Tai Chi for Osteopenic Women: A Pilot Randomized Controlled Trial

描述（由申请人提供）：骨质减少是一个严重的和日益增长的妇女公共卫生问题。未经治疗的骨质疏松症妇女有很高的风险成为骨质疏松症，也有更大的风险骨折比妇女正常骨矿物质密度（BMD）。低BMD相关骨折与显著的长期损伤、高发病率和高医疗费用相关。与骨质疏松症的治疗指南相反，骨质疏松妇女的最佳预防和可持续干预措施尚未明确。目前的骨质减少妇女的治疗指南一般包括定期锻炼的建议。太极，一种在美国越来越受欢迎的身心运动，显示出作为低骨密度妇女的有效、可持续、安全和实用干预措施的强大潜力。初步研究表明，太极拳可以降低绝经后妇女的BMD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BMD较低且骨几何形状和骨折风险与其他种族群体不同的亚洲女性。太极也被证明是有效的改善平衡，减少福尔斯和增加肌肉骨骼的力量和灵活性。此外，太极拳已被证明是安全的老龄化和条件反射的人群。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妇女标准护理的辅助手段的有效性和可行性。将从一个大型的多专业小组实践中招募48名年龄在45-65岁之间的骨质疏松症（T评分-1.0至-2.5）女性。我们的主要目的是评估招募和保留骨质疏松症妇女进入9个月太极拳的随机对照试验的可行性。我们的第二个目的是收集太极拳在减少骨质疏松妇女骨丢失率的有效性的初步数据，使用敏感的骨转换标志物和双能X线吸收测定法。对于一部分参与者（n=16），还将评估太极拳的生物力学反应（例如骨骼特定机械负荷和姿势稳定性）。这项研究的结果将为未来试验的设计提供信息，该试验评估太极拳对骨质疏松女性的益处和安全性，以及太极拳可能影响BMD和骨质疏松相关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.