EFFECTS OF TAI CHI ON MULTISITE PAIN AND BRAIN FUNCTIONS IN OLDER ADULTS

太极拳对老年人多部位疼痛和大脑功能的影响

• 批准号: 8637277
• 负责人: Suzanne G. Leveille
• 金额: $ 21.2万
• 依托单位: UNIVERSITY OF MASSACHUSETTS BOSTON
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-05-15 至 2016-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8637277
• 关键词: Adherence; Analgesics; Applications Grants; Area; Attention; Behavior Therapy; Biological Markers; Brain; Brain imaging; C-reactive protein; Characteristics; Chronic; Clinical Trials Design; Cognition; Cognitive; Communities; Complex; Control Groups; Data; Data Collection; Development; Disease; Elderly; Endorphins; Enrollment; Exercise; Exploratory/Developmental Grant; Fibromyalgia; Foundations; Gait; Human Genetics; Image; Individual; Inflammation; Inflammatory; Interleukin-6; Intervention; Link; Maintenance; Measures; Mediating; Meditation; Mind-Body Intervention; Motor; Musculoskeletal Pain; Older Population; Outcome Measure; Pain; Pain interference; Participant; Pathway interactions; Performance; Physical Function; Physical activity; Pilot Projects; Preparation; Production; Protocols documentation; Randomized; Randomized Controlled Trials; Recording of previous events; Recruitment Activity; Research Design; Role; Severities; Site; Symptoms; TNF gene; Tai Ji; Testing; Tumor Necrosis Factor-Beta; Tumor Necrosis Factor-alpha; Variant; Work; Yoga; beta-Endorphin; body-mind; central sensitization; chronic pain; clinically significant; cognitive function; disability; endogenous opioids; executive function; fall risk; falls; high risk; human old age (65+); improved; improved mobility; insight; novel; older patient; primary outcome; programs; public health relevance

DESCRIPTION (provided by applicant): Accumulating evidence supports that more pain, whether measured by number of pain sites or pain severity, is associated with poorer cognitive function and mobility, and fall risk in older persons. The attentional burden of pain may be a factor in the high rate of falls among older persons who have chronic multisite pain. Tai Chi which holistically integrates physical and cognitive functions offers the possibility not only of alleviating pain but also improving attention and mobility in the many older adults who have chronic multisite pain. This proposed pilot study of a Tai Chi intervention among older adults with multisite pain is a direct extension of our current work examining attentional demands of chronic pain in the older population. The main purpose of this randomized controlled trial is to assess the feasibility and acceptability of a 12-week Tai Chi program for older adults with chronic multisite pain and a history of falling. We will examine the effects of Tai Chi on pain characteristics, cognitive function, cognitively-mediated mobility, and levels of pain-related biomarkers in community-dwelling older adults with multisite pain and at least one fall in the past year (65 years and older, N=30 for Tai Chi group and N=30 for mild exercise control group). Our specific aims for this R21 developmental grant application are: 1) to assess the feasibility and acceptability of a 12-week randomized controlled Tai Chi program in preparation for a larger trial in community-residing older adults. Specifically, we will: 1A) Evaluate the feasibility of recruitment and engagement of older adults who have chronic multisite pain in a 12-week Tai Chi intervention; 1B) Determine the optimal Tai Chi/exercise protocol and data collection protocol for planning a larger trial; 1C) Assess the adherence of randomized participants to their assigned treatment; 1D) Obtain information on differences in outcome measures and variations to be used for power analysis in a larger trial. 2) To examine the efficacy of Tai Chi on pain characteristics, pain-related biomarkers, cognitive function and cognitively-mediated mobility. Specifically, we will: 2A) Determine the effects of Tai Chi on measures of pain severity and pain interference; 2B) Determine the effects of Tai Chi on performance in tests of attention and executive function; 2C) Determine the effects of Tai Chi on performance in complex mobility tasks (dual task gait measures); 2D) Determine the effects of Tai Chi on levels of C-reactive protein (CRP), interleukin 6 (IL-6), tumor necrosis factor alpha (TNF-¿), and beta endorphin (¿-endorphin). This study will provide novel insights into the effects of a non-invasive behavioral intervention, Tai Chi, on chronic multisite pain and the associated cognitive-motor functions in older adults. The results of this exploratory study will provide critical pilot data that will guid and inform a larger randomized controlled trial designed to establish the clinical significance of Tai Chi on chronic multisite pain in older adults and to investigate the mechanisms by which Tai Chi may improve chronic pain and pain-related cognitive-motor functions using brain imaging and human genetic approaches.

描述(由申请人提供)：越来越多的证据支持，更多的疼痛，无论是以疼痛部位的数量或疼痛严重程度衡量，都与老年人认知功能和灵活性较差以及跌倒风险有关。疼痛的注意力负担可能是患有慢性多部位疼痛的老年人跌倒发生率高的一个因素。太极从整体上整合了身体和认知功能，不仅可以缓解疼痛，还可以改善许多患有慢性多部位疼痛的老年人的注意力和灵活性。这项拟对患有多部位疼痛的老年人进行太极干预的试点研究是我们目前研究老年人慢性疼痛的注意力需求的直接扩展。这项随机对照试验的主要目的是评估对有慢性多部位疼痛和跌倒病史的老年人实施为期12周的太极计划的可行性和可接受性。我们将研究太极对有多部位疼痛和过去至少一次跌倒的社区老年人疼痛特征、认知功能、认知调节的活动能力和疼痛相关生物标记物水平的影响。 年龄(65岁及以上，太极组30人，轻度运动对照组30人)。我们对R21发展助学金申请的具体目的是：1)评估为期12周的随机对照太极计划的可行性和可接受性，为在社区居住的老年人进行更大规模的试验做准备。具体地说，我们将：1A)评估在为期12周的太极干预措施中招募和招募患有慢性多部位疼痛的老年人的可行性；1B)确定策划一项更大规模试验的最佳太极/锻炼方案和数据收集方案；1C)评估随机受试者对其分配的治疗的坚持情况；1D)获取关于结果衡量标准和变量方面的差异信息，以用于更大规模试验的能量分析。2)观察太极拳对疼痛特征、疼痛相关生物标志物、认知功能和认知活动的影响。具体地说，我们将：2A)确定太极对疼痛严重程度和疼痛干扰的影响；2B)确定太极对注意力和执行功能测试中表现的影响；2C)确定太极对复杂活动任务中表现的影响(双重任务步态测量)；2D)确定太极对C-反应蛋白(CRP)、白介素6(IL-6)、肿瘤坏死因子α(TNF-β)和β-内啡肽(β-EP)水平的影响。这项研究将为非侵入性行为干预--太极--对老年人慢性多部位疼痛及其相关认知运动功能的影响提供新的见解。这项探索性研究的结果将提供关键的先导数据，为一项更大规模的随机对照试验提供指导和信息，该试验旨在建立太极对老年人慢性多部位疼痛的临床意义，并利用脑成像和人类遗传方法研究太极可能改善慢性疼痛和与疼痛相关的认知运动功能的机制。