RecruitingACTRN12623001209684

The CHILL BONES trial: testing Tai Chi and high intensity resistance and impact training (HiRIT) as therapy for older adults with low bone mass.

A semi-randomised controlled trial investigating the effect of Tai Chi combined with high-intensity resistance and impact training (HiRIT) versus HiRIT alone on bone mass and autonomic nervous system activity in older adults with low bone mass.

Sponsor

Griffith University

Enrollment

168 participants

Start Date

Oct 20, 2023

Study Type

Interventional

Conditions

Autonomic Dysfunction Osteoporosis Fracture Osteopenia

Summary

Ageing results in gradual loss of bone mass, which increases our risk of fracture. Increased stress responses are also associated with ageing and may contribute to accelerated bone loss. This study will be the first to investigate whether Tai Chi (a gentle, mind-body exercise) is able to reduce stress responses and optimise osteoporosis rehabilitation outcomes (i.e. improve bone mass, falls risk) when practised in combination with high-intensity resistance and impact exercise.

Eligibility

Sex: Both males and femalesMin Age: 60 Yearss

Plain Language Summary

Simplified for easier understanding

As we age, our bones naturally become weaker, raising the risk of fractures from minor falls. This is called osteoporosis or low bone mass, and it is a major cause of disability in older Australians. High-intensity resistance and impact exercise (HiRIT) has been shown to build bone density in people with this condition, but it is demanding — and stress levels, which also rise with age, may be working against the gains. The CHILL BONES trial is exploring whether adding Tai Chi — a gentle, meditative movement practice — to HiRIT can enhance bone health outcomes by also lowering stress. Tai Chi is thought to calm the nervous system and reduce the stress hormones that accelerate bone loss. This study will be the first to test this combination. You may be eligible if you are aged 60 or older, live independently in the community, have a T-score below -1.0 (indicating low bone mass), are able to exercise twice per week for 8 months without a walking aid, and are not currently doing resistance training, impact training, or Tai Chi. People with uncontrolled cardiovascular disease, a pacemaker, recent fracture, or metal hip/spine implants are not eligible.

This summary was AI-generated to explain the trial in plain language. It is not medical advice. Always discuss eligibility with your doctor before enrolling in a clinical trial.

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Interventions

Arm 1: Tai Chi Participants will learn the 18 foundational movements of Shibashi style Tai Chi/Quigong. Progression will be achieved through altering the direction of exercise (incorporate multi-dire

Arm 1: Tai Chi Participants will learn the 18 foundational movements of Shibashi style Tai Chi/Quigong. Progression will be achieved through altering the direction of exercise (incorporate multi-directional movements) and increasing the challenge to balance through modification of base of support (foot position).. The instructor will provide participants with a selection of exercise progressions for each movement, and they will be encouraged to progress their exercises as able. Each week, participants will complete a 60-minute community-based Tai Chi group session, supervised by a qualified Tai Chi instructor, and an unsupervised, 30-minute session of home-based exercise with a standardised instructional video (delivered by the same instructor). The intervention will be performed on non-consecutive days over a period of 8 months. A participant logbook will be completed after every session, to monitor compliance. Arm 2: HiRIT A recognised bone-targeted program comprised of 5 sets of 5 repetitions of four exercises (jumping chin up with drop landing, back squat, overhead press, deadlift) will be completed. Resistance exercises will be progressed by gradually increasing the load over the first 2 months to achieve an intensity of 80-85% of 1 repetition maximum (1RM) (based on individual strength). The load for each exercise will continue to increase across the remainder of the intervention period, ensuring an intensity of 80-85% 1RM is maintained as participants adapt to the resistance exercise. The impact exercise (jumping chin up) will progress from a soft knee landing style to a stiff legged landing style, as able. Each week, participants will complete two supervised, 30-minute sessions of HiRIT in a group setting, on the university campus. These sessions will be performed on non-consecutive days, supervised by a trained physiotherapist for a period of 8 months. A participant logbook will be completed after every session, to monitor compliance and progression. Arm 3: Combined Tai Chi + HiRIT As this is a combined intervention, participants will undertake all components of Arm 1 and Arm 2 (Tai Chi and HiRIT) for the 8-month intervention period. Participants will complete HiRIT (30 mins) followed by supervised community-based Tai Chi (60 mins) once per week. They will also complete a second HiRIT session (30 mins) followed by an unsupervised home-based Tai Chi session (30 mins) performed with the same instructional video as per Arm 1. Each intervention day will be separated by at least 24 hours. Progressions for each intervention are as per Arm 1 and Arm 2. A participant logbook will be completed after every session to monitor compliance and progression.