Stress Reactivity and Low Back Pain in Older Adults: Influences on Disability (ReLOAD)

项目摘要/摘要 以下是保罗·B·比森老年新兴领袖职业发展奖(K76)的申请表 科里·西蒙博士，他是一名物理治疗师和老年疼痛研究员，专门研究下腰痛。腰背 对于老年人来说，疼痛是世界上最令人残疾的疾病之一，超过75%的人报告说持续疼痛 发病后1-2年致残。老年人腰痛的一种新的残疾机制是高度的 应激反应，这是一种以血液异常变化为特征的急性生理反应 在紧张的遭遇后的生物标记物。高度应激反应与较差的健康结果有关，包括 其他慢性疾病的残疾；累积的研究表明，高应激反应是由 不正常的想法和感觉，可以通过生物行为干预来改变。然而，压力 对患有下腰痛的老年人的反应性研究还很缺乏。在一项为期5年的创新研究中提出了这一建议 该计划建立在西蒙博士的试点研究的基础上，展示了令人兴奋的初步联系 应激反应、身体功能和心理痛苦。这项提议将利用新的实验室压力 反应性测试、患者报告的结果和定性访谈，以：1)识别和量化压力 有下腰痛的老年人的反应性；和2)为了减少残疾风险，制定 针对患有下腰痛的老年人的高应激反应的生物行为干预。这一计划将 验证他的中心假设，即腰痛和高应激反应的老年人患上糖尿病的风险更大 由于消极的想法和感觉以及糟糕的应对策略而导致的残疾。此外，该计划还将 为西蒙博士提供应激反应科学、行为干预方面的高级职业发展 开发和研究领导力。在完成这个项目后，西蒙博士将准备好帮助 NIA资助的临床试验(R34/R01)的开发，以测试HIS创新生物行为的有效性 针对高应激反应的老年人下腰痛的康复干预。总而言之，这 该计划是西蒙博士长期目标的下一步，他的目标是成为开发 有针对性的干预措施，以消除患有下腰痛的老年人的残疾。

PROJECT SUMMARY/ABSTRACT This application for the Paul B. Beeson Emerging Leaders Career Development Award in Aging (K76) is for Dr. Corey Simon, a physical therapist and geriatric pain researcher specializing in low back pain. Low back pain is one of the world’s most disabling conditions for older adults, with more than 75% reporting persistent disability 1-2 years after onset. A novel disability mechanism among older adults with low back pain is high stress reactivity, which is an acute physiologic response characterized by abnormal changes in blood biomarkers after stressful encounters. High stress reactivity is linked to poorer health outcomes including disability in other chronic conditions; and accumulating research suggests high stress reactivity is mediated by abnormal thoughts and feelings and is modifiable through biobehavioral interventions. However, stress reactivity research in older adults with low back pain is lacking. This proposal in an innovative 5-year research program that builds upon Dr. Simon’s pilot study demonstrating exciting preliminary associations between stress reactivity, physical function, and psychological distress. This proposal will utilize novel laboratory stress reactivity tests, patient-reported outcomes, and qualitative interviews to: 1) Identify and quantify stress reactivity in older adults with low back pain; and 2) For the purpose of reducing disability risks, develop a biobehavioral intervention that targets high stress reactivity in older adults with low back pain. This program will test his central hypothesis that older adults with low back pain and high stress reactivity are at greater risk for disability due to negative thoughts and feelings and poor coping strategies. In addition, this program will provide Dr. Simon with advanced career development in stress reactivity science, behavioral intervention development, and research leadership. Upon completion of this program, Dr. Simon will be poised to facilitate the development of an NIA-funded clinical trial (R34/R01) to test the efficacy of his innovative biobehavioral rehabilitation intervention for older adults with low back pain that targets high stress reactivity. Collectively, this program is the next step in Dr. Simon’s long-term goal to become an international leader in the development of targeted interventions to eradicate disability in older adults with low back pain.