Chronic pain from rheumatic conditions is experienced by over 50 million Americans and interferes with quality of life, sleep, and progress, and increases utilization of health care resources. One of the most debilitating of rheumatic conditions is Fibromyalgia (FM), affecting over 20% of cases seen in rheumatology practices. As an alternative, exercise has become a routine treatment regimen to accompany pharmacological and non-pharmacological approaches to this painful health condition. Nevertheless, types of exercise modalities, their optimum amounts of intensity, frequency, and duration in reducing pain and related FM symptomatology remain to be determined. Tai Chi, a rhythmic form of low-to-moderate intensity exercise has been shown to increase physical function and mental well being, reduce anxiety, stress and depression and enhance other quality of life indicators, but its efficacy has not yet been scientifically evaluated in fibromyalgia patient populations. This application has the primary Aims of evaluating the impact of a new simplified form of Tai Chi on FM pain and quality of life indicators among adults 40 years and over, in a 16-week, single-blind randomized controlled trial. Secondary Aims will examine self-efficacy as a potential mechanism of the FM pain relationship, and explore the maintenance of intervention effects at a 3-month follow-up. One hundred and twenty participants aged 40 and over, diagnosed with fibromyalgia, will be randomly assigned to either a Tai Chi training condition (n = 60) or a usual care control condition (n = 60). The exercise condition will meet for one hour, twice a week for 16 weeks, whereas the control group will receive a directed usual care program, equivalent in time and attention. The primary endpoint measures will be FM pain and quality of life indicators including sleep quality, fatigue, anxiety and depression, to be assessed at baseline, the 4-month study termination, and at 3-months post-intervention. Secondary outcomes will explore potential mediating effects of self-efficacy and treatment expectations on outcomes, and sustainability of effects at the 3 months post intervention. The outcomes from this exploratory research will inform the efficacy of a new form of Tai Chi exercise in reducing FM pain, provide insight to possible mechanisms underpinning the exercise - pain relationship, and may lead to increased knowledge and understanding of how pain may be reduced by an accessible, low cost, low intensity exercise, that has growing public appeal. ? ? ?
| Jones, Kim D; Sherman, Christy A; Mist, Scott D et al. (2012) A randomized controlled trial of 8-form Tai chi improves symptoms and functional mobility in fibromyalgia patients. Clin Rheumatol 31:1205-14 |
