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Effect of tai chi versus aerobic exercise for fibromyalgia: comparative effectiveness randomized controlled trial.

Abstract To determine the effectiveness of tai chi interventions compared with aerobic exercise, a current core standard treatment in patients with fibromyalgia, and to test whether the effectiveness of tai chi depends on its dosage or duration.
PMID
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Authors

Mayor MeshTerms

Exercise

Tai Ji

Keywords
Journal Title bmj (clinical research ed.)
Publication Year Start




PMID- 29563100
OWN - NLM
STAT- MEDLINE
DCOM- 20180405
LR  - 20180405
IS  - 1756-1833 (Electronic)
IS  - 0959-535X (Linking)
VI  - 360
DP  - 2018 Mar 21
TI  - Effect of tai chi versus aerobic exercise for fibromyalgia: comparative
      effectiveness randomized controlled trial.
PG  - k851
LID - 10.1136/bmj.k851 [doi]
AB  - OBJECTIVES: To determine the effectiveness of tai chi interventions compared with
      aerobic exercise, a current core standard treatment in patients with
      fibromyalgia, and to test whether the effectiveness of tai chi depends on its
      dosage or duration. DESIGN: Prospective, randomized, 52 week, single blind
      comparative effectiveness trial. SETTING: Urban tertiary care academic hospital
      in the United States between March 2012 and September 2016. PARTICIPANTS: 226
      adults with fibromyalgia (as defined by the American College of Rheumatology 1990
      and 2010 criteria) were included in the intention to treat analyses: 151 were
      assigned to one of four tai chi groups and 75 to an aerobic exercise group.
      INTERVENTIONS: Participants were randomly assigned to either supervised aerobic
      exercise (24 weeks, twice weekly) or one of four classic Yang style supervised
      tai chi interventions (12 or 24 weeks, once or twice weekly). Participants were
      followed for 52 weeks. Adherence was rigorously encouraged in person and by
      telephone. MAIN OUTCOME MEASURES: The primary outcome was change in the revised
      fibromyalgia impact questionnaire (FIQR) scores at 24 weeks compared with
      baseline. Secondary outcomes included changes of scores in patient's global
      assessment, anxiety, depression, self efficacy, coping strategies, physical
      functional performance, functional limitation, sleep, and health related quality 
      of life. RESULTS: FIQR scores improved in all five treatment groups, but the
      combined tai chi groups improved statistically significantly more than the
      aerobic exercise group in FIQR scores at 24 weeks (difference between groups=5.5 
      points, 95% confidence interval 0.6 to 10.4, P=0.03) and several secondary
      outcomes (patient's global assessment=0.9 points, 0.3 to 1.4, P=0.005;
      anxiety=1.2 points, 0.3 to 2.1, P=0.006; self efficacy=1.0 points, 0.5 to 1.6,
      P=0.0004; and coping strategies, 2.6 points, 0.8 to 4.3, P=0.005). Tai chi
      treatment compared with aerobic exercise administered with the same intensity and
      duration (24 weeks, twice weekly) had greater benefit (between group difference
      in FIQR scores=16.2 points, 8.7 to 23.6, P<0.001). The groups who received tai
      chi for 24 weeks showed greater improvements than those who received it for 12
      weeks (difference in FIQR scores=9.6 points, 2.6 to 16.6, P=0.007). There was no 
      significant increase in benefit for groups who received tai chi twice weekly
      compared with once weekly. Participants attended the tai chi training sessions
      more often than participants attended aerobic exercise. The effects of tai chi
      were consistent across all instructors. No serious adverse events related to the 
      interventions were reported. CONCLUSION: 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. Longer duration of tai chi showed greater
      improvement. This mind-body approach may be considered a therapeutic option in
      the multidisciplinary management of fibromyalgia. TRIAL REGISTRATION:
      ClinicalTrials.gov NCT01420640.
CI  - Published by the BMJ Publishing Group Limited. For permission to use (where not
      already granted under a licence) please go to
      http://group.bmj.com/group/rights-licensing/permissions.
FAU - Wang, Chenchen
AU  - Wang C
AD  - Center for Complementary and Integrative Medicine and Division of Rheumatology,
      Tufts Medical Center, Tufts University School of Medicine, Boston, MA 02111, USA 
      [email protected]
FAU - Schmid, Christopher H
AU  - Schmid CH
AD  - Department of Biostatistics and Center for Evidence Synthesis in Health, Brown
      University School of Public Health, Providence, RI, USA.
FAU - Fielding, Roger A
AU  - Fielding RA
AD  - Nutrition, Exercise Physiology and Sarcopenia Laboratory, Jean Mayer USDA Human
      Nutrition Research Center on Aging, Tufts University, Tufts University School of 
      Medicine, Boston, USA.
FAU - Harvey, William F
AU  - Harvey WF
AD  - Center for Complementary and Integrative Medicine and Division of Rheumatology,
      Tufts Medical Center, Tufts University School of Medicine, Boston, MA 02111, USA.
FAU - Reid, Kieran F
AU  - Reid KF
AD  - Nutrition, Exercise Physiology and Sarcopenia Laboratory, Jean Mayer USDA Human
      Nutrition Research Center on Aging, Tufts University, Tufts University School of 
      Medicine, Boston, USA.
FAU - Price, Lori Lyn
AU  - Price LL
AD  - The Institute for Clinical Research and Health Policy Studies, Tufts Medical
      Center, Tufts Clinical and Translational Science Institute, Tufts University,
      Boston, MA, USA.
FAU - Driban, Jeffrey B
AU  - Driban JB
AD  - Center for Complementary and Integrative Medicine and Division of Rheumatology,
      Tufts Medical Center, Tufts University School of Medicine, Boston, MA 02111, USA.
FAU - Kalish, Robert
AU  - Kalish R
AD  - Division of Rheumatology, Tufts Medical Center, Tufts University School of
      Medicine, Boston, MA, USA.
FAU - Rones, Ramel
AU  - Rones R
AD  - Center for Mind-Body Therapies, Boston, MA, USA.
FAU - McAlindon, Timothy
AU  - McAlindon T
AD  - Center for Complementary and Integrative Medicine and Division of Rheumatology,
      Tufts Medical Center, Tufts University School of Medicine, Boston, MA 02111, USA.
LA  - eng
SI  - ClinicalTrials.gov/NCT01420640
GR  - R01 AT006367/AT/NCCIH NIH HHS/United States
GR  - K24 AT007323/AT/NCCIH NIH HHS/United States
GR  - UL1 RR025752/RR/NCRR NIH HHS/United States
GR  - UL1 TR000073/TR/NCATS NIH HHS/United States
GR  - UL1 TR001064/TR/NCATS NIH HHS/United States
GR  - P30 AG031679/AG/NIA NIH HHS/United States
PT  - Comparative Study
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, U.S. Gov't, Non-P.H.S.
DEP - 20180321
PL  - England
TA  - BMJ
JT  - BMJ (Clinical research ed.)
JID - 8900488
SB  - AIM
SB  - IM
MH  - Comparative Effectiveness Research
MH  - *Exercise
MH  - Female
MH  - Fibromyalgia/*therapy
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Pain Measurement
MH  - Prospective Studies
MH  - Single-Blind Method
MH  - *Tai Ji
MH  - Treatment Outcome
MH  - United States
PMC - PMC5861462
COIS- Competing interests: All authors have completed the ICMJE uniform disclosure form
      at www.icmje.org/coi_disclosure.pdf and declare: all authors had financial
      support from National Center for Complementary and Integrative Health at the
      National Institutes of Health in the US for the submitted work; no financial
      relationships with any organizations that might have an interest in the submitted
      work in the previous three years; no other relationships or activities that could
      appear to have influenced the submitted work.
EDAT- 2018/03/23 06:00
MHDA- 2018/04/06 06:00
CRDT- 2018/03/23 06:00
PHST- 2018/03/23 06:00 [entrez]
PHST- 2018/03/23 06:00 [pubmed]
PHST- 2018/04/06 06:00 [medline]
PST - epublish
SO  - BMJ. 2018 Mar 21;360:k851.