Tai Chi for Osteopenic Women: A Pilot Randomized Controlled Trial

骨质疏松女性太极拳：一项随机对照试验

• 批准号: 7472778
• 负责人: Peter Michael Wayne
• 金额: $ 3.88万
• 依托单位: HARVARD MEDICAL SCHOOL
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-09-30 至 2009-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7472778
• 关键词: Activities of Daily Living; Address; Age; Aging; Asia; Asians; Biochemical Markers; Biomechanics; Bone Density; Bone Resorption; Caring; Clinical Trials; Condition; Consensus; Data; Diagnostic; Equilibrium; Equipment; Ethnic group; Exercise; Femur; Fracture; Future; Gait; Group Practice; Guidelines; Health; High Risk Woman; Hip region structure; Impairment; Intervention; Measures; Mechanics; Medical; Monitor; Morbidity - disease rate; Motivation; Musculoskeletal; Neck; Numbers; Osteocalcin; Osteogenesis; Osteoporosis; Outcome; Participant; Pathway interactions; Patients; Pattern; Pharmacodynamics; Pharmacologic Substance; Physiological; Pliability; Population; Postmenopause; Prevalence; Prevention; Preventive; Protocols documentation; Public Health; Randomized; Randomized Controlled Clinical Trials; Randomized Controlled Trials; Rate; Recommendation; Recruitment Activity; Regulation; Relative Risks; Reporting; Research Personnel; Risk; Risk Factors; Safety; Sample Size; Score; Screening procedure; Serum; Standards of Weights and Measures; Stress; Surgeon; Tai Ji; Testing; Treatment Protocols; Trochanters; Urine; Vertebral column; Visit; Weight-Bearing state; Woman; aged; body-mind; bone; bone loss; bone quality; bone turnover; cost; design; falls; follow-up; improved; insight; interest; muscle strength; novel; programs; response; trend

Osteopenia is a serious and growing public health concern for women. Untreated osteopenic women are at high risk of becoming osteoporotic, and also are at greater risk for fractures than women with normal bone mineral densities (BMD). Low BMD-related fractures are associated with significant long-term impairment, high morbidity rates and high medical costs. In contrast to the treatment guidelines for osteoporosis, optimal preventive and sustainable interventions for osteopenic women are not yet well-defined. Current guidelines for the treatment of osteopenic women generally include the recommendation of regular exercise. Tai Chi,a mind-body exercise that is growing in popularity in the U.S., shows strong potential as an effective, sustainable, safe and practical intervention for women with low bone density. Preliminary studies suggest Tai Chi can reduce rates of BMD decline in post-menopausal women. While suggestive, these studies are small, have numerous design limitations, and include primarily Asian women who are known to have lower BMD and different bone geometry and fracture risk than other ethnic groups. Tai Chi has also been shown to be effective in improving balance, reducing falls and increasing musculoskeletal strength and flexibility. Moreover, Tai Chi has been shown to be safe in aging and de-conditioned populations. We propose a pilot randomized controlled trial to assess the efficacy and feasibility of Tai Chi as an adjunct to standard care for post-menopausal osteopenic women. Forty-eight osteopenic (T-scores -1.0 to -2.5) women ages 45-65 will be recruited from a large multispecialty group practice. Our primary aim is to assess the feasibility of recruiting and retaining osteopenic women into a randomized controlled trial of 9 months of Tai Chi.Our secondary aim is to collect preliminary data on the efficacy of Tai Chi in reducing rates of bone loss in osteopenic women using sensitive markers of bone turnover and dual-energy x-ray absorptiometry. For a subset of participants (n=16), biomechanical responses to Tai Chi (e.g.bone-specific mechanical loading and postural stability) will also be assessed. The results of this study will inform the design of a future trial evaluating the benefits and safety of Tai Chi for osteopenic women, as well as the biomechanical and physiological mechanisms through which Tai Chi may impact BMD and fracture risks associated with osteopenia.

骨质减少症是女性的严重且日益严重的公共卫生关注。未经治疗的骨质减少妇女是 与正常骨骼的女性相比 矿物密度（BMD）。低BMD相关裂缝与重大长期损害有关， 高发病率和高医疗费用。与骨质疏松症的治疗指南相反，最佳 骨质减少妇女的预防和可持续干预措施尚未明确定义。 当前治疗骨质减少妇女治疗的指南通常包括常规的建议 锻炼。 Tai Chi是一种在美国越来越受欢迎的思维体育练习，作为一种强大的潜力 对于低骨密度的女性，有效，可持续，安全和实用的干预措施。初步研究 表明太极拳可以降低绝经后妇女的BMD降低率。虽然暗示，但这些 研究很小，有许多设计局限性，主要包括亚洲妇女 与其他种族相比，BMD较低，骨几何形状和骨折风险不同。太极也有 显示可有效改善平衡，减少跌倒和增加肌肉骨骼强度和 灵活性。此外，Tai Chi已被证明在老龄化和解调的人群中是安全的。 我们提出了一项试验随机对照试验，以评估Tai Chi作为辅助的功效和可行性 为绝经后骨质减少妇女提供标准护理。 48骨骨减少术（T分数-1.0至-2.5） 45-65岁的妇女将从大型多专业团体实践中招募。我们的主要目的是评估 招募和将骨质减少妇女招募和保留的可行性为9个月的随机对照试验 泰奇的次要目的是收集有关泰奇在降低骨骼速率的有效性的初步数据 骨质减少妇女使用骨骼更新和双能X射线吸收率的敏感标志物的损失。 对于参与者的一部分（n = 16），生物力学对太极的反应（例如，特定机械 负载和姿势稳定性）也将进行评估。这项研究的结果将为未来的设计提供信息 评估骨质减少妇女以及生物力学和生物力学和 太极拳可能会影响BMD和与骨折风险相关的生理机制 骨质减少。