Tai Chi for Osteopenic Women: A Pilot Randomized Controlled Trial

骨质疏松症是一个严重的和日益增长的公共卫生问题的妇女。未经治疗的骨质疏松妇女 患骨质疏松症的风险很高，骨折的风险也比骨骼正常的女性更高。 矿物质密度（BMD）。低BMD相关骨折与显著的长期损伤相关， 高发病率和高医疗费用。与骨质疏松症的治疗指南相比， 对骨质减少妇女的预防性和可持续干预措施尚未得到明确界定。 目前治疗骨质减少妇女的指南一般包括建议定期 锻炼的太极，一种在美国越来越受欢迎的身心运动，显示出强大的潜力， 有效、可持续、安全和实用的干预措施。初步研究 提示太极拳可以降低绝经后妇女骨密度下降率。虽然暗示，这些 研究规模较小，有许多设计限制，主要包括亚洲女性， 与其他种族相比，具有较低的BMD和不同的骨几何形状和骨折风险。太极也 已被证明有效改善平衡，减少福尔斯和增加肌肉骨骼力量， 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。 我们建议进行一项随机对照试验，以评估太极拳作为辅助疗法的有效性和可行性 绝经后骨质疏松症妇女的标准治疗。48例骨质减少（T评分-1.0至-2.5） 年龄在45-65岁之间的妇女将从一个大型的多专业小组中招募。我们的主要目标是评估 招募和保留骨质疏松症妇女参加9个月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降低骨密度方面的初步数据。 使用骨转换敏感标志物和双能x线吸收测定法研究骨质减少妇女的骨丢失。 对于参与者的一个子集（n=16），太极拳的生物力学反应（例如，骨特异性机械 负荷和姿势稳定性）也将被评估。这项研究的结果将告知未来的设计 一项评估太极拳对骨质疏松妇女的益处和安全性的试验，以及生物力学和 生理机制，通过太极拳可能会影响BMD和骨折风险相关 骨质减少

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.