Saturday, August 6, 2011

Tai Chi and Fibromyalgia

There was a study published recently in the New England Journal of Medicine showing that tai chi improves the symptoms of fibromyalgia. There is something that we need to keep in mind when reading medical studies. The word "significant" is used to mean that there is a measurable difference between the test group and the control group. However, this word does not mean that the difference is enough to make a difference in the patient's lives. The word "important" means that there is difference that matters to the patients.

For this study, a total of 66 patients with fibromyalgia were divided into two groups. Half the patients (33) were controls and were given wellness education and stretching for the treatment of fibromyalgia. The other half of the patients (33) were placed in a class where they learned classic yang-style tai chi. Both groups met for an hour twice a week.

The primary measured effect was a change in the Fibromyalgia Impact Questionnaire (FIQ) score. According to the authors, the tai chi group had "clinically important improvements in the FIQ total score and quality of life."

This is really important. Fibromyalgia is very difficult to treat and many patients do not feel that get any benefit from Western medicine. Tai chi can really change lives for people with fibromyalgia.

Below is the citation and abstract of the article. (I added some paragraph breaks to make it easier to read.)

Wang, C., C. H. Schmid, et al. "A randomized trial of tai chi for fibromyalgia." N Engl J Med 363(8): 743-54.

BACKGROUND: Previous research has suggested that tai chi offers a therapeutic benefit in patients with fibromyalgia. METHODS: We conducted a single-blind, randomized trial of classic Yang-style tai chi as compared with a control intervention consisting of wellness education and stretching for the treatment of fibromyalgia (defined by American College of Rheumatology 1990 criteria). Sessions lasted 60 minutes each and took place twice a week for 12 weeks for each of the study groups.

The primary end point was a change in the Fibromyalgia Impact Questionnaire (FIQ) score (ranging from 0 to 100, with higher scores indicating more severe symptoms) at the end of 12 weeks. Secondary end points included summary scores on the physical and mental components of the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). All assessments were repeated at 24 weeks to test the durability of the response.

RESULTS: Of the 66 randomly assigned patients, the 33 in the tai chi group had clinically important improvements in the FIQ total score and quality of life. Mean (+/-SD) baseline and 12-week FIQ scores for the tai chi group were 62.9+/-15.5 and 35.1+/-18.8, respectively, versus 68.0+/-11 and 58.6+/-17.6, respectively, for the control group (change from baseline in the tai chi group vs. change from baseline in the control group, -18.4 points; P<0 .001=".001" p="p">
The corresponding SF-36 physical-component scores were 28.5+/-8.4 and 37.0+/-10.5 for the tai chi group versus 28.0+/-7.8 and 29.4+/-7.4 for the control group (between-group difference, 7.1 points; P=0.001), and the mental-component scores were 42.6+/-12.2 and 50.3+/-10.2 for the tai chi group versus 37.8+/-10.5 and 39.4+/-11.9 for the control group (between-group difference, 6.1 points; P=0.03). Improvements were maintained at 24 weeks (between-group difference in the FIQ score, -18.3 points; P<0 .001=".001" br="br"> 
CONCLUSIONS: Tai chi may be a useful treatment for fibromyalgia and merits long-term study in larger study populations. (Funded by the National Center for Complementary and Alternative Medicine and others; ClinicalTrials.gov number, NCT00515008.)

© 2011 Eric Borreson