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Tai chi ‘as good as or better’ than aerobic exercise for chronic pain

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The ancient martial art of tai chi has similar or greater benefits than aerobic exercise for patients with fibromyalgia, a US trial has found, suggesting it may be an alternative treatment strategy.

According to the researches behind the study, their findings suggest it may be time to rethink what type of exercise is most effective for patients with chronic pain conditions.

“Tai chi mind-body treatment results in similar or greater improvement in symptoms than aerobic exercise”

Study authors

Aerobic exercise is currently recommended as a standard treatment for fibromyalgia, but many patients find it difficult to exercise due to fluctuations in symptoms.

The researchers noted that some previous trials had suggested that tai chi might alleviate pain and improve physical and mental health in patients with fibromyalgia.

To investigate further, they set out to compare the effectiveness of tai chi with aerobic exercise and to test whether frequency or duration was important.

They identified 226 adults with fibromyalgia who had not participated in tai chi or other similar types of complementary and alternative medicine within the past six months.

The average age of participants was 52 years, 92% were women, 61% were white, and average duration of body pain was nine years.

At the start of the trial, participants completed the fibromyalgia impact questionnaire (FIQR), which scores physical and psychological symptoms such as pain intensity, fatigue and overall wellbeing.

Participants were then randomised to either supervised aerobic exercise twice weekly for 24 weeks or to one of four tai chi interventions – 12 or 24 weeks of supervised tai chi completed once or twice weekly.

Changes in symptom scores were assessed at 12, 24 and 52 weeks and participants were able to continue routine drugs and usual visits to their physicians throughout the trial.

The researchers found 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.

Tai chi also showed greater benefit when compared with aerobic exercise of the same intensity and duration – twice weekly for 24 weeks – said the study authors in the British Medical Journal.

Those who received tai chi for 24 weeks showed greater improvements than those who received it for 12 weeks, but receiving it twice weekly compared with once did not seem to have an impact.

The effects of tai chi were consistent across all instructors and no serious adverse events related to the interventions were reported, noted the researchers.

Tufts University

Tai chi ‘as good as or better’ than aerobic exercise for chronic pain

Chenchen Wang

“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,” said the authors.

“This mind-body approach may be considered a therapeutic option in the multi-disciplinary management of fibromyalgia,” they added.

However, they acknowledged several study limitations. For example, participants were aware of their treatment group assignment, and attendance differed between the two treatment groups.

The study’s lead researcher Dr Chenchen Wang, from Tufts University in Boston, said the public health problem of chronic pain called 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,” she said in a linked opinion article.

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