Mind-Body Therapies to Prevent Chronic Low Back Pain

预防慢性腰痛的身心疗法

• 批准号: 7046184
• 负责人: WOLF E MEHLING
• 金额: $ 12.18万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-04-01 至 2010-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7046184
• 关键词: alternative medicine; avoidance behavior; backache; behavioral /social science research tag; chronic disease /disorder; chronic pain; clinical research; cognition; coping; disease /disorder proneness /risk; emotional adjustment; fear; human data; human subject; human therapy evaluation; medical outreach /case finding; meditation; pain; pathologic process; patient oriented research; prognosis; psychometrics; psychosomatic disorders; social psychology; stress management

DESCRIPTION (provided by applicant): While about 10% of patients presenting with acute low back pain (aLBP) will develop chronic low back pain (cLBP), they consume about 75% of LBP related health care expenses and constitute a major economic burden for society. The transition from acute to cLBP is associated with multiple risk factors, of which psychosocial risk factors have the greatest predictive power. This suggests an interaction between emotion, coping, and cognition (mind) and the physical experience of LBP (body). CAM modalities emphasizing the mind-body link, such as Mindfulness Based Stress Reduction, Feldenkrais, and Yoga, may modify these risk factors and help prevent cLBP. Clinicians currently do not have a simple, validated tool for identifying patients with aLBP at high risk for chronic pain and it is unclear whether (and, if so, which) CAM therapies can modify the risk profile and outcome in patients presenting with aLBP. Such information would aid in planning controlled trials of mind-body therapies for LBP, in identifying possible mechanisms of action of these therapies, and in targeting health care resources for cLBP prevention. The candidate will conduct 2 projects: (1) a prospective cohort study (n = 620) at Kaiser Permanente, Northern California (a) to develop and validate a brief prediction tool for primary care clinics and (b) to assess changes in risk factors over time and their association with changes in LBP outcomes; (2) an assessment of whether specific mind-body therapies alter the variables measured with the new prediction tool in randomized and observational studies. The candidate will pursue a structured educational program that includes coursework, mentoring, and supervision of these projects to develop the necessary skills in behavioral science, psychometric evaluation of measures, and clinical research implementation. The candidate's overall goal is to become an independent investigator conducting clinical research of mind-body approaches for the prevention of cLBP.

描述（由申请人提供）：虽然大约10％的患有急性下背部疼痛（ALBP）的患者会出现慢性腰痛（CLBP），但他们消耗了约75％的LBP相关医疗保健费用，构成了社会的重大经济负担。从急性到CLBP的过渡与多种危险因素有关，这些风险因素具有最大的预测能力。这表明情绪，应对和认知（思维）与LBP（身体）的身体经历之间的相互作用。 CAM模式强调了思维链接，例如基于正念的压力减轻，Feldenkrais和Yoga，可能会改变这些危险因素，并有助于防止CLBP。目前，临床医生没有一个简单的，经过验证的工具来识别患有慢性疼痛的ALBP高风险的患者，目前尚不清楚（以及，如果是的，哪种）CAM疗法可以改变出现ALBP的患者的风险概况和结果。这些信息将有助于计划LBP的心身疗法的对照试验，确定这些疗法的可能作用机制，并针对预防CLBP的医疗保健资源。 候选人将进行2个项目：（1）在北加州Kaiser Permanente（a）开发和验证初级保健诊所的简短预测工具和（b）以评估风险因素随时间变化及其与LBP癌症的变化的关联； （2）评估特定思维疗法是否会改变随机和观察性研究中使用新预测工具测量的变量。候选人将遵循一项结构化的教育计划，其中包括对这些项目的课程，指导和监督，以发展行为科学的必要技能，措施的心理测量评估以及临床研究实施。 候选人的总体目标是成为一名独立研究者，从事心理方法的临床研究，以预防CLBP。