Les effets du Tai Chi Chuan sur la Fibromyalgie
ALTERNATIVE MEDICINES CORNER Nicole M. Maisch, Section Advisor
Tai chi decreases symptoms of fibromyalgia
Key point: The Chinese martial art of tai chi significantly decreased the symptoms of fibromyalgia and improved patients’ quality of life in a study recently published in the New England Journal of Medicine.
Finer points: A total of 66 patients diagnosed with fibromyalgia as defined by the American College of Rheumatology 1990 criteria participated in this single-center, single-blind, randomized trial from July 2007 through May 2009. Patients were randomized to either tai chi (n = 33) or control intervention (n = 33). Patients were allowed to continue seeing their primary care physicians and/or rheumatologists and to continue taking routine medications throughout the study.
Patients randomized to tai chi participated in interventions twice a week for 12 weeks in the form of 60-minute sessions. These classes were facilitated by a tai chi master who had more than 20 years of teaching experience. During the first session, the master explained the theory behind tai chi and provided the patients with written materials. In subsequent sessions, patients participated in 10 forms of classic Yang-style tai chi. Patients were encouraged to practice tai chi for at least 20 minutes each day in addition to the biweekly sessions. At the end of the 12 week period, patients were also encouraged to continue practicing tai chi at home daily until the 24-week follow-up visit.
Patients randomized to the control intervention also participated in 60-minute sessions held twice weekly for 12 weeks. During these sessions, patients were given didactic lesions on topics related to fibromyalgia, such as diagnostic criteria, coping strategies, problem-solving techniques, diet and nutrition, sleep disturbances, pain management, physical and mental health, exercise, and wellness and lifestyle management. For the last 20 minutes of each session, patients practiced stretching exercises supervised by the research staff. Patients were encouraged to continue the stretching exercises at home for 20 minutes each day.
The primary endpoint in the study was a change in the Fibromyalgia Impact Questionnaire (FIQ) score after 12 weeks. Secondary endpoints included summary scores on the physical and mental health components of the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36). All of the assessments were repeated at 24 weeks to test the durability of the response.
Patients randomized to tai chi experienced clinically significant improvements in the FIQ total score and quality of life. At 12 weeks, FIQ scores in the tai chi group declined by 18.4 points more than FIQ scores in the control group (P < 0.001). Intervention with tai chi was also associated in significant improvements in SF-36 physical-component and mental-component scores. These improvements were maintained at 24 weeks (P < 0.001). No adverse events were observed in the study.
What you need to know: In an accompanying editorial, researchers encouraged clinicians to consider tai chi for patients with fibromyalgia because of its potential efficacy and lack of adverse effects.
What your patients need to know: Tai chi may be a useful treatment for fibromyalgia. Long-term studies in larger study populations are needed to confirm the findings.
Yeh GY et al. Prescribing tai chi for fibromyalgia—are we there yet? N Engl J Med. 2010;363:783–4.
Wang C et al. A randomized trial of tai chi for fibromyalgia. N Engl J Med. 2010;363:743–54.
Tags : tai, chi, patients, fibromyalgia, session
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