The assessment of lower back mechanical behavior and spinal loads in veterans with non-specific low back pain: a feasibility study

患有非特异性腰痛的退伍军人的下背部机械行为和脊柱负荷的评估：可行性研究

• 批准号: 10183358
• 负责人: Babak Bazrgari
• 金额: --
• 依托单位: VA MEDICAL CENTER - LEXINGTON, KY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-06-01 至 2022-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10183358
• 关键词: Activities of Daily Living; Acute; Address; Affect; Applications Grants; Back; Behavior; Biomechanics; Characteristics; Chronic; Chronic low back pain; Clinic; Clinical; Clinical Management; Control Groups; Development; Elements; Etiology; Evaluation; Failure; Feasibility Studies; Financial compensation; Future; Gender; Goals; Health Status; Individual; Investigation; Life; Low Back Pain; Manuals; Measurement; Measures; Mechanics; Medical center; Methods; Muscle; Nature; Opioid; Outcome; Pain; Participant; Patient Self-Report; Patients; Pelvis; Physical Function; Plant Roots; Population; Preventive treatment; Questionnaires; Recording of previous events; Recurrence; Reflex action; Relapse; Relaxation; Reporting; Research; Research Personnel; Risk; Role; Screening procedure; Source; Spinal; Stress; Surveys; Symptoms; Testing; Tissues; Treatment outcome; Vertebral column; Veterans; Walking; design; disability; effective intervention; effective therapy; experience; high risk; human model; improved; innovation; mechanical behavior; mechanical properties; neuromuscular; neuromusculoskeletal; novel; opioid use; opioid user; pain relief; prescription pain reliever; psychologic; recruit; response; stem; symptom management; tool

Low back pain (LBP) is strongly associated with opioid consumption among veterans, and improved clinical management of LBP is likely to reduce reliance on opioid among veterans. Up to 60% of patients with an acute episode of non-specific LBP experience either symptom persistence or symptom relapse within one year. This is likely an indication of a failure in addressing the underlying mechanisms of pain or initiation of a new etiology; both may stem from a mismatch between patients and treatments. The overall goal of our research is to develop, validate and implement measures that are relevant to known mechanisms of LBP, which can then be used to holistically gauge the health status of patients’ lower backs beyond self-reporting of symptoms. More accurate measurements will help better match of patients with existing treatments or development of more effective new treatments. The specific objective of this study is to generate evidence in support of the feasibility of our methods for 1) the evaluation of relative contribution of lower back tissues to spinal loads, and 2) the investigation of the resultant spinal loads in veterans with non-specific LBP. We have developed a powerful set of tools for the comprehensive assessment of spinal loads and lower back mechanical behavior (MB), that will enable us to examine the existence or development of abnormalities in spinal loads and lower back MB in [five] groups of veterans with different experiences with non-specific LBP. These groups will include [1) veterans with chronic, non-specific LBP and high level of disability (n=10), 2) veterans with chronic, non-specific LBP and low level of disability (n=10),] 3) veterans with non-chronic, non-specific LBP (n=10), 4) asymptomatic veterans with a recent history (i.e., during the past year) of non-specific LBP (n=10), and 5) asymptomatic veterans without a recent history of non-specific LBP (n=10; serving as control group). Successful completion of this feasibility project will pave the way for future studies (merit grant applications) that will verify the role of abnormalities in lower back MB and spinal loads in the clinical presentation of LBP. Such an understanding has the potential to help the affected veterans with disabling non-specific LBP. Specifically, measures of lower back MB and spinal loads can be used not only to identify veterans with mechanical abnormalities in their lower back who are likely to experience LBP in the future, but also to guide novel integrated physical and psychological preventative treatments aimed at improved lower back mechanics. Ultimately, the goal and resultant improvement in clinical outcomes of treatment for non-specific LBP is to diminish reliance on opioids for the symptom management of particularly veterans with chronic LBP.

腰痛（LBP）与退伍军人的阿片类药物消耗密切相关，并改善了临床 LBP的管理可能会减少退伍军人中对阿片类药物的依赖。多达60％的急性患者 非特异性LBP经验的发作症状持久性或症状继电器一年之内。这 可能表明无法解决疼痛的潜在机制或新的主动性 病因；两者都可能源于患者与治疗之间的不匹配。我们研究的总体目标 是开发，验证和实施与LBP的已知机制相关的措施，可以 然后用来整体评估患者下背部的健康状况，而不是自我报告的症状。 更准确的测量将有助于更好地匹配患者现有治疗或开发的患者 更有效的新疗法。这项研究的具体目的是生成证据以支持 我们方法的可行性1）评估下背部组织对脊柱负荷的相对贡献，以及 2）在非特异性LBP的退伍军人中，所得的脊柱载荷的投资。我们已经开发了 强大的一组工具，用于全面评估脊柱负荷和下背部机械行为 （MB），这将使我们能够检查脊柱负荷中异常的存在或发展 在[五个]的退伍军人组中，具有不同特异性LBP经验的退伍军人组。这些小组会 包括[1）具有慢性，非特异性LBP和高水平残疾（n = 10）的退伍军人，2）具有慢性的退伍军人， 非特异性LBP和低水平的残疾（n = 10），] 3）具有非智力，非特异性LBP（n = 10）的退伍军人 非特异性LBP（n = 10）的近期历史（即，在过去的一年中）的无症状退伍军人，5） 没有最近非特异性LBP史的无症状退伍军人（n = 10；用作对照组）。 成功完成此可行性项目将为未来的研究铺平道路（优异赠款申请） 这将验证异常在下背部MB和脊柱载荷中的作用在LBP的临床表现中。 这样的理解有可能帮助受影响的退伍军人禁用非特异性LBP。 具体而言，下背部MB和脊柱负荷的测量不仅可以用于识别具有的退伍军人 下背部的机械异常，将来可能会经历LBP，但也可以指导 旨在改善下背部力学的新型物理和心理预防治疗。 最终，非特异性LBP治疗临床结果的目标和结果改善 是为了减少对阿片类药物的依赖 LBP。