Tai Chi Equals or Betters Aerobic Exercise in Fibromyalgia

from Physician's First Watch

By Joe Elia
Edited by
- Susan Sadoughi, MD, and
- Richard Saitz, MD, MPH, FACP, DFASAM

Fibromyalgia responds to tai chi as well as - or better than - it does to commonly prescribed aerobic exercises, The BMJ reports.

Researchers randomized 226 patients to one of four tai chi regimens or to aerobic exercise. Tai chi entailed once or twice weekly supervised sessions, for 12 or 24 weeks; aerobic exercise included twice weekly supervised sessions for 24 weeks. Participants were also advised to perform tai chi or aerobic exercise on their own for 30 minutes daily.

At 24 weeks, the change in fibromyalgia severity score was significantly greater in the four tai chi groups combined than in the aerobic exercise group, but the difference was not clinically meaningful. However, when the more-intense tai chi group (twice weekly for 24 weeks) was compared with aerobic exercise, a substantial clinical benefit was seen.

Link(s):
The BMJ article (Free) http://response.jwatch.org/t?ctl=3030A:5FF9B588B7CB016CE85FD7AA7BA7A434D2B71D9A95FA21D3&

The BMJ comment #1 (Free) http://response.jwatch.org/t?ctl=3030B:5FF9B588B7CB016CE85FD7AA7BA7A434D2B71D9A95FA21D3&

The BMJ comment #2 (written by study's first author) (Free) http://response.jwatch.org/t?ctl=3030C:5FF9B588B7CB016CE85FD7AA7BA7A434D2B71D9A95FA21D3&

Background: NEJM Journal Watch Neurology coverage of a 2010 study from the same group (Your NEJM Journal Watch registration required) http://response.jwatch.org/t?ctl=3030D:5FF9B588B7CB016CE85FD7AA7BA7A434D2B71D9A95FA21D3&

 

I love Tai Chi and try to do it a minute at a time ( when possible). I can imagine it would be better as it helps your flexibility and strength...and you can do it at your own speed, so more possible to do on a bad day.

 

Yet more proof that although FM may be a common co-morbid condition in ME patients, they are not the same illness.

During the first year after my ME diagnosis, it was suggested Tai Chi would be a good low-intensity exercise for me (previously an extreme athlete). I signed up for a beginners' course twice weekly at our local Tai Chi organization. I thoroughly enjoyed it, and did pretty well for the first few weeks. The only observable side effect was that after every session, it was as if a blank white sheet was drawn down over my face, and I became pretty much "absent". This was actually commented on by my husband, and other participants.

The longer I attended, the more difficult it became -- both physically, and from a cognitive perspective. Initially, I was able to learn and remember a short sequence of moves at the beginning of the set. But as I continued, I couldn't even remember one small component of each move, despite the instructor demonstrating over and over again. And, I completely lost my coordination and started breaking into a sweat with minimal movement.

I tried Tai Chi three other times during the 30-year course of my illness -- each time with the same disappointing result. At one point, I even contemplated becoming an instructor for a "seated" set designed for those with illnesses and disabilities. Even this was too much for me. My ability was abysmal compared with the other participants, most of whom had MS, Parkinson's or chronic pain for various reasons.

 

I tried Tai Chi but I couldn't manage it cognitively or physically. This was a class for elderly people at risk of falling!

Epic fail for me.

 

Another example of my lucky escape when I was going to go to Tai Chi lessons but couldn't arrange the transport. That was at the beginning of my illness.

 

Is more intense tai-chi even slower?
And was the trial done by Tai-Chi therapists? (in red cardigans)

 

Answer to your first question- yes. Definitely.

EDIT: based on 10 years of weekly tai chi classes. Stopped about 2 years into ME. Unable to continue.

 

I did a tai chi course weekly for about 9 years before I had ME. I really loved it. We followed a Master Lam's form and learned a miniform, short form and then the movements of the first 3 parts of a long form. During the summer we practiced in Richmond Park amongst the trees.

Each class started with a warm up, automatically rotating the knees each way while bending. Sometimes the tutor would tell us Chinese tales. Other physical massage elements would follow. Tapping on head, back etc. Many of these involved standing.

Then would come learning and practicing of the form, a series of movements following a pattern. It was a challenge physically and mentally. Not sure that it was meant to be a challenge. Maybe that is a Western concept.

I very much enjoyed it until I had a hip replacement which affected balance, and then a year later, ME struck hard. I then couldn't do the class warm up: standing was impossible so I had to go and sit down. Rotating through the 'form' became harder, more unbalanced.

Eventually I stopped. I would recommend tai chi to the fit or not orthostatically challenged unfit. Memory helps because remembering the form takes effort. I really enjoyed it but couldn't continue.

Really keen members of the class would do chi gong, to my uninformed eye, seemed to mean not moving, staying in postures. The bit I tried was hard.

We sometimes did the tai chi form at different speeds, fast or very slow. Very slow movements of the form, intense, was tough as @Jonathan Edwards said.

Wish I could do it again.

 

Okay.

Looks like this did include some objective outcomes, but they haven't published these yet (unless I missed them):

"Assessments of physical function included the chair stand, six minute walk, and balance tests.55565758 Participants’ muscle strength and power were also assessed using a leg press.59 Several secondary outcomes will be reported in separate publications."

 

I tried a 10 minute beginner's lesson a few years back. The next morning I couldn't even raise an arm to brush my teeth, it PM'd me quite badly. Now that my functional baseline is even lower than back then, I wouldn't dare attempt it again.

 

I successfully did a Tai Chi class early in my ME and really enjoyed it. I was not able to keep it up as I declined and no longer remember how. It was a thoroughly Western, physical form of Tai Chi. There was no spiritual/psychosocial/behavioral aspect. The movement was also equally to the right and left. Traditional Tai Chi moves to the right, as that was considered the 'good' direction by the ancient Chinese.

 

Interesting how another proponent of mind-body therapy only reports on mind assessments and relegates body assessments to a later date.