Real time biofeedback Tai Chi training for knee osteoarthritis: A feasibility study

项目总监/首席调查员(刘伟)： 摘要 这个导师职业发展奖(K23)的总体目标是支持刘伟博士成为一名 补充和替代医学(CAM)和慢性疼痛领域的独立研究员，具有 专注于生物反馈太极拳干预的开发和测试。由典型的残疾引起的残疾 膝骨性关节炎(OA)的损害包括肌肉力量下降，活动范围减少，以及 有氧心血管功能下降。大量膝骨性关节炎患者出现残疾 需要康复。传统的太极干预疗法(TC)已被看好的治疗介入治疗 膝骨性关节炎的疼痛减轻，但TC作为膝骨性关节炎干预的疗效已被证明是非决定性的，因为 膝关节骨性关节炎患者表现为膝关节机械负荷差异很大的TC，这种变化可能是 TC研究中的混杂因素。因此，刘博士建议在目标1中进行可行性研究，以量化 膝关节外收瞬间(EKAM)是TC期间膝骨性关节炎疾病严重程度和进展的有力预测指标 练习，在目标2中，他将引入实时生物反馈太极训练(BTC)，并看看是否可行 使用作用在膝盖上的扭矩的生物反馈，通过减少Ekam来修改一些TC形式。在《目标3》中，他将 进行一项初步研究，以确定使用优化的BTC训练减轻膝骨关节炎疼痛的可行性。 这项拟议的研究是第一次确定TC运动的生物力学机制的研究。 (目标1和目标2)和目标Ekam，使用实时生物反馈方法和独立操作Ekam 用于TC干预(目标3)。我们可以改变TC的膝关节内侧负荷反应。Ekam将是一个 膝骨性关节炎患者TC干预的生物力学指标与临床结果的关系。在完成时 在AIM 3的试点试验中，优化的BTC干预将准备在R33上进行测试，以评估其 功效。这项建议代表了一个为期5年的全面指导、培训和研究过渡计划。 这位候选人刘博士将成为一名成功的独立调查员。到颁奖期结束时，Dr。 刘将对CAM研究领域做出重大贡献。已经是生物力学专家了 接近太极，他将被定位为开发和测试新型CAM的领导者 这一领域的干预措施，包括进行行为临床试验。 OMB编号0925-0001/0002(03/16修订版批准至2018年10月31日)页面续格式页面

Program Director/Principal Investigator (Liu, Wei): Abstract The overall goal of this mentored career development award (K23) is to support Wei Liu, PhD to become an independent investigator in the field of complementary and alternative medicine (CAM) and chronic pain, with a focus on biofeedback Tai Chi intervention development and testing. Disabilities that arise from typical impairments of knee osteoarthritis (OA) include decreased muscle strength, reduced range of motion, and decreased aerobic cardiovascular function. A large number of individuals with knee OA experience disability and require rehabilitation. Traditional Tai Chi intervention (TC) has been promising therapeutic intervention for pain reduction in knee OA, but the efficacy of TC as a knee OA intervention have proven inconclusive because individual with knee OA performed TC with widely varying mechanical knee joint loads, this variation could be a confounding factor in any study of TC. Therefore, Dr. Liu proposes a feasibility study in Aim 1 to quantify external knee adduction moment (EKAM), a strong predictor of OA disease severity and progression during TC practice, and in Aim 2, he will introduce real time biofeedback Tai Chi training (BTC) and see if it is feasible to use biofeedback of torque acting on the knee to modify some TC forms by reducing EKAM. In Aim 3, he will conduct a pilot study to determine the feasibility of using optimized BTC training for OA knee pain reduction. The proposed research represents the first study to identify the biomechanical mechanisms of TC exercise (Aim 1 and 2) and target EKAM by using real-time biofeedback approach and manipulate EKAM independently for TC intervention (Aim 3). We can alter medial knee joint loading response of TC. EKAM would be a biomechanical marker for TC intervention associated with clinical outcomes in knee OA. At the completion of the pilot trial in Aim 3, the optimized BTC intervention will be ready to be tested in an R33 to evaluate its efficacy. This proposal represents a 5-year comprehensive mentoring, training and research plan to transition the candidate, Dr. Liu, to a career as a successful independent investigator. By end of the award period, Dr. Liu will have contributed substantially to the field of CAM research. Already an expert on biomechanical approaches to Tai Chi, he will be positioned to become a leader in developing and testing novel CAM interventions in this area, including conducting behavioural clinical trials. OMB No. 0925-0001/0002 (Rev. 03/16 Approved Through 10/31/2018) Page Continuation Format Page