Document text
Principal Investigator: Deanna L. Mori
Organization: BOSTON UNIVERSITY MEDICAL CAMPUS
Fiscal Year: 2024
Award: $229,976
Funding agency: National Center for Complementary and Integrative Health
Project Summary
Posttraumatic stress disorder (PTSD) affects almost one quarter of military Veterans seeking care from
Veterans Administration healthcare facilities. PTSD is associated with many health-related issues, especially
chronic musculoskeletal pain, and is increasingly considered a systemic disorder, affecting both mind and
body. Accessible treatments that address PTSD and chronic pain are urgently needed. Tai Chi is an ancient
Chinese exercise that uses an integrated mind-body approach to enhance quality of life. Tai Chi delivered in
groups has been shown to improve both mental health and physical health in patients with a variety of chronic
conditions. However, no studies to date have examined Tai Chi for PTSD and pain in Veterans. Since the
onset of COVID-19, interventions that can be delivered without the need for face-to-face contact are greatly
needed. Remote mind-body interventions delivered via videoconferencing platforms can reduce barriers to
treatment for Veterans isolated by PTSD-related avoidance, travel related challenges, or public health social
distancing restrictions. The proposed study will evaluate the feasibility of remotely delivered Tai Chi for PTSD
and pain in Veterans. This trial represents first steps toward a long-term goal of establishing this mind-body
treatment to address these maladies for Veterans via a remote videoconferencing platform. In Phase One, the
research team will adapt and do a ‘dry run’ of two existing 12-week, twice per week interventions (Tai Chi and
a Wellness control) for delivery via videoconferencing for the study population. In Phase One, the team will
recruit 12 participants (6 in each group) and utilize quantitative and qualitative feedback to refine and
standardize the interventions. In Phase Two, 36 participants will be randomly assigned over 3 cohorts (n = 12
for each cohort, n = 6 for each group) to either a Tai Chi or a Wellness group for 12 weeks with a three-month
post-treatment follow up assessment. The feasibility and acceptability of a remotely delivered randomized trial
of these two interventions and the assessment protocols will be determined. Feasibility will be quantified using
rates of participant eligibility, recruitment, attrition, and adherence to the treatment and assessment protocols.
Feasibility will be indicated (1) by the ability to meet recruitment goals, including women and minority
participation, and (2) by having at least 75% of participants regularly attend sessions and engage in home
practice and 70% complete post-intervention and follow-up assessments. Acceptability will be assessed via
participants’ ratings on a standardized measure of treatment satisfaction, supplemented by qualitative exit
interviews. Acceptability will be indicated by 70% of the participants reporting treatment satisfaction and
credibility. Information from this trial will be utilized to design a large randomized control study evaluating the
efficacy of Tai Chi for improving outcomes for Veterans with PTSD and chronic musculoskeletal pain. The
proposed study will be pivotal to establish procedures to fully evaluate a novel, accessible, nonpharmacologic
approach for symptom management of PTSD and chronic pain in a future large-scale trial of Tai Chi.
Terms: <Access to Care><Active Follow-up><Address><Adherence><Aerobic><Affect><After Care><After-Treatment><Aftercare><Armed Forces Personnel><Boston><COVID crisis><COVID epidemic><COVID pandemic><COVID-19><COVID-19 crisis><COVID-19 epidemic><COVID-19 era><COVID-19 global health crisis><COVID-19 global pandemic><COVID-19 health crisis><COVID-19 pandemic><COVID-19 period><COVID-19 public health crisis><COVID-19 years><CV-19><Cardiovascular><Cardiovascular Body System><Cardiovascular Organ System><Cardiovascular system><Caring><Chinese><Chronic><Clinical Trials><Coronavirus Infectious Disease 2019><Data><Development><Diagnosis><Disease><Disorder><Emotional well being><Ensure><Exercise><Feasibility Studies><Feedback><Feels well><Future><Goals><Health><Health Care Systems><Health Facilities><Health Services Accessibility><Health care facility><Healthcare Facility><Healthcare Systems><Heart Vascular><Home><Integrative Therapy><Integrative Treatment><Integrative intervention><Intervention><Intervention Strategies><Interview><Life><Measures><Memory><Mental Health><Mental Hygiene><Mental disorders><Mental health disorders><Military><Military Personnel><Mind-Body Intervention><Mind-Body Medicine><Minority Participation><Muscle><Muscle Tissue><Non-pharmacologic Therapy><Nonpharmacologic Intervention><Nonpharmacologic Therapy><Nonpharmacologic approach><Nonpharmacologic treatment><Normal mental condition><Normal mental state><Normal psyche><Outcome><Outcome Measure><PTSD><Pain><Painful><Participant><Patients><Perception><Phase><Physical Function><Physical distancing><Population><Post-Traumatic Neuroses><Post-Traumatic Stress Disorders><Posttraumatic Neuroses><Procedures><Protocol><Protocols documentation><Psychiatric Disease><Psychiatric Disorder><Psychological Health><Psychological Well Being><Public Health><QOL><Quality of life><Randomization trial><Randomized><Reporting><Research><SARS-CoV-2 epidemic><SARS-CoV-2 global health crisis><SARS-CoV-2 global pandemic><SARS-CoV-2 pandemic><SARS-coronavirus-2 epidemic><SARS-coronavirus-2 pandemic><Sense of well-being><Severe Acute Respiratory Syndrome CoV 2 epidemic><Severe Acute Respiratory Syndrome CoV 2 pandemic><Severe acute respiratory syndrome coronavirus 2 epidemic><Severe acute respiratory syndrome coronavirus 2 pandemic><Severities><Social Distance><Standardization><Symptoms><T'ai Chi><Tai Chi><Tai Chi Chih><Tai Chi Chuan><Tai Ji><Tai Ji Quan><Tai Qi><TaiChi><Taiji><Taijiquan><Trauma><Travel><Treatment Protocols><Treatment Regimen><Treatment Schedule><United States Department of Veterans Affairs><United States Veterans Administration><Veterans><Veterans Administration><Veterans Affairs><Veterans Health Administration><Veterans Health Affairs><Videoconferencing><Well in self><Woman><acceptability and feasibility><access to health services><access to services><access to treatment><accessibility to health services><active followup><availability of services><barrier to care><barrier to health care><barrier to healthcare><barrier to treatment><care access><care facilities><care seeking><chronic MSK pain><chronic musculoskeletal pain><chronic pain><circulatory system><cohort><conditioning><coronavirus disease 2019><coronavirus disease 2019 crisis><coronavirus disease 2019 epidemic><coronavirus disease 2019 global health crisis><coronavirus disease 2019 global pandemic><coronavirus disease 2019 health crisis><coronavirus disease 2019 pandemic><coronavirus disease 2019 public health crisis><coronavirus disease crisis><coronavirus disease epidemic><coronavirus disease pandemic><coronavirus disease-19><coronavirus disease-19 global pandemic><coronavirus disease-19 pandemic><coronavirus infectious disease-19><cost><delivered remotely><design><designing><determine efficacy><developmental><disability><effective therapy><effective treatment><efficacy analysis><efficacy assessment><efficacy determination><efficacy evaluation><efficacy examination><eligible participant><emotional wellbeing><emotional wellness><evaluate efficacy><examine efficacy><feasibility trial><flexibility><flexible><follow up><follow up assessment><follow-up><followed up><followup><followup assessment><global health><health service access><health services availability><homes><improved><improved outcome><intervention delivery><interventional strategy><manage symptom><measurable outcome><mental illness><mental well-being><mental wellbeing><mental wellness><military population><military veteran><mind body approach><mind body medicine skills><mind body techniques><mind body therapy><mind body treatments><mind body wellness><mind/body><muscular><non-drug therapy><non-drug treatment><nondrug therapy><nondrug treatment><novel><obstacle to care><obstacle to healthcare><outcome measurement><participant retention><physical conditioning><physical health><post intervention><post treatment><post-trauma stress disorder><posttrauma stress disorder><psychiatric illness><psychological disorder><psychological wellbeing><psychological wellness><psychosocial><randomisation><randomization><randomized control study><randomized trial><randomized, controlled study><randomly assigned><recruit><remote delivery><satisfaction><self wellness><sense of wellbeing><service availability><severe acute respiratory syndrome coronavirus 2 global health crisis><severe acute respiratory syndrome coronavirus 2 global pandemic><standardize measure><study population><success><symptom management><traumatic neurosis><treatment access><veteran population><video conferencing><videoconference><videoconferences>