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

基本信息

批准号：
7676185
负责人：
Peter Michael Wayne
金额：
$ 4.11万
依托单位：
HARVARD MEDICAL SCHOOL
依托单位国家：
美国
项目类别：
财政年份：
2006
资助国家：
美国
起止时间：
2006-09-30 至 2010-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7676185
关键词：
Activities of Daily Living Address Age Aging Asia Asians Biochemical Markers Biomechanics Bone Density Bone Resorption Clinical Trials 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 Osteocalcin Osteogenesis Osteoporosis Outcome Participant Pathway interactions Patients Pattern Pharmacodynamics Pharmacologic Substance Physiological Population Postmenopause Prevalence Prevention Preventive Protocols documentation Public Health Randomized Randomized Controlled Clinical Trials Randomized Controlled Trials Recommendation Recruitment Activity Regulation Relative Risks Reporting Research Personnel Risk Risk Factors Safety Sample Size Screening procedure Serum Stress Surgeon Tai Ji Testing Treatment Protocols Trochanters Urine Vertebral column Visit Weight-Bearing state Woman aged body-mind bone bone geometry bone loss bone quality bone turnover cost design falls flexibility follow-up high risk improved insight interest muscle strength novel post intervention programs response standard care treatment strategy trend

项目摘要

DESCRIPTION (provided by applicant): 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.

描述（由申请人提供）：骨质减少症是妇女严重且日益严重的公共卫生问题。未经治疗的骨质减少妇女与骨矿物质密度正常（BMD）相比，骨质疏松性的高风险也更大。与BMD相关的低骨折与重大的长期障碍，高发病率和高医疗费用有关。与骨质疏松症的治疗指南相反，骨质减少妇女的最佳预防和可持续干预措施尚未明确定义。治疗骨质减少妇女的当前指南通常包括定期运动的建议。 Tai Chi是一种在美国越来越受欢迎的心身运动，对低骨密度的女性具有有效，可持续，安全和实用的干预效果。初步研究表明，泰志可以降低绝经后妇女的BMD下降率。这些研究虽然暗示性，但具有许多设计局限性，主要是亚洲妇女，这些亚洲妇女的BMD较低，骨几何形状和骨折风险与其他种族相比。 Tai Chi还被证明可以有效改善平衡，减少跌倒并增加肌肉骨骼的力量和柔韧性。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作为绝经后骨质减少妇女标准护理的辅助性的功效和可行性。 45-65岁的妇女将从大型多人小组实践中招募45-65岁的妇女45-65岁的45-65岁妇女。我们的主要目的是评估招募和保留骨质减少妇女的可行性，进入9个月的Tai Chi的随机对照试验。我们的次要目的是收集有关太极拳在降低骨质减少妇女骨质流失率的初步数据，该数据使用骨骼更新和双能X射线吸收仪的敏感标记。对于参与者的一部分（n = 16），还将评估对太极拳的生物力学反应（例如骨特异性的机械负荷和姿势稳定性）。这项研究的结果将为未来的试验设计，该试验评估了骨质减少妇女对泰济的益处和安全性，以及Tai Chi可能会影响BMD和与骨质骨质相关的骨折风险的生物力学和生理机制。