Tai Chi for Osteopenic Women: A Pilot Randomized Controlled Trial

描述(由申请人提供)：骨量减少是一个严重的和日益严重的妇女公共卫生问题。未经治疗的骨质疏松症女性患骨质疏松症的风险很高，而且与骨矿密度正常的女性相比，骨折的风险也更大。低骨密度相关骨折与严重的长期损伤、高发病率和高医疗费用相关。与骨质疏松症的治疗指南相比，针对骨质疏松妇女的最佳预防和可持续干预措施尚未得到明确定义。目前治疗骨质疏松症女性的指南一般包括定期锻炼的建议。太极是一种在美国越来越受欢迎的身心运动，它显示出强大的潜力，可以作为一种有效、可持续、安全和实用的干预措施，适用于骨密度较低的女性。初步研究表明，太极可以降低绝经后女性的骨密度下降率。虽然这些研究具有提示性，但这些研究规模较小，存在许多设计限制，主要包括亚洲女性，她们已知骨密度较低，骨几何形状和骨折风险与其他种族群体不同。太极还被证明在改善平衡、减少跌倒以及增加肌肉骨骼力量和灵活性方面都很有效。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，以评估太极作为绝经后骨质疏松症女性标准护理的辅助手段的有效性和可行性。年龄在45-65岁之间的48名骨质疏松症(T-Score-1.0至-2.5)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女性参加9个月太极的随机对照试验的可行性。我们的第二个目标是使用骨转换的敏感标记物和双能X射线吸收测量法收集太极在减少骨量减少妇女骨丢失率方面的有效性的初步数据。对于一组参与者(n=16)，也将评估对太极的生物力学反应(例如，特定于骨骼的机械负荷和姿势稳定性)。这项研究的结果将为未来的试验设计提供参考，评估太极对骨质疏松症女性的益处和安全性，以及太极可能影响与骨质疏松症相关的骨密度和骨折风险的生物力学和生理机制。

DESCRIPTION (provided by applicant): 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.