Sensory-emotional-cognitive effects of resistance exercise and Tai Chi exercise in Japanese community-dwelling older adults with chronic pain: a non-randomized controlled trial.

Abstract

Background: Although Tai Chi has demonstrated efficacy in alleviating pain and improving functional mobility in people with chronic pain, the mechanisms underlying its pain-relieving effects remain poorly understood. We assessed the efficacy of a Tai Chi intervention on pain-related sensory, emotional, and cognitive indices in Japanese community-dwelling older adults with chronic pain.

Methods: A non-randomized controlled trial was conducted for 12 weeks in the community of Itoshima City, Fukuoka, Japan. Adults aged ≥ 60 years with chronic pain were recruited and allocated to an intervention group or a control group. A total of 84 participants were allocated, with 44 in the intervention group and 40 in the control group. Chronic pain was defined as musculoskeletal pain lasting ≥ 3 months. Baseline characteristics of participants included age, sex, education, body mass index, comorbidities, current tobacco consumption, current alcohol consumption, and fall history. The control group received resistance training; the intervention group received resistance training and Tai Chi exercise. The main outcomes were assessed at baseline and after 12 weeks of intervention: a pain numeric rating scale (NRS), the pressure pain threshold (PPT), the Tampa Scale of Kinesiophobia (TSK), the Pain Catastrophizing Scale (PCS), and the Central Sensitization Inventory (CSI). As secondary outcomes, TSK and PCS subscales were evaluated with the same procedures. The statistical analyses used the t-test, χ²-test, Wilcoxon rank-sum test, and analysis of covariance with adjustment for baseline characteristics.

Results: No baseline characteristics differed significantly between the groups. At 12 weeks, the intervention group showed significant improvements in the NRS (p = 0.02, 95%CI: -2.20, - 0.18), PPT (p = 0.003, 95%CI: 0.22, 0.99), TSK (p = 0.004, 95%CI: -6.35, - 1.22), and PCS (p = 0.01, 95%CI: -10.18, - 1.43) versus the control group. There was no significant between-group difference in the CSI values. After adjustment for baseline characteristics, significant interactions were revealed between time and group for PPT (p = 0.02), TSK (p = 0.02), and PCS (p = 0.03) as well as the subscales TSK-Somatic Focus (p = 0.02) and PCS-Rumination (p = 0.01).

Conclusion: Tai Chi intervention may serve as a potential treatment for chronic pain by addressing sensory, emotional, and cognitive aspects of pain.

Trial registration: The University Hospital Medical Information Network Clinical Trials Registry, UMIN000052727, Date: 2023-11-13. https://center6.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000058307 .