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

 描述(申请人提供)：慢性下腰痛(CLBP)和慢性颈部疼痛(CNP)是常见的疾病，军事人员和退伍军人的慢性下腰痛(CLBP)的发生率高于普通美国人。慢性支气管炎和慢性支气管炎是现役军人致残的主要原因，往往伴随着并存的疾病，构成额外的挑战，并可能干扰治疗。CLBP和CNP的推荐治疗从药物管理和自我护理指导开始，但由于阿片类止痛药使用的效果有限和风险，还需要其他非药物方法。在非药物治疗方法中，没有一种是CLBP的首选治疗方法。因此，包括瑜伽在内的综合疗法越来越受到军事人员的重视和重视。瑜伽疗法包括整合特定的姿势或动作序列，专门使用呼吸，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，对患有CLBP和CNP的人的身体和心理益处有据可查，包括a)通过表演身体姿势增加力量、灵活性和调理能力，以及b)通过呼吸练习、注意力集中和积极思想促进压力减轻/放松和改善心理功能。为了准备一场完整的 通过量表研究，我们的研究目标是考察在军事和社区环境中在患有CLBP/CNP的现役军事人员中进行瑜伽RCT的可行性和可接受性。这项研究将分两个阶段进行：第一阶段将包括获得IRB的批准，在军事环境中进行研究，收集利益相关者关于瑜伽干预态度和偏好的定性数据，以及完善现有的用于CLBP干预的瑜伽，以满足现役军人和CNP患者的需求。第二阶段将招募50名患有CLBP或CNP的军事人员，并随机安排他们进行积极的哈他或恢复性瑜伽。疼痛干预、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感兴趣的因素。机制也将被研究。实现这些目标将为R01提案做好准备，该提案将在一项全面的随机对照试验中研究瑜伽对患有CLBP的军事人员的疗效。为了取得成功并最大限度地利用从R01研究中获得的科学知识，关键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是可行的，试点测试测量战略，并确保这两种干预措施都得到了最佳选择。

 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.