Challenges inherent to T'ai Chi research:: Part II -: Defining the intervention and optimal study design
Challenges inherent to T'ai Chi research:: Part II -: Defining the intervention and optimal study design
复制标题
DOI：
10.1089/acm.2007.7170b
复制
发表时间：
2008-03-01
影响因子：
2.6
通讯作者：
Kaptchuk, Ted J.
中科院分区：
文献类型：
--
作者：
Wayne, Peter M.;Kaptchuk, Ted J.
尽管越来越多的临床研究已经开始评估太极拳作为治疗多种健康状况的工具的有效性和安全性，但很少有人关注评估太极拳的科学研究“如何”以及不同方法的优点或局限性。在本文的配套文件（第一部分）中，我们认为太极拳是一种复杂的、多成分的干预措施，它对区分特定与非特定效果以及使用简化研究框架的局限性提出了独特的挑战。在第二篇配套论文中，我们讨论了在实验范式中精确定义太极拳干预所固有的其他障碍。这些挑战包括太极拳的多元化、太极拳剂量的概念以及太极拳功效和安全性的长期与短期评估。为了应对这些挑战，并以提供完整和公正的证据为目标，我们提出了一种多元化的临床研究方法，包括固定方案的对照随机试验、基于社区的实用试验、长期从业者的横断面研究以及整合定性方法的研究。
Although a growing body of clinical research has begun to evaluate the efficacy and safety of t'ai chi as a therapeutic tool for a variety of health conditions, little attention has been devoted to evaluating "how" t'ai chi is scientifically studied, and the advantages or limitations of different methodological approaches. In a companion to this paper ( Part I), we argued that t'ai chi is a complex, multicomponent intervention, which poses unique challenges regarding the distinction of specific versus nonspecific effects and limitations regarding the use of reductionistic research frameworks. In this second, companion paper, we discuss additional obstacles inherent in precisely defining the t'ai chi intervention in an experimental paradigm. These challenges include t'ai chi's pluralism, the concept of t'ai chi dosage, and long-versus short-term evaluations of t'ai chi's efficacy and safety. To address these challenges, and with a goal to provide complete and unbiased evidence, we propose a pluralistic methodological approach to clinical research that includes controlled randomized trials of fixed protocols, community-based pragmatic trials, cross-sectional studies of long-term practitioners, and studies that integrate qualitative methods.