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

实时生物反馈太极拳训练治疗膝骨关节炎：可行性研究

• 批准号: 9976459
• 负责人: Wei Liu
• 金额: $ 16.48万
• 依托单位: VIRGINIA COLLEGE OF OSTEOPATHIC MEDICINE
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-08-15 至 2020-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9976459
• 关键词: Aerobic; Affect; Area; Articular Range of Motion; Award; Biofeedback; Biofeedback Training; Biomechanics; Calibration; Cardiovascular Physiology; Chronic; Clinical; Clinical Investigator; Clinical Trials Design; Collaborations; Complementary Health; Complementary and alternative medicine; Data; Degenerative polyarthritis; Development; Diagnostic radiologic examination; Disease Progression; Doctor of Philosophy; Educational Intervention; Effectiveness; Equilibrium; Exercise; Exercise Test; Feasibility Studies; Future; Goals; Grant; Health; Impairment; Individual; Integrative Medicine; Intervention; Joint Instability; K-Series Research Career Programs; Knee; Knee Osteoarthritis; Knee joint; Knowledge; Learning; Measures; Mechanics; Medial; Mentored Patient-Oriented Research Career Development Award; Mentors; Mentorship; Mind-Body Intervention; Mission; Movement; Muscle Weakness; Outcome; Pain; Patients; Performance; Pilot Projects; Population; Positioning Attribute; Principal Investigator; Publishing; Rehabilitation therapy; Research; Research Personnel; Research Training; Rheumatology; Risk; Series; Severity of illness; Speed; Statistical Data Interpretation; Strategic Planning; Tai Ji; Technology; Testing; Therapeutic Intervention; Time; Torque; Training; Training Programs; Variant; Walking; Western Ontario and McMaster Universities Arthritis Index; Work; base; behavioral clinical trial; career; chronic pain; compliance behavior; design; disability; exercise intervention; experience; experimental analysis; functional improvement; improved; insight; joint loading; knee pain; mechanical load; muscle strength; novel; osteoarthritis pain; pain reduction; pain symptom; patient oriented research; pilot trial; programs; public health relevance; recruit; reduced muscle strength; response; therapy development

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

项目负责人/主要研究者（刘伟）： 摘要 这个指导职业发展奖（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调查员， 专注于生物反馈太极拳干预的开发和测试。由典型的 膝骨关节炎（OA）的损伤包括肌肉力量降低、运动范围减小， 有氧心血管功能下降。大量膝关节骨性关节炎患者出现残疾 需要康复治疗传统的太极拳干预（TC）已经成为有前途的治疗干预， 膝关节OA的疼痛减轻，但TC作为膝关节OA干预的有效性尚未得到证实，因为 膝关节OA患者在膝关节机械负荷变化很大的情况下进行TC，这种变化可能是 任何TC研究中的混杂因素。因此，刘博士在目标1中提出了一项可行性研究， 膝关节外收力矩（EKAM），TC期间OA疾病严重程度和进展的强预测因子 在目标2中，他将介绍真实的时间生物反馈太极训练（BTC），看看是否可行， 使用作用于膝关节的扭矩的生物反馈，通过减少EKAM来修改某些TC形式。在目标3中，他将 进行一项试点研究，以确定使用优化的BTC训练减轻OA膝关节疼痛的可行性。 这项研究是第一个确定TC运动生物力学机制的研究 (Aim 1和2），并通过使用实时生物反馈方法靶向EKAM，并独立操纵EKAM 用于TC干预（目标3）。我们可以改变TC的内侧膝关节负荷反应。EKAM将是一个 TC干预的生物力学指标与膝关节OA的临床结局相关。完成时 目标3中的试点试验，优化的BTC干预将准备在R33中进行测试，以评估其 功效本提案是一项为期5年的全面指导、培训和研究计划， 候选人，刘博士，作为一个成功的独立调查员的职业生涯。在奖励期结束时，博士。 刘将为CAM研究领域做出重大贡献。已经是生物力学专家了 接近太极拳，他将被定位成为开发和测试新型CAM的领导者 这方面的干预措施，包括进行行为临床试验。 OMB编号0925-0001/0002（2016年3月修订版，批准至2018年10月31日）