Stress-Evoked Muscle Activity in Occupational Myalgia

描述(由申请人提供)：工作场所日益普遍的肌肉骨骼疾病已被确定为工业化国家面临的最昂贵的健康问题之一。流行病学研究表明，生理和心理社会因素在与工作相关的颈部疼痛的发生中都起着关键作用，但这些危险因素之间的相互作用仍然知之甚少。对于大多数病例来说，慢性颈部疼痛的根本原因仍然没有得到诊断，可能导致许多个别患者的治疗效果不佳。该项目的总体目标是评估一种新的筛查方案的有效性，以确定可能导致或加剧易感个体颈部疼痛的应激诱发肌肉活动。目的1将使用病例对照研究设计来评估标准化筛查方案在检测患有和不患有慢性颈部疼痛的受试者中对应激的精神运动反应升高的判别性和同时有效性。AIM 2将使用一项前瞻性研究设计，通过评估无症状办公室工作人员在高危职业就业的第一年发生慢性颈部疼痛的风险，来确定这一筛查方案的预测有效性。这一目标还将确定压力诱发肌肉活动的诊断分界值，该分界值最能预测慢性颈痛的未来发展。该项目的结果将为未来临床试验的设计提供一种经过验证的工具，以确定最有可能从预防或治疗慢性颈部疼痛的压力管理干预中受益的个体亚群，这最终将改善治疗这种疾病的从业者的临床决策。该项目还将提供关于慢性颈痛的可改变的生理和心理社会风险因素的新信息，这与该领域一个多学科特别工作组概述的研究优先事项一致。

DESCRIPTION (provided by applicant): The increasing prevalence of musculoskeletal disorders in the workplace has been identified as one of the most costly health concerns faced by industrialized nations. Epidemiologic studies suggest that both physical and psychosocial factors play a critical role in the development of work-related neck pain, yet interactions among these risk factors remain poorly understood. The underlying cause of chronic neck pain remains undiagnosed for the majority of cases, likely resulting in suboptimal treatment for many individual patients. The overall goal of this project is to assess the validity of a new screening protocol to identify stress-evoked muscle activity that may either cause or exacerbate neck pain in susceptible individuals. Aim 1 will use a case- control study design to assess the discriminant and concurrent validity of a standardized screening protocol to detect elevated psychomotor responses to stress in subjects with and without chronic neck pain. Aim 2 will use a prospective study design to determine the predictive validity of this screening protocol by assessing the risk of developing chronic neck pain in asymptomatic office workers during the first year of employment in a high-risk occupation. This aim will also determine the diagnostic cutoff score for stress-evoked muscle activity that best predicts the future development of chronic neck pain. Findings from this project will inform the design of future clinical trials by providing a validated tool to identify subgroups of individuals that are most likely to benefit from stress-management interventions to prevent or treat chronic neck pain, which will ultimately improve clinical decision-making for practitioners who treat this disorder. This project will also provide new information on modifiable physical and psychosocial risk factors for chronic neck pain, consistent with research priorities outlined by a multidisciplinary task force of experts in the field.