Tai Chi and Parkinson's Disease

太极拳与帕金森病

• 批准号: 7742643
• 负责人: FUZHONG LI
• 金额: $ 61.41万
• 依托单位: OREGON RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-12-19 至 2011-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7742643
• 关键词: Acupuncture procedure; Address; Affect; Age; Binding; Blinded; Characteristics; Clinical Trials; Code; Complementary and alternative medicine; Consultations; Data; Double-Blind Method; Elderly; Ensure; Equilibrium; Exclusion; Exercise; Fall prevention; Frequencies; Health Benefit; Home environment; Incidence; Individual; Intervention; Intervention Studies; Investigation; Lower Extremity; Manuals; Measures; Mediating; Modality; Monitor; Musculoskeletal Equilibrium; Non-Prescription Drugs; Outcome; Outcome Measure; Parkinson Disease; Participant; Patients; Performance; Persons; Pharmaceutical Preparations; Phase; Physical Function; Physical activity; Physical activity scale; Physicians; Principal Investigator; Published Comment; Questionnaires; Randomized; Records; Reporting; Research; Research Personnel; Sampling; Schedule; Self Efficacy; Sex Characteristics; Staging; Stratification; Structure; Surveys; Tai Ji; Testing; Therapeutic; Time; Time Factors; TimeLine; Training; Training Programs; Variant; Work; Workload; Writing; age group; age related; alternative treatment; arm; base; blind; dosage; expectation; falls; fear of falling; follow up assessment; follow-up; improved; information gathering; innovation; instructor; muscle strength; nervous system disorder; novel; operation; post intervention; primary outcome; programs; prospective; response; secondary outcome; sex; strength training

DESCRIPTION (provided by applicant): Parkinson's disease (PD) is a progressive neurological disorder that often results in postural instability, exemplified by increasing loss of balance and incidence of falls. Research has been limited on identifying innovative physical interventions that improve postural balance and lower-extremity muscle strength to maintain daily physical functioning in individuals with PD. Tai Chi, a balance-exercise modality, shown to be effective in improving balance and preventing falls, may be beneficial for individuals with PD; however, little evidence is available concerning the effects of Tai Chi on PD. Based on preliminary work, this application proposes a prospective, 6-month randomized, controlled, double-blind clinical trial to investigate the effects of a Parkinson-specific Tai Chi exercise program in persons with PD. The study will be comprised of three experimental arms: Tai Chi, conventional strength training, and a low-impact exercise control. The primary aim of this investigation is to test the hypothesis that a specially tailored Tai Chi program will improve primary outcome measures of balance and lower-extremity muscle strength, and secondary outcome measures of physical performance, falls self-efficacy, fear of falling, and falls frequency, in persons with mild to moderate PD (stages 1, 2, or 3 of the Hoehn and Yahr scale). Three secondary aims are to examine: (a) whether improvements in the endpoint of balance resulting from the 6-month Tai Chi intervention are associated with reductions in subsequent falls during a 6-month post-intervention period; (b) whether gains in lower-extremity muscle strength following the Tai Chi intervention mediate the relationship between the Tai Chi intervention and the endpoint of balance; and (c) whether gains in balance and muscle strength measures achieved by the Tai Chi group at the end of the trial phase will be sustained during the 6-month post-intervention follow-up phase. Randomized participants (N = 135) in each intervention arm will receive a 60-minute exercise program, 2 times per week, for 26 consecutive weeks. Primary and secondary endpoint outcomes will be collected at baseline, 3 months, and at the 6-month termination, and again at 6 months post-intervention. Data will be analyzed through repeated-measures analysis of covariance on the continuous variables, with the group assignment as a between-group factor, and time to follow-up assessment as a repeated measures factor, using baseline measures as covariates. Based on theoretical considerations and pilot work, the general structure of our hypotheses is that Tai Chi will show better performance results on primary and secondary outcome measures compared to the strength training condition or the low-impact exercise control. This study is unique because it represents an effort to offer a novel exercise intervention to a sample of PD patients who are confronted with postural instability and mobility problems.

描述（由申请人提供）：帕金森病 (PD) 是一种进行性神经系统疾病，通常会导致姿势不稳定，例如失去平衡和跌倒发生率增加。研究仅限于确定创新的物理干预措施，以改善姿势平衡和下肢肌肉力量，以维持帕金森病患者的日常身体机能。太极拳是一种平衡运动方式，已被证明可以有效改善平衡和预防跌倒，可能对帕金森病患者有益；然而，关于太极拳对帕金森病的影响的证据很少。基于前期工作，本申请提出了一项为期 6 个月的前瞻性、随机、对照、双盲临床试验，以研究帕金森病特异性太极拳运动计划对帕金森病患者的效果。该研究将包括三个实验组：太极拳、传统力量训练和低冲击运动控制。这项调查的主要目的是检验这样的假设：专门定制的太极拳计划将改善平衡和下肢肌肉力量的主要结果指标，以及身体表现、跌倒自我效能、跌倒恐惧和跌倒的恐惧等次要结果指标。轻度至中度 PD 患者（Hoehn 和 Yahr 量表 1、2 或 3 级）的跌倒频率。三个次要目标是检查：(a) 6 个月的太极干预带来的平衡终点的改善是否与干预后 6 个月期间跌倒的减少有关； (b) 太极干预后下肢肌肉力量的增加是否调节了太极干预与平衡终点之间的关系； (c) 太极拳组在试验阶段结束时所取得的平衡和肌肉力量指标的改善是否会在干预后 6 个月的随访阶段得以维持。每个干预组的随机参与者 (N = 135) 将接受 60 分钟的锻炼计划，每周 2 次，连续 26 周。主要和次要终点结果将在基线、3 个月、6 个月终止时以及干预后 6 个月时收集。将通过连续变量协方差的重复测量分析来分析数据，其中组分配作为组间因素，随访评估时间作为重复测量因素，使用基线测量作为协变量。基于理论考虑和试点工作，我们假设的总体结构是，与力量训练条件或低影响运动控制相比，太极拳在主要和次要结果指标上将表现出更好的表现结果。这项研究是独一无二的，因为它代表了一项努力，为面临姿势不稳定和活动问题的帕金森病患者样本提供一种新颖的运动干预措施。