Mind-Body Therapies to Prevent Chronic Low Back Pain

预防慢性腰痛的身心疗法

• 批准号: 7459751
• 负责人: WOLF E MEHLING
• 金额: $ 12.18万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-04-01 至 2010-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7459751
• 关键词: Acute; Attention; Back Pain; Behavioral Sciences; California; Chronic low back pain; Clinic; Clinical; Clinical Research; Clinical Trials; Cognition; Cohort Studies; Complementary and alternative medicine; Complex; Data Analyses; Development; Economic Burden; Elements; Emotions; Europe; Evaluation; Event; Foundations; Fright; Goals; Healthcare; Healthcare Systems; Impairment; Integrative Medicine; Intervention; Link; Low Back Pain; Measures; Meditation; Mental Depression; Mentors; Methods; Mind; Mind-Body Intervention; Modality; Movement; Observational Study; Outcome; Pain; Participant; Patients; Prevention; Primary Care Physician; Primary Health Care; Provider; Psychometrics; Randomized; Recovery; Research; Research Personnel; Resources; Risk; Risk Factors; San Francisco; Screening procedure; Secondary Prevention; Societies; Structure; Supervision; Tai Ji; Testing; Time; United States; Week; Wolves; Yoga; avoidance behavior; body-mind; chronic pain; coping; cost; experience; feldenkrais; improved; mindfulness-based stress reduction; modifiable risk; prevent; programs; prospective; psychosocial; skills; tool

DESCRIPTION (provided by applicant): While about 10% of patients presenting with acute low back pain (aLBP) will develop chronic low back pain (cLBP), they consume about 75% of LBP related health care expenses and constitute a major economic burden for society. The transition from acute to cLBP is associated with multiple risk factors, of which psychosocial risk factors have the greatest predictive power. This suggests an interaction between emotion, coping, and cognition (mind) and the physical experience of LBP (body). CAM modalities emphasizing the mind-body link, such as Mindfulness Based Stress Reduction, Feldenkrais, and Yoga, may modify these risk factors and help prevent cLBP. Clinicians currently do not have a simple, validated tool for identifying patients with aLBP at high risk for chronic pain and it is unclear whether (and, if so, which) CAM therapies can modify the risk profile and outcome in patients presenting with aLBP. Such information would aid in planning controlled trials of mind-body therapies for LBP, in identifying possible mechanisms of action of these therapies, and in targeting health care resources for cLBP prevention. The candidate will conduct 2 projects: (1) a prospective cohort study (n = 620) at Kaiser Permanente, Northern California (a) to develop and validate a brief prediction tool for primary care clinics and (b) to assess changes in risk factors over time and their association with changes in LBP outcomes; (2) an assessment of whether specific mind-body therapies alter the variables measured with the new prediction tool in randomized and observational studies. The candidate will pursue a structured educational program that includes coursework, mentoring, and supervision of these projects to develop the necessary skills in behavioral science, psychometric evaluation of measures, and clinical research implementation. The candidate's overall goal is to become an independent investigator conducting clinical research of mind-body approaches for the prevention of cLBP.

描述（由申请人提供）：虽然约 10% 的急性腰痛 (aLBP) 患者会发展为慢性腰痛 (cLBP)，但他们消耗了约 75% 的腰痛相关医疗费用，并构成了社会的主要经济负担。从急性到cLBP的转变与多种危险因素相关，其中心理社会危险因素具有最大的预测能力。这表明情绪、应对和认知（心灵）与 LBP（身体）的身体体验之间存在相互作用。强调身心联系的 CAM 模式，例如基于正念的减压、Feldenkrais 和瑜伽，可能会改变这些风险因素并有助于预防 cLBP。临床医生目前没有一种简单、经过验证的工具来识别慢性疼痛高风险 aLBP 患者，并且尚不清楚 CAM 疗法是否（如果可以的话，哪种）可以改变 aLBP 患者的风险状况和结果。这些信息将有助于规划腰痛身心疗法的对照试验，确定这些疗法可能的作用机制，并确定医疗保健资源用于预防腰痛。 候选人将开展 2 个项目：(1) 在北加州 Kaiser Permanente 进行一项前瞻性队列研究 (n = 620)，(a) 开发和验证初级保健诊所的简要预测工具，以及 (b) 评估风险因素随时间的变化及其与腰痛结果变化的关系； (2) 评估特定的身心疗法是否会改变随机和观察性研究中使用新预测工具测量的变量。候选人将追求结构化的教育计划，包括课程作业、指导和这些项目的监督，以培养行为科学、心理测量评估和临床研究实施方面的必要技能。 候选人的总体目标是成为一名独立研究者，进行预防 cLBP 的身心方法的临床研究。