A randomized trial of tai chi for fibromyalgia

Chenchen Wang, M.D., M.P.H., Christopher H. Schmid, Ph.D., Ramel Rones, B.S., Robert Kalish, M.D., Janeth Yinh, M.D., Don L. Goldenberg, M.D., Yoojin Lee, M.S., and Timothy McAlindon, M.D., M.P.H.

Fibromyalgia is a common and complex clinical syndrome characterized by chronic and widespread musculoskeletal pain, fatigue, sleep disturbance, and physical and psychological impairment. Evidence-based guidelines suggest that fibromyalgia is typically managed with multidisciplinary therapies involving medication, cognitive behavioral therapy, education, and exercise.

Although exercise is beneficial for fibromyalgia and has been advocated as a core component of its treatment, most patients continue to be in considerable pain years after the original diagnosis and require medication to control symptoms; they also remain aerobically unfit, with poor muscle strength and limited flexibility. New approaches are needed to reduce musculoskeletal pain in patients with fibromyalgia and to improve their physical and emotional functioning and quality of life.

Tai chi is a mind–body practice that originated in China as a martial art. It combines meditation with slow, gentle, graceful movements, as well as deep breathing and relaxation, to move vital energy (or qi) throughout the body. It is considered a complex, multicomponent intervention that integrates physical, psychosocial, emotional, spiritual, and behavioral elements. Because of its mind–body attributes, tai chi could be especially well suited to the treatment of fibromyalgia. In fact, tai chi is practiced preferentially in the United States by persons with musculoskeletal and mental health conditions.  A small, nonrandomized study showed that tai chi reduced symptoms and improved quality of life in patients with fibromyalgia, and it has also been shown to have potential therapeutic benefits in patients with other chronic rheumatic conditions, such as rheumatoid arthritis and osteoarthritis.

We conducted a single-blind, randomized, controlled trial to compare the physical and psychological benefits of tai chi with those of a control intervention that consisted of wellness education and stretching. We hypothesized that at the end of the 12-week intervention period, patients in the tai chi group would have a greater reduction in musculoskeletal pain and greater improvements in sleep quality, physical and psychological function, and health-related quality-of-life scores than those in the control group.

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