Tai chi can reduce arthritis pain, pilot study finds

CLEVELAND -- Tai Chi, a gentle form of exercise long practiced in China, can significantly reduce arthritic pain in the elderly, according to a pilot study by a doctoral student at Case Western Reserve University's Frances Payne Bolton School of Nursing.

Tai Chi combines meditation with slow, circular motions, making it an ideal exercise for elderly people, says researcher Patricia Adler, an advanced practice nurse with 25 years of clinical and research experience.

"I've modified the traditional form of Tai Chi to accommodate the functional level of seniors," Adler explains. "I've also taught Tai Chi to people in wheelchairs."

For her study, which is reported in the "Journal of Nursing Scholarship," Adler randomly divided 16 people -- all age 68-87 and with chronic arthritis pain -- into two groups. One group attended 10 weekly hour-long Tai Chi classes. Members of the control group maintained their usual activities.

After beginning each class with warm-up exercises, Adler taught 16 Tai Chi exercises or postures over the 10 weeks. "Subjects were encouraged to practice daily but not to worry about remembering or practicing all movements," she notes.

At the beginning and end of the 10-week course, she measured the pain levels and health status of study participants using two standard instruments. Weekly, all participants reported their current pain from zero (no pain) to 10 (worst possible pain), which was their Pain Intensity Number Score (PINS).

The severity of pain decreased significantly for the Tai Chi group, but increased in the control group, Adler reports. Over the 10 weeks, the average PINS for the Tai Chi group dropped from 3.25 to 1.75, while the PINS for the control group went from .50 to 1.50.

Exercise such as Tai Chi helps reduce arthritis pain by increasing circulation and stimulating repair of damaged joint surfaces, Adler explains. "In addition, it stabilizes joint structure by strengthening the soft tissue support of the joint."

As pain decreases, the arthritis sufferer's outlook on life can improve as well. "Less pain promotes greater physical function of the affected joint and decreases the adverse mental health affects related to living with arthritic pain," Adler says.

Although the benefits of exercise are clear, getting the elderly involved in an exercise class is still a challenge.

"Often older people will not come to class, because they're afraid they're going to fall, they're afraid their needs won't be met, and they're afraid of the pain," Adler says. But when they learn that Tai Chi is gentle exercise that can help their pain, she adds, they become interested.

"The social component is very important for the elderly, too," she points out. "If they try to exercise at home, they often times don't have that support."

For her doctoral dissertation, Adler is planning a larger study based upon the pilot project.

"Older people in China have been doing Tai Chi for hundreds, if not thousands, of years," she said. "Although we know anecdotally that Tai Chi helps chronic arthritis pain, we don't have the research to substantiate it." She hopes her doctoral study will be a step in that direction.

Co-authors on Adler's pilot study report are Marion Good, associate professor at the Bolton School; Beverly Roberts, professor and associate dean for academic affairs at the Bolton School; and Scott Snyder, a doctoral candidate in CWRU's Department of Statistics.