Background/Purpose:  Fibromyalgia is a complex disorder with strong psychological and pain components and is best managed with multidisciplinary therapies. Previous studies have suggested that Tai Chi is an integrated mind-body approach that enhances both physical and mental health and may be an effective treatment for fibromyalgia. It is unknown however whether Tai Chi is better than aerobic exercise, a common treatment for this population, and if so whether the effectiveness of Tai Chi depends on its duration and intensity.

Methods:  We conducted a 52-week, single-blind, randomized trial of Tai Chi vs. aerobic exercise for fibromyalgia (ACR 1990 and 2010 diagnostic criteria). Participants were randomized to 1 of 4 Tai Chi intervention groups: 12 or 24 weeks of Tai Chi once or twice per week, or an aerobic exercise intervention held twice per week for 24 weeks. The primary endpoint was change in the Revised Fibromyalgia Impact Questionnaire (FIQR) score at 24 weeks. Secondary endpoints included change in patient global assessments, the Hospital Anxiety and Depression scale (HADS), depression (Beck II), sleep quality (PSQI), arthritis self-efficacy scale (ASES-8), and 6-minute walk tests and health-related quality of life (SF-36 PCS and SF-36 MCS). The comparative efficacy of the five treatments was determined using longitudinal regression based on the intent-to-treat principal using evaluations made at 0, 12, 24 and 52 weeks. We report treatment contrasts at 24 weeks focusing on comparisons of: 1) Aerobic Exercise vs. average of four Tai Chi groups; 2) average of 12 week Tai Chi vs 24 week Tai Chi; and 3) average of once per week Tai Chi vs. twice per week Tai Chi.

Results: The mean age of subjects was 51.8y (SD 12.4), mean disease duration 8.8y (7.5), mean BMI 30.0 kg/m² (SD 6.7), 93% were female, and 61% were white. Treatment groups did not differ in baseline outcome expectation. All Tai Chi groups (averaged across the 4 groups), compared to aerobic exercise showed statistically significant improvements in FIQR (p=0.03), patient global assessment (p=0.005), anxiety and depression (p=0.006), and self-efficacy (p=0.0004). Significant improvements for most but not all outcomes favor 24 week vs. 12 weeks, compared to aerobic exercise (Table 1). Participants in Tai Chi groups had significantly higher class attendance than the Aerobic Exercise group (54-63% vs 35%), p<0.0001). No serious adverse events were observed.

Conclusion:  Tai Chi significantly reduced the symptom severity of fibromyalgia and was more effective than aerobic exercise for a variety of physical and mental health outcomes among a general population of individuals with fibromyalgia. The higher attendance rate in Tai Chi could also indicate that it is a preferable intervention in this patient population, though further study is warranted. Tai Chi should be considered as an important non-pharmacologic treatment option in patients with Fibromyalgia.  

*higher values indicate worse function, negative change value indicates improvement. ^higher values indicate better function, positive change value indicates improvement

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/tai-chi-is-more-effective-than-aerobic-exercise-in-treating-fibromyalgia-a-randomized-controlled-trial/