Resilience Factors, Pain, and Physical Activity in Adolescent Chronic Musculoskeletal Pain

青少年慢性肌肉骨骼疼痛的弹性因素、疼痛和体力活动

• 批准号: 10302147
• 负责人: William Robert Black
• 金额: $ 15.92万
• 依托单位: UNIVERSITY OF KANSAS MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-01 至 2026-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10302147
• 关键词: Academic Medical Centers; Accelerometer; Adolescent; Adult; Affect; Aftercare; Age; Behavior Therapy; Behavioral; Buffers; Child Health; Childhood; Clinical; Clinical Research; Clinical Trials Cooperative Group; Cognitive; Complement; Coping Skills; Cross-Sectional Studies; Data; Development; Development Plans; Diagnosis; Effectiveness; Evaluation; Extramural Activities; Feasibility Studies; Feedback; Foundations; Fright; Funding; Goals; Growth and Development function; Health Services Research; Hydrocortisone; Intervention; Intervention Studies; Interview; Joints; Knowledge; Lead; Ligaments; Light; Manuals; Measures; Mediating; Mediator of activation protein; Mentorship; Modeling; Motivation; Muscle; Outcome; Pain; Pain Clinics; Pain Measurement; Pain interference; Pain management; Pathway interactions; Patient Self-Report; Patients; Physical Function; Physical activity; Physiology; Psychological Factors; Regulation; Reporting; Research; Research Design; Research Institute; Risk; Risk Factors; Salivary; Science; Self Efficacy; Sensory; Stress; Stressful Event; Structure; Teenagers; Testing; Time; Training; Translational Research; Treatment outcome; United States; Waiting Lists; Youth; acceptability and feasibility; awake; base; bone; career development; chronic musculoskeletal pain; chronic pain; cohort; conditioned pain modulation; coping; early life stress; exercise intervention; experience; faculty research; flexibility; functional disability; implementation intervention; improved; innovation; moderate-to-vigorous physical activity; novel; optimal treatments; pain catastrophizing; pain inhibition; pain patient; pain perception; pain processing; patient oriented; pediatric department; potential biomarker; programs; psychobiologic; psychologic; recruit; resilience; response; sedentary; sedentary activity; therapy development; treatment program; treatment strategy

PROJECT SUMMARY AND ABSTRACT: Chronic musculoskeletal pain (CMSKP) is common in adolescents. Participation in regular physical activity (PA) is effective in reducing CMSKP but PA participation is still below recommended levels. There is a need to better understand ways to better promote PA in adolescent CMSKP (e.g., decreasing sedentary activity vs. increasing moderate to vigorous PA), factors that affect PA (e.g., resilience, pain modulation, stress dysregulation), and the mechanistic underpinnings of how these factors affect PA and pain. This knowledge may lead to the development of improved interventions for CMSKP. Psychological resilience factors that build on positive attributes, such as self-efficacy, motivation, and psychological flexibility may help adolescents to engage in PA. While resilience factors are important for overall pain coping, they only recently are being considered as predictors for PA. The overall goal of this proposal is to develop and pilot a feasibility study of an intervention that increases resilience for PA in adolescents with CMSKP. This is significant because the development of such an intervention may lead to improved PA and subsequently improved chronic pain for adolescents with CMSKP. This study first evaluates pathways of resilience factors on PA and pain in adolescents with CMSKP (Aim 1), and the modulation of pain and stress. 60 adolescents with CMSKP will complete self-report measures of resilience and vulnerability factors, and objectively measured PA, pain (Quantitative Sensory Testing), and stress (Cortisol Awaking Response). We will evaluate whether endogenous pain modulation and stress regulation mediate the relationships between resilience and PA. This study also will consider resilience factors that are significant in predicting less sedentary PA as intervention targets, and it will develop, refine (Aim 2) and (Aim 3) conduct a pilot feasibility and acceptability study of a resilience-focused chronic pain intervention for youth (Pain REsilience Promotion for Youth [PREP-Y]). The manual will be developed based on an established treatment program for adolescent CMSKP in adolescents (i.e., FIT Teens) and modified to target resilience mechanisms and sedentary activity. This will be done with integrated feedback from content experts in pediatric pain and CMSKP patients. The intervention will then be provided to 30 patients in groups of 4 to 6. This project will be implemented as part of a strong career development plan consisting coursework, experiential training, and intensive mentorship from a team of experts in pediatric behavioral intervention development and evaluation, psychological factors of pediatric pain, physical activity intervention, and pain physiology and assessment. Completion of this study will occur across two academic medical centers with a joint department of pediatrics, a well-establish pain treatment service, and research institutes to promote the growth and development of research faculty. This study and career development plan will promote the establishment of independent, extramurally funded clinical-research program focused on improving clinically meaningful outcomes for adolescents CMSKP.

项目摘要和摘要： 慢性肌肉骨骼疼痛(CMSKP)在青少年中很常见。参加常规体力活动(PA) 在减少CMSKP方面是有效的，但PA的参与率仍然低于建议的水平。有必要更好地 了解在青少年CMSKP中更好地促进PA的方法(例如，减少久坐活动与增加 中度到剧烈的PA)，影响PA的因素(例如，弹性、疼痛调节、压力失调)，以及 这些因素如何影响PA和疼痛的机械基础。这一知识可能会导致 改善对CMSKP的干预。建立在积极属性基础上的心理弹性因素，例如 自我效能感、动机和心理灵活性可能有助于青少年参与PA。在弹性的同时 这些因素对整体疼痛的应对很重要，直到最近才被认为是PA的预测因素。这个 这项提议的总体目标是开发和试点一项提高韧性的干预措施的可行性研究 对于患有CMSKP的青少年的PA。这一点意义重大，因为这种干预的发展可能 导致改善PA，并随后改善患有CMSKP的青少年的慢性疼痛。这项研究首先 评估弹性因素对患有CMSKP的青少年PA和疼痛的影响途径(目标1)，及其调节 痛苦和压力。60名患有CMSKP的青少年将完成复原力和脆弱性的自我报告 因素，并客观测量PA、疼痛(定量感觉测试)和压力(皮质醇唤醒 回应)。我们将评估内源性疼痛调制和应激调节是否介导 复原力与PA的关系。这项研究还将考虑在以下方面具有重要意义的弹性因素 预测较少久坐的PA作为干预目标，它将发展、完善(目标2)和(目标3)进行 青少年慢性疼痛干预(疼痛弹性)的试点可行性和可接受性研究 青年促进会[预科-Y])该手册将基于一项既定的治疗计划进行开发 青少年(即，适合青少年)的青少年CMSKP，并针对弹性机制和久坐不动进行修改 活动。这将与儿科疼痛和CMSKP患者的内容专家的综合反馈一起完成。 然后，将向4至6人一组的30名患者提供干预。该项目将作为 强大的职业发展计划，包括课程、经验培训和来自 儿科行为干预开发和评估专家团队，心理因素 儿科疼痛，体力活动干预，以及疼痛生理学和评估。这项研究的完成将 发生在两个学术医疗中心与儿科的联合部门，一个完善的疼痛治疗 服务，促进科研院所科研队伍的成长和发展。这项研究和 职业发展计划将促进建立独立的、由外部资助的临床研究 该计划侧重于改善青少年CMSKP的临床有意义的结果。