Impact of Tai Chi exercise on multiple fracture-related risk factors in post-menopausal osteopenic women: a pilot pragmatic, randomized trial

BMC Complementary and Alternative Medicine

Research Article

Ellen M Connors¹  Chiara Mancinelli¹  Paolo Bonato¹  Peter M Wayne²  Julie E Buring²  Gloria Y Yeh³  Roger B Davis⁴  Calvin J Cohen⁴  Douglas P Kiel⁵ 

[1] Department of Physical Medicine and Rehabilitation, Harvard Medical School, Spaulding Rehabilitation Hospital, 02114, Boston, MA, USA;Division for Preventive Medicine, Brigham and Women's Hospital, Harvard Medical School, 02215, Boston, MA, USA;Division of General Medicine and Primary Care, Department of Medicine, Beth Israel Deaconess Medical Center, 330 Brookline Ave, 02215, Boston, MA, USA;Harvard Vanguard Medical Associates, Internal Medicine, 133 Brookline Avenue, 02215, Boston, MA, USA;Institute for Aging Research, Hebrew SeniorLife, Harvard Medical School, 1200 Centre Street, 02131, Boston, MA, USA;Division of Gerontology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave, 02215, Boston, MA, USA;

关键词: Bone Mineral Density;    Usual Care Group;    Bone Mineral Density Loss;    Quiet Standing;    Physical Activity Recall;   

DOI  :  10.1186/1472-6882-12-7

 received in 2011-08-30, accepted in 2012-01-30,  发布年份 2012

来源: Springer

【 摘 要 】

BackgroundTai Chi (TC) is a mind-body exercise that shows potential as an effective and safe intervention for preventing fall-related fractures in the elderly. Few randomized trials have simultaneously evaluated TC's potential to reduce bone loss and improve fall-predictive balance parameters in osteopenic women.MethodsIn a pragmatic randomized trial, 86 post-menopausal osteopenic women, aged 45-70, were recruited from community clinics. Women were assigned to either nine months of TC training plus usual care (UC) vs. UC alone. Primary outcomes were changes between baseline and nine months of bone mineral density (BMD) of the proximal femur and lumbar spine (dual-energy X-ray absorptiometry) and serum markers of bone resorption and formation. Secondary outcomes included quality of life. In a subsample (n = 16), quiet standing fall-predictive sway parameters and clinical balance tests were also assessed. Both intent-to-treat and per-protocol analyses were employed.ResultsFor BMD, no intent-to-treat analyses were statistically significant; however, per protocol analyses (i.e., only including TC participants who completed ≥ 75% training requirements) of femoral neck BMD changes were significantly different between TC and UC (+0.04 vs. -0.98%; P = 0.05). Changes in bone formation markers and physical domains of quality of life were also more favorable in per protocol TC vs. UC (P = 0.05). Changes in sway parameters were significantly improved by TC vs. UC (average sway velocity, P = 0.027; anterior-posterior sway range, P = 0.014). Clinical measures of balance and function showed non-significant trends in favor of TC.ConclusionsTC training offered through existing community-based programs is a safe, feasible, and promising intervention for reducing multiple fracture risks. Our results affirm the value of a more definitive, longer-term trial of TC for osteopenic women, adequately powered to detect clinically relevant effects of TC on attenuation of BMD loss and reduction of fall risk in this population.Trial RegistrationClinicalTrials.gov: NCT01039012

【 授权许可】

CC BY   
© Wayne et al; licensee BioMed Central Ltd. 2012