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Does Obesity in Patients with Fibromyalgia Modify Response to Tai Chi Therapy: Analysis of a Randomized Controlled Trial.

Arthritis and Rheumatism
An Official Journal of the American College of Rheumatology
Volume  62  Number 10 (Supplement)  October 2010


Chenchen Wang1, Christopher H. Schmid2, Yoojin Lee2 and Timothy
McAlindon1. 1Tufts Medical Center, Boston, MA, 2Tufts Medical

Purpose: Fibromyalgia (FM) is a chronic pain disorder of complex
etiology. Recent evidence about the association between obesity and
FM suggests that this might obfuscate therapy. We evaluated the
association of obesity and changes in FM severity, sleep quality and
health related quality of life in a randomized controlled trial of FM

Methods: We studied a sample of 66 eligible individuals (age 21 or
older and fulfilled the American College of Rheumatology 1990
diagnostic criteria for FM) who participated in a single-blind, randomized
controlled trial. Using computer-generated numbers, we randomly
assigned participants to Tai Chi mind-body exercise (Classical Yang
style, n_33) or attention control (stretching and wellness education
n_33) in three cycles of 22 patients each. The 60-minute group
sessions occurred twice-weekly for 12 weeks. We defined obesity as
body mass index (BMI) _30.00 kg/m2. Study endpoints included
changes from baseline to 12 weeks in FM Impact Questionnaire (FIQ)
score (range, 0 to 100; higher scores indicate more severe symptoms),
Pittsburgh Sleep Quality Index (range, 0–21, higher scores indicate
worse sleep quality), and Physical Component Summary and Mental
Component Summary of the Short Form-36 (SF-36) to assess quality
of life (range 0–100; lower scores indicate worse health status). We
estimated the relationship between obesity and the treatment effect by
the interaction of treatment and obesity in linear regression using each
of the three study endpoints.

Results: The 66 participants had mean age 50y (SD 11.1), mean
disease duration 11 y (SD 7.1), mean BMI 33 kg/m2 (SD 8.2), and were
mainly female (86%) and white (56%). Thirty-six patients were
obese (BMI_30) and 29 patients were not obese (_ 30.00) and 1 had
missing BMI. The proportion of obese BMI remained stable in both
Tai Chi and control groups. Obese patients assigned to Tai Chi group
exhibited significantly greater improvement in FIQ total score
(between-group difference _17.5, 95% CI, [_34.1 to _1.0]; P_0.04)
than the non-obese group. The SF-36 Physical Component Summary
and Mental Component Summary tests also favored obese group but
did not reach statistical significance. Both groups improved their sleep
quality (Pittsburgh Sleep Quality Index) equally (Table).

NOTE FROM JUDE- This research report included a table of statistics that would not reproduce in this text report. For that information, please visit the site below for the actual article. 

Conclusion: Despite no weight loss in either group, obese patients with
FM improved more in their symptoms and quality of life with Tai Chi than
with attention control. Tai Chi mind-body exercise may be a particularly
beneficial treatment for obese patients with FM. BMI should be considered in
future behavioral intervention design.

Disclosure: C. Wang: None; C. H. Schmid: None; Y. Lee: None; T. McAlindon: