Biopsychosocial influence on shoulder pain

生物心理社会对肩痛的影响

• 批准号: 7532849
• 负责人: STEVEN Z GEORGE
• 金额: $ 54.16万
• 依托单位: UNIVERSITY OF FLORIDA
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-07-01 至 2013-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7532849
• 关键词: Activities of Daily Living; Affect; Age; Award; Back; Candidate Disease Gene; Caring; Characteristics; Chronic; Clinical; Clinical Management; Cohort Studies; Collaborations; Comorbidity; Condition; Data; Development; Exercise; Exhibits; Fright; Future; Genetic; Genetic Markers; Genetic Polymorphism; Genetic Risk; Goals; Impairment; Individual; Inflammatory Response; Injury; Interdisciplinary Study; Knee; Lead; Literature; Mediating; Medical; Methodology; Modeling; Musculoskeletal Diseases; Musculoskeletal Pain; Operative Surgical Procedures; Outcome; Outcome Study; Pain; Pain Research; Pain management; Pathology; Patients; Population Study; Postoperative Pain; Postoperative Period; Prevalence; Probability; Process; Prognostic Factor; Psychological Factors; Public Health; Purpose; Race; Randomized Controlled Clinical Trials; Range; Rate; Recovery; Recruitment Activity; Rehabilitation therapy; Reporting; Research; Research Personnel; Resources; Risk Factors; Role playing therapy; Rotator Cuff; Sampling; Shoulder; Shoulder Pain; Societies; Standards of Weights and Measures; Study models; Surgeon; Syndrome; Testing; Time; Translating; Validation; base; biopsychosocial; chronic pain; cohort; design; disability; experience; genetic risk factor; health care delivery; improved; innovation; model development; multidisciplinary; negative mood; novel; pre-clinical; preclinical study; predictive modeling; psychologic; response; sex; size

DESCRIPTION (provided by applicant): Treatment tailored to specific patient characteristics will have a significant positive impact on the delivery of healthcare. Using individual characteristics to effectively manage musculoskeletal pain syndromes is particularly intriguing because these conditions are commonly experienced and a burden to society. Promising information obtained from basic and pre-clinical pain research has not been translated into clinical settings to improve the management of musculoskeletal pain. This R01 Award will provide the resources for a multidisciplinary research team to investigate how pain-related psychological and genetic factors lead to the development of chronic musculoskeletal pain. Our primary hypothesis is that subjects with psychological and genetic risk factors will be more likely to exhibit elevated experimental pain sensitivity, resulting in a) increased exercise-induced shoulder pain and b) development of post-operative chronic shoulder pain. We have assembled promising preliminary data and will investigate our predictive model in two separate cohort studies that use the same psychological and genetic markers, but different pain models. This design is innovative because it allows us to investigate mechanisms involved with development of chronic pain in a controlled setting, as well as to determine whether these same risk factors have a clinically meaningful impact on post- operative shoulder pain. The ultimate goal of this line of research is to offer individualized musculoskeletal pain management based on a patient's psychological and genetic make up. This proposal represents an important first step in this process, as we will determine if the selected psychological and genetic risk factors allow for early and accurate identification of the development of chronic shoulder pain. This line of study will eventually allow us to a) conduct future randomized trials to determine if individualized treatment based on psychological and genetic risk profiles decreases the probability of developing chronic shoulder pain and b) study this predictive model in other commonly experienced musculoskeletal pain conditions (i.e. back and knee pain). PUBLIC HEALTH RELEVANCE Chronic shoulder pain is a prevalent and disabling problem for society. Promising information obtained from basic and pre-clinical studies has not been tested in clinical settings to determine if early and accurate identification of individuals likely to develop chronic shoulder pain is possible. The purpose of this study is to investigate whether psychological and genetic risk factors can be used to determine whether the development of chronic shoulder pain is likely to occur.

描述（由申请人提供）：针对特定患者特征量身定制的治疗将对医疗保健的提供产生重大积极影响。使用个体特征有效地管理肌肉骨骼疼痛综合症特别有趣，因为这些条件通常是经历的，并且会给社会带来负担。从基本和临床前疼痛研究获得的有希望的信息尚未转化为临床环境，以改善肌肉骨骼疼痛的治疗。该R01奖将为多学科研究团队提供资源，以研究与疼痛有关的心理和遗传因素如何导致慢性肌肉骨骼疼痛的发展。我们的主要假设是，患有心理和遗传危险因素的受试者将更有可能表现出升高的实验性疼痛敏感性，从而导致a）运动引起的肩部疼痛和b）术后术后慢性肩部疼痛的发展。我们组装了有希望的初步数据，并将在使用相同的心理和遗传标记但不同的疼痛模型的两项单独的队列研究中研究我们的预测模型。这种设计具有创新性，因为它使我们能够调查在受控环境中与慢性疼痛发展有关的机制，并确定这些相同的危险因素是否对手术后的肩部疼痛产生了有意义的影响。这一研究的最终目标是基于患者的心理和遗传组成提供个性化的肌肉骨骼疼痛管理。该提案代表了此过程中的重要第一步，因为我们将确定所选的心理和遗传危险因素是否允许早日准确地识别慢性肩部疼痛的发展。这项研究最终将使我们能够a）进行未来的随机试验，以确定基于心理和遗传风险谱的个性化治疗是否会降低发展慢性肩部疼痛的可能性，b）研究这种预测模型在其他经常经历的肌肉骨骼疼痛状况（即背部和膝盖疼痛）中。 公共卫生相关性慢性肩痛是社会普遍存在的残疾问题。从基本和临床前研究获得的有希望的信息尚未在临床环境中进行测试，旨在确定是否可以早期且准确地识别可能出现慢性肩部疼痛的个体。这项研究的目的是研究是否可以使用心理和遗传危险因素来确定是否可能发生慢性肩痛的发展。