June 25, 2018 - A random clinical trial by Tufts Medical Center in Boston directly compared the effectiveness of long-term Tai Chi with aerobic exercise on symptoms and function of patients with fibromyalgia (FM). Their findings are published in the June, 2018 issue of Annals of internal medicine.
This trial involved 226 adults (older than 21 with mean age 52 year) who had FM with a Widespread Pain Index >= 7 plus a Symptom Severity Scale score >= 5 or a Widespread Pain Index of 3 to 6 plus a Symptom Severity Scale score >= 9.
Tai chi was implemented in 2 doses for 2 different durations, an important advantage over previous studies. Of the 226 participants, 151 did the 60-minute sessions of Yang-style tai chi while the other 75 did the aerobic exercise. Tai chi was provided once weekly for 12 weeks or 24 weeks, or twice weekly for 12 weeks or 24 weeks. The individually tailored aerobic exercise program was provided twice weekly for 24 weeks and comprised active warm-up, choreographed aerobic training, and cool-down. Patients in both groups were encouraged to practice their interventions for more than 30 minutes per day for 52 weeks.
The trial found that in patients with FM, high-intensity and frequent Tai Chi reduced symptom severity at 24 weeks compared with aerobic exercise.
The high demands of the interventions (30 minutes per day plus a weekly 60-min session) raise doubts about the translational value of this study to clinic settings. Such amounts of daily tai chi or exercise may be unrealistic goals for most patients with FM. Curiously, the trial reported the intervention effects on symptom aggregate outcome measures but not specifically on pain intensity, one of the most important FM symptoms.
Further studies are needed to explore the mechanisms responsible for the observed improvements in study outcomes. Changes in central pain sensitivity may be the important mediators of effective FM therapies, such as tai chi and exercise.