SCI AND AMPUTATION PAIN PREVENTION AND TREATMENT

疼痛对患有以下疾病的人的功能有重大影响 脊髓损伤(IWSCI)和截肢者(IWA)。 对预防后遗症的方法给予的关注有限 截肢痛(PAP)，IWSCI中的过度疼痛，或用于治疗慢性 这些群体中的痛苦。该计划的核心包括：行政、 评估、临床服务、工程和数据分析部门。 计划核心的主要目的是促进：(A) 顺利完成计划中包含的3个项目 项目；(B)获得有助于预防的知识 慢性疼痛和伴随残疾的发展；以及，(C) 信息传播。将责任集中在 核心应减少重复，促进社区联系，协助 招聘，以及跨项目的问题。本项目中的3个项目 计划项目旨在涵盖从预防到 疼痛对慢性疼痛患者康复的影响 仅次于脊髓损伤和截肢。项目一.轮椅人体工程学和 慢性疼痛预防将使用运动学和运动学分析来：(A) 通过以下方式减少IWSCI的疼痛频率、严重程度和持续时间 最佳的轮椅配件和有软垫、高摩擦的推圈；以及 (B)通过最佳方案减少外周病变的进展 轮椅配件和有垫子的高摩擦推圈。项目II。 治疗脊髓损伤和截肢后的慢性疼痛将：(A)比较 IWSCI和IWA对慢性疼痛患者的心理社会影响， 行为和功能措施；(B)评估 物理疗法与认知-行为疗法的结合(CBT PT) 用于IWSCI和IWA和疼痛；以及(C)评估 在CBT PT中增加阿片类药物的试验。项目三.计量 脊髓损伤和截肢疼痛治疗的结果将：(A)轨迹 急性脊髓损伤的功能改变；(B)评估一组体能 测定人体运动功能的方案和运动学分析技术 IWSCI和IWA对疼痛的功能能力及对疼痛的影响 对这些措施的处理；以及(C)使用项目反应理论 评估一套用于评估慢性疼痛的措施的充分性 使用SCI和PAP的患者，并评估它们的有效性 量化治疗结果的措施。这是它的一个独特之处 建议将康复科学和先进的 临床干预下的生物测定分析。整合了 项目应促进获得有关疼痛和 脊髓损伤和截肢。它为方法的发展提供了希望 预防截肢后的疼痛和过度使用综合症，以及 在这些人群中，疼痛控制和功能改善。

Pain has a significant impact on the functioning of individuals with spinal cord injuries (IWSCI) and individuals with amputations (IWA). Limited attention has been given to methods for preventing post- amputation pain (PAP), overuse pain in IWSCI, or to treating chronic pain in these groups. The Program Core includes: Administrative, Assessment, Clinical Services, Engineering, and Data Analysis divisions. The main purposes of the Program Core are to facilitate: (a) the successful completion of the 3 projects contained in the program project; (b) the acquisition of knowledge that will permit prevention of the development of chronic pain and accompanying disability; and, (c) dissemination of information. Centralizing responsibilities within the Core should reduce duplication, facilitate community liaison, assist in recruitment of, and issues across projects. The 3 projects in this Program Project are designed to cover the spectrum from prevention of pain to rehabilitation of individuals who suffer from chronic pain secondary to SCI and amputations. PROJECT I. WHEELCHAIR ERGONOMICS AND CHRONIC PAIN PREVENTION will use kinetic and kinematic analysis to: (a) reduce the frequency, severity, and duration of pain in IWSCI through optimal wheelchair fitting and a cushioned, high-friction pushrim; and (b) reduce the progression of peripheral pathology through optimal wheelchair fitting and a cushioned, high-friction pushrim. PROJECT II. TREATING CHRONIC PAIN FOLLOWING SCI AND AMPUTATION will: (a) compare IWSCI and IWA with pain to chronic pain patients on psychosocial, behavioral, and functional measures; (b) assess the efficacy of the combination of physical therapy = cognitive-behavioral therapy (CBT+PT) for IWSCI and IWA and pain; and (c) to evaluate the usefulness of a trial of opioid medication added to the CBT+PT. PROJECT III. MEASURING OUTCOMES IN PAIN TREATMENT OF SCI & AMPUTATION will: (a) track functional changes in acute SCI; (b) evaluate a set of physical capacity protocols and kinesiological analytic techniques for determining the functional abilities of IWSCI and IWA with pain and the impact of treatment on these measures; and (c) use Item Response Theory to evaluate the adequacy of a set of measures used to evaluate chronic pain patients for use with SCI and PAP and assess the utility of these measures in quantifying treatment outcomes. A unique feature of this proposal is the inclusion of rehabilitation science and advanced biometric analyses with clinical interventions. The integration of the projects should facilitate the acquisition of knowledge about pain and SCI and amputations. It offers promise for the development of methods to prevent pain following amputations and overuse syndromes, as well as pain control and improved functioning in these populations.