Tai chi's mechanism of action is purported to appropriately distribute the body's vital energy, termed "qi." Tai chi can be easily modified to account for the central and peripheral dysfunctions associated with FM. The practice is progressive in intensity, timing, and type of physical and mental challenge [9]. Tai chi has gained popularity in the USA and has been demonstrated to be effective in elders or persons with painful musculoskeletal disorders including rheumatoid and osteoarthritis [10][11][12]. HHS Public AccessThree Tai chi studies in FM have resulted in symptom or fitness improvement. The first was a positive "proof of concept" study, but it was limited by lack of a control group [13].Another was limited by a sample size of six [14]. However...

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