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.

膝盖骨关节炎（OA）是持续肌肉骨骼疼痛的最有问题的来源之一 功能和流动性，以及老年人的生活质量降低。虽然这些是共同的结果 与OA相关的是，在非洲裔美国人中，它们的情况不成比例差。这些对健康衰老的威胁 要求进一步研究OA疼痛和残疾的最重要驱动力，即运动。 因运动而引起的疼痛经验，称为运动诱发的疼痛（MEP），通常禁止完全参与 在日常生活和自我管理的行动中，例如体育活动/锻炼。因此，MEP是一个 OA患者的高影响力慢性疼痛和残疾的大量贡献；但是，我们对 有助于MEP及其在非裔美国人老年人的管理的机制受到严重限制。所以， 这项两步指导的以患者为导向的研究职业发展奖（K23）的总体目标是 通过（1）表征MEP和功能的生物心理社会行为机制来填补这一知识差距 （2）开发一种基于机制的自我管理干预措施（使用骨关节炎缓解疼痛 黑人长老的文化规定干预措施[积极主动]）。这种干预将解决最关键的问题 以及与文化相关的MEP和非洲裔美国人功能受损的预测指标。我们的方法 代表了与当前慢性肌肉骨骼中当前的静态疼痛评估的新事物的不同 通过运动来测量疼痛来疾病。这项K23提出的培训和研究活动将启动 一项研究计划，促进了非裔美国人老年人的疼痛和残疾科学。到 这个目的，我组建了一个跨学科的高级科学家团队，代表护士，心理学/痛苦 科学，衰老和流行病学/社区参与，他们将提供精神训练以帮助我实现 拟议的培训目标并促进了我向独立研究职业的过渡。初级培训目标 我的研究计划至关重要的是：（1）提前了解生物心理社会和行为 - OA疼痛的环境机制，（2）在应用方面建立了全面的知识库 社区参与实验设计中的参与研究，（3）增强翻译研究 作为独立研究者的技能，能够进行严格的临床试验测试 非药理，行为慢性疼痛自我管理干预措施的有效性 社区（例如南部非裔美国人）。 K23的第2阶段将应用基于社区的参与 混合方法可以协作创建主动的干预措施。佛罗里达大学和大学 康涅狄格州是疼痛研究的强大孵化器，并提供了理想的环境来扩展PI的先前 努力并为理解多种生物心理社会和行为机制的理解途径唯一 参与慢性疼痛的种族内经历，这是发现更好治疗的关键 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