Investigating Movement-evoked Pain in osteoArthritic Conditions (IMPACT): An Observational Study to Inform Culturally-Tailored Intervention Development

调查骨关节炎疾病中运动诱发的疼痛 (IMPACT)：一项观察性研究，为文化定制干预措施的开发提供信息

• 批准号: 10332756
• 负责人: Staja Booker
• 金额: $ 12.64万
• 依托单位: UNIVERSITY OF FLORIDA
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-02-01 至 2024-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10332756
• 关键词: Accelerometer; Achievement; Activities of Daily Living; Address; African American; African American population; Aging; Arthralgia; Arthritis; Articular Range of Motion; Attenuated; Automobile Driving; Behavior; Behavioral; Behavioral Mechanisms; Behavioral Research; Biology; Black race; Brain; Chronic; Clinical Trials; Communities; Connecticut; Decision Making; Degenerative polyarthritis; Development; Discipline of Nursing; Ecological momentary assessment; Economics; Education; Elderly; Environment; Epidemiology; Evidence based intervention; Exercise; Exhibits; Experimental Designs; Florida; Foundations; Fright; Gait; Goals; High Chair; Home; Impairment; Incubators; Intervention; Investigation; Joints; Knee Osteoarthritis; Knowledge; Laboratories; Measures; Mentored Patient-Oriented Research Career Development Award; Mentorship; Methods; Motion; Motivation; Movement; Musculoskeletal Diseases; Musculoskeletal Pain; Not Hispanic or Latino; Observational Study; Older Population; Outcome; Pain; Pain Measurement; Pain Research; Patient Self-Report; Pattern; Performance; Persons; Phase; Phenotype; Physical Function; Physical Performance; Physical activity; Preventive; Psychology; Quality of life; Questionnaires; Race; Rehabilitation therapy; Reporting; Research; Research Activity; Research Personnel; Rest; Risk Factors; Sampling; Science; Self Management; Senior Scientist; Sensory; Source; Spirituality; Standardization; Subgroup; Testing; Therapeutic Intervention; Training; Training Activity; Translational Research; Universities; Walking; Work; base; biopsychosocial; career; chronic pain; community engagement; design; disability; effectiveness testing; ethnic difference; experience; feasibility testing; functional disability; functional outcomes; health disparity; health literacy; health outcome disparity; healthy aging; inter-individual variation; knee pain; knowledge base; mHealth; middle age; osteoarthritis pain; pain relief; pain self-management; pain-related disability; premature; programs; protective factors; psychologic; racial minority; racial minority population; reduced muscle strength; skills; social; therapy development

Knee osteoarthritis (OA) is one the most problematic sources of persistent musculoskeletal pain, impaired function and mobility, and reduced quality of life in older adults. Although these are common outcomes associated with OA, they are disproportionately worse in older African Americans. These threats to healthy aging demand further investigation into the most significant driver of OA pain and disability, which is movement. The experience of pain due to movement, known as movement-evoked pain (MEP), often prohibits full participation in daily living activities and self-management actions such as physical activity/exercise. MEP is consequently a substantial contributor to high-impact chronic pain and disability in people with OA; yet, our understanding of the mechanisms contributing to MEP and its management in older African Americans is severely limited. Therefore, the overall goals for this two-phased Mentored Patient-Oriented Research Career Development Award (K23) is to fill this knowledge gap by (1) characterizing the biopsychosocial-behavioral mechanisms of MEP and function and (2) develop a mechanism-based self-management intervention (Pain Relief for OsteoArthritis using Culturally-Tailored InterVentions for Black Elders [PROACTIVE]). This intervention will address the most pivotal and culturally-relevant predictors of MEP and impaired function in older African Americans. Our methods represent a new and substantive departure from current static pain assessments in chronic musculoskeletal disorders by measuring pain with movement. This K23 proposes training and research activities that will launch a program of research which advances the science of pain and disability in African American older adults. To this end, I have assembled an interdisciplinary team of senior scientists representing nursing, psychology/pain science, aging, and epidemiology/community engagement who will provide mentorship to help me achieve proposed training goals and facilitate my transition to an independent research career. Primary training goals essential to my research program include: (1) advance understanding of biopsychosocial and behavioral- environmental mechanisms of OA pain, (2) develop a comprehensive knowledge base in the application of community-engaged participatory research within experimental designs, and (3) enhance translational research skills to function as an independent investigator capable of conducting rigorous clinical trials testing the effectiveness of non-pharmacological, behavioral chronic pain self-management interventions within a cultured community (e.g., southern African Americans). Phase 2 of the K23 will apply community-based participatory mixed-methods to collaboratively create the PROACTIVE intervention. The University of Florida and University of Connecticut are strong incubators for pain research and provide ideal environments to extend the PI’s prior work and forge a path towards understanding multiple biopsychosocial and behavioral mechanisms uniquely involved in the intra-ethnic experience of chronic pain, which are key to the discovery of better therapeutic interventions and self-management behaviors.

膝关节骨关节炎（OA）是持续性肌肉骨骼疼痛的最有问题的来源之一， 功能和流动性，以及老年人生活质量下降。虽然这些都是常见的结果 与OA相关，他们在老年非裔美国人中不成比例地更糟。这些对健康老龄化的威胁 需要进一步调查OA疼痛和残疾的最重要驱动因素，即运动。的 由于运动引起的疼痛，称为运动诱发疼痛（MEP），通常禁止完全参与 在日常生活活动和自我管理行动，如身体活动/锻炼。因此，MEP是 OA患者中高影响慢性疼痛和残疾的重要贡献者;然而，我们对 机制有助于MEP和它的管理在老年非裔美国人是非常有限的。因此，我们认为， 这两个阶段的指导患者为导向的研究职业发展奖（K23）的总体目标是 为了填补这一知识空白，（1）表征MEP的生物心理社会行为机制和功能 和（2）开发基于机制的自我管理干预（使用 为黑人老年人量身定制的文化干预[PROACTIVE]）。这次干预将解决最关键的问题， 和文化相关的预测MEP和受损的功能在老年非裔美国人。我们的方法 代表了一个新的和实质性的偏离目前的静态疼痛评估慢性肌肉骨骼 通过测量运动的疼痛来测量疾病。K23提出了培训和研究活动， 一项研究计划，促进非洲裔美国老年人疼痛和残疾的科学。到 为此，我组建了一个由资深科学家组成的跨学科团队，代表护理、心理学/疼痛 科学、老龄化和流行病学/社区参与，他们将提供指导，帮助我实现 提出了培训目标，并促进我过渡到一个独立的研究生涯。主要培训目标 对我的研究计划至关重要的包括：（1）深入了解生物心理社会和行为- OA疼痛的环境机制，（2）开发一个全面的知识库， 在实验设计中进行社区参与式研究，以及（3）加强转化研究 技能作为一个独立的研究者能够进行严格的临床试验测试， 非药物性、行为性慢性疼痛自我管理干预在培养的 社区（例如，美国南部）。K23的第二阶段将采用基于社区的参与式 混合方法，以协同创建主动干预。佛罗里达大学 是疼痛研究的强大孵化器，并提供理想的环境，以扩展PI的优先 工作和开拓一条独特的理解多种生物心理社会和行为机制的道路 参与慢性疼痛的种族内体验，这是发现更好的治疗方法的关键。 干预和自我管理行为。

项目成果

A Paradigm Shift for Movement-based Pain Assessment in Older Adults: Practice, Policy and Regulatory Drivers.

• DOI: 10.1016/j.pmn.2020.08.003
• 发表时间: 2021-03
• 期刊: Pain management nursing : official journal of the American Society of Pain Management Nurses
• 作者: Booker SQ;Herr KA;Horgas AL
• 通讯作者: Horgas AL

CE: Overcoming Movement-Evoked Pain to Facilitate Postoperative Recovery.

CE：克服运动引起的疼痛以促进术后恢复。

• DOI: 10.1097/01.naj.0000944916.30662.5c
• 发表时间: 2023
• 期刊: The American journal of nursing
• 作者: Arnstein,Paul;vanBoekel,Rianne;Booker,StajaQ
• 通讯作者: Booker,StajaQ