Tai Chi for Chronic Low Back Pain in Older Adults

太极拳治疗老年人慢性腰痛

• 批准号: 9076169
• 负责人: KAREN J SHERMAN
• 金额: $ 17.18万
• 依托单位: KAISER FOUNDATION HEALTH PLAN OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-05-01 至 2019-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9076169
• 关键词: Address; Adherence; Adult; Adverse effects; Affect; Age-Years; Aging; American; Area; Attention; Back; Back Pain; Beryllium; Caring; Chronic low back pain; Clinical Trials; Cognitive Therapy; Comorbidity; Control Groups; Dose; Effectiveness; Elderly; Elements; Equilibrium; Evaluation; Exclusion; Exclusion Criteria; Exercise; Feasibility Studies; Foundations; Future; Goals; Guidelines; Health; Image; Integrative Medicine; Knowledge; Maintenance; Medical; Mind; Mind-Body Intervention; Movement; Muscle; Muscle relaxants; National Center for Complementary and Alternative Medicine; Non-Steroidal Anti-Inflammatory Agents; Older Population; Opioid; Osteoporosis; Outcome; Pain; Participant; Pathology; Patients; Pharmaceutical Preparations; Phase; Physical Function; Physiological; Population; Prevalence; Procedures; Protocols documentation; Randomized; Randomized Clinical Trials; Randomized Controlled Trials; Research; Research Priority; Risk; Safety; Spinal Manipulation; Stretching; Supervision; Syndrome; Tai Ji; Techniques; Therapeutic; Treatment Effectiveness; United States National Institutes of Health; Wit; Work; Yoga; arm; chronic back pain; chronic pain; depressive symptoms; effective therapy; evidence based guidelines; exercise program; follow-up; high risk; improved; improved functioning; interest; named group; preference; protocol development; public health relevance; randomized trial; strength training; treatment as usual; trial comparing; young adult

 DESCRIPTION (provided by applicant): The ultimate goal of this project is to help fill the substantial gap in knowledge about safe and effective treatments for older adults with chronic low back pain. This deficiency is a particular problem because treatments that have been found safe and effective for younger adults may not be appropriate for an older population that is at higher risk of adverse effects and that may have different needs and treatment preferences. Tai Chi, which has been found effective for chronic back pain in younger adults, seems particularly well-suited for older adults with chronic low back pain because it includes multiple therapeutic elements, is gentle and has been found beneficial for a variety of health conditions more common to older adults. The goal of this project is to prepare the foundation for successfully conducting a full-scale trial evaluating the effectiveness of two doses of Tai Chi (Standard and Enhanced, which includes Standard + Maintenance Tai Chi) for improving chronic low back pain in older adults over the course of a year. In the first phase of this study (Aim 1), we will focus n finalization of a Standard Tai Chi protocol, development of the maintenance Tai Chi protocol and assessment of the feasibility of developing a credible attention control group. In the course of finalizing our feasibility trial documents, we will work with patient partners (older adults wit chronic low back pain) to adapt strategies for recruitment, adherence to Tai Chi, safety, and optimizing follow-up rates for this population and we will finalize the inclusion/exclusion criteri to maximize safety and generalizability. After finalizing the key study components, we will conduct a randomized feasibility trial comparing Enhanced Tai Chi with Usual Medical Care. Sixty-four older adults with cLBP - 65+ years of age will be randomized---32 to the Enhanced (standard + maintenance) Tai Chi and 32 to Usual Medical Care. Outcomes will be collected at 12, 26, and 52 weeks. We will evaluate the adequacy of key elements of the study developed in Aim 1 for inclusion in a full-scale trial. Finally, we will conduct debriefing discussion groups wih 30 trial participants to elicit their ideas for improving the procedures and protocols. This evaluation will address the overall feasibility of conducting a large trial and the value of includng the Enhanced dose Tai Chi treatment arm. If successful, this feasibility study will pave the way for conducting an adequately-powered randomized controlled trial evaluating the ability of Tai Chi to reduce the impact of chronic low back pain on older adults. In view of the absence of knowledge about clearly safe and effective treatments for this population, this line of research has the potential for substantially reducing the suffering of many Americans with back pain.

 描述（由申请人提供）：该项目的最终目标是帮助填补对患有慢性腰痛的老年人的安全和有效治疗的知识空白，这种缺陷是一个特殊的问题，因为已经发现安全和有效的治疗方法。对年轻人有效的太极拳可能不适用于出现不良反应的风险较高且可能有不同需求和治疗偏好的老年人群，而太极拳已被发现对年轻人的慢性背痛有效，但似乎特别有效。适合患有慢性腰痛的老年人，因为它包含多种治疗成分，性质温和，已被发现对老年人常见的各种健康状况有益。该项目的目标是为成功开展评估两剂 Tai 有效性的全面试验奠定基础。太极拳（标准太极拳和增强太极拳，包括标准太极拳 + 维持太极拳）在一年内改善老年人的慢性腰痛 在本研究的第一阶段（目标 1），我们将重点关注标准的最终确定。太极协议，开发维护太极协议评估建立可靠的注意力对照组的可行性 在最终确定可行性试验文件的过程中，我们将与患者伙伴（患有慢性腰痛的老年人）合作，调整招募、坚持太极拳、安全等策略。 ，并优化该人群的随访率，我们将最终确定纳入/排除标准，以最大限度地提高安全性和普遍性。在最终确定关键研究内容后，我们将进行一项随机可行性试验，比较增强太极拳与普通医疗护理。四个老年人患有 cLBP - 65 岁以上的患者将被随机分配——32 名参加增强型（标准 + 维持）太极拳，32 名参加常规医疗护理，我们将在第 12、26 和 52 周时收集结果。最后，我们将与 30 名试验参与者进行汇报讨论小组，以征求他们对改进程序和结果的想法。该评估将讨论进行大型试验的总体可行性以及包括增强剂量太极拳治疗组的价值。如果成功，该可行性研究将为评估能力的充分随机对照试验铺平道路。太极拳减少慢性腰痛对老年人的影响鉴于缺乏对这一人群明确安全有效的治疗方法的了解，这一研究有可能大大减少许多美国人的背痛痛苦。 。