Behavioral Interventions and Long Term Outcomes in Juvenile Fibromyalgia Syndrome

青少年纤维肌痛综合征的行为干预和长期结果

• 批准号: 8629178
• 负责人: Susmita Kashikar-Zuck
• 金额: $ 16.71万
• 依托单位: CINCINNATI CHILDRENS HOSP MED CTR
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-08-01 至 2019-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8629178
• 关键词: 19 year old; 21 year old; 3-Dimensional; Achievement; Adherence; Adolescence; Adolescent; Adult; Aftercare; Age; Anxiety; Anxiety Disorders; Award; Behavior Therapy; Body measure procedure; Build-it; Child; Childhood; Clinical Investigator; Clinical Research; Clinical Trials; Cognitive Therapy; Collaborations; Coping Skills; DSM-IV; Data; Data Collection; Development; Diagnosis; Educational Status; Exercise; Faculty; Fatigue; Fibromyalgia; Flare; Fright; Funding; Future; Goals; Grant; Human; Impairment; Individual; Institution; Interdisciplinary Study; Intervention; Longitudinal Studies; Maintenance; Manuscripts; Measures; Medicine; Mental Depression; Mentors; Mentorship; Methods; Migraine; Modeling; Mood Disorders; Moods; Motion; Musculoskeletal; National Institute of Arthritis and Musculoskeletal and Skin Diseases; Neurology; Outcome; Pain; Pain Research; Pain intensity; Pain interference; Pain management; Pain quality; Paper; Patients; Pharmaceutical Preparations; Physical activity; Postdoctoral Fellow; Prevention; Process; Public Health; Publishing; Recording of previous events; Reporting; Research; Research Methodology; Research Personnel; Research Project Grants; Rheumatology; Science; Scientist; Self Management; Severities; Site; Social Functioning; Social support; Sports Medicine; Symptoms; Teenagers; Testing; Time; Training; Training Programs; United States National Institutes of Health; Work; Writing; base; body mechanics; career; chronic pain; cohort; control trial; coping; depressive symptoms; disability; effective intervention; follow-up; functional disability; improved; injury prevention; innovation; interest; meetings; neuromuscular; next generation; novel; patient oriented research; pilot trial; primary outcome; programs; prospective; psychologic; psychosocial; public health relevance; randomized trial; secondary outcome; skills training; success; tool; young adult

DESCRIPTION (provided by applicant): The Specific Aims of this Midcareer Investigator Award renewal application are to 1) successfully implement an ongoing prospective longitudinal study to determine long term outcomes of pediatric patients with juvenile- onset fibromyalgia (JFM), 2) to refine and test a novel intervention, i.e., combined cognitive-behavioral therapy (CBT) and physical exercise to reduce pain and impairment, and increase coping and physical activity in adolescents with JFM, and 3) continue to use the candidate's ongoing and planned clinical studies in pediatric pain to train postdoctoral fellows and junior faculty. The Candidate s a nationally recognized pediatric pain researcher with a history of >10 years of independently funded patient-oriented research focused on clinical trials of behavioral treatment for JFM and other pain conditions, longitudinal studies, and mentorship of early career researchers. In the first 3.5 years of her current K24 funding, she completed the first rigorously controlled trial demonstrating that CBT is a safe and effective intervention for reduction of disability and depression in JFM and she published 22 papers (along with her mentees) based on her JFM and pediatric pain research. The proposed Research Plan for this renewal application includes two projects: 1) an ongoing NIAMS (R01) funded longitudinal study of long-term outcomes of adolescents with JFM, and 2) an ongoing pilot trial of a novel combined CBT and exercise - FIT Teens (Fibromyalgia Integrative Training for Teens) intervention. The innovation of this new program is that it builds on the candidate's established CBT program and seamlessly integrates an exercise component modified from sports-medicine/injury prevention to improve body mechanics and increase physical activity without fear of pain-flares and activity avoidance which is central to inactivity in JFM patients. Results will inform the next multi-site RCT in JFM. The Mentoring Plan is to train future clinical investigators in the field of clinical trials and outcoms research in pediatric chronic pain. The candidate's plan consists of 1) individualized mentoring of postdoctoral fellows/junior faculty supported by currently funded studies (longitudinal study in JFM (R01), PROMIS in pediatric pain and rheumatology (U01), a 40-site clinical trial of prevention medication for pediatric migraine (U01), and other ongoing studies, 2) mentoring of fellows/faculty to develop their own independent research and 3) participation of fellows in established didactic programs on manuscript/grant writing, research methodology and responsible conduct of human research. Cincinnati Children's provides an ideal setting for this award because of the strong institutional support for patient-oriented research and team-science, presence of an award winning chronic pain program, strong interdisciplinary research collaborations with pediatric rheumatology, pain medicine, sports medicine and neurology researchers interested in pediatric pain, a divisional data core and a commitment of the institution to "change the outcomes" for pediatric patients.

描述（由申请人提供）：本中期研究者奖更新申请的具体目的是：1）成功实施一项正在进行的前瞻性纵向研究，以确定青少年纤维肌痛（JFM）儿科患者的长期结局，2）完善和测试一种新的干预措施，即，结合认知行为疗法（CBT）和体育锻炼，以减少疼痛和损伤，并增加应对和身体活动的青少年与JFM，和3）继续使用候选人的正在进行的和计划的临床研究，在儿科疼痛培训博士后研究员和初级教师。候选人是一位全国公认的儿科疼痛研究人员，拥有超过10年的独立资助的以患者为导向的研究历史，专注于JFM和其他疼痛状况的行为治疗的临床试验，纵向研究和早期职业研究人员的指导。在她目前的K24资助的前3.5年里，她完成了第一个严格对照的试验，证明CBT是一种安全有效的干预措施，可以减少JFM中的残疾和抑郁症，她发表了22篇论文（沿着她的学员）基于她的JFM和儿科疼痛研究。本次更新申请的拟议研究计划包括两个项目：1）正在进行的NIAMS（R 01）资助的JFM青少年长期结局的纵向研究，以及2）正在进行的新型CBT和运动组合的试点试验- FIT Teens（青少年纤维肌痛综合训练）干预。这项新计划的创新之处在于，它建立在候选人既定的CBT计划的基础上，并无缝集成了从运动医学/损伤预防修改的运动组成部分，以改善身体力学和增加身体活动，而无需担心疼痛发作和活动避免，这是JFM患者不活动的核心。结果将告知JFM的下一个多中心RCT。指导计划旨在培训未来儿科慢性疼痛临床试验和结局研究领域的临床研究者。候选人的计划包括：1）由目前资助的研究支持的博士后研究员/初级教师的个性化指导（纵向研究， JFM（R 01），PROMIS在儿科疼痛和风湿病学（U 01），40个临床试验点的预防药物治疗小儿偏头痛（U 01），和其他正在进行的研究，2）指导研究员/教师发展自己的独立研究和3）研究员参与既定的教学计划的手稿/赠款写作，研究方法和负责任的人类研究行为。辛辛那提儿童医院为这一奖项提供了理想的环境，因为它为以患者为导向的研究和团队科学提供了强大的机构支持，有一个屡获殊荣的慢性疼痛项目，与儿科风湿病学、疼痛医学、运动医学和对儿科疼痛感兴趣的神经病学研究人员进行了强有力的跨学科研究合作，一个部门的数据核心和机构的承诺，以“改变结果”的儿科患者。