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

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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 FM-modified 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), self-efficacy, 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 variables including timed get up and go (−.9 vs. −.3, p = 0.0001), static balance (7.5 vs. −0.3, p =  0.0001), and dynamic balance (1.6 vs. 0.3, p = 0.0001) were significantly improved with Tai chi compared with education control. No adverse events were noted. Twelve weeks of Tai chi, practice twice weekly, provided worthwhile improvement in common FM symptoms including pain and physical function including mobility. Tai chi appears to be a safe and an acceptable exercise modality that may be useful as adjunctive therapy in the management of FM patients. (ClinicalTrials.gov Identifier, NCT01311427)

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References

  1. Wolfe F, Smythe HA, Yunus MB, Bennett RM, Bombardier C, Goldenberg DL, Tugwell P, Campbell SM, Abeles M, Clark P (1990) The American College of Rheumatology 1990 Criteria for the Classification of Fibromyalgia. Report of the Multicenter Criteria Committee. Arthritis Rheum 33:160–172

    Article  PubMed  CAS  Google Scholar 

  2. Wolfe F, Anderson J, Harkness D, Bennett RM, Caro XJ, Goldenberg DL, Russell IJ, Yunus MB (1997) A prospective, longitudinal, multicenter study of service utilization and costs in fibromyalgia. Arthritis Rheum 40:1560–1570

    Article  PubMed  CAS  Google Scholar 

  3. Carville SF, Arendt-Nielsen S, Bliddal H, Blotman F, Branco JC, Buskila D, Da Silva JA, Danneskiold-Samsoe B, Dincer F, Henriksson C, Henriksson KG, Kosek E, Longley K, McCarthy GM, Perrot S, Puszczewicz M, Sarzi-Puttini P, Silman A, Spath M, Choy EH (2008) EULAR evidence-based recommendations for the management of fibromyalgia syndrome. Ann Rheum Dis 67:536–541

    Article  PubMed  CAS  Google Scholar 

  4. Goldenberg DL, Burckhardt C, Crofford L (2004) Management of fibromyalgia syndrome. JAMA 292:2388–2395

    Article  PubMed  CAS  Google Scholar 

  5. Paiva ES, Jones KD (2010) Rational treatment of fibromyalgia for a solo practitioner. Best Pract Res Clin Rheumatol 24:341–352

    Article  PubMed  Google Scholar 

  6. Jones KD, Liptan GL (2009) Exercise interventions in fibromyalgia: clinical applications from the evidence. Rheum Dis Clin North Am 35:373–391

    Article  PubMed  Google Scholar 

  7. Hauser W, Klose P, Langhorst J, Moradi B, Steinbach M, Schiltenwolf M, Busch A (2010) Efficacy of different types of aerobic exercise in fibromyalgia syndrome: a systematic review and meta-analysis of randomised controlled trials. Arthritis Res Ther 12:R79

    Article  PubMed  Google Scholar 

  8. Carson JW, Carson KM, Jones KD, Bennett RM, Wright CL, Mist SD (2010) A pilot randomized controlled trial of the Yoga of Awareness program in the management of fibromyalgia. Pain 151:530–539

    Article  PubMed  Google Scholar 

  9. Wang C, Schmid CH, Hibberd PL, Kalish R, Roubenoff R, Rones R, Okparavero A, McAlindon T (2008) Tai Chi for treating knee osteoarthritis: designing a long-term follow up randomized controlled trial. BMC Musculoskelet Disord 9:108

    Article  PubMed  Google Scholar 

  10. Li F, Harmer P, Fisher KJ, McAuley E, Chaumeton N, Eckstrom E, Wilson NL (2005) Tai Chi and fall reductions in older adults: a randomized controlled trial. J Gerontol A Biol Sci Med Sci 60:187–194

    Article  PubMed  Google Scholar 

  11. Wang C, Roubenoff R, Lau J, Kalish R, Schmid CH, Tighiouart H, Rones R, Hibberd PL (2005) Effect of Tai Chi in adults with rheumatoid arthritis. Rheumatology (Oxford) 44:685–687

    Article  CAS  Google Scholar 

  12. Wang C, Schmid CH, Hibberd PL, Kalish R, Roubenoff R, Rones R, McAlindon T (2009) Tai Chi is effective in treating knee osteoarthritis: a randomized controlled trial. Arthritis Rheum 61:1545–1553

    Article  PubMed  Google Scholar 

  13. Taggart HM, Arslanian CL, Bae S, Singh K (2003) Effects of T'ai Chi exercise on fibromyalgia symptoms and health-related quality of life. Orthop Nurs 22:353–360

    Article  PubMed  Google Scholar 

  14. Carbonell-Baeza A, Romero A, Aparicio VA, Ortega FB, Tercedor P, Delgado-Fernandez M, Ruiz JR (2011) Preliminary findings of a 4-month Tai Chi intervention on tenderness, functional capacity, symptomatology, and quality of life in men with fibromyalgia. Am J Mens Health 5:421–429

    Article  PubMed  Google Scholar 

  15. Wang C, Schmid CH, Rones R, Kalish R, Yinh J, Goldenberg DL, Lee Y, McAlindon T (2010) A randomized trial of tai chi for fibromyalgia. N Engl J Med 363:743–754

    Article  PubMed  CAS  Google Scholar 

  16. Jones CJ, Rutledge DN, Aquino J (2010) Predictors of physical performance and functional ability in people 50+ with and without fibromyalgia. J Aging Phys Act 18:353–368

    PubMed  Google Scholar 

  17. Jones KD, Horak FB, Winters-Stone K, Irvine JM, Bennett RM (2009) Fibromyalgia is associated with impaired balance and falls. J Clin Rheumatol 15:16–21

    Article  PubMed  Google Scholar 

  18. Rutledge DN, Cherry BJ, Rose DJ, Rakovski C, Jones CJ (2010) Do fall predictors in middle aged and older adults predict fall status in persons 50+ with fibromyalgia? An exploratory study. Res Nurs Health 33:192–206

    PubMed  Google Scholar 

  19. Jones KD, Reiner AC (2010) A multistep recruitment strategy to a participant-intensive clinical trial. Appl Nurs Res 23:227–232

    Article  PubMed  Google Scholar 

  20. Bennett R (2005) The Fibromyalgia Impact Questionnaire (FIQ): a review of its development, current version, operating characteristics and uses. Clin Exp Rheumatol 23:S154–S162

    PubMed  CAS  Google Scholar 

  21. Bennett RM, Bushmakin AG, Cappelleri JC, Zlateva G, Sadosky AB (2009) Minimal clinically important difference in the fibromyalgia impact questionnaire. J Rheumatol 36:1304–1311

    Article  PubMed  Google Scholar 

  22. Mannerkorpi K, Nordeman L, Cider A, Jonsson G (2010) Does moderate-to-high intensity Nordic walking improve functional capacity and pain in fibromyalgia? A prospective randomized controlled trial. Arthritis Res Ther 12:R189

    Article  PubMed  Google Scholar 

  23. Bennett RM, Kamin M, Karim R, Rosenthal N (2003) Tramadol and acetaminophen combination tablets in the treatment of fibromyalgia pain: a double-blind, randomized, placebo-controlled study. Am J Med 114:537–545

    Article  PubMed  CAS  Google Scholar 

  24. Jones KD, Adams D, Winters-Stone K, Burckhardt CS (2006) A comprehensive review of 46 exercise treatment studies in fibromyalgia (1988–2005). Health Qual Life Outcomes 4:67

    Article  PubMed  Google Scholar 

  25. Dworkin RH, Turk DC, Wyrwich KW, Beaton D, Cleeland CS, Farrar JT, Haythornthwaite JA, Jensen MP, Kerns RD, Ader DN, Brandenburg N, Burke LB, Cella D, Chandler J, Cowan P, Dimitrova R, Dionne R, Hertz S, Jadad AR, Katz NP, Kehlet H, Kramer LD, Manning DC, McCormick C, McDermott MP, McQuay HJ, Patel S, Porter L, Quessy S, Rappaport BA, Rauschkolb C, Revicki DA, Rothman M, Schmader KE, Stacey BR, Stauffer JW, von Stein T, White RE, Witter J, Zavisic S (2008) Interpreting the clinical importance of treatment outcomes in chronic pain clinical trials: IMMPACT recommendations. J Pain 9:105–121

    Article  PubMed  Google Scholar 

  26. Cleeland CS, Ryan KM (1994) Pain assessment: global use of the Brief Pain Inventory. Ann Acad Med Singapore 23:129–138

    PubMed  CAS  Google Scholar 

  27. Ang D, Kesavalu R, Lydon JR, Lane KA, Bigatti S (2007) Exercise-based motivational interviewing for female patients with fibromyalgia: a case series. Clin Rheumatol 26:1843–1849

    Article  PubMed  Google Scholar 

  28. Mease PJ, Spaeth M, Clauw DJ, Arnold LM, Bradley LA, Jon R, I, Kajdasz DK, Walker DJ, Chappell AS (2011) Estimation of minimum clinically important difference for pain in fibromyalgia. Arthritis Care Res (Hoboken) 63:821–826

  29. Jones KD, Burckhardt CS, Clark SR, Bennett RM, Potempa KM (2002) A randomized controlled trial of muscle strengthening versus flexibility training in fibromyalgia. J Rheumatol 29:1041–1048

    PubMed  Google Scholar 

  30. Lorig K, Chastain RL, Ung E (1989) Development and evaluation of a scale to measure perceived self-efficacy in people with arthritis. Arthritis Rheum 32:37–44

    Article  PubMed  CAS  Google Scholar 

  31. Podsiadlo D, Richardson S (1991) The timed “Up & Go”: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc 39:142–148

    PubMed  CAS  Google Scholar 

  32. Wu G, Keyes L, Callas P, Ren X, Bookchin B (2010) Comparison of telecommunication, community, and home-based Tai Chi exercise programs on compliance and effectiveness in elders at risk for falls. Arch Phys Med Rehabil 91:849–856

    Article  PubMed  Google Scholar 

  33. Jones KD, King LA, Mist SD, Bennett RM, Horak FB (2011) Postural control deficits in people with fibromyalgia: a pilot study. Arthritis Res Ther 13:R127

    Article  PubMed  Google Scholar 

  34. ACSM’s guidelines for exercise testing and prescription 8th ed. Media, PA, Lippincott, Williams & Wilkins, 2009

  35. Tomas-Carus P, Gusi N, Hakkinen A, Hakkinen K, Raimundo A, Ortega-Alonso A (2009) Improvements of muscle strength predicted benefits in HRQOL and postural balance in women with fibromyalgia: an 8-month randomized controlled trial. Rheumatol (Oxford) 48:1147–1151

    Article  Google Scholar 

  36. Mannerkorpi K, Burckhardt CS, Bjelle A (1994) Physical performance characteristics of women with fibromyalgia. Arthritis Care Res 7:123–129

    Article  PubMed  CAS  Google Scholar 

  37. Jones KD, Burckhardt CS, Deodhar AA, Perrin NA, Hanson GC, Bennett RM (2008) A six-month randomized controlled trial of exercise and pyridostigmine in the treatment of fibromyalgia. Arthritis Rheum 58:612–622

    Article  PubMed  CAS  Google Scholar 

  38. Aickin M (2009) Dealing with change: using the conditional change model for clinical research. Perm J 13:80–84

    PubMed  Google Scholar 

  39. Holm S (1979) A simple sequentially rejective multiple test procedure. Scand J Stat 6:65–70

    Google Scholar 

  40. Fisher KJ, Li F, Shirai ME (2004) Ezy Tai Chi: a simpler practice for seniors. J Active Aging 3:18–26

    Google Scholar 

  41. Li F, Harmer P, Fitzgerald K, Eckstrom E, Stock R, Galver J, Maddalozzo G, Batya SS (2012) Tai chi and postural stability in patients with Parkinson's disease. N Engl J Med 366:511–519

    Article  PubMed  CAS  Google Scholar 

  42. Brosseau L, Wells GA, Tugwell P, Egan M, Wilson KG, Dubouloz CJ, Casimiro L, Robinson VA, McGowan J, Busch A, Poitras S, Moldofsky H, Harth M, Finestone HM, Nielson W, Haines-Wangda A, Russell-Doreleyers M, Lambert K, Marshall AD, Veilleux L (2008) Ottawa Panel evidence-based clinical practice guidelines for strengthening exercises in the management of fibromyalgia: part 2. Phys Ther 88:873–886

    Article  PubMed  Google Scholar 

  43. Brosseau L, Wells GA, Tugwell P, Egan M, Wilson KG, Dubouloz CJ, Casimiro L, Robinson VA, McGowan J, Busch A, Poitras S, Moldofsky H, Harth M, Finestone HM, Nielson W, Haines-Wangda A, Russell-Doreleyers M, Lambert K, Marshall AD, Veilleux L (2008) Ottawa Panel evidence-based clinical practice guidelines for aerobic fitness exercises in the management of fibromyalgia: part 1. Phys Ther 88:857–871

    Article  PubMed  Google Scholar 

  44. Busch AJ, Barber KA, Overend TJ, Peloso PM, Schachter CL (2007) Exercise for treating fibromyalgia syndrome. Cochrane Database Syst Rev:CD003786

  45. Jones KD, Liptan GL (2009) Exercise interventions in fibromyalgia: clinical applications from the evidence. Rheum Dis Clin N Am 35:373–391

    Article  Google Scholar 

  46. Busch AJ, Webber SC, Brachaniec M, Bidonde J, Bello-Haas VD, Danyliw AD, Overend TJ, Richards RS, Sawant A, Schachter CL (2011) Exercise therapy for fibromyalgia. Curr Pain Headache Rep 15:358–367

    Article  PubMed  Google Scholar 

  47. Kelley GA, Kelley KS, Hootman JM, Jones DL (2010) Exercise and global well-being in community-dwelling adults with fibromyalgia: a systematic review with meta-analysis. BMC Publ Health 10:198

    Article  Google Scholar 

  48. Cazzola M, Atzeni F, Salaffi F, Stisi S, Cassisi G, Sarzi-Puttini P (2010) Which kind of exercise is best in fibromyalgia therapeutic programmes? A practical review. Clin Exp Rheumatol 28:S117–S124

    PubMed  CAS  Google Scholar 

  49. Meyer BB, Lemley KJ (2000) Utilizing exercise to affect the symptomology of fibromyalgia: a pilot study. Med Sci Sports Exerc 32:1691–1697

    Article  PubMed  CAS  Google Scholar 

  50. Norregaard J, Lykkegaard JJ, Mehlsen J, Danneskiold-Samsoe B (2011) Exercise training in treatment of fibromyalgia. Journal of Musculoskelet Pain 5:71–79

    Article  Google Scholar 

  51. Ang DC, Kaleth AS, Bigatti S, Mazzuca S, Saha C, Hilligoss J, Lengerich M, Bandy R (2011) Research to Encourage Exercise for Fibromyalgia (REEF): use of motivational interviewing design and method. Contemp Clin Trials 32:59–68

    Article  PubMed  Google Scholar 

  52. Fontaine KR, Conn L, Clauw DJ (2011) Effects of lifestyle physical activity in adults with fibromyalgia: results at follow-up. J Clin Rheumatol 17:64–68

    PubMed  Google Scholar 

  53. Clark SR (1994) Prescribing exercise for fibromyalgia patients. Arthritis Care Res 7:221–225

    Article  PubMed  CAS  Google Scholar 

  54. Jones KD, Clark SR, Bennett RM (2002) Prescribing exercise for people with fibromyalgia. AACN Clin Issues 13:277–293

    Article  PubMed  Google Scholar 

  55. Jones KD, Hoffman JH (2006) Exercise and chronic pain: opening the therapueutic window. Functional Fitness: An ICCA Publication 4:1–9

    Google Scholar 

  56. Williams DA, Clauw DJ (2009) Understanding fibromyalgia: lessons from the broader pain research community. J Pain 10:777–791

    PubMed  Google Scholar 

  57. Kerr CE, Shaw JR, Wasserman RH, Chen VW, Kanojia A, Bayer T, Kelley JM (2008) Tactile acuity in experienced Tai Chi practitioners: evidence for use dependent plasticity as an effect of sensory-attentional training. Exp Brain Res 188:317–322

    Article  PubMed  Google Scholar 

  58. da Silva GD, Lorenzi-Filho G, Lage LV (2007) Effects of yoga and the addition of Tui Na in patients with fibromyalgia. J Altern Complement Med 13:1107–1113

    Article  PubMed  Google Scholar 

  59. Zautra AJ, Fasman R, Davis MC, Craig AD (2010) The effects of slow breathing on affective responses to pain stimuli: an experimental study. Pain 149:12–18

    Article  PubMed  Google Scholar 

  60. Horak FB (2006) Postural orientation and equilibrium: what do we need to know about neural control of balance to prevent falls? Age Ageing 35(Suppl 2):ii7–ii11

    Article  PubMed  Google Scholar 

  61. Russek LN, Fulk GD (2009) Pilot study assessing balance in women with fibromyalgia syndrome. Physiother Theory Pract 25:555–565

    Article  PubMed  Google Scholar 

  62. Tsang WW, Hui-Chan CW (2004) Effect of 4- and 8-wk intensive Tai Chi Training on balance control in the elderly. Med Sci Sports Exerc 36:648–657

    Article  PubMed  Google Scholar 

  63. Cherry BJ, Weiss J, Barakat BK, Rutledge DN, Jones CJ (2009) Physical performance as a predictor of attention and processing speed in fibromyalgia. Arch Phys Med Rehabil 90:2066–2073

    Article  PubMed  Google Scholar 

  64. Dworkin RH, Turk DC, Peirce-Sandner S, Baron R, Bellamy N, Burke LB, Chappell A, Chartier K, Cleeland CS, Costello A, Cowan P, Dimitrova R, Ellenberg S, Farrar JT, French JA, Gilron I, Hertz S, Jadad AR, Jay GW, Kalliomaki J, Katz NP, Kerns RD, Manning DC, McDermott MP, McGrath PJ, Narayana A, Porter L, Quessy S, Rappaport BA, Rauschkolb C, Reeve BB, Rhodes T, Sampaio C, Simpson DM, Stauffer JW, Stucki G, Tobias J, White RE, Witter J (2010) Research design considerations for confirmatory chronic pain clinical trials: IMMPACT recommendations. Pain 149:177–193

    Article  PubMed  Google Scholar 

  65. Fregni F, Imamura M, Chien HF, Lew HL, Boggio P, Kaptchuk TJ, Riberto M, Hsing WT, Battistella LR, Furlan A (2010) Challenges and recommendations for placebo controls in randomized trials in physical and rehabilitation medicine: a report of the international placebo symposium working group. Am J Phys Med Rehabil 89:160–172

    Article  PubMed  Google Scholar 

  66. Yeh GY, Kaptchuk TJ, Shmerling RH (2010) Prescribing tai chi for fibromyalgia–are we there yet? N Engl J Med 363:783–784

    Article  PubMed  CAS  Google Scholar 

  67. So DW (2002) Acupuncture outcomes, expectations, patient-provider relationship, and the placebo effect: implications for health promotion. Am J Public Health 92:1662–1667

    Article  PubMed  Google Scholar 

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Acknowledgments

Primary Funding Source: National Institutes of Health/NIAMS 5R21 AR053506 NIH/NCCAM1K23AT006392-01. We extend our heartfelt acknowledgment to Dr. John Fisher who was unable to see his study through to fruition. Thanks also to Cheryl Weimer, Lisa Marion, Debbie Blanchard, Damini Branen, Lindsay Kindler, and Cheryl Wright for their assistance with intervention implementation and/or data collection.

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Authors and Affiliations

  1. Fibromyalgia Research Unit, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd., Mail Code: SN-ORD, Portland, OR, 97239-3011, USA

    Kim D. Jones, Scott D. Mist, James W. Carson & Robert M. Bennett

  2. Oregon Research Institute, 1715 Franklin Blvd, Eugene, OR, 97403, USA

    Christy A. Sherman & Fuzhong Li

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  1. Kim D. Jones
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  2. Christy A. Sherman
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Correspondence to Kim D. Jones.

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Jones, K.D., Sherman, C.A., Mist, S.D. et al. A randomized controlled trial of 8-form Tai chi improves symptoms and functional mobility in fibromyalgia patients. Clin Rheumatol 31, 1205–1214 (2012). https://doi.org/10.1007/s10067-012-1996-2

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