Mind/Body Interventions for Chronic Low Back and Neck Pain in Military Personnel

军事人员慢性腰背和颈部疼痛的身心干预

• 批准号: 9291426
• 负责人: Erik J Groessl
• 金额: $ 22.28万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-07-01 至 2019-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9291426
• 关键词: Activities of Daily Living; Address; Adherence; Adverse effects; Analgesics; Attention; Attention Concentration; Attitude; Breathing; Breathing Exercises; Caring; Chronic; Chronic low back pain; Chronic neck pain; Clinical; Clinical Trials; Cognitive; Comorbidity; Data; Effectiveness; Ensure; General Population; Guidelines; Health; Health Benefit; Health Care Costs; Individual; Institutional Review Boards; Instruction; Intervention; Intervention Studies; Knowledge; Measurement; Medication Management; Meditation; Mental Depression; Mental Health; Military Personnel; Mind-Body Intervention; Movement; National Center for Complementary and Alternative Medicine; Neck Pain; Opioid; Opioid Analgesics; Outcome; Pain; Pain interference; Patients; Persons; Pharmaceutical Preparations; Phase; Physical Function; Physical Performance; Population; Posture; Pragmatic clinical trial; Preparation; Randomized; Randomized Controlled Trials; Recruitment Activity; Relaxation; Research; Research Personnel; Research Priority; Risk; Self Care; Severities; Spinal; Stress; System; Testing; Thinking; Veterans; Work; Yoga; bodily sensation; career; community setting; conditioning; deep breathing exercises; design; disability; efficacy study; flexibility; health organization; improved; interest; multi-component intervention; power analysis; preference; primary outcome; psychologic; psychological symptom; public health relevance; therapy design; treatment choice; treatment strategy

 DESCRIPTION (provided by applicant): Chronic low back pain (CLBP) and chronic neck pain (CNP) are prevalent conditions and military personnel and veterans have higher rates of chronic low back pain (CLBP) than the general US population. CLBP and CNP are leading causes of disability among active-duty military personnel and are often accompanied by co- morbid conditions that pose additional challenges and can interfere with treatment. Recommended treatments for CLBP and CNP begins with medication management and self-care instruction, but other non-pharmacologic approaches are needed because of limited effectiveness and the risks associated with opioid pain medication use. Of the non-pharmacologic approaches, none stand out as the treatment of choice for CLBP. Thus, integrative therapies including yoga are an increasingly important and valued option among military personnel. Yoga therapies involve the integration of specific postures or movement sequences, specialized use of the breath, and focused attention (directed to physical alignment, the breath and other bodily sensations). Meditation and other cognitive activities may also be included. Thus, yoga is a multifaceted intervention, with documented physical and psychological benefits for people with CLBP and CNP including a) increased strength, flexibility, and conditioning through the performance of physical postures, and b) stress reduction/relaxation and improved psychological functioning facilitated by breathing exercises, concentration, and positive thoughts. In preparation for a full scale study, our study objective is to examine the feasibility and acceptability of conducting a yoga RCT among active-duty military personnel with CLBP/CNP in military and community settings. The study will be conducted in two phases: Phase 1 will involve obtaining IRB approval to conduct research in military settings, collecting qualitative data from stakeholders on attitude and preferences for yoga interventions, and refining the existing Yoga for CLBP intervention for the needs of active-duty military and persons with CNP. Phase 2 will recruit and randomize 50 military personnel with CLBP or CNP to either active hatha or restorative yoga. Pain interference, pain severity, physical function, opioid medication use, and mental health outcomes are of primary interest. Mechanisms will also be studied. Accomplishing these aims will prepare us for an R01 proposal to study the efficacy of yoga for military personnel with CLBP in a full-scale randomized, controlled trial. To be successful and maximize the scientific knowledge obtained from an R01 study, it is crucial to first establish working relationships with military researchers, ensure that recruitment and randomized assignment are feasible, pilot test measurement strategies, and ensure that both interventions have been optimally chosen.

 描述（由申请人提供）：慢性腰痛 (CLBP) 和慢性颈痛 (CNP) 是普遍存在的疾病，军人和退伍军人的慢性腰痛 (CLBP) 发病率高于美国普通人群。 CLBP 和 CNP 是现役军人残疾的主要原因，并且常常伴有合并症，这些病症带来额外的挑战并可能干扰治疗。 CLBP 和 CNP 的推荐治疗方法从药物管理和自我护理指导开始，但由于效果有限且存在与阿片类止痛药使用相关的风险，因此需要其他非药物方法。在非药物方法中，没有一种方法能够成为 CLBP 的首选治疗方法。因此，包括瑜伽在内的综合疗法对于军事人员来说是一个越来越重要和有价值的选择。瑜伽疗法涉及特定姿势或运动顺序的整合、呼吸的专门使用以及集中注意力（针对身体排列、呼吸和其他身体感觉）。冥想和其他认知活动也可能包括在内。因此，瑜伽是一种多方面的干预措施，已被证明对 CLBP 和 CNP 患者的身体和心理益处包括：a) 通过身体姿势的表现增强力量、灵活性和调节能力；b) 通过呼吸练习、集中注意力和积极思考来减轻压力/放松并改善心理功能。为全面做好准备 规模研究，我们的研究目标是检验在军事和社区环境中对现役军人进行 CLBP/CNP 瑜伽随机对照试验的可行性和可接受性。该研究将分两个阶段进行：第一阶段将涉及获得 IRB 批准在军事环境中进行研究，从利益相关者收集有关瑜伽干预的态度和偏好的定性数据，并完善现有的 CLBP 瑜伽干预以满足现役军人和 CNP 人员的需求。第二阶段将招募 50 名具有 CLBP 或 CNP 的军事人员，并随机分配他们参加主动哈他或恢复性瑜伽。疼痛干扰、疼痛严重程度、身体功能、阿片类药物使用和心理健康结果是主要关注点。机制也将被研究。实现这些目标将使我们为 R01 提案做好准备，通过全面的随机对照试验研究瑜伽对患有 CLBP 的军事人员的功效。为了取得成功并最大限度地从 R01 研究中获得科学知识，至关重要的是首先与军事研究人员建立工作关系，确保招募和随机分配可行，试点测试测量策略，并确保两种干预措施都得到最佳选择。