BMJ — | March 23, 2018
Wang C, et al. – Experts undertook a comparative scrutiny of the effectiveness of Tai chi interventions vs aerobic exercise, a current core standard treatment in patients with fibromyalgia. Furthermore, they intended to contemplate if the effectiveness of Tai chi depended on its dosage or duration. Results illustrated similar or greater improvement in symptoms through Tai chi mind-body treatment compared to aerobic exercise, the current most commonly prescribed non-drug treatment, for a variety of outcomes for patients with fibromyalgia. It was discovered that longer duration of Tai chi exhibited greater improvement. Therefore, this mind-body approach possibly served as a therapeutic option in the multidisciplinary management of fibromyalgia.
Methods
- The scheme of this research was a prospective, randomized, 52 week, single blind comparative effectiveness trial.
- It was carried out at the Urban tertiary care academic hospital in the United States between March 2012 and September 2016.
- The enrollment consisted of 226 adults with fibromyalgia (as defined by the American College of Rheumatology 1990 and 2010 criteria).
- Among the eligible candidates, 151 were assigned to 1 of 4 Tai chi groups and 75 to an aerobic exercise group.
- They were randomly allocated to either supervised aerobic exercise (24 weeks, twice weekly) or 1 of 4 classic Yang style supervised Tai chi interventions (12 or 24 weeks, once or twice weekly).
- Follow-up was undertaken for 52 weeks.
- Herein, adherence was rigorously encouraged in person and by telephone.
- The primary outcome included change in the revised fibromyalgia impact questionnaire (FIQR) scores at 24 weeks compared with baseline.
- Changes of scores in patient’s global assessment, anxiety, depression, self efficacy, coping strategies, physical functional performance, functional limitation, sleep, and health related quality of life served as the secondary outcomes.
Results
- All 5 treatment groups reported improvement in the FIQR scores.
- Nevertheless, the combined Tai chi groups improved statistically substantially more compared to the aerobic exercise group in FIQR scores at 24 weeks (difference between groups=5.5 points, 95% confidence interval 0.6 to 10.4, P=0.03) and several secondary outcomes (patient’s global assessment=0.9 points, 0.3 to 1.4, P=0.005; anxiety=1.2 points, 0.3 to 2.1, P=0.006; self efficacy=1.0 points, 0.5 to 1.6, P=0.0004; and coping strategies, 2.6 points, 0.8 to 4.3, P=0.005).
- Greater benefit (between group difference in FIQR scores=16.2 points, 8.7 to 23.6, P < 0.001) was yielded via Tai chi treatment compared with aerobic exercise administered with the same intensity and duration (24 weeks, twice weekly).
- Findings illustrated that the groups who received Tai chi for 24 weeks conferred greater improvements vs those who received it for 12 weeks (difference in FIQR scores=9.6 points, 2.6 to 16.6, P=0.007).
- No notable rise was discovered in the benefit for groups who received Tai chi twice weekly compared with once weekly.
- It was noted that the candidates attended the Tai chi training sessions more often compared to those who attended aerobic exercise.
- Consistent effects of Tai chi were brought to the forefront across all instructors.
- Data did not unveil any serious adverse events associated with the interventions.
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