Using an interactive game to reduce fear & increase spine motion in low back pain

使用互动游戏减少恐惧

• 批准号: 8667104
• 负责人: Christopher R France
• 金额: $ 19.6万
• 依托单位: OHIO UNIVERSITY ATHENS
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-05-01 至 2016-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8667104
• 关键词: Address; Attention; Back; Chronic; Chronic low back pain; Clinical; Computer software; Data; Environment; Feedback; Fright; Individual; Injury; Intervention; Laboratories; Lead; Low Back Pain; Medical; Motion; Movement; Nature; Pain; Pain Disorder; Participant; Patients; Pattern; Physicians; Play; Public Health; Randomized Clinical Trials; Randomized Controlled Trials; Recovery; Relative (related person); Spinal; Testing; Time; United States; Vertebral column; Video Games; Visit; chronic back pain; chronic pain; cost; design; disability; effective intervention; expectation; experience; functional restoration; improved; in vivo; innovation; instrument; joint mobilization; novel strategies; public health relevance; sensor; virtual; virtual reality; visual feedback

DESCRIPTION (provided by applicant): Low back pain is the second most common reason for a visit to a physician, with direct medical costs exceeding $90 billion per year in the United States alone. These costs are driven primarily by 7-10% of patients who develop a chronic pain disorder that can last for many years. A fundamental clinical problem in individuals with chronic low back pain is the significant alteration in movement patterns that restrict lumbar spine motion. This restriction of lumbar motion is particularly evident in patients with "kinesiophobia"; that isa fear of movement due to possible injury or reinjure. Accordingly, we propose a novel approach that manipulates movement feedback in a gaming environment to improve spinal motion and decrease expectation of pain and harm in participants with chronic low back pain and high kinesiophobia. We will compare the ability of this game to increase lumbar motion when compared to a no treatment control condition. Participants in the game condition will complete laboratory sessions on five consecutive days. Session 1 (baseline) will be used to assess lumbar spine motion and expectations of pain and harm during standardized reaching tasks. In lab sessions 2 through 4 participants will play a game of virtual dodge ball. They will be instrumented with sensors that track their body movements in real time and display them as an on-screen avatar. The game has 4 levels of difficulty that are tailored to each participant's baseline lumbar spine flexion. Session 5 (post-test) will be used to reassess lumbar spine motion and expectations of pain and harm during constrained and unconstrained reaching. Participants in the control condition will complete baseline and post-test standardized reaching tasks, but will not play the game in the intervening three days. Aim 1 will determine the effect of game play on lumbar spine motion and expectations of pain and harm and Aim 2 will determine the effect of altered movement gain on lumbar spine flexion. The use of a gaming environment is an innovative approach to address fear of movement and reduced lumbar motion in chronic low back pain patients with kinesiophobia, and this proof-of-concept study represents the critical first step to evaluate a promising new approach for chronic back pain and will provide the data necessary to assess power for a full-scale randomized clinical trial.

描述（由申请人提供）：腰痛是就医的第二大常见原因，仅在美国每年的直接医疗费用就超过 900 亿美元。这些费用主要是由 7-10% 的患者患有可持续多年的慢性疼痛疾病造成的。慢性腰痛患者的一个基本临床问题是限制腰椎运动的运动模式的显着改变。 这种腰部运动的限制在患有“运动恐惧症”的患者中尤其明显。这是一种由于可能受伤或再次受伤而对运动的恐惧。因此，我们提出了一种新颖的方法，可以在游戏环境中操纵运动反馈，以改善脊柱运动并减少患有慢性腰痛和高度运动恐惧症的参与者对疼痛和伤害的预期。我们将比较该游戏与无治疗控制条件相比增加腰部运动的能力。游戏条件下的参与者将连续五天完成实验室课程。第 1 部分（基线）将用于评估标准化伸展任务期间腰椎运动以及疼痛和伤害的预期。在实验室课程 2 至 4 中，参与者将玩虚拟躲避球游戏。他们将配备传感器，实时跟踪他们的身体运动并将其显示为屏幕上的头像。该游戏有 4 个难度级别，适合每个参与者的基线腰椎弯曲程度。第 5 节（测试后）将用于重新评估腰椎运动以及受约束和不受约束伸手过程中对疼痛和伤害的预期。控制条件下的参与者将完成基线和测试后标准化达到任务，但在干预的三天内不会玩游戏。目标 1 将决定效果 游戏对腰椎运动的影响以及对疼痛和伤害的预期以及目标 2 将确定改变运动增益对腰椎弯曲的影响。使用游戏环境是一种创新方法，可以解决患有运动恐惧症的慢性腰背痛患者对运动的恐惧和减少腰部运动，这项概念验证研究代表了评估有前途的慢性背痛新方法的关键的第一步，并将提供评估全面随机临床试验功效所需的数据。