Feasibility Clinical Trial of Integrated Mind-Body Therapy for Chronic Low Back Pain

身心综合疗法治疗慢性腰痛的可行性临床试验

基本信息

项目摘要

PROJECT SUMMARY/ABSTRACT The treatment of chronic low back pain (cLBP) remains a major public health concern. Medication is of limited value. Current guidelines recommend using non-pharmacologic approaches for cLBP, which include yoga, tai chi, Mindfulness-Based Stress Reduction (MBSR), and Cognitive-Behavioral Therapy (CBT). While these approaches have been shown to be beneficial, all current approaches have important limitations in efficacy. We hypothesize that these interventions can be strengthened to be more effective for cLBP. In response to the FOA PAR-18-417 for high-priority topics, this proposal focuses on modifying MBSR to develop an optimized program for cLBP, Mindfulness-Based Pain Reduction (MBPR). Based on recent advances in the understanding of the central processing of pain, we plan modifications in three closely related and potentially synergistic areas: (1) strengthening the skill development of interoceptive awareness to address chronic pain through focused attention in the specific region of pain; (2) emphasizing mindful movement that is optimized by using cLBP-specific yoga movements; (3) shifting some of the emphasis in didactic content toward a better understanding of chronic pain and its neurophysiology, incorporating elements of cognitive-behavioral therapy for pain and neurophysiological pain education. The format will be the same as MBSR: 8 weeks of weekly 2½- hour group sessions and a daylong retreat, but with a smaller group size: 10 participants per class to allow for more individualized support. Key goals are to reduce avoidance, rumination, pain catastrophizing, and fear of movement. We have developed an initial outline of the intervention. To refine it, we will convene an international panel of behavioral and yoga therapists with expertise in chronic pain education and management to obtain expert advice on intervention optimization and produce a first draft of a MBPR manual. We will enroll 4 x 10 = 40 patients with cLBP into 4 consecutive MBPR classes to iteratively refine the manualized MBPR protocol through mixed-methods evaluations after each 8-week round of MBPR. We will assess feasibility and acceptability of the MBPR protocol by questionnaires, mobile technology to assess home use of MBPR practices, and qualitative interviews. We will assess feasibility and acceptability of randomization by recruiting 20 participants and randomizing them to standard MBSR (n ≈10) or to the fourth MBPR class (total n ≈10). Key pain outcomes will be assessed at baseline, 8 weeks and 6 months. To prepare for a larger clinical trial, we will also test and refine a smartphone platform to obtain an ecological momentary assessment measure of pain outcomes and assess adherence to meditation practices. This clinical feasibility trial will prepare for a large multi-center efficacy trial in cLBP patients comparing MBPR with MBSR. This holds promise not only to advance integrative health approaches to cLBP, but to other forms of chronic pain.
项目总结/文摘

项目成果

期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)

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Frederick M Hecht其他文献

Sedentary Behavior and Dementia.
久坐行为和痴呆症。
Sex Differences in the Variability of Physical Activity Measurements Across Multiple Timescales Recorded by a Wearable Device: Observational Retrospective Cohort Study
可穿戴设备记录的多时间尺度下身体活动测量变异性的性别差异:观察性回顾性队列研究
  • DOI:
    10.2196/66231
  • 发表时间:
    2025-01-01
  • 期刊:
  • 影响因子:
    6.000
  • 作者:
    Kristin J Varner;Lauryn Keeler Bruce;Severine Soltani;Wendy Hartogensis;Stephan Dilchert;Frederick M Hecht;Anoushka Chowdhary;Leena Pandya;Subhasis Dasgupta;Ilkay Altintas;Amarnath Gupta;Ashley E Mason;Benjamin L Smarr
  • 通讯作者:
    Benjamin L Smarr
Testing the Impact of Intensive, Longitudinal Sampling on Assessments of Statistical Power and Effect Size Within a Heterogeneous Human Population: Natural Experiment Using Change in Heart Rate on Weekends as a Surrogate Intervention
在异质人群中测试密集纵向抽样对统计功效和效应量评估的影响:以周末心率变化作为替代干预的自然实验
  • DOI:
    10.2196/60284
  • 发表时间:
    2025-01-01
  • 期刊:
  • 影响因子:
    6.000
  • 作者:
    Severine Soltani;Varun K Viswanath;Patrick Kasl;Wendy Hartogensis;Stephan Dilchert;Frederick M Hecht;Ashley E Mason;Benjamin L Smarr
  • 通讯作者:
    Benjamin L Smarr

Frederick M Hecht的其他文献

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{{ truncateString('Frederick M Hecht', 18)}}的其他基金

Optimizing an integrated whole-body hyperthermia and behavioral intervention for major depressive disorder
优化重度抑郁症的综合全身热疗和行为干预
  • 批准号:
    10303773
  • 财政年份:
    2021
  • 资助金额:
    $ 24.23万
  • 项目类别:
Optimizing an integrated whole-body hyperthermia and behavioral intervention for major depressive disorder
优化重度抑郁症的综合全身热疗和行为干预
  • 批准号:
    10640897
  • 财政年份:
    2021
  • 资助金额:
    $ 24.23万
  • 项目类别:
Optimizing an integrated whole-body hyperthermia and behavioral intervention for major depressive disorder
优化重度抑郁症的综合全身热疗和行为干预
  • 批准号:
    10462652
  • 财政年份:
    2021
  • 资助金额:
    $ 24.23万
  • 项目类别:
Feasibility Clinical Trial of Integrated Mind-Body Therapy for Chronic Low Back Pain
身心综合疗法治疗慢性腰痛的可行性临床试验
  • 批准号:
    10318650
  • 财政年份:
    2020
  • 资助金额:
    $ 24.23万
  • 项目类别:
2020 International Congress for Integrative Medicine and Health
2020年国际中西医结合医学与健康大会
  • 批准号:
    9914819
  • 财政年份:
    2019
  • 资助金额:
    $ 24.23万
  • 项目类别:
Training Researchers in Clinical Integrative Medicine (TRIM)
培训临床整合医学 (TRIM) 研究人员
  • 批准号:
    9428196
  • 财政年份:
    2017
  • 资助金额:
    $ 24.23万
  • 项目类别:
2016 International Congress on Integrative Medicine and Health
2016国际中西医结合健康大会
  • 批准号:
    9126022
  • 财政年份:
    2016
  • 资助金额:
    $ 24.23万
  • 项目类别:
Mentoring and Research in Integrative Medicine
中西医结合的指导和研究
  • 批准号:
    8487898
  • 财政年份:
    2013
  • 资助金额:
    $ 24.23万
  • 项目类别:
Mentoring and Research in Integrative Medicine
中西医结合的指导和研究
  • 批准号:
    8997448
  • 财政年份:
    2013
  • 资助金额:
    $ 24.23万
  • 项目类别:
Mentoring and Research in Integrative Medicine
中西医结合的指导和研究
  • 批准号:
    10350623
  • 财政年份:
    2013
  • 资助金额:
    $ 24.23万
  • 项目类别:

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