Developing a Novel Clinical Care Model for Chronic Patellar Tendinopathy Utilizing Whole Person Healthcare

利用全人医疗保健开发慢性髌腱病的新型临床护理模式

基本信息

批准号：
10739428
负责人：
Laura Stanley Pietrosimone
金额：
$ 15.18万
依托单位：
DUKE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2023
资助国家：
美国
起止时间：
2023-08-10 至 2028-07-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10739428
关键词：
Address Adopted Behavioral Benchmarking Biofeedback Biological Biomechanics Cancer Burden Caring Case Series Chronic Chronic Disease Clinical Clinical Management Clinical Research Clinical Trials Comprehensive Health Care Data Development Diabetes Mellitus Economic Burden Enrollment Etiology Exercise Fostering Frequencies Funding Future Goals Health Healthcare Heart Diseases Individual Intervention Interview K-Series Research Career Programs Knee Knowledge Lead Literature Manuals Measurement Measures Mechanics Mental Health Mentors Methodology Methods Military Personnel Mission Modeling Movement Musculoskeletal Musculoskeletal Pain Outcome Outcomes Research Pain Pathway interactions Patient Care Patient Self-Report Patient-Focused Outcomes Patients Performance Personal Satisfaction Physical Function Physical activity Procedures Protocols documentation Public Health Quality of life Randomized, Controlled Trials Rehabilitation therapy Research Safety Standardization Structure Symptoms Techniques Tendinopathy Tendon structure Testing Therapeutic Intervention Tissues Training Treatment outcome United States National Institutes of Health Work acceptability and feasibility appropriate dose biopsychosocial career chronic care model chronic musculoskeletal pain clinical care design disability effective intervention efficacy evaluation evidence base experience high risk improved innovation intervention refinement model design multimodality novel patellar tendon patient engagement patient oriented patient population personalized care physical conditioning pragmatic trial primary outcome programs progressive care psychologic psychological distress randomized, clinical trials randomized, controlled study recruit retention rate secondary outcome social standard of care therapy development tool traditional care treatment group treatment strategy wearable sensor technology whole health years lived with disability

项目摘要

Abstract Individuals with chronic MSK pain conditions who experience disability-related limitations in physical activity participation are at higher risk for poor physical and mental health outcomes. Chronic patellar tendinopathy is a highly prevalent chronic MSK condition that severely limits performance, physical activity, self-perceived function, and quality of life. Whole person health (WPH) is a comprehensive framework that considers interconnected domains (biological, behavioral, social, environmental) that foster health, and is designed to facilitate multicomponent therapeutic interventions. The applicant’s long-term career objective is to establish a funded research program that develops and evaluates a WPH model to decrease disability and improve quality of life for individuals with for chronic musculoskeletal pain conditions. Current standard of clinical care for patients with chronic patellar tendinopathy take a unifocal approach, emphasizing local tendon pain and capacity, does not incorporate other factors (psychological, social, environmental) that may contribute to the patient’s overall health. The overall objective of this study for this career development award is to develop a WHP framework that is responsive to the critical gaps in the literature and will inform future intervention approaches for patellar tendinopathy. The approach will expand the standard of care progressive loading exercise treatment (PLE) utilizing individualized biofeedback augmented movement retraining and behavioral graded exposure techniques to develop and refine a novel patellar tendon WPH intervention (WPH), and evaluate feasibility, acceptability, and responsiveness of key biopsychosocial outcomes (landing mechanics, psychological distress, tendon stiffness). The central hypothesis of this study is that individuals with chronic patellar tendinopathy who utilize novel WPH for patellar tendinopathy rehabilitation will demonstrate improvements in self-reported function, landing biomechanics, and tissue capacity. The hypothesis will be tested through three specific aims: 1) refine WPH intervention protocols through a small case series study using mixed-methods approach, 2) establish feasibility and acceptability benchmarks, and 3) determine safety and responsiveness of WPH compared to PLE on primary outcome of (a) patient self-reported function and psychological distress, and secondary outcomes of (b) landing biomechanics and (c) patellar tendon stiffness through a pilot randomized controlled study. The proposed work is innovative, in that: 1) it will be the first study to utilize a WPH framework compared to standard of care and evaluate a novel combination of outcomes for the treatment of chronic tendinopathy. The study is significant as it addresses an important gap in knowledge, moving beyond outdated traditional care models to create novel clinical care model designed to mitigate the debilitating effects of tendon pain on quality of life. Doing so takes a substantial step forward to enhance patient-oriented long-term outcomes for individuals with chronic musculoskeletal pain conditions.

抽象的患有慢性MSK疼痛状况的人在体育锻炼中遇到与残疾相关的限制参与的身体和心理健康状况不佳的风险更高。慢性tellar肌腱病是高度普遍的慢性MSK状况严重限制了表现，体育锻炼，自我感知功能和生活质量。全人健康（WPH）是一个考虑的综合框架促进健康的互连领域（生物学，行为，社会，环境），旨在促进多组分治疗干预措施。申请人的长期职业目标是建立一项资助的研究计划，开发和评估WPH模型以减少残疾并改善患有慢性肌肉骨骼疼痛状况的个人的生活质量。当前的临床护理标准对于患有慢性tellar肌腱病的患者，采用统一方法，强调局部肌腱疼痛和能力，不纳入可能有助于促成的其他因素（心理，社会，环境）患者的整体健康状况。这项研究的总体目标是该职业发展奖 WHP框架响应文献中的关键差距，并将告知将来的干预 tellar肌腱病的方法。该方法将扩大护理标准渐进式加载使用个性化生物反馈增强运动再培训和行为的运动治疗（PLE）开发和完善新型tellar肌腱WPH干预（WPH）的分级暴露技术，并且评估关键生物心理社会结果的可行性，可接受性和响应能力（着陆力学，心理困扰，肌腱僵硬）。这项研究的中心假设是利用新颖的WPH进行patelar肌腱病康复的patelar肌腱病将证明自我报告的功能，着陆生物力学和组织能力的改善。假设将是通过三个特定目的测试：1）通过小型案例系列研究完善WPH干预方案使用混合方法方法，2）建立可行性和可接受性基准，3）确定安全性与（a）患者自我报告功能的主要结果相比，WPH的响应能力和心理困扰和（b）着陆生物力学和（c）patelar肌腱刚度的次要结果通过试验随机对照研究。拟议的工作是创新的，其中：1）这将是第一个与护理标准相比，研究使用WPH框架并评估了新的结果组合用于治疗慢性肌腱病。这项研究很重要，因为它解决了重要的差距知识，超越过时的传统护理模型，创建了旨在的新型临床护理模型减轻肌腱疼痛对生活质量的衰弱影响。这样做迈出了巨大的一步改善患有慢性肌肉骨骼疼痛疾病患者的患者长期结局。