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

项目摘要/摘要 在美国，慢性颈痛是一种重大的社会经济负担，也是导致残疾的主要原因。 静态成像和身体检查往往无法确定疼痛的具体来源，阻碍了 制定有针对性的干预措施，导致结果不佳。有证据表明，个人 对于广泛性关节过度活动(GJH)，跨多个关节的过度运动范围会影响 大约20%的人更有可能发展为慢性颈痛。的长期目标是 这项研究旨在开发有效和有针对性的干预措施，以改善慢性颈痛的预后。作为一名 为了达到这一目标，拟议研究的目标是确定临床特征和生物力学 GJH慢性颈痛的发病机制。目标1将确定慢性病的患病率和临床特征 GJH的颈部疼痛。这项研究第一阶段的数据收集工作将在 明尼苏达州博览会，提供了一个大的，不同的样本的普通公众在整个生命周期。目标2将 确定节段间动态不稳定与慢性颈痛的关联程度 在GJH患者中，通过颈部力量和耐力来调节。研究小组将包括患有慢性疾病的GJH 颈部疼痛，无症状的GJH，以及年龄和性别匹配的健康对照组。动态特性的测量 节段间不稳需要活体颈椎运动学。我们将利用先进的成像技术 双平面摄像技术，用于捕捉主动运动过程中的动态椎间运动。这个 结果将阐明动态节段间不稳定和颈部力量和耐力在慢性颈椎病中的作用。 颈部疼痛和GJH。生物标志物的识别将为靶向研究提供机制基础 治疗慢性颈痛的方法。 这项建议提供了一个优秀的指导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。培训计划中包括以下方面的培训： 生物统计学和光学运动捕捉、教学课程和指导 人类受试者研究设计，参与职业发展活动，包括手稿和 格兰特准备。这项提案中的研究与美国国立卫生研究院及其参与机构的使命密切相关。 机构，确定颈部疼痛的机制，以制定改善治疗策略 在慢性的、致残的情况下产生的结果。拟议的研究将提供基础知识和 当受训人员过渡到独立调查员角色时，进行特殊的研究员培训。

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.