SCI AND AMPUTATION PAIN PREVENTION AND TREATMENT

疼痛对个体的功能有显著影响， 脊髓损伤（IWSCI）和截肢者（IWA）。 对预防产后出血的方法给予的关注有限。 截肢疼痛（PAP），IWSCI中的过度使用疼痛，或治疗慢性 这些群体的痛苦。 该计划的核心包括：行政， 评估、临床服务、工程和数据分析部门。 核心方案的主要目的是促进：（a） 成功完成了该计划中包含的3个项目 项目;（B）获得知识， 慢性疼痛和伴随的残疾的发展;以及（c） 传播信息。 将责任集中在 核心应减少重复，促进社区联络，协助 招聘和项目之间的问题。 这三个项目中 方案项目旨在涵盖从预防 慢性疼痛患者的康复 继发于SCI和截肢。项目I.轮椅人体工程学和 慢性疼痛预防将使用动力学和运动学分析：（a） 减少IWSCI疼痛的频率、严重程度和持续时间， 最佳的轮椅拟合和一个缓冲，高摩擦pushrim; (b)通过最佳方案减少外周病理的进展 轮椅配件和高摩擦力的推框 项目二. 治疗SCI和截肢后的慢性疼痛将：（a）比较 IWSCI和IWA对慢性疼痛患者的社会心理影响， 行为和功能测量;（B）评估 综合物理疗法=认知行为疗法（CBT+PT） （c）评估IWSCI和IWA与疼痛的有效性， 在CBT+PT中添加阿片类药物试验。项目三.测量 SCI和截肢疼痛治疗的结果将：（a）跟踪 急性SCI中的功能变化;（B）评估一组体能 方案和运动学分析技术，用于确定 IWSCI和IWA的功能能力与疼痛以及 （c）使用项目反应理论， 评估一组用于评估慢性疼痛的措施的充分性 患者用于SCI和PAP，并评估这些的效用 量化治疗结果的措施。 这其中的一个独特之处就是 建议将康复科学和先进的 生物统计分析和临床干预。 的整合 项目应有助于获得有关疼痛的知识， SCI和截肢。 它为发展新的方法提供了希望 预防截肢后疼痛和过度使用综合征，以及 疼痛控制和改善这些人群的功能。

Pain has a significant impact on the functioning of individuals with spinal cord injuries (IWSCI) and individuals with amputations (IWA). Limited attention has been given to methods for preventing post- amputation pain (PAP), overuse pain in IWSCI, or to treating chronic pain in these groups. The Program Core includes: Administrative, Assessment, Clinical Services, Engineering, and Data Analysis divisions. The main purposes of the Program Core are to facilitate: (a) the successful completion of the 3 projects contained in the program project; (b) the acquisition of knowledge that will permit prevention of the development of chronic pain and accompanying disability; and, (c) dissemination of information. Centralizing responsibilities within the Core should reduce duplication, facilitate community liaison, assist in recruitment of, and issues across projects. The 3 projects in this Program Project are designed to cover the spectrum from prevention of pain to rehabilitation of individuals who suffer from chronic pain secondary to SCI and amputations. PROJECT I. WHEELCHAIR ERGONOMICS AND CHRONIC PAIN PREVENTION will use kinetic and kinematic analysis to: (a) reduce the frequency, severity, and duration of pain in IWSCI through optimal wheelchair fitting and a cushioned, high-friction pushrim; and (b) reduce the progression of peripheral pathology through optimal wheelchair fitting and a cushioned, high-friction pushrim. PROJECT II. TREATING CHRONIC PAIN FOLLOWING SCI AND AMPUTATION will: (a) compare IWSCI and IWA with pain to chronic pain patients on psychosocial, behavioral, and functional measures; (b) assess the efficacy of the combination of physical therapy = cognitive-behavioral therapy (CBT+PT) for IWSCI and IWA and pain; and (c) to evaluate the usefulness of a trial of opioid medication added to the CBT+PT. PROJECT III. MEASURING OUTCOMES IN PAIN TREATMENT OF SCI & AMPUTATION will: (a) track functional changes in acute SCI; (b) evaluate a set of physical capacity protocols and kinesiological analytic techniques for determining the functional abilities of IWSCI and IWA with pain and the impact of treatment on these measures; and (c) use Item Response Theory to evaluate the adequacy of a set of measures used to evaluate chronic pain patients for use with SCI and PAP and assess the utility of these measures in quantifying treatment outcomes. A unique feature of this proposal is the inclusion of rehabilitation science and advanced biometric analyses with clinical interventions. The integration of the projects should facilitate the acquisition of knowledge about pain and SCI and amputations. It offers promise for the development of methods to prevent pain following amputations and overuse syndromes, as well as pain control and improved functioning in these populations.