Musculoskeletal and Pelvic Floor Health in Female Chronic Overlapping Pelvic Pain Conditions (The MSK-PELVIC Study)

女性慢性盆腔重叠疼痛的肌肉骨骼和盆底健康（MSK-PELVIC 研究）

• 批准号: 10527205
• 负责人: Colleen Marie Fitzgerald
• 金额: $ 22.7万
• 依托单位: LOYOLA UNIVERSITY CHICAGO
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-16 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10527205
• 关键词: Abdomen; Address; Adolescent; Adult; Affect; Aging; Anatomy; Anxiety; Area; Ataxia; Biomechanics; Characteristics; Chronic; Classification; Clinical; Clinical Research; Contracts; Degenerative polyarthritis; Devices; Diagnosis; Electromyography; Etiology; Exercise; Face; Female; Fibromyalgia; Future; Goals; Health; High Prevalence; Hip region structure; Hormonal; Hypersensitivity; Impaired health; Injections; Injury; Interstitial Cystitis; Intervention; Irritable Bowel Syndrome; Joint Laxity; Knowledge; Learning; Link; Longevity; Measurement; Measures; Medical; Mental Depression; Methods; Muscle; Muscle function; Musculoskeletal; Musculoskeletal Pain; Myofascial Pain Syndromes; Operative Surgical Procedures; Outcome Measure; Outcome Study; Pain; Patients; Pelvic Floor Muscle; Pelvic Girdle; Pelvic Pain; Pelvic floor structure; Peripheral; Pharmacology; Physical Examination; Physical activity; Physical therapy exercises; Physiological; Physiological Processes; Postmenopausal Osteoporosis; Postpartum Women; Pregnancy; Pregnant Women; Prevalence; Process; Provider; Public Health; Pudendal Neuralgia; Quality of life; Research; Research Personnel; Risk; Role; Sports; Surface; Treatment outcome; United States National Institutes of Health; Vertebral column; Viscera; Visceral pain; Vulvodynia; Woman; Work; base; central sensitization; chronic pain; chronic pelvic pain; clinically relevant; comparative; effectiveness clinical trial; endometriosis; evidence base; high risk men; improved; innovation; instrument; muscular structure; musculoskeletal injury; neuromuscular; neuromuscular function; new therapeutic target; novel; osteoporosis with pathological fracture; physical conditioning; pressure; response; side effect; success; tool; trigger point; ultrasound

Project Abstract Chronic pelvic pain (CPP) may affect up to a quarter of all women. Traditionally, CPP has been thought to be driven by visceral pain mechanisms such as Interstitial Cystitis/Painful Bladder Syndrome (IC/PBS), Irritable bowel syndrome (IBS) and endometriosis. It is also established that these visceral pain conditions overlap with vulvodynia, fibromyalgia, depression, and anxiety. More recently, underlying pelvic floor myofascial (PFMP) and dyssynergia have been identified as additional overlapping CPP conditions. Prior work suggests PFMP may be a viscera-somatic response, however, PFMP as a compensatory consequence of other regional musculoskeletal (MSK) conditions has also been proposed. Indeed, across their lifespan, women face higher risks than men for a plethora of MSK injuries and chronic MSK conditions, including an increased prevalence of sports-related injuries, joint hypermobility, fibromyalgia, osteoarthritic conditions (post-menopause), and osteoporosis/osteoporosis-associated fractures. These elevated risks are thought to be due to the unique anatomic (structural), biomechanical, and hormonal factors that can be attributed to the physiologic process of pregnancy and aging. The current application aims to address the significant knowledge gap regarding the limited understanding of the neuromuscular function of the PFM in CPP as well as the role of overlapping MSK conditions and MSK health that may be influencing PFM response. The short-term goal is to examine PFM biomechanics by identifying the most precise muscle measures in women with CPP of various overlapping diagnoses compared to asymptomatic controls, along with assessing overall MSK health/physical activity. The long-term goal is to determine MSK pelvic pain mechanisms that will inform clinically relevant classification, develop evidence-based non-pharmacologic (physical therapy/exercise) treatments for women with CPP, and advance research tools in the area of PFM function and CPP as it relates to overall MSK health. Our innovative strategy combines neuromuscular measures using novel devices and validated measures in evaluating CPP, MSK health, and physical activity. Our central hypothesis is that women with CPP will demonstrate quantifiable PFM abnormalities and clinical MSK characteristics that differ from asymptomatic controls. The results from this study will have a significant public health impact with contributions of rigorous objective and comprehensive PFM and MSK methods, which will be suitable for future NIH clinical research networks/trials, to evaluate and assess the MSK contribution and potential treatment outcomes in women with CPP.

项目摘要 多达四分之一的女性可能患有慢性盆腔疼痛 (CPP)。传统上，CPP 被认为是 由内脏疼痛机制驱动，如间质性膀胱炎/膀胱疼痛综合征 (IC/PBS)、易激惹 肠综合症（IBS）和子宫内膜异位症。还确定这些内脏疼痛状况与 外阴痛、纤维肌痛、抑郁和焦虑。最近，盆底肌筋膜 (PFMP) 和协同失调已被确定为额外的重叠 CPP 条件。之前的工作建议 PFMP 然而，PFMP 可能是一种内脏-躯体反应，作为其他区域的补偿结果 还提出了肌肉骨骼（MSK）病症。事实上，在一生中，女性面临着更高的压力 与男性相比，存在大量 MSK 损伤和慢性 MSK 病症的风险，包括患病率增加 运动相关损伤、关节过度活动、纤维肌痛、骨关节炎（绝经后）和 骨质疏松症/骨质疏松症相关骨折。这些升高的风险被认为是由于独特的 可归因于生理过程的解剖学（结构）、生物力学和激素因素 怀孕和衰老。当前的应用程序旨在解决有关 对 CPP 中 PFM 的神经肌肉功能以及重叠 MSK 的作用了解有限 可能影响 PFM 响应的条件和 MSK 斯隆健康状况。短期目标是检查 PFM 通过确定患有各种重叠 CPP 的女性最精确的肌肉测量来进行生物力学 将诊断结果与无症状对照进行比较，并评估 MSK 斯隆的整体健康/身体活动。这 长期目标是确定 MSK 盆腔疼痛机制，为临床相关分类提供信息， 为患有 CPP 的女性开发基于证据的非药物（物理治疗/运动）治疗方法，以及 推进 PFM 功能和 CPP 领域的研究工具，因为它与 MSK 整体健康相关。我们的 创新策略结合了使用新颖设备的神经肌肉测量和经过验证的测量 评估 CPP、MSK 健康状况和身体活动。我们的中心假设是患有 CPP 的女性会 表现出与无症状患者不同的可量化的 PFM 异常和临床 MSK 特征 控制。这项研究的结果将对公共健康产生重大影响，并做出严格的贡献 客观全面的PFM和MSK方法，适合未来NIH临床研究 网络/试验，以评估 MSK 对患有以下疾病的女性的贡献和潜在治疗结果 菲律宾人民党。