Psychosocial effects of Tai Chi exercise on people with rheumatoid arthritis.

AIMS AND OBJECTIVES: To investigate the perceived psychosocial effects of participating in taught sessions of Tai Chi on people diagnosed with rheumatoid arthritis (RA). BACKGROUND: Tai Chi is thought to be psychologically as well as physically beneficial for people with arthritis. DESIGN: This study adopted a qualitative approach to follow-up participants who had previously demonstrated physical and psychological benefits from a specifically modified Tai Chi programme in an attempt to explore perceived psychosocial improvements. METHODS: Nineteen semi-structured, audio-taped, interviews were carried out with participants who had taken part in, twice weekly, group-based Tai Chi sessions for 12 weeks. Data from transcripts were analysed using thematic analysis. RESULTS: Analysis suggests that participating in shared Tai Chi sessions provides increased awareness of the links between mind and body; reduces anxiety and depression; and improves self-esteem, self-efficacy and motivation. It was particularly striking to find that the highly structured nature of Tai Chi was felt to improve memory and seemed to offer aesthetic experiences through developing graceful, 'fluid' moves rather than the 'jarring' movements often imposed by having RA. Such group sessions were found to provide social support and help improve participants' sense of perspective. CONCLUSION: Although small scale, this study suggests that Tai Chi has the potential to offer psychosocial benefits for people with RA. RELEVANCE TO CLINICAL PRACTICE: Offering Tai Chi alongside traditional treatments for RA could promote psychological health and well-being, help inform clinical decision-making and prove cost-effective.

Tai Chi exercise and auricular acupressure for people with rheumatoid arthritis: an evaluation study.

AIMS AND OBJECTIVES: (i) To assess the effectiveness of Tai Chi exercise in people with rheumatoid arthritis (RA). (ii) To ascertain if Tai Chi and auricular acupressure have a potentiation effect in controlling pain. (iii) To evaluate the acceptability and enjoyment of the classes. BACKGROUND: Tai Chi has been suggested as a suitable exercise for people with arthritis and specific programmes have been developed. Auricular acupressure is a therapeutic method by which points on the ear are stimulated to treat various disorders. DESIGN: A pragmatic non-randomised before/after study to compare the effects of the interventions. METHODS: People with RA (n=21) were recruited and allocated into two groups. Both groups followed a Tai Chi exercise programme, twice a week for 12 weeks, but one group (n=14) had, in addition, the auricular acupressure. Physical symptoms and function, pain, quality of life and self-efficacy were measured in both groups before and after the programme. Acceptability and enjoyment were assessed at the end. RESULTS: At 12 weeks, both groups had achieved statistically significant improvements in balance, grip strength, pinch strength, 50 foot walk time self reported joint pain, swollen joint count, tender joint count and in self efficacy in relation to pain control. All participants stated that they enjoyed the classes. There was no evidence to suggest that the auricular acupressure enhanced the effects of the Tai Chi intervention. CONCLUSION: The classes appeared to be mentally as well as physically helpful to participants. RELEVANCE TO CLINICAL PRACTICE: People with a chronic debilitating disease such as RA should be encouraged to undertake gentle strengthening exercise such as Tai Chi because of its potential for physical and psychological improvements.