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Effects of yoga and Tui Na in patients with fibromyalgia.

Gerson D, daSilva MS, Geraldo LF, Lais V, Lage MD. Effects of yoga and the addition of Tui Na in patients with fibromyalgia. Journal of Alternative and Complementary Medicine 2007;13(10):1107-1113.

Aim Of This Study

The aim of this study was to evaluate the effects of relaxing yoga with and without the addition of Tui Na touch therapy in fibromyalgia (FMS) patients.

Method

Thirty-three female participants who had been diagnosed with FMS completed this study. The fibromyalgic diagnosis was made according to criteria specified by the American College of Rheumatology. The criteria stipulate that patients must have pain in at least 11 of 18 tender points and widespread pain in a minimum of three of the four body quadrants. The participants were aged between 25 and 60 years and had normal cognitive function.

Two groups were randomly selected so that 17 participants formed the relaxing yoga group (RY) and 16 participants formed the relaxing yoga plus touch group (RYT). Each group took part in eight weekly sessions with a median duration of 50 minutes each. Each session was taught on a one-on-one basis so that all participants received the full attention of the therapist. During these interventions, relaxing background music played and the lighting was lowered.

The yoga sessions comprised of postures, breathing and relaxation. The postures started with neck stretches and then moved on to stretch the entire body. After the postures, the participants practised seven minutes of diaphragmatic yogic breathing while laying supine. They then undertook 15 minutes of relaxation techniques that involved focusing on different body parts. At the conclusion of the yoga session, the participants listened to the therapist reading about the principles of yogic philosophy.

Those in the RYT group received Tui Na touch therapy during the 15-minute relaxation phase of the intervention. Tui Na techniques consisted of multidirectional gliding movements over the trunk and qi-directed gliding movements on the limbs. Pressure was also applied to the trunk and limbs. All movements were conducted over clothing. Participants were required to focus on the area being touched.

Measurements

Pain thresholds at tender points were measured using an algometer one week before interventions and four to six weeks after completion of the eight sessions. The Fibromyalgia Impact Questionnaire (FIQ) was also completed one week before intervention and four to six weeks afterwards. This questionnaire consists of 10 items that measure physical functioning, job difficulty, pain, fatigue, morning tiredness, stiffness, overall well-being, depression and anxiety. These items are measured on a scale of 0 to 10 with higher scores representing worse states.

In addition, a 10 cm Visual Analog Scale (VAS) was used to measure pain. It was completed at each visit before and after each session. The VAS was also completed during the week between two sessions and at the four to six week follow-up.

Results

The results showed that both groups had a significant decrease in FIQ scores after intervention with no significant differences between groups. However, neither group showed an increased pain threshold after the sessions, again with no differences between groups.

When evaluations were made between VAS measurements taken before the first treatment, at the end of all the sessions and at the four to six week follow-up, the RY group showed significant results only when comparisons were made between the initial VAS measurement and the final follow-up measurement. The RYT group, on the other hand, only showed significant results when comparing the initial result and the measurement taken after the last session.

Conclusion

The researchers concluded that
 Touch intervention may be, in the short term, a very
 helpful resource. On the other hand, for long-term
 effects, it may be better to teach FMS patients to fully
 participate in therapeutic programs, changing their self-defeating
 beliefs, and, for this purpose, it is possible that
 an intervention with yogic techniques alone may be a
 better option.


Limitations Of This Study

Another group, trained in the yoga components and given relevant yogic philosophy texts to read, could have been left to practice the intervention on their own. This would help to determine how much of the benefit can be attributed to the attention received from the therapist and how much to the yoga itself.
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Article Details
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Title Annotation:Study Review
Author:Robertshawe, Penny
Publication:Journal of the Australian Traditional-Medicine Society
Article Type:Report
Geographic Code:8AUST
Date:Jun 1, 2009
Words:699
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