Relaxation-related CAM Therapies for Chronic Back Pain

美国外科医生学会肿瘤组，芝加哥，伊利诺伊州补充或替代医学（CAM）治疗的所有年龄的成年人。尽管CAM疗法在背痛中的应用很普遍，但在有效性和成本方面，它们之间的比较或与传统医学疗法的比较却知之甚少。评估老年人背痛治疗的研究特别罕见。这项研究将为一项全面的试验奠定基础，该试验评估了三种有前途的放松相关技术（按摩，太极和冥想）的相对有效性和成本，这些技术适用于患有慢性腰痛的老年人和年轻人。在第一阶段，我们将开发、测试和完善一项随机临床试验的具体组成部分，评估太极、按摩和冥想对慢性背痛的影响。这将包括治疗组和对照组的规范、受试者选择标准、招募和保留策略以及用于测量结果的工具的开发。在第二阶段，我们将使用在第一阶段开发的研究组件进行一项试点研究，旨在评估三种放松相关的治疗。30名慢性腰痛患者将被随机分配到以下各组：太极拳，按摩，冥想和持续的日常护理。随机分配至每种干预措施的受试者将在65岁以上和65岁以下的受试者之间平均分配。（招募对象将包括70多岁、80多岁及以上的受试者。试点研究将使我们能够识别和解决意想不到的问题，并估计一个足够的把握度的全面试验所需的样本量。在本项目结束时，我们将准备一个有竞争力的赠款提案，以评估与放松相关的CAM治疗慢性腰痛的老年人和年轻人。

American College of Surgeons Oncology Group, Chicago, Illinois complementary or alternative medical (CAM) therapies by adults of all ages. Despite the common use of CAM therapies for back pain, little is known about how they compare with each other or with conventional medical therapies in terms of effectiveness and cost. Studies evaluating back pain treatments for older adults are particularly rare. This study will lay the groundwork for a full-scale trial that evaluates the relative effectiveness and costs of three promising relaxation-related techniques (massage, tai chi, and meditation) that are appropriate for both older and younger adults with chronic low back pain. During Phase I, we will develop, test and refine specific components of a randomized clinical trial evaluating tai chi, massage and meditation for chronic back pain. This will include specification of treatment and comparison groups, subject selection criteria, recruitment and retention strategies, and development of instruments for measuring outcomes. During Phase II, we will use the study components developed during Phase I to conduct a pilot study designed to evaluate the three relaxation-related treatments. Thirty persons with chronic low back pain will be randomized to each of the following groups: tai chi, massage, meditation and continued usual care. The subjects randomized to each intervention will be divided equally between persons over and under age 65. (Recruitment will include subjects in their 70s, 80s, and older.) The pilot study will permit us to identify and resolve unanticipated problems and to estimate the sample sizes required for an adequately powered full-scale trial. At the conclusion of this project, we will be well positioned to prepare a competitive grant proposal to evaluate relaxation-related CAM therapies for treating both older and younger adults with chronic low back pain.