Development of a Mind Body Program to Reduce Knee Pain in Obese Osteoarthritis Patients with Comorbid Depression

制定身心计划以减轻患有抑郁症的肥胖骨关节炎患者的膝部疼痛

• 批准号: 9896561
• 负责人: Cale Jacobs
• 金额: $ 21.57万
• 依托单位: UNIVERSITY OF KENTUCKY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-01-01 至 2022-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9896561
• 关键词: Accelerometer; Address; Adherence; Age; Attention; Biochemical; Biological; Biological Markers; Blood; Blood specimen; Body Weight; Body Weight decreased; Cartilage; Catabolism; Classification; Clinic; Clinical; Clinical Trials; Complex; Data; Data Collection; Degenerative polyarthritis; Detection; Development; Effectiveness; Eligibility Determination; Focus Groups; Functional disorder; Goals; Grant; Health; Individual; Inflammation; Inflammatory; Instruction; Interleukin-1; Interleukin-1 beta; International; Intervention; Interview; Kentucky; Knee; Knee Osteoarthritis; Link; Logistics; Manuals; Measures; Mechanics; Medical; Mental Depression; Methods; Mind-Body Intervention; Obesity; Pain; Participant; Patient Preferences; Patient Self-Report; Patients; Phase; Physical Function; Physical activity; Placebos; Population; Procedures; Program Acceptability; Protocols documentation; Psychology; Relaxation; Reporting; Research; Secure; TLR4 gene; Testing; Thinking; Time; Travel; Universities; Urine; Walking; arthropathies; articular cartilage; biopsychosocial; body-mind; cartilage degradation; chronic pain patient; comorbid depression; comorbidity; coping; cytokine; depressive symptoms; disability; high risk; improved; knee pain; mechanical load; medical schools; mind body interaction; mindfulness; multimodality; osteoarthritis pain; overexpression; pilot trial; programs; psychologic; recruit; resilience; response; sample collection; satisfaction; screening; skills; statistics; success; symptomatology; telehealth; theories

PROJECT SUMMARY Development of a mind body program to reduce cartilage breakdown and knee pain in obese osteoarthritis patients with comorbid depression This is a R34 application that follows the recently released IMMPACT criteria, and the International Classification of Functioning, Disability and Health (ICF) framework to adapt a multimodal, theory grounded mind body program (The Relaxation Response Resilience Program; 3RP) with prior success in patients with medical illness in pilot and effectiveness studies for the needs of obese patients with knee osteoarthritis (OA) and depression and to specifically target increased physical activity (p3RP-OA). Depression, obesity and OA exacerbate one another and share a common pathophysiology involving systemic inflammation and pro- inflammatory cytokines, reflecting a complex mind-body interaction. Current treatments for knee OA offer little to no benefit over a placebo, and do not emphasize mind-body practices or physical activity to target the underlying pathophysiology. Physical activity alone has shown benefit in the treatment of depression, obesity and OA individually, but adequate implementation remains challenging. Our guiding hypothesis is that the synergistic interaction between mindfulness, adaptive thinking, positive psychology and healthy living skills of the 3RP adapted for the needs of OA patients and to target increased physical activity reduces pro- inflammatory cytokine expression while also promoting optimal mechanical loading of the cartilage will slow the progression of symptomatic knee OA. Toward this goal, this R34 proposal aims to 1) adapt the 3RP for the needs of knee OA patients with depression (PHQ-910) and obesity (BMI30 kg/m2) with a focus of increasing physical activity; and 2) establish the feasibility, credibility and acceptability of the programs and research procedures. Using the R34 NCCIH mechanism, we propose to use an iterative mixed methods strategy to adapt the 3RP for the specific needs of obese OA patients with depression including increased activity to maximize their feasibility, acceptability, and credibility. This R34 grant will set the stage for us to conduct a fully powered RCT through the R61/R33 mechanisms to assess the biopsychosocial mechanisms associated with OA progression.

项目总结 开发心身计划以减少肥胖性骨关节炎患者的软骨破坏和膝关节疼痛 伴发抑郁症的患者 这是一个R34应用程序，遵循最近发布的IMMPACT标准，并且国际 适应多模式的功能、残疾和健康分类(ICF)框架，理论基础 心身计划(松弛反应复原力计划；3RP)对患有抑郁症的患者具有先前的成功 针对肥胖膝骨性关节炎患者需求的内科疾病试点和有效性研究 和抑郁，并特别针对增加的体力活动(p3rp-OA)。抑郁、肥胖与骨性关节炎 相互加剧，并分享共同的病理生理学涉及全身炎症和促进性 炎性细胞因子，反映复杂的身心相互作用。膝关节骨性关节炎目前的治疗方法 与安慰剂相比几乎没有好处，而且不要强调身心练习或体力活动来针对 潜在的病理生理学。仅体力活动就显示出对治疗抑郁症、肥胖症的益处。 和开放式获取单独进行，但适当的实施仍然具有挑战性。我们的指导性假设是 正念、适应性思维、积极心理与健康生活技能的协同作用 3RP适应了OA患者的需求，并以增加体力活动为目标，减少了 炎症细胞因子的表达，同时也促进了软骨的最佳机械负荷将放缓 症状性膝骨性关节炎的进展。为了实现这一目标，R34提案旨在1)调整3RP以适应 膝关节骨性关节炎患者抑郁(PHQ-9，10)和肥胖(BMI，，30 kg/m2)的需求重点增加 体力活动；以及2)确定方案和研究的可行性、可信度和可接受性 程序。利用R34 NCCIH机制，我们提出了使用迭代混合方法策略来适应 针对肥胖骨性关节炎患者抑郁的具体需求，包括增加活动量，最大限度地 它们的可行性、可接受性和可信度。这笔R34拨款将为我们进行全功率 通过R61/R33机制进行随机对照试验，以评估与骨性关节炎相关的生物、心理和社会机制 进步。