Tai Chi for Osteopenic Women: A Pilot Randomized Controlled Trial

骨质疏松症是一个严重且日益严重的女性公共健康问题。未经治疗的骨质疏松症女性 有很高的骨质疏松风险，也比骨骼正常的女性有更大的骨折风险 矿物质密度(BMD)。与低骨密度相关的骨折与显著的长期损伤有关， 发病率高，医疗费用高。与骨质疏松症的治疗指南相比，最佳 对骨质疏松症妇女的预防性和可持续干预措施还没有明确的定义。 目前对骨质疏松症妇女的治疗指南一般包括推荐常规的 锻炼身体。太极，一种在美国越来越受欢迎的身心健康运动，显示出强大的潜力 对低骨密度妇女进行有效、可持续、安全、实用的干预。初步研究 提示太极拳可以降低绝经后妇女骨密度下降率。虽然具有提示性，但这些 研究规模较小，有许多设计限制，主要包括已知的 与其他民族相比，他们的骨密度较低，骨几何形状和骨折风险也不同。太极也有 已被证明在改善平衡、减少跌倒和增加肌肉骨骼力量方面有效 灵活性。此外，太极已被证明在老龄化和身体状况不佳的人群中是安全的。 我们提出了一项试点随机对照试验来评估太极作为辅助运动的有效性和可行性。 绝经后骨质疏松症妇女的标准护理。48名骨质疏松症患者(T分-1.0至-2.5) 年龄在45-65岁的女性将从一个大型的多专业团体诊所招募。我们的主要目标是评估 招募和保留骨质疏松症妇女参加为期9个月的随机对照试验的可行性 太极。我们的次要目标是收集太极在降低骨量方面的效果的初步数据 使用骨转换敏感标记物和双能x射线骨密度仪测定骨量减少妇女的骨丢失。 对于一组参与者(n=16)，太极的生物力学反应(例如，特定于骨骼的机械反应 负荷和体位稳定性)也将被评估。这项研究的结果将为未来的设计提供参考 试验评估太极对骨质疏松症女性的益处和安全性，以及生物力学和 太极拳可能影响骨密度和骨折风险的生理机制 骨量减少。

Osteopenia is a serious and growing public health concern for women. Untreated osteopenic women are at high risk of becoming osteoporotic, and also are at greater risk for fractures than women with normal bone mineral densities (BMD). Low BMD-related fractures are associated with significant long-term impairment, high morbidity rates and high medical costs. In contrast to the treatment guidelines for osteoporosis, optimal preventive and sustainable interventions for osteopenic women are not yet well-defined. Current guidelines for the treatment of osteopenic women generally include the recommendation of regular exercise. Tai Chi,a mind-body exercise that is growing in popularity in the U.S., shows strong potential as an effective, sustainable, safe and practical intervention for women with low bone density. Preliminary studies suggest Tai Chi can reduce rates of BMD decline in post-menopausal women. While suggestive, these studies are small, have numerous design limitations, and include primarily Asian women who are known to have lower BMD and different bone geometry and fracture risk than other ethnic groups. Tai Chi has also been shown to be effective in improving balance, reducing falls and increasing musculoskeletal strength and flexibility. Moreover, Tai Chi has been shown to be safe in aging and de-conditioned populations. We propose a pilot randomized controlled trial to assess the efficacy and feasibility of Tai Chi as an adjunct to standard care for post-menopausal osteopenic women. Forty-eight osteopenic (T-scores -1.0 to -2.5) women ages 45-65 will be recruited from a large multispecialty group practice. Our primary aim is to assess the feasibility of recruiting and retaining osteopenic women into a randomized controlled trial of 9 months of Tai Chi.Our secondary aim is to collect preliminary data on the efficacy of Tai Chi in reducing rates of bone loss in osteopenic women using sensitive markers of bone turnover and dual-energy x-ray absorptiometry. For a subset of participants (n=16), biomechanical responses to Tai Chi (e.g.bone-specific mechanical loading and postural stability) will also be assessed. The results of this study will inform the design of a future trial evaluating the benefits and safety of Tai Chi for osteopenic women, as well as the biomechanical and physiological mechanisms through which Tai Chi may impact BMD and fracture risks associated with osteopenia.