A Tai chi and qigong mind-body program for low back pain: A virtually delivered randomized control trial

Author: Yang Yang1, Sydne McCluskey2, Mohamad Bydon3, Jaspal Ricky Singh4, Robert D Sheeler5, Karim Rizwan Nathani3, Ana C Krieger6, Neel D Mehta7, Joshua Weaver8, Libin Jia9, Sharon DeCelle10, Robert C Schlagal11, Jay Ayar12, Sahar Abduljawad13, Steven D Stovitz13, Ravindra Ganesh14, Jay Verkuilen15, Kenneth A Knapp12, Lin Yang16, Roger Härtl17
Affiliation:
1 Center for Taiji and Qigong Studies, 151 E 81st St 7D, New York, NY 10028, United States.
2 Educational Psychology Program, CUNY Graduate Center, 365 Fifth Av, New York, NY 10016, United States.
3 Department of Neurological Surgery, Neuro-Informatics Laboratory, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, United States.
4 Department of Rehabilitation Medicine, Weill Cornell Medicine, 525 E. 68th St, New York, NY 10065, United States.
5 Department of Family Medicine, Mayo Clinic, College of Medicine, Rochester, Minnesota, Next Level Concierge Care, 10250 N 92nd St Suite 210, Scottsdale, AZ 85258, United States.
6 Weill Cornell Center for Sleep Medicine, Department of Medicine, Weill Cornell Medical College, 425 East 61st St - 5th floor, New York, NY 10065, United States.
7 Department of Anesthesiology, Division of Pain Management, Och Spine at Weill Cornell Medicine/NewYork-Presbyterian Hospital, 240 East 59th St, 2nd Floor, New York, NY 10022, United States.
8 Department of Neurology, Weill Cornell Medicine, 1305 York Ave, Floor 2, New York, NY 10021, United States.
9 Office of Cancer Complementary and Alternative Medicine, Division of Cancer Treatment and Diagnosis, National Cancer Institute, 9609 Medical Center Dr. 1W704, Rockville, MD 20850, United States.
10 Private Practice, 309 E Holmes St, Urbana, IL 61801, United States.
11 Department of Reading Education and Special Education, Appalachian State University, Boone, North Carolina, 4717 Valero Ct, Laredo, TX 78046, United States.
12 Department of Public Health, School of Health Sciences and Practice, New York Medical College, 40 Sunshine Cottage Road, Valhalla, NY 10595, United States.
13 Department of Family Medicine and Community Health, University of Minnesota Medical School, Minneapolis, Minnesota, Mill City Clinic, 901 South 2nd St, Minneapolis, MN 55415, United States.
14 Division of General Internal Medicine, Mayo Clinic College of Medicine, 200 1st St SW, Rochester, MN 55905, United States.
15 Educational Psychology Program, CUNY Graduate Center, 365 Fifth Ave, New York, NY 10016, United States.
16 Department of Cancer Epidemiology and Prevention Research, Cancer Care Alberta, Alberta Health Services, Calgary, Alberta, Canada; Departments of Oncology and Community Health Sciences, Cumming School of Medicine, University of Calgary, 5th Floor, Holy Cross Centre, Box ACB, 2210 - 2 St. SW, Calgary AB T2S 3C3, Canada.
17 Department of Neurological Surgery, Division of Spine Surgery, Och Spine at Weill Cornell Medicine/NewYork-Presbyterian Hospital, 525 East 68th St, Box 99, New York, NY 10065, United States.
Conference/Journal: N Am Spine Soc J
Date published: 2024 Sep 8
Other: Volume ID: 20 , Pages: 100557 , Special Notes: doi: 10.1016/j.xnsj.2024.100557. , Word Count: 301

Background:
Mind-body treatments have the potential to manage pain, yet their effectiveness when delivered online for the treatment of low back pain (LBP) is unknown. We sought to evaluate whether a virtually delivered mind-body program integrating tai chi, qigong, and meditation (VDTQM) is effective for treating LBP.

Methods:
This randomized controlled trial compared VDTQM (n=175) to waitlist control (n=175). Eligible participants were at least 18 years old, had LBP for at least 6 weeks, were not pregnant, had not previously taken tai chi classes, and had not undergone spine surgery within 6 months. The treatment group received a 12-week VDTQM program in live online 60-minute twice-weekly group classes from September 2022 to December 2022. All participants continued their usual activities and care. Primary outcome was pain-related disability assessed by the Oswestry Disability Index (ODI) score. Secondary outcomes included pain intensity, sleep quality, and quality of life (QOL). Intent-to-treat analyses were conducted.

Results:
Of the 350 participants 278 (79%) were female, mean age was 58.8 years (range: 21-92), 244 (69.7%) completed the 8-week survey, 248 (70.9%) the 12-week, and 238 (68%) the 16 -week. No participants withdrew due to adverse treatment effects. Compared with control group, treatment group experienced statistically and clinically significant improvement in ODI score by -4.7 (95% CI: -6.24 to -3.16, p<.01), -6.42 (95% CI: -7.96 to -4.88, p<.01), and -8.14 (95% CI: -9.68 to -6.59, p<.01) points at weeks 8, 12, and 16, respectively. Treatment group also experienced statistically significant improvement at all time points in the other outcomes.

Conclusions:
Among adults with LBP, VDTQM treatment resulted in small to moderate improvements in pain-related disability, pain intensity, sleep quality, and QOL. Improvements persisted 1 month after treatment concluded. These findings suggest VDTQM may be a viable treatment option for patients with LBP.Trial registration: clincaltrials.gov Identifier: NCT05801588.

Keywords: Back pain; Meditation; Mind-body; Nonpharmacological intervention; Qigong; Randomized controlled trial; Tai chi; Telerehabilitation.

PMID: 39469294 PMCID: PMC11513803 DOI: 10.1016/j.xnsj.2024.100557

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