Behavioral Interventions and Long Term Outcomes in Juvenile Fibromyalgia Syndrome

青少年纤维肌痛综合征的行为干预和长期结果

基本信息

批准号：
9110174
负责人：
Susmita Kashikar-Zuck
金额：
$ 16.71万
依托单位：
CINCINNATI CHILDRENS HOSP MED CTR
依托单位国家：
美国
项目类别：
财政年份：
2009
资助国家：
美国
起止时间：
2009-08-01 至 2019-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9110174
关键词：
19 year old 21 year old 3-Dimensional Accelerometer Achievement Adherence Adolescence Adolescent Adult Aftercare Age Anxiety Disorders Award Behavior Therapy Body measure procedure Child Childhood Clinical Investigator Clinical Research Clinical Trials Cognitive Therapy Collaborations Coping Skills DSM-IV Data Data Collection Development Diagnosis Educational Status Exercise Faculty Fatigue Fibromyalgia Flare Fright Funding Future Goals Grant Health Human Impairment Individual Institution Interdisciplinary Study Intervention Longitudinal Studies Maintenance Manuscripts Measures Medicine Mental Depression Mentors Mentorship Methods Migraine Modeling Mood Disorders Motion Musculoskeletal National Institute of Arthritis and Musculoskeletal and Skin Diseases Neurology Outcome Pain Pain Research Pain intensity Pain interference Pain management Pain quality Paper Patients Pharmaceutical Preparations Physical Exercise Physical activity Postdoctoral Fellow Prevention Process Public Health Publishing Recording of previous events Reporting Research Research Methodology Research Personnel Research Project Grants Rheumatology Science Scientist Self Management Severities Site Social Functioning Social support Sports Medicine Symptoms Teenagers Testing Therapy trial Time Training United States National Institutes of Health Work Writing anxiety symptoms base body mechanics career chronic pain cohort control trial coping depressive symptoms disability effective intervention exercise training faculty support follow-up functional disability improved injury prevention innovation interest meetings mood symptom neuromuscular next generation novel patient oriented research pediatric patients physical symptom pilot trial primary outcome programs prospective psychiatric symptom psychologic psychosocial randomized trial secondary outcome skills training success tool young adult

项目摘要

DESCRIPTION (provided by applicant): The Specific Aims of this Midcareer Investigator Award renewal application are to 1) successfully implement an ongoing prospective longitudinal study to determine long term outcomes of pediatric patients with juvenile- onset fibromyalgia (JFM), 2) to refine and test a novel intervention, i.e., combined cognitive-behavioral therapy (CBT) and physical exercise to reduce pain and impairment, and increase coping and physical activity in adolescents with JFM, and 3) continue to use the candidate's ongoing and planned clinical studies in pediatric pain to train postdoctoral fellows and junior faculty. The Candidate s a nationally recognized pediatric pain researcher with a history of >10 years of independently funded patient-oriented research focused on clinical trials of behavioral treatment for JFM and other pain conditions, longitudinal studies, and mentorship of early career researchers. In the first 3.5 years of her current K24 funding, she completed the first rigorously controlled trial demonstrating that CBT is a safe and effective intervention for reduction of disability and depression in JFM and she published 22 papers (along with her mentees) based on her JFM and pediatric pain research. The proposed Research Plan for this renewal application includes two projects: 1) an ongoing NIAMS (R01) funded longitudinal study of long-term outcomes of adolescents with JFM, and 2) an ongoing pilot trial of a novel combined CBT and exercise - FIT Teens (Fibromyalgia Integrative Training for Teens) intervention. The innovation of this new program is that it builds on the candidate's established CBT program and seamlessly integrates an exercise component modified from sports-medicine/injury prevention to improve body mechanics and increase physical activity without fear of pain-flares and activity avoidance which is central to inactivity in JFM patients. Results will inform the next multi-site RCT in JFM. The Mentoring Plan is to train future clinical investigators in the field of clinical trials and outcoms research in pediatric chronic pain. The candidate's plan consists of 1) individualized mentoring of postdoctoral fellows/junior faculty supported by currently funded studies (longitudinal study in JFM (R01), PROMIS in pediatric pain and rheumatology (U01), a 40-site clinical trial of prevention medication for pediatric migraine (U01), and other ongoing studies, 2) mentoring of fellows/faculty to develop their own independent research and 3) participation of fellows in established didactic programs on manuscript/grant writing, research methodology and responsible conduct of human research. Cincinnati Children's provides an ideal setting for this award because of the strong institutional support for patient-oriented research and team-science, presence of an award winning chronic pain program, strong interdisciplinary research collaborations with pediatric rheumatology, pain medicine, sports medicine and neurology researchers interested in pediatric pain, a divisional data core and a commitment of the institution to "change the outcomes" for pediatric patients.

描述（由申请人提供）：本中期职业研究者奖续展申请的具体目标是 1) 成功实施一项正在进行的前瞻性纵向研究，以确定青少年发病纤维肌痛 (JFM) 儿科患者的长期结果，2) 完善和测试一种新的干预措施，即联合认知行为疗法（CBT）和体育锻炼，以减轻 JFM 青少年的疼痛和损伤，并增加应对和体育活动，以及3）继续利用候选人正在进行的和计划中的儿科疼痛临床研究来培训博士后研究员和初级教师。该候选人是一位全国公认的儿科疼痛研究员，拥有 10 年以上独立资助的以患者为导向的研究历史，专注于 JFM 和其他疼痛状况的行为治疗临床试验、纵向研究以及早期职业研究人员的指导。在她当前 K24 资助的前 3.5 年里，她完成了第一个严格对照试验，证明 CBT 是减少 JFM 残疾和抑郁的安全有效的干预措施，她（与她的学员一起）基于她的 JFM 发表了 22 篇论文和儿科疼痛研究。此次更新申请的拟议研究计划包括两个项目：1) 一项正在进行的 NIAMS (R01) 资助的针对 JFM 青少年长期结果的纵向研究，以及 2) 一项正在进行的新型 CBT 和运动相结合的试点试验 - FIT Teens （青少年纤维肌痛综合训练）干预。这个新计划的创新之处在于，它建立在候选人已建立的CBT计划的基础上，无缝地整合了从运动医学/伤害预防中修改而来的运动成分，以改善身体力学并增加身体活动，而不必担心疼痛发作和避免活动，这是核心JFM 患者不活动。结果将为 JFM 的下一个多站点随机对照试验提供信息。指导计划旨在培训儿科慢性疼痛临床试验和结果研究领域的未来临床研究人员。候选人的计划包括 1) 对博士后研究员/初级教师的个性化指导，由当前资助的研究（纵向研究）支持 JFM (R01)、儿科疼痛和风湿病学中的 PROMIS (U01)、儿科偏头痛预防药物的 40 个站点临床试验 (U01) 以及其他正在进行的研究，2) 指导研究员/教员开展自己的独立研究和3) 研究员参与已建立的关于手稿/资助写作、研究方法和负责任的人类研究行为的教学计划。辛辛那提儿童医院为该奖项提供了理想的环境，因为它为以患者为中心的研究和团队科学提供了强有力的机构支持，拥有屡获殊荣的慢性疼痛项目，与儿科风湿病学、疼痛医学、运动医学和神经病学研究人员建立了强有力的跨学科研究合作对儿科疼痛感兴趣、部门数据核心以及该机构对儿科患者“改变结果”的承诺。