Tai Chi and wellness interventions for Veterans with Gulf War illness: A randomized controlled feasibility trial
Abstract: Background: Gulf War Illness (GWI) is a chronic multi-symptom illness that affects up to one-third of the 700,000 American military personnel deployed to the Persian Gulf region in 1990 and 1991. We conducted a randomized controlled trial to examine feasibility and the relative efficacy of two 12-week in-person group treatments (Tai Chi and Wellness) to address GWI symptoms of chronic pain, fatigue, and changes in mood and cognitive functioning. Method: Male and female veterans were randomly assigned to Tai Chi (n = 27) or Wellness (n = 26) group interventions and assessed at four time points: baseline, post-treatment, 3-, and 9-month follow-up. Multilevel models with a treatment-by-time interaction term were utilized to evaluate treatment effects and changes in GWI-related outcomes over time. Results: Satisfaction was high, there were no adverse events, and over half the participants attended 75% or more sessions with no significant differences between groups. For pain interference, analyses revealed a significant quadratic effect of time with no differences between treatment groups. For general fatigue and a cognitive test of trail making, no significant effects were detected. For depressed mood, linear and quadratic time effects and the group x linear time interaction were significant indicating greater reductions for Tai Chi participants. For a verbal learning test, linear and quadratic time and the group x quadratic time interaction significantly predicted total recall with Tai Chi participants demonstrating more rapid initial improvements. Conclusion: Findings indicate that both Tai Chi and Wellness are feasible and acceptable. Both interventions may have a salutary impact on pain interference, depression, and verbal learning with some advantages for Tai Chi.