Objectives To determine the effectiveness of tai chi interventions compared with aerobic exercise, a current core standard treatment in patients with fibromyalgia, and to test whether the effectiveness of tai chi depends on its dosage or duration.

Design Prospective, randomized, 52 week, single blind comparative effectiveness trial.
Setting Urban tertiary care academic hospital in the United States between March 2012 and September 2016.
Participants 226 adults with fibromyalgia (as defined by the American College of Rheumatology 1990 and 2010 criteria) were included in the intention to treat analyses: 151 were assigned to one of four tai chi groups and 75 to an aerobic exercise group.
Interventions Participants were randomly assigned to either supervised aerobic exercise (24 weeks, twice weekly) or one of four classic Yang style supervised tai chi interventions (12 or 24 weeks, once or twice weekly). Participants were followed for 52 weeks. Adherence was rigorously encouraged in person and by telephone.
Main outcome measures The primary outcome was change in the revised fibromyalgia impact questionnaire (FIQR) scores at 24 weeks compared with baseline. Secondary outcomes included changes of scores in patient’s global assessment, anxiety, depression, self efficacy, coping strategies, physical functional performance, functional limitation, sleep, and health related quality of life.
Results FIQR scores improved in all five treatment groups, but the combined tai chi groups improved statistically significantly more than the aerobic exercise group in FIQR scores at 24 weeks (difference between groups=5.5 points, 95% confidence interval 0.6 to 10.4, P=0.03) and several secondary outcomes (patient’s global assessment=0.9 points, 0.3 to 1.4, P=0.005; anxiety=1.2 points, 0.3 to 2.1, P=0.006; self efficacy=1.0 points, 0.5 to 1.6, P=0.0004; and coping strategies, 2.6 points, 0.8 to 4.3, P=0.005). Tai chi treatment compared with aerobic exercise administered with the same intensity and duration (24 weeks, twice weekly) had greater benefit (between group difference in FIQR scores=16.2 points, 8.7 to 23.6, P<0.001). The groups who received tai chi for 24 weeks showed greater improvements than those who received it for 12 weeks (difference in FIQR scores=9.6 points, 2.6 to 16.6, P=0.007). There was no significant increase in benefit for groups who received tai chi twice weekly compared with once weekly. Participants attended the tai chi training sessions more often than participants attended aerobic exercise. The effects of tai chi were consistent across all instructors. No serious adverse events related to the interventions were reported.
Conclusion Tai chi mind-body treatment results in similar or greater improvement in symptoms than aerobic exercise, the current most commonly prescribed non-drug treatment, for a variety of outcomes for patients with fibromyalgia. Longer duration of tai chi showed greater improvement. This mind-body approach may be considered a therapeutic option in the multidisciplinary management of fibromyalgia.
Trial registration ClinicalTrials.gov NCT01420640.

目的确定太极拳干预与有氧运动相比的有效性，而有氧运动是目前纤维肌痛患者的核心标准治疗方法，并测试太极拳的有效性是否取决于其剂量或持续时间。

设计前瞻性，随机，52周，单盲比较有效性试验。
设置城市三级医疗在美国教学医院2012年3月与月之间的2016年
参加226名成人纤维肌痛（如1990年和风湿病2010个标准的美国大学所定义的）被纳入意向性治疗分析：151被分配到一个四个太极拳组和75个有氧运动组。
干预措施参与者被随机分为有氧运动（24周，每周两次）或四种经典的杨式有氧太极拳干预之一（12或24周，每周一次或两次）。参与者被追踪了52周。亲自或通过电话严格鼓励遵守。
主要结局指标主要结局指标是与基线相比，第24周修订后的纤维肌痛影响问卷（FIQR）评分的变化。次要结果包括患者总体评估得分的变化，焦虑，抑郁，自我效能感，应对策略，身体功能表现，功能受限，睡眠以及与健康相关的生活质量。
结果在所有五个治疗组中，FIQR评分均得到改善，但是在24周时，综合太极组的FIQR评分在统计学上显着高于有氧运动组（组之间的差异= 5.5分，95％置信区间0.6到10.4，P = 0.03）和一些次要结局（患者的整体评估= 0.9分，0.3至1.4，P = 0.005;焦虑= 1.2分，0.3至2.1，P = 0.006;自我效能感= 1.0分，0.5至1.6，P = 0.0004;应对策略，2.6点，0.8到4.3，P = 0.005）。太极拳治疗与有氧运动强度和持续时间相同（24周，每周两次）相比，具有更大的益处（组间FIQR评分差异为16.2分，为8.7至23.6，P <0.001）。接受太极拳24周的组比接受太极拳12周的组表现出更大的进步（FIQR得分= 9.6分，从2.6到16.6，P = 0.007）。与每周一次相比，每周两次接受太极拳的人群的收益没有显着增加。与参加有氧运动相比，参加太极拳训练的频率更高。太极拳对所有教练的影响都是一致的。没有报告与干预措施有关的严重不良事件。太极拳对所有教练的影响都是一致的。没有报告与干预措施有关的严重不良事件。太极拳对所有教练的影响都是一致的。没有报告与干预措施有关的严重不良事件。
结论太极拳身心疗法与有氧运动（目前最常用的非药物疗法）相比，在纤维肌痛患者的各种结局上，其症状改善或相似或更大。太极拳时间越长，则表现出更大的进步。这种心身方法在纤维肌痛的多学科治疗中可以被认为是一种治疗选择。
试用注册ClinicalTrials.gov NCT01420640。