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（由适用提供）：慢性下背痛（CLBP）和慢性颈部疼痛（CNP）是普遍的状况，而军事人员和退伍军人的慢性下背痛（CLBP）比美国一般人群更高。 CLBP和CNP是现役军事人员中残疾的主要原因，并且经常伴随着伴随着额外挑战的合并症，并可能干扰治疗。 CLBP和CNP的建议治疗始于药物管理和自我护理说明，但是由于有效性有限，并且与阿片类药物药物使用相关的风险，需要其他非药物方法。在非药物方法中，没有一个脱颖而出作为CLBP选择的治疗方法。这是综合疗法包括瑜伽是军事人员中越来越重要且有价值的选择。瑜伽疗法涉及特定姿势或运动序列的整合，呼吸的专门使用以及集中注意力（针对身体对准，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。瑜伽是一种多方面的干预措施，对患有CLBP和CNP患者的身体和心理益处有记录在a）通过身体姿势的表现增加的力量，灵活性和调节，b）通过呼吸，集中精力，集中度，积极的想法来提高压力/放松和改善心理功能。为充实做准备 比例研究，我们的研究目标是检查在军事和社区环境中使用CLBP/CNP在现役军事人员中进行瑜伽RCT的可行性和可接受性。这项研究将分为两个阶段：第1阶段将涉及获得IRB批准以在军事环境中进行研究，从利益相关者那里收集有关瑜伽干预态度的态度和偏好的定性数据，并完善现有的CLBP干预瑜伽，以实现现役军事和CNP。第2阶段将用CLBP或CNP招募和随机将50名军事人员招募到活跃的Hatha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兴趣的。还将研究机制。实现这些目标将使我们为R01提案做好准备，以在全面随机，对照试验中研究瑜伽对军事人员的效率。为了取得成功并最大化从R01研究获得的科学知识，首先与军事研究人员建立工作关系，确保招聘和随机分配是可行的，试验测试测量策略，并确保两种干预措施是最佳选择的。