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Tai chi at least as beneficial as aerobic exercise for fibromyalgia

People doing tai chi had more benefit than those doing same intensity and frequency of aerobic exercise

Louise Prime

Thursday, 22 March 2018

People with fibromyalgia get at least as much benefit from tai chi as they do from aerobic exercise, US research has shown. The authors of the study*, published in the BMJ today, said the mind-body approach might be considered a therapeutic option in the multidisciplinary management of fibromyalgia.

The US researchers said drug interventions such as analgesics seem to confer modest short-term benefits for fibromyalgia symptoms, but that recent reviews question whether they have a sustained, clinically meaningful response; and although moderate aerobic exercise is currently recommended as part of standard management, many patients have difficulties performing and adhering to exercise programmes because of fluctuations in symptoms and so remain unfit.

They recruited 226 adults with fibromyalgia (as defined by the American College of Rheumatology 1990 and 2010 criteria), most of them women, with an average duration of body pain of nine years, from an urban tertiary care academic hospital in the US between March 2012 and September 2016; none had participated in tai chi or other similar types of complementary and alternative medicine within the previous six months. They randomised 151 to one of four classic Yang-style supervised tai chi interventions (12 or 24 weeks, once or twice weekly), and 75 to supervised aerobic exercise (24 weeks, twice weekly); participants were able to continue routine drugs and usual visits to their physicians throughout the trial.

The research team followed participants for 52 weeks and assessed changes in symptom scores at 12, 24 and 52 weeks. They reported that revised fibromyalgia impact questionnaire (FIQR) scores improved in all five treatment groups at each assessment, but the combined tai chi groups improved significantly more than the aerobic exercise group at 24 weeks. Those assigned to tai chi also showed greater benefit when compared with aerobic exercise of the same intensity and duration (twice weekly for 24 weeks).

People who received tai chi for 24 weeks showed greater improvements than those who received it for 12 weeks; but there was no significant extra benefit in receiving tai chi twice weekly compared with once weekly.

The study authors added that the effects of tai chi were consistent across all instructors, and they had no serious adverse events related to the interventions reported. Although they noted that their study had some limitations, such as unblinded interventions, and attendance being better in the tai chi than aerobic exercise groups, it had a large, diverse sample and long follow-up.

They concluded: “Tai chi mind-body treatment results in similar or greater improvement in symptoms than aerobic exercise, the current most commonly prescribed non-drug treatment, for a variety of outcomes for patients with fibromyalgia. Longer duration of tai chi showed greater improvement. This mind-body approach may be considered a therapeutic option in the multidisciplinary management of fibromyalgia.”

The lead author added, in her linked opinion piece**: “The public health problem of chronic pain calls for an ‘all hands on deck’ approach to give patients feasible therapeutic options for the management of fibromyalgia. It is time, therefore, for physicians to explore new approaches and rethink their strategies in order to provide the best care for patients with chronic pain conditions.”

*Wang C, Schmid CH, Fielding RA, et al. Effect of tai chi versus aerobic exercise for fibromyalgia: comparative effectiveness randomized controlled trial. BMJ 2018; 360: k851 doi: 10.1136/bmj.k851
**Wang C. Time to rethink exercise for fibromyalgia care. BMJ. 21 March 2018.

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