Tai Chi for Osteopenic Women: Design and Rationale of a Pragmatic Randomized Controlled Trial

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Tai Chi for Osteopenic Women: Design and Rationale of a Pragmatic Randomized Controlled Trial

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dc.contributor.author Connors, Ellen M
dc.contributor.author Fischer, Mary
dc.contributor.author Carroll, Danette
dc.contributor.author Wayne, Peter Michael
dc.contributor.author Buring, Julie Elizabeth
dc.contributor.author Davis, Roger B.
dc.contributor.author Bonato, Paolo
dc.contributor.author Patritti, Benjamin Lorenzo
dc.contributor.author Yeh, Gloria Y.
dc.contributor.author Cohen, Calvin Jay
dc.contributor.author Kiel, Douglas P.
dc.date.accessioned 2012-01-29T18:07:46Z
dc.date.issued 2010
dc.identifier.citation Wayne, Peter M, Julie E Buring, Roger B Davis, Ellen M Connors, Paolo Bonato, Benjamin Patritti, Mary Fischer, Gloria Y Yeh, Calvin J Cohen, Danette Carroll, and Douglas P Kiel. 2010. Tai Chi for osteopenic women: design and rationale of a pragmatic randomized controlled trial. BMC Musculoskeletal Disorders 11: 40. en_US
dc.identifier.issn 1471-2474 en_US
dc.identifier.uri http://nrs.harvard.edu/urn-3:HUL.InstRepos:8063391
dc.description.abstract Background: Post-menopausal osteopenic women are at increased risk for skeletal fractures. Current osteopenia treatment guidelines include exercise, however, optimal exercise regimens for attenuating bone mineral density (BMD) loss, or for addressing other fracture-related risk factors (e.g. poor balance, decreased muscle strength) are not well-defined. Tai Chi is an increasingly popular weight bearing mind-body exercise that has been reported to positively impact BMD dynamics and improve postural control, however, current evidence is inconclusive. This study will determine the effectiveness of Tai Chi in reducing rates of bone turnover in post-menopausal osteopenic women, compared with standard care, and will preliminarily explore biomechanical processes that might inform how Tai Chi impacts BMD and associated fracture risks. Methods/Design: A total of 86 post-menopausal women, aged 45-70y, T-score of the hip and/or spine -1.0 and -2.5, have been recruited from primary care clinics of a large healthcare system based in Boston. They have been randomized to a group-based 9-month Tai Chi program plus standard care or to standard care only. A unique aspect of this trial is its pragmatic design, which allows participants randomized to Tai Chi to choose from a pre-screened list of community-based Tai Chi programs. Interviewers masked to participants' treatment group assess outcomes at baseline and 3 and 9 months after randomization. Primary outcomes are serum markers of bone resorption (C-terminal cross linking telopeptide of type I collagen), bone formation (osteocalcin), and BMD of the lumbar spine and proximal femur (dual-energy X-ray absorptiometry). Secondary outcomes include health-related quality-of-life, exercise behavior, and psychological well-being. In addition, kinetic and kinematic characterization of gait, standing, and rising from a chair are assessed in subset of participants (n = 16) to explore the feasibility of modeling skeletal mechanical loads and postural control as mediators of fracture risk. Discussion: Results of this study will provide preliminary evidence regarding the value of Tai Chi as an intervention for decreasing fracture risk in osteopenic women. They will also inform the feasibility, value and potential limitations related to the use of pragmatic designs for the study of Tai Chi and related mind-body exercise. If the results are positive, this will help focus future, more in-depth, research on the most promising potential mechanisms of action identified by this study. Trial registration: This trial is registered in Clinical Trials.gov, with the ID number of NCT01039012. en_US
dc.language.iso en_US en_US
dc.publisher BioMed Central en_US
dc.relation.isversionof doi://10.1186/1471-2474-11-40 en_US
dc.relation.hasversion http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2845096/pdf/ en_US
dash.license LAA
dc.title Tai Chi for Osteopenic Women: Design and Rationale of a Pragmatic Randomized Controlled Trial en_US
dc.type Journal Article en_US
dc.description.version Version of Record en_US
dc.relation.journal BMC Musculoskeletal Disorders en_US
dash.depositing.author Wayne, Peter Michael
dc.date.available 2012-01-29T18:07:46Z
dash.affiliation.other SPH^Epidemiology en_US
dash.affiliation.other HMS^Population Medicine en_US
dash.affiliation.other HMS^Medicine-Brigham and Women's Hospital en_US
dash.affiliation.other SPH^Biostatistics en_US
dash.affiliation.other HMS^Medicine- Beth Israel-Deaconess en_US
dash.affiliation.other SPH^Biostatistics en_US

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