פיברומיאלגיה עם טאי צ'י Fibromyalgia

קישור ישיר למאמר N Engl J Med 2010; 363:743-754

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). 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). No adverse events were observed.

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. opens in new tab.)

Fibromyalgia is a common and complex clinical syndrome characterized by chronic and widespread musculoskeletal pain, fatigue, sleep disturbance, and physical and psychological impairment.1,2 Evidence-based guidelines suggest that fibromyalgia is typically managed with multidisciplinary therapies involving medication, cognitive behavioral therapy, education, and exercise.3-5

Although exercise is beneficial for fibromyalgia and has been advocated as a core component of its treatment,6-8 most patients continue to be in considerable pain years after the original diagnosis and require medication to control symptoms; they also remain aerobically unfit, with poor muscle strength and limited flexibility.9 New approaches are needed to reduce musculoskeletal pain in patients with fibromyalgia and to improve their physical and emotional functioning and quality of life.

Tai chi is a mind–body practice that originated in China as a martial art. It combines meditation with slow, gentle, graceful movements, as well as deep breathing and relaxation, to move vital energy (or qi) throughout the body. It is considered a complex, multicomponent intervention that integrates physical, psychosocial, emotional, spiritual, and behavioral elements.10 Because of its mind–body attributes, tai chi could be especially well suited to the treatment of fibromyalgia. In fact, tai chi is practiced preferentially in the United States by persons with musculoskeletal and mental health conditions.11,12 A small, nonrandomized study showed that tai chi reduced symptoms and improved quality of life in patients with fibromyalgia,13 and it has also been shown to have potential therapeutic benefits in patients with other chronic rheumatic conditions, such as rheumatoid arthritis and osteoarthritis.14,15

We conducted a single-blind, randomized, controlled trial to compare the physical and psychological benefits of tai chi with those of a control intervention that consisted of wellness education and stretching. We hypothesized that at the end of the 12-week intervention period, patients in the tai chi group would have a greater reduction in musculoskeletal pain and greater improvements in sleep quality, physical and psychological function, and health-related quality-of-life scores than those in the control group.

כתיבת תגובה

אתר זה עושה שימוש באקיזמט למניעת הודעות זבל. לחצו כאן כדי ללמוד איך נתוני התגובה שלכם מעובדים.

Call Now Button