权益分类	功能权益	普通用户	{{item.name}}会员
{{category.name}}	{{benefitItem.name}}

Identifying risk for transition from acute to chronic musculoskeletal pain in youth

确定青少年从急性肌肉骨骼疼痛转变为慢性肌肉骨骼疼痛的风险

基本信息

批准号：
10455657
负责人：
Amy S Lewandowski Holley
金额：
$ 54.11万
依托单位：
OREGON HEALTH & SCIENCE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-09-01 至 2024-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10455657
关键词：
Acute Acute Pain Address Adolescence Adolescent Adult Affect Affective Age Anxiety Behavioral Characteristics Child Childhood Chronic Cognitive Data Data Collection Development Early identification Eligibility Determination Family health status Future Goals Healthcare Healthcare Systems Impairment Individual Knowledge Longitudinal cohort study Mediating Mediator of activation protein Medical Mental Depression Modeling Musculoskeletal Pain Pain Pain Research Parents Pathway interactions Polysomnography Prevalence Prevention Psychosocial Assessment and Care Psychosocial Factor Quality of life Reporting Research Research Priority Risk Risk Factors Sampling Schools Sensory Sleep Deprivation Testing Time Treatment Cost United States United States National Institutes of Health Visit Youth actigraphy biopsychosocial central pain central sensitization chronic musculoskeletal pain chronic pain chronic pain management conditioned pain modulation cost disability experience follow-up high risk innovation pain catastrophizing pain chronification pain inhibition pain outcome pain sensitivity pain signal pain-related disability physically handicapped preventive intervention prospective protective behavior psychosocial response sex sleep pattern

项目摘要

PROJECT SUMMARY Musculoskeletal (MSK) pain affects 18-32% of youth and places a high level of burden on children, families, and the health care system. During childhood, prevalence of MSK pain increases with age, placing adolescents at highest risk. When MSK pain becomes chronic, youth experience significant psychosocial difficulties, physical disability, and impaired school functioning. Treatment costs of pediatric chronic pain are estimated at $19 billion annually in the United States. There is an urgent need to reduce the costs and impact of pediatric chronic MSK pain, particularly given that risk for pain, disability, and high health care use can extend from adolescence into adulthood. A key first step is identifying mechanisms underlying the transition from acute to chronic MSK pain in youth. A pivotal mechanism thought to underlie chronic pain is sensitization of central pain pathways and impairment in conditioned pain modulation. Research shows differences in pain modulation in children and adults with chronic pain compared to healthy samples, and that poor pain inhibition predictsrisk for future chronic painin adults. A critical gap in knowledge is how pain modulation, psychosocial factors and behavioral vulnerabilities confer risk for the transition from acute to chronic MSK pain in youth. As outlined in the NIH's Federal Pain Strategy Research Report, evaluating episode prospective individuals the course of pain from an acute to a chronic pain state is a top research priority. need for studies examining the transition from acute to chronic pain to identify transition mechanisms and at greatest risk. Further, the report highlights the urgent To fill these important knowledge gaps, we propose the first large-scale longitudinal cohort study of youth with acute MSK pain (n=300) to test a biopsychosocial model of risk for transition from acute to chronic pain. Youth will complete assessments at 4 data waves over one year and using a combination of: a) quantitative sensory testing of the pain modulation b) psychosocial assessment, and c) actigraphic monitoring of sleep, the central aim is to identify mechanisms in the transition from acute to chronic MSK pain. We will also characterize the contribution of sleep deficiencies, cognitive-affective vulnerabilities, parent pain-specific responses, and key child demographic characteristics in conferring risk for poor pain outcomes. The aims of this innovative study address a major gap in current pediatric MSK pain research by informing our understanding of how pain transitions from an acute to chronic state and will provide knowledge of early risk factors for developing chronic MSK pain. Data generated from this proposal will also directly inform our team's development of screening protocols and targeted preventive interventions directed at youth at greatest risk for developing chronic MSK pain. Aligning with the goals of the Federal Pain Strategy Research Report, with this research we shift the focus from treatment of chronic pain to prevention through early identification of at-risk youth.

项目摘要肌肉骨骼（MSK）疼痛影响18-32%的青少年，并给儿童，家庭，和医疗保健系统。在儿童时期，MSK疼痛的患病率随着年龄的增长而增加，青少年处于最高风险当MSK疼痛成为慢性时，青少年会经历显著的心理社会困难、身体残疾和学校功能受损。儿科慢性疼痛的治疗费用是估计在美国每年有190亿美元。迫切需要减少成本和影响儿童慢性MSK疼痛，特别是给定的疼痛、残疾和高医疗保健使用的风险可能从青春期延续到成年期。关键的第一步是确定过渡的机制从急性到慢性的MSK疼痛。一个被认为是慢性疼痛基础的关键机制是致敏中枢疼痛通路和条件性疼痛调制的损伤。研究显示疼痛的差异与健康样本相比，儿童和成人慢性疼痛的调制，预测成年人未来慢性疼痛的风险。一个关键的知识缺口是如何疼痛调制，心理社会因素和行为脆弱性赋予风险的过渡，从急性到慢性MSK疼痛的青年。作为美国国立卫生研究院的联邦疼痛战略研究报告中概述，集前瞻性个人急性脑梗死的疼痛过程慢性疼痛状态是一个首要的研究重点。需要研究从急性疼痛到慢性疼痛的转变，以确定转变机制，冒着最大的风险此外，报告还强调，为了填补这些重要的知识空白，我们提出了第一个大规模的纵向对患有急性MSK疼痛的年轻人（n=300）进行队列研究，以测试从急性至慢性疼痛。青年将在一年内完成4个数据波的评估，并使用 a）疼痛调节的定量感觉测试，B）心理社会评估，和c）睡眠的活动监测，中心目的是确定从急性到慢性过渡的机制 MSK疼痛。我们还将描述睡眠不足，认知情感脆弱性，父母的疼痛特异性反应，以及儿童的主要人口统计学特征，结果。这项创新研究的目的是解决目前儿科MSK疼痛研究的主要差距，告知我们对疼痛如何从急性转变为慢性状态的理解，并将提供知识慢性MSK疼痛的早期危险因素。本提案产生的数据也将直接告知我们的团队制定了针对青年的筛查方案和有针对性的预防干预措施，最大的风险发展为慢性MSK疼痛。与联邦疼痛战略研究的目标保持一致报告，通过这项研究，我们将重点从治疗慢性疼痛转移到通过早期预防识别问题青年。