Musculoskeletal and Pelvic Floor Health in Female Chronic Overlapping Pelvic Pain Conditions (The MSK-PELVIC Study)

女性慢性盆腔重叠疼痛的肌肉骨骼和盆底健康（MSK-PELVIC 研究）

• 批准号: 10705656
• 负责人: Colleen Marie Fitzgerald
• 金额: $ 19.25万
• 依托单位: LOYOLA UNIVERSITY CHICAGO
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-16 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10705656
• 关键词: Abdomen; Address; Adolescent; Adult; Affect; Aging; Anatomy; Anxiety; Area; Ataxia; Biomechanics; Characteristics; Chronic; Classification; Clinical; Clinical Research; Contracts; Degenerative polyarthritis; Devices; Diagnosis; Electromyography; Etiology; Exercise; Face; Female; Fibromyalgia; Future; Goals; Health; High Prevalence; Hip region structure; Hormonal; Hypersensitivity; Impaired health; Injections; Injury; Interstitial Cystitis; Intervention; Irritable Bowel Syndrome; Joint Laxity; Knowledge; Learning; Link; Longevity; Measurement; Measures; Medical; Mental Depression; Methods; Muscle; Muscle function; Musculoskeletal; Musculoskeletal Pain; Myofascial Pain Syndromes; Operative Surgical Procedures; Osteoporosis; Outcome Measure; Outcome Study; Pain; Patients; Pelvic Examination; Pelvic Floor Muscle; Pelvic Girdle; Pelvic Pain; Pelvic floor structure; Peripheral; Physical Examination; Physical activity; Physical therapy; Physiological; Physiological Processes; Postmenopause; Postpartum Women; Pregnancy; Pregnant Women; Prevalence; Process; Provider; Public Health; Pudendal Neuralgia; Quality of life; Relaxation; Research; Research Personnel; Risk; Role; Sports; Surface; Treatment outcome; United States National Institutes of Health; Vertebral column; Viscera; Visceral pain; Vulvodynia; Woman; Work; central sensitization; chronic pain; chronic pelvic pain; clinically relevant; comparative; effectiveness clinical trial; endometriosis; evidence base; high risk men; improved; innovation; instrument; muscular structure; musculoskeletal injury; neuromuscular; neuromuscular function; new therapeutic target; novel; osteoporosis with pathological fracture; pharmacologic; pressure; response; side effect; success; tool; trigger point; ultrasound

Project Abstract Chronic pelvic pain (CPP) may affect up to a quarter of all women. Traditionally, CPP has been thought to be driven by visceral pain mechanisms such as Interstitial Cystitis/Painful Bladder Syndrome (IC/PBS), Irritable bowel syndrome (IBS) and endometriosis. It is also established that these visceral pain conditions overlap with vulvodynia, fibromyalgia, depression, and anxiety. More recently, underlying pelvic floor myofascial (PFMP) and dyssynergia have been identified as additional overlapping CPP conditions. Prior work suggests PFMP may be a viscera-somatic response, however, PFMP as a compensatory consequence of other regional musculoskeletal (MSK) conditions has also been proposed. Indeed, across their lifespan, women face higher risks than men for a plethora of MSK injuries and chronic MSK conditions, including an increased prevalence of sports-related injuries, joint hypermobility, fibromyalgia, osteoarthritic conditions (post-menopause), and osteoporosis/osteoporosis-associated fractures. These elevated risks are thought to be due to the unique anatomic (structural), biomechanical, and hormonal factors that can be attributed to the physiologic process of pregnancy and aging. The current application aims to address the significant knowledge gap regarding the limited understanding of the neuromuscular function of the PFM in CPP as well as the role of overlapping MSK conditions and MSK health that may be influencing PFM response. The short-term goal is to examine PFM biomechanics by identifying the most precise muscle measures in women with CPP of various overlapping diagnoses compared to asymptomatic controls, along with assessing overall MSK health/physical activity. The long-term goal is to determine MSK pelvic pain mechanisms that will inform clinically relevant classification, develop evidence-based non-pharmacologic (physical therapy/exercise) treatments for women with CPP, and advance research tools in the area of PFM function and CPP as it relates to overall MSK health. Our innovative strategy combines neuromuscular measures using novel devices and validated measures in evaluating CPP, MSK health, and physical activity. Our central hypothesis is that women with CPP will demonstrate quantifiable PFM abnormalities and clinical MSK characteristics that differ from asymptomatic controls. The results from this study will have a significant public health impact with contributions of rigorous objective and comprehensive PFM and MSK methods, which will be suitable for future NIH clinical research networks/trials, to evaluate and assess the MSK contribution and potential treatment outcomes in women with CPP.

项目摘要 慢性骨盆疼痛（CPP）可能会影响多达四分之一的女性。传统上，CPP被认为是 由内脏疼痛机制（例如间质性膀胱炎/疼痛膀胱综合征（IC/PBS））驱动的，易怒 肠综合征（IBS）和子宫内膜异位症。还确定这些内脏疼痛状况与 外阴痛，纤维肌痛，抑郁和焦虑。最近，底部骨盆底肌筋膜（PFMP） Dyssynergia已被确定为其他重叠的CPP条件。先前的工作建议PFMP 但是，可能是内脏响应，但是，PFMP是其他区域的补偿结果 还提出了肌肉骨骼（MSK）条件。确实，在终生的一生中，女人面临更高的 与男性相比，有很多MSK伤害和慢性MSK条件的风险，包括患病率增加 与运动有关的伤害，关节过度运动，纤维肌痛，骨关节炎状况（绝经后）和 骨质疏松/骨质疏松相关的骨折。这些升高的风险被认为是由于独特的 解剖（结构），生物力学和激素因素，可以归因于生理过程 怀孕和衰老。当前的应用程序旨在解决有关 对PFM在CPP中的神经肌肉功能以及重叠MSK的作用的有限理解有限 可能影响PFM反应的状况和MSK健康。短期目标是检查PFM 生物力学通过确定各种重叠的CPP女性的最精确的肌肉度量 与无症状对照相比，诊断以及评估MSK健康/体育活动的总体诊断。这 长期目标是确定将为临床相关分类的MSK骨盆疼痛机制， 为患有CPP的女性和 与MSK健康有关的PFM功能和CPP领域的提前研究工具。我们的 创新策略结合了使用新型设备的神经肌肉测量，并在 评估CPP，MSK健康和体育活动。我们的中心假设是CPP女性将 证明可量化的PFM异常和临床MSK特征与无症状不同 控件。这项研究的结果将对公共卫生产生重大影响，并有严格的贡献 客观且全面的PFM和MSK方法，适用于未来的NIH临床研究 网络/试验，评估和评估MSK的贡献和潜在治疗结果 CPP。