Adherence to Physical Activity among Midlife Adults with Chronic Pain: The Role of Acute Increases in Pain during Physical Activity

患有慢性疼痛的中年成年人坚持体育活动：体育活动期间疼痛急剧增加的作用

基本信息

批准号：
10315424
负责人：
Lisa LaRowe
金额：
$ 6.83万
依托单位：
BROWN UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-09-01 至 2022-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10315424
关键词：
Acceleration Accelerometer Acute Acute Pain Adherence Adult Age Aging Alzheimer&apos s Disease American Area Award Behavior Behavioral Behavioral Medicine Cognitive Collaborations Collection Data Development Distal Ecological momentary assessment Environment Exercise Frequencies Funding Future Goals Guidelines Health Care Costs Health Promotion Health Status Healthcare Systems Individual Infrastructure Intervention Manuscripts Measures Mediation Medicine Mental disorders Methodology Modeling Morbidity - disease rate Outcome Pain Pain intensity Parents Participant Pathogenesis Persons Physical Exercise Physical Function Physical activity Pilot Projects Population Positioning Attribute Prevalence Process Productivity Protocols documentation Quality of life Randomized Recommendation Reporting Research Research Personnel Research Training Risk Role Severities Sleep disturbances Testing Training Universities Work age related base behavior test career chronic pain clinical practice economic impact exercise intervention exercise prescription exercise program exercise regimen experience follow up assessment follow-up functional disability healthy aging improved indexing innovation meetings middle age novel pain reduction pain symptom programs prospective test

项目摘要

Project Summary/Abstract Over 25% of midlife adults suffer from chronic pain, and promotion of physical activity (PA) among this population is essential to increasing quality of life and function at older age. Exercise programs have increasingly been offered in healthcare systems, however, adherence to exercise prescription is poor, with attrition rates as high as 50%. One of the major challenges to increasing PA among adults with chronic pain is that up to 70% experience increased pain during activity. Although increased pain during PA has frequently been cited as a major barrier to PA, additional work is needed to establish PA-induced pain as a key mechanism explaining nonadherence to PA among midlife adults with chronic pain. The proposed study will leverage an ongoing RCT by our research team (R01AG069349), which aims to test the effects of a recommendation for self-paced PA (i.e., PA of a self-selected intensity) versus prescribed moderate intensity PA on PA behavior among midlife adults using ecological momentary assessment (EMA) methodology. We will capitalize on this infrastructure to test two novel research questions among the subset of participants who endorse chronic pain: (1) Does increased pain during PA predict subsequent PA behavior? and (2) Does a recommendation for self-paced (vs. prescribed moderate intensity) PA reduce PA-induced pain, and subsequently increase future PA behavior? Indeed, self-paced PA may reduce PA-induced pain by providing the opportunity to reduce PA intensity when pain begins to increase. We will leverage this experimental manipulation (i.e., randomization to self-paced vs. prescribed moderate intensity) to use an experimental medicine approach to test whether manipulation-driven reductions in PA-induced pain (test of target engagement) increase subsequent PA behavior (test of target validity). We will also explore the more distal effects of PA on chronic pain severity and indices of successful aging at a six-month follow-up assessment. The applicant’s long-term goal is to conduct research focused on promoting adherence to healthful behaviors among individuals with chronic pain, and this study represents an important next step in a systematic line of research that has the potential to inform clinical practice. This award will allow the applicant to receive specialized training in the development/provision of physical activity promotion interventions, the healthy aging process, and the collection/analysis of intensive longitudinal and ambulatory assessment data. This award will also facilitate further development of the applicant’s research program via completion of manuscripts, presentation of research findings at scientific meetings, and development of additional research questions. Brown University is the ideal research/training environment for this project, as the applicant will have extensive opportunities for collaboration and training with expert behavioral medicine researchers. The hands-on training and pilot data obtained through this project will improve the applicant’s ability to obtain a competitive academic research position and increase potential for a productive research career.

项目概要/摘要超过 25% 的中年成年人患有慢性疼痛，其中促进体力活动 (PA) 锻炼计划对于提高老年人的生活质量和功能至关重要。医疗保健系统越来越多地提供运动处方，然而，人们对运动处方的遵守情况却很差，流失率高达 50%，增加慢性疼痛成人 PA 的主要挑战之一是。高达 70% 的人在活动期间会感到疼痛加剧，尽管 PA 期间的疼痛经常会加剧。已被认为是 PA 的主要障碍，需要开展更多工作来确定 PA 引起的疼痛是关键这项研究将解释患有慢性疼痛的中年成年人不遵守 PA 的机制。利用我们研究团队正在进行的随机对照试验 (R01AG069349)，该试验旨在测试推荐自定进度的 PA（即自选强度的 PA）与规定的中等强度我们将使用生态瞬时评估 (EMA) 方法来研究中年成年人的 PA 行为。利用该基础设施在参与者子集中测试两个新颖的研究问题支持慢性疼痛：(1) PA 期间疼痛加剧是否预示着后续的 PA 行为？建议自定进度（与规定的中等强度）PA 减少 PA 引起的疼痛，以及随后增加未来的 PA 行为？确实，自定进度的 PA 可以通过提供以下方式减少 PA 引起的疼痛：当疼痛开始增加时，我们将利用这个实验来降低 PA 强度。操纵（即随机化为自定进度与规定的中等强度）以使用实验医学方法来测试是否通过操作驱动减少 PA 引起的疼痛（目标测试参与）增加后续的 PA 行为（目标有效性测试）我们还将探索更远端的内容。在六个月的随访评估中，PA 对慢性疼痛严重程度和成功衰老指数的影响。申请人的长期目标是开展专注于促进坚持健康的研究慢性疼痛患者的行为，这项研究代表了下一步重要的一步有潜力为临床实践提供信息的系统研究系列将允许申请人。为了接受制定/提供身体活动促进干预措施的专门培训，健康老龄化过程，以及密集纵向和动态评估数据的收集/分析。该奖项还将通过完成以下项目促进申请人的研究计划的进一步发展手稿、在科学会议上展示研究成果以及开展其他研究正如申请人所希望的那样，布朗大学是该项目的理想研究/培训环境。拥有与行为医学专家研究人员合作和培训的广泛机会。通过该项目获得的实践培训和试点数据将提高申请人获得具有竞争力的学术研究地位，并增加富有成效的研究生涯的潜力。