Tai Chi for osteopenic women: design and rationale of a pragmatic randomized controlled trial.
Tai Chi for osteopenic women: design and rationale of a pragmatic randomized controlled trial.
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DOI：
10.1186/1471-2474-11-40
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发表时间：
2010-03-01
影响因子：
2.3
通讯作者：
Kiel DP
中科院分区：
文献类型：
--
作者：
Wayne PM;Buring JE;Davis RB;Connors EM;Bonato P;Patritti B;Fischer M;Yeh GY;Cohen CJ;Carroll D;Kiel DP
绝经后骨质减少的妇女骨折的风险增加。目前的骨量减少治疗指南包括运动，然而，用于减轻骨矿物质密度（BMD）损失或用于解决其他骨质疏松相关风险因素（例如平衡不良，肌肉力量下降）的最佳运动方案尚未明确定义。太极是一种越来越受欢迎的负重身心运动，据报道，它对BMD动态有积极影响，并改善姿势控制，然而，目前的证据还不确定。这项研究将确定太极拳在降低绝经后骨质疏松妇女骨转换率方面的有效性，与标准治疗相比，并将初步探索生物力学过程，可能会告知太极拳如何影响BMD和相关的骨折风险。从位于波士顿的大型医疗保健系统的初级保健诊所招募了总共86名绝经后妇女，年龄为45- 70岁，髋关节和/或脊柱的T评分为-1.0和-2.5。他们被随机分配到一个基于组的9个月太极计划加标准护理或标准护理。这项试验的一个独特之处在于其务实的设计，它允许随机分配到太极拳的参与者从基于社区的太极拳计划的预先筛选列表中进行选择。对参与者治疗组不知情的访谈者评估了基线和随机化后3个月和9个月的结果。主要结果是骨吸收的血清标志物（I型胶原的C末端交联端肽）、骨形成（骨钙素）和腰椎和股骨近端的BMD（双能X线吸收测定法）。次要结果包括与健康相关的生活质量、锻炼行为和心理健康。此外，步态，站立，从椅子上站起来的动力学和运动学特征进行了评估的参与者（n = 16）的子集，探讨建模骨骼机械负荷和姿势控制的骨折风险的介质的可行性。这项研究的结果将提供有关太极拳作为减少骨质疏松妇女骨折风险的干预价值的初步证据。他们还将告知与太极拳和相关身心锻炼研究的实用设计的使用相关的可行性，价值和潜在的限制。如果结果是积极的，这将有助于将未来的重点放在本研究确定的最有希望的潜在作用机制上。本试验在Clinical Trials.gov注册，ID编号为NCT 01039012。
Post-menopausal osteopenic women are at increased risk for skeletal fractures. Current osteopenia treatment guidelines include exercise, however, optimal exercise regimens for attenuating bone mineral density (BMD) loss, or for addressing other fracture-related risk factors (e.g. poor balance, decreased muscle strength) are not well-defined. Tai Chi is an increasingly popular weight bearing mind-body exercise that has been reported to positively impact BMD dynamics and improve postural control, however, current evidence is inconclusive. This study will determine the effectiveness of Tai Chi in reducing rates of bone turnover in post-menopausal osteopenic women, compared with standard care, and will preliminarily explore biomechanical processes that might inform how Tai Chi impacts BMD and associated fracture risks. A total of 86 post-menopausal women, aged 45-70y, T-score of the hip and/or spine -1.0 and -2.5, have been recruited from primary care clinics of a large healthcare system based in Boston. They have been randomized to a group-based 9-month Tai Chi program plus standard care or to standard care only. A unique aspect of this trial is its pragmatic design, which allows participants randomized to Tai Chi to choose from a pre-screened list of community-based Tai Chi programs. Interviewers masked to participants' treatment group assess outcomes at baseline and 3 and 9 months after randomization. Primary outcomes are serum markers of bone resorption (C-terminal cross linking telopeptide of type I collagen), bone formation (osteocalcin), and BMD of the lumbar spine and proximal femur (dual-energy X-ray absorptiometry). Secondary outcomes include health-related quality-of-life, exercise behavior, and psychological well-being. In addition, kinetic and kinematic characterization of gait, standing, and rising from a chair are assessed in subset of participants (n = 16) to explore the feasibility of modeling skeletal mechanical loads and postural control as mediators of fracture risk. Results of this study will provide preliminary evidence regarding the value of Tai Chi as an intervention for decreasing fracture risk in osteopenic women. They will also inform the feasibility, value and potential limitations related to the use of pragmatic designs for the study of Tai Chi and related mind-body exercise. If the results are positive, this will help focus future, more in-depth, research on the most promising potential mechanisms of action identified by this study. This trial is registered in Clinical Trials.gov, with the ID number of NCT01039012.
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DOI：
10.1111/j.1532-5415.1998.tb02461.x
发表时间：
1998-04-01
影响因子：
6.3
作者：
Cho, CY;Kamen, G
通讯作者：
Kamen, G
影响因子：
4
作者：
Fall, PM;Kennedy, D;Raisz, LG
通讯作者：
Raisz, LG
DOI：
10.1249/01.mss.0000064941.43869.4e
发表时间：
2003-05-01
期刊：
MEDICINE AND SCIENCE IN SPORTS AND EXERCISE
影响因子：
--
作者：
Hayden-Wade, HA;Coleman, KJ;Armstrong, C
通讯作者：
Armstrong, C
影响因子：
4
作者：
Berard, A;Bravo, G;Gauthier, P
通讯作者：
Gauthier, P
影响因子：
4
作者：
Genant, HK;Majumdar, S
通讯作者：
Majumdar, S