Tai Chi for Chronic Low Back Pain in Older Adults

太极拳治疗老年人慢性腰痛

• 批准号: 9076169
• 负责人: KAREN J SHERMAN
• 金额: $ 17.18万
• 依托单位: KAISER FOUNDATION HEALTH PLAN OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-05-01 至 2019-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9076169
• 关键词: Address; Adherence; Adult; Adverse effects; Affect; Age-Years; Aging; American; Area; Attention; Back; Back Pain; Beryllium; Caring; Chronic low back pain; Clinical Trials; Cognitive Therapy; Comorbidity; Control Groups; Dose; Effectiveness; Elderly; Elements; Equilibrium; Evaluation; Exclusion; Exclusion Criteria; Exercise; Feasibility Studies; Foundations; Future; Goals; Guidelines; Health; Image; Integrative Medicine; Knowledge; Maintenance; Medical; Mind; Mind-Body Intervention; Movement; Muscle; Muscle relaxants; National Center for Complementary and Alternative Medicine; Non-Steroidal Anti-Inflammatory Agents; Older Population; Opioid; Osteoporosis; Outcome; Pain; Participant; Pathology; Patients; Pharmaceutical Preparations; Phase; Physical Function; Physiological; Population; Prevalence; Procedures; Protocols documentation; Randomized; Randomized Clinical Trials; Randomized Controlled Trials; Research; Research Priority; Risk; Safety; Spinal Manipulation; Stretching; Supervision; Syndrome; Tai Ji; Techniques; Therapeutic; Treatment Effectiveness; United States National Institutes of Health; Wit; Work; Yoga; arm; chronic back pain; chronic pain; depressive symptoms; effective therapy; evidence based guidelines; exercise program; follow-up; high risk; improved; improved functioning; interest; named group; preference; protocol development; public health relevance; randomized trial; strength training; treatment as usual; trial comparing; young adult

 DESCRIPTION (provided by applicant): The ultimate goal of this project is to help fill the substantial gap in knowledge about safe and effective treatments for older adults with chronic low back pain. This deficiency is a particular problem because treatments that have been found safe and effective for younger adults may not be appropriate for an older population that is at higher risk of adverse effects and that may have different needs and treatment preferences. Tai Chi, which has been found effective for chronic back pain in younger adults, seems particularly well-suited for older adults with chronic low back pain because it includes multiple therapeutic elements, is gentle and has been found beneficial for a variety of health conditions more common to older adults. The goal of this project is to prepare the foundation for successfully conducting a full-scale trial evaluating the effectiveness of two doses of Tai Chi (Standard and Enhanced, which includes Standard + Maintenance Tai Chi) for improving chronic low back pain in older adults over the course of a year. In the first phase of this study (Aim 1), we will focus n finalization of a Standard Tai Chi protocol, development of the maintenance Tai Chi protocol and assessment of the feasibility of developing a credible attention control group. In the course of finalizing our feasibility trial documents, we will work with patient partners (older adults wit chronic low back pain) to adapt strategies for recruitment, adherence to Tai Chi, safety, and optimizing follow-up rates for this population and we will finalize the inclusion/exclusion criteri to maximize safety and generalizability. After finalizing the key study components, we will conduct a randomized feasibility trial comparing Enhanced Tai Chi with Usual Medical Care. Sixty-four older adults with cLBP - 65+ years of age will be randomized---32 to the Enhanced (standard + maintenance) Tai Chi and 32 to Usual Medical Care. Outcomes will be collected at 12, 26, and 52 weeks. We will evaluate the adequacy of key elements of the study developed in Aim 1 for inclusion in a full-scale trial. Finally, we will conduct debriefing discussion groups wih 30 trial participants to elicit their ideas for improving the procedures and protocols. This evaluation will address the overall feasibility of conducting a large trial and the value of includng the Enhanced dose Tai Chi treatment arm. If successful, this feasibility study will pave the way for conducting an adequately-powered randomized controlled trial evaluating the ability of Tai Chi to reduce the impact of chronic low back pain on older adults. In view of the absence of knowledge about clearly safe and effective treatments for this population, this line of research has the potential for substantially reducing the suffering of many Americans with back pain.

 描述（由适用提供）：该项目的最终目标是帮助填补有关慢性下背痛的老年人安全有效治疗方面的巨大差距。这种缺陷是一个特殊的问题，因为发现对年轻人的安全有效的治疗可能不适合面临不良影响风险且可能具有不同需求和治疗偏好的老年人。 Tai Chi对年轻人的慢性背痛有效，似乎特别适合患有慢性下背部疼痛的老年人，因为它包含多种治疗元素，很温和，并且被发现对各种健康状况更为常见的老年人有益。该项目的目的是为成功进行全面试验做好准备，以评估两次Tai Chi的有效性（标准和增强，包括标准 +维护Tai Chi），以改善一年中老年人的慢性下背痛。在这项研究的第一阶段（AIM 1），我们将重点核算标准的太极拳协议的最终确定，开发维护Tai Chi协议以及评估开发可靠的注意控制组的可行性。在最终确定可行性试验文件的过程中，我们将与患者伴侣（老年人）慢性腰痛）合作，以适应该人群的招募，遵守TAI CHI，安全性和优化的随访率，我们将最终确定纳入/排斥标准以最大程度地提高安全性和概括性。最终确定了关键研究组件后，我们将进行一项随机可行性试验，将增强的TAI CHI与通常的医疗保健进行比较。 64岁的CLBP-65岁以上的老年人将被随机分配--- 32年增强（标准 +维护）Tai Chi和32岁的Tai Chi和通常的医疗服务。结果将在12、26和52周收集。我们将评估AIM 1中开发的研究的关键要素的充分性，以纳入全面试验。最后，我们将进行汇报讨论小组WIH 30审判参与者，以提出他们改善程序和协议的想法。该评估将解决进行大型试验的总体可行性以及包括增强剂量的Tai Chi治疗组的价值。如果成功的话，这项可行性研究将为进行足够的随机对照试验铺平道路，以评估太极chi降低慢性下腰痛对老年人的影响的能力。鉴于对这一人群的明显安全有效治疗的知识，这一研究有可能大大减少许多背痛的美国人的苦难。