After attending tai chi classes twice a week for 12 weeks, people with rheumatoid arthritis (RA) experienced significant health improvements, both mentally and physically, according to recent research.

The study, “Tai Chi exercise and auricular acupressure for people with rheumatoid arthritis: an evaluation study,” involved 21 people with an average age of 61 years, most of whom were female, white and single. The average time since diagnosis with RA was 10 years.

Inclusion criteria for the study were a diagnosis of RA by a rheumatologist, the ability to walk indoors without a walking aid, the ability to complete a 50-foot walk test without becoming short of breath, no pain on the external ear, and not currently exercising more than two times a week.

Upon inclusion, participants were asked which of two venues they would prefer to travel to for the study. Fourteen chose one venue, and seven chose the other. This decision determined each person’s group assignment, as one venue had been selected for the tai chi classes alone, and the other venue had been selected for the tai chi classes followed by auricular acupressure.

The intervention time lasted 12 weeks, with all participants attending tai chi classes twice a week for one hour. These classes were led by one of the researchers, who is a certified tai chi instructor for arthritis. During the first class, subjects watched the “Introduction of the Tai Chi for Arthritis Videotape.” In subsequent classes, the subjects learned and performed the 21 movements of Sun-style tai chi. They also were given notes on the exercises, so they could practice at home if desired.

Seven subjects participated in the tai chi classes in combination with auricular acupressure. The auricular acupressure took place once a week following the tai chi exercises and was led by the same researcher, who also is a certified ear reflex-zone therapist. Three auricular acupressure points were used for this study: shenmen, or “Gate of Spirit,” used to relieve pain and induce calm; ear apex, used to reduce inflammation, fever, swelling and acute pain; and wind stream, used to alleviate allergies.

The acupressure was performed with small, round vaccaria seeds, which were covered with an opaque ear patch. According to the researchers, in traditional Chinese medicine, these seeds are known as Wang-Bu-Liu-Xing. Subjects were instructed to press on the adhered seeds regularly to achieve the optimal therapeutic effect.

Outcome measures for this study included the following physical symptoms: swollen and tender joints, joint pain, overall pain in the last week, as well as fatigue in the last week. The following aspects of physical function also served as outcome measures: balance, flexibility, grip strength, pinch strength and 50-foot walk time. The two psychosocial outcomes were impact of arthritis, as measured by the Arthritis Impact Measurement Scale 2, and self-efficacy, as measured by the Arthritis Self Efficacy Scale.

All markers of physical function and swollen and tender joint counts were measured by the same person before and after the 12-week intervention. In addition, a short questionnaire on the subjects’ views about their experience with the tai chi classes was administered at the end of the 12-week period.

Results of the research revealed a significant improvement in all the physical symptoms that were measured, apart from overall pain scores. The data also showed a significant improvement in all measures of physical function, with the exception of right-arm flexibility. Both the psychosocial measures showed significant improvements following the 12-week intervention period as well, and 100 percent of the subjects reported they enjoyed the classes on tai chi and would like to continue doing tai chi.

“The benefits of Tai Chi alone were so dramatic that they are likely to have swamped any potential incremental change brought about by the auricular acupressure,” state the study’s authors. “A very much larger study would therefore be needed to test any potentiation effect of auricular acupressure alongside Tai Chi.”

The researchers conclude that health professionals who work with people with RA should encourage them to consider taking tai chi for the potential physical and psychological benefits.

“This study demonstrated that even people with severe disabilities were able to undertake gentle strengthening exercise such as Tai Chi and benefit from it,” state the study’s authors.

 

Authors: Hea-Young Lee, Claire A. Hale, Beverly Hemingway and Michael W. Woolridge.

Sources: Nursing Policy Research Institute, Korean Nurse Association, Seoul, Korea; School of Healthcare, University of Leeds, United Kingdom; Mid Yorks NHS Trust, Wakefield, Yorkshire, United Kingdom. Originally published in 2012 in the Journal of Clinical Nursing.

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