Generalized joint hypermobility and chronic neck pain: associations with dynamic cervical spine instability

项目总结/摘要 在美国，慢性颈部疼痛是一种重要的社会经济负担，也是导致残疾的主要原因。 静态成像和体格检查通常无法识别疼痛的具体来源，阻碍了治疗。 制定有针对性的干预措施，导致不良结果。有证据表明， 泛发性关节过度活动（GJH），多个关节活动范围过大， 大约20%的人更容易患上慢性颈部疼痛。的长期目标 本研究旨在开发有效和有针对性的干预措施，以改善慢性颈痛的结局。作为 为了实现这一目标，拟议研究的目的是确定临床特征和生物力学 GJH中慢性颈部疼痛的机制。目的1将确定慢性胰腺炎的患病率和临床特征 颈部疼痛在GJH。研究第一阶段的数据收集将在位于纽约的一个研究机构进行。 明尼苏达州博览会，提供了一个大的，不同的样本，一般公众在整个生命周期。目标2将 确定动态节段间不稳定与慢性颈痛相关的程度，以及 通过颈部力量和耐力介导，在GJH个体中。研究组将包括GJH与慢性 颈痛、无症状GJH和年龄性别匹配的健康对照。动态测量 节段间不稳定需要体内颈椎运动学。我们将利用先进的成像技术 技术，双平面视频放射摄影，以捕获主动运动过程中的动态椎间运动。的 结果将阐明动态节段间不稳定和颈部力量和耐力的作用， 颈部疼痛和GJH。生物标志物的鉴定将为靶向治疗的发展提供机制基础。 治疗慢性颈部疼痛。 该提案提供了一个优秀的导师团队在一个研究丰富的环境中的培训， 明尼苏达大学医学院。培训计划包括以下技术培训： 双平面视频放射照相术和光学运动捕捉，生物统计学教学课程和指导， 人类受试者研究设计，并参与职业发展活动，包括手稿和 准备补助金。该提案中的研究与NIH的使命密切相关， 机构，确定颈部疼痛的机制，以制定治疗策略， 慢性致残性疾病的后果拟议的研究将提供基础知识， 在受训人员过渡到独立调查员角色时提供特殊的研究金培训。

Project Summary/Abstract Chronic neck pain is a significant socioeconomic burden and a leading cause of disability in the United States. Static imaging and physical examination often fail to identify a specific source of pain, hindering the development of targeted interventions and contributing to poor outcomes. Evidence suggests that individuals with generalized joint hypermobility (GJH), an excessive range of motion across multiple joints affecting approximately 20% of the population, are more likely to develop chronic neck pain. The long-term objective of this research is to develop effective and targeted interventions to improve outcomes in chronic neck pain. As a step towards this goal, the objective of the proposed study is to identify clinical features and biomechanical mechanisms of chronic neck pain in GJH. Aim 1 will determine the prevalence and clinical features of chronic neck pain in GJH. Data collection for this first phase of the study will take place at a research facility at the Minnesota State Fair, providing a large, diverse sample of the general public across the lifespan. Aim 2 will determine the extent to which dynamic intersegmental instability is associated with chronic neck pain, and mediated by neck strength and endurance, in individuals with GJH. Study groups will include GJH with chronic neck pain, asymptomatic GJH, and age- and sex- matched healthy controls. The measurement of dynamic intersegmental instability requires in vivo cervical spine kinematics. We will utilize an advanced imaging technique, biplane videoradiography, to capture dynamic intervertebral motion during active movement. The results will elucidate the roles of dynamic intersegmental instability and neck strength and endurance in chronic neck pain and GJH. Identification of biomarkers will provide a mechanistic basis for development of targeted therapies for chronic neck pain. This proposal provides training from an outstanding mentorship team in a research-rich environment within the Medical School at the University of Minnesota. Included in the training plan are training in the techniques of biplane videoradiography and optical motion capture, didactic courses and mentorship in biostatistics and human subjects research design, and engagement in career development activities including manuscript and grant preparation. The research in this proposal aligns closely with the missions of the NIH and participating institutions, identifying mechanisms in neck pain for the development of treatment strategies to improve outcomes in a chronic, disabling condition. The proposed study will provide foundational knowledge and exceptional fellowship training as the trainee transitions to an independent investigator role.