Impact of exercise training on pain and brain function in Gulf War Veterans
运动训练对海湾战争退伍军人疼痛和大脑功能的影响
基本信息
- 批准号:8698364
- 负责人:
- 金额:--
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2011
- 资助国家:美国
- 起止时间:2011-07-01 至 2016-06-30
- 项目状态:已结题
- 来源:
- 关键词:AcuteAddressAdoptionAerobicAerobic ExerciseAffectAnisotropyAnxietyAreaArthralgiaAttentionAttenuatedAwardBehaviorBehavioralBiological MarkersBrainBrain regionChronicClinicalClinical Trials DesignCognitiveControlled Clinical TrialsCountryDataDiffusion Magnetic Resonance ImagingDiseaseEpidemiologic StudiesExerciseExhibitsFatigueFibromyalgiaFinancial compensationFreedomFunctional Magnetic Resonance ImagingFundingGoalsGulf WarHealthHourImage AnalysisInsula of ReilInterventionLaboratoriesLinkMaintenanceMeasurementMeasuresMedicalMental DepressionMental HealthMethodsMilitary PersonnelMusculoskeletal PainMyalgiaNeuraxisNociceptionOutcomePainPain ResearchPainlessParticipantPathway interactionsPatient Self-ReportPatientsPatternPerformancePersian GulfPersonal SatisfactionPhysical FunctionPhysical activityPopulationProcessPropertyProtocols documentationPsychophysicsQuality of lifeRandomizedRandomized Controlled TrialsRecruitment ActivityRegulationReportingResearchResistanceRestSF-36Sensory ProcessServicesSleepSoldierStimulusStructureSymptomsTechniquesTestingThalamic structureTimeTrainingTraining ProgramsTreatment EffectivenessUnited StatesVeteransVisualWaiting ListsWarWomanWorkanalogbasebehavior testblood oxygen level dependentcare seekingchronic paincingulate cortexclinically significantcookingcopingdesigndisabilitydiscounteffective therapyexperiencefollow-upheat stimulushemodynamicsimaging modalityimpressionimprovedmenmidbrain central gray substanceneuroimagingnovelnovel strategiesoperationpain inhibitionphysical conditioningprematureprimary outcomerelating to nervous systemresponsesecondary outcomeself esteemsensory cortexsensory stimulussocialtreatment responsetreatment trialtrial comparingwhite matter
项目摘要
Summary
The overall aim is to determine the efficacy of resistance exercise training (RET) for the treatment of Gulf War
Veterans (GVs) suffering from chronic musculoskeletal pain (CMP). In addition, we will assess the influence of
RET on total physical activity levels, pain sensitivity and pain regulation, and brain white matter tracts. By
applying functional neuroimaging techniques in conjunction with pain psychophysics, we will be able to
determine how the brains of Veterans with CMP respond to pain and whether these responses can be modified
by RET. We plan to use blood oxygen level dependent (BOLD) and diffusion tensor imaging (DTI) methods in
conjunction to evaluate brain regions involved in pain processing and control and the microstructural properties
of white matter tract pathways that connect these regions. In addition, we will determine the influence of RET
on physical activity behaviors. The primary goals of this project will be accomplished by comparing GVs with
CMP assigned to RET with those assigned to wait-list control (WLC) in a randomized controlled trial. The
specific aims of the project are to determine the influence of RET on: 1) pain symptoms, physical function, and
patient global impression of change (PGIC); 2) total daily physical activity levels; 3) brain mechanisms of pain
sensitivity and regulation; and 4) pain-relevant brain white matter tracts involved in pain processing and
control. Sixty-four Veterans will be randomly assigned to either 16 weeks of either RET or WLC. Follow-up
assessments of primary and secondary outcomes will occur at 6 and 12 months post RET and WLC. RET will
consist of exercises that target the entire body and gradually progress from low to moderate intensity loads
over time. Total work will be measured during exercise to demonstrate a training effect. Physical activity levels
in both groups will be assessed via self-report and accelerometry methods. Physical activity will be assessed
at baseline; at weeks 5, 10, and 16 of RET and WLC; and at 6- and 12-month follow-ups. Pain sensitivity and
pain regulation will be assessed using pain psychophysical and functional magnetic resonance imaging
methods. Pain sensitivity and pain regulation will be assessed at baseline; at weeks 6, 11, and 17 of RET and
WLC; and at 6- and 12-month follow-ups. Brain white matter tract structure will be determined using DTI
methods and will be assessed at baseline; at weeks 6, 11, and 17 of RET and WLC; and at 6- and 12-month
follow-ups. We expect that by the end of the trial, GVs with CMP assigned to RET will show: 1) statistically
significant and clinically meaningful improvements in self-reported pain, physical function & PGIC and
secondary outcomes (sleep, self-esteem, fatigue, anxiety and depression); 2) increases in total physical
activity that are attributable to an increase in RET; 3) decreased pain ratings and decreased brain responses
to experimental pain stimuli; 4) decreased brain responses in areas that process the sensory aspects of pain
and increased brain responses in areas that modulate or inhibit pain processing during a distracting cognitive
task; and 5) improvements in DTI measures of brain white matter tract structures. The goals of this project are
consistent with the Department of Veterans Affairs' call for "Research on New Treatments for Gulf War
Veterans' Illness" by proposing a controlled clinical trial 1) in a clearly defined Gulf War Veteran population with
a specific symptom (CMP), 2) with appropriately defined and clinically meaningful endpoints, and 3) that
identifies potential biomarkers that are explanatory or predictive of a treatment response. No efficacious
treatments have been identified for GVs with CMP; however, resistance exercise training remains an
inadequately explored yet promising treatment based on successful trials with civilians suffering from chronic
pain. We have designed a resistance exercise treatment trial that has the potential to benefit Veterans' health
and to begin to determine potential mechanisms of pain maintenance in CMP.
概括
总体目标是确定抵抗运动训练(RET)对于治疗海湾战争的功效
患有慢性肌肉骨骼疼痛 (CMP) 的退伍军人 (GV)。此外,我们还将评估以下因素的影响:
RET 对总身体活动水平、疼痛敏感性和疼痛调节以及脑白质束的影响。经过
应用功能性神经影像技术与疼痛心理物理学相结合,我们将能够
确定患有 CMP 的退伍军人的大脑如何应对疼痛以及这些反应是否可以改变
通过 RET。我们计划使用血氧水平依赖(BOLD)和扩散张量成像(DTI)方法
结合评估参与疼痛处理和控制的大脑区域以及微观结构特性
连接这些区域的白质束通路。此外,我们将确定 RET 的影响
关于身体活动行为。该项目的主要目标将通过比较 GV 和
在一项随机对照试验中,CMP 被分配到 RET 组,而 CMP 则被分配到等待名单控制组 (WLC)。这
该项目的具体目标是确定 RET 对以下方面的影响:1) 疼痛症状、身体功能和
患者整体印象变化(PGIC); 2) 每日总体力活动水平; 3)疼痛的大脑机制
敏感性和调节性; 4) 与疼痛相关的大脑白质束参与疼痛处理和
控制。 64 名退伍军人将被随机分配到为期 16 周的 RET 或 WLC。跟进
主要和次要结果的评估将在 RET 和 WLC 后 6 个月和 12 个月进行。 RET将
包括针对整个身体的练习,并从低强度负荷逐渐进展到中等强度负荷
随着时间的推移。运动期间将测量总做功,以展示训练效果。身体活动水平
两组的评估将通过自我报告和加速测量方法进行。将评估身体活动
处于基线;在 RET 和 WLC 的第 5、10 和 16 周;以及 6 个月和 12 个月的随访。疼痛敏感性和
将使用疼痛心理物理和功能磁共振成像来评估疼痛调节
方法。将在基线时评估疼痛敏感性和疼痛调节;在 RET 的第 6、11 和 17 周
无线控制器;以及 6 个月和 12 个月的随访。将使用 DTI 确定脑白质束结构
方法并将在基线时进行评估;在 RET 和 WLC 第 6、11 和 17 周;以及 6 个月和 12 个月时
后续行动。我们预计,到试验结束时,分配给 RET 的 CMP 的 GV 将显示:1) 统计上
在自我报告的疼痛、身体功能和 PGIC 方面有显着且有临床意义的改善,
次要结果(睡眠、自尊、疲劳、焦虑和抑郁); 2)体力总量的增加
可归因于 RET 增加的活动; 3)疼痛等级降低,大脑反应减弱
实验性疼痛刺激; 4)处理疼痛感觉方面的大脑反应减弱
以及在分散注意力的认知过程中调节或抑制疼痛处理的大脑区域的反应增加
任务; 5) 大脑白质束结构 DTI 测量的改进。该项目的目标是
符合退伍军人事务部“研究海湾战争新疗法”的号召
退伍军人疾病”,提出在明确定义的海湾战争退伍军人群体中进行一项对照临床试验 1)
特定症状 (CMP),2) 具有适当定义且具有临床意义的终点,以及 3)
识别解释或预测治疗反应的潜在生物标志物。没有效果
已确定采用 CMP 治疗 GV 的方法;然而,阻力运动训练仍然是一种
基于对患有慢性病的平民进行的成功试验,尚未充分探索但有希望的治疗方法
疼痛。我们设计了一项阻力运动治疗试验,有可能有益于退伍军人的健康
并开始确定 CMP 中疼痛维持的潜在机制。
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
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DANE B. COOK其他文献
DANE B. COOK的其他文献
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{{ truncateString('DANE B. COOK', 18)}}的其他基金
Post exertion malaise in GWI_Brain autonomic and behavioral interactions
GWI_Brain 自主神经和行为相互作用中的劳累后不适
- 批准号:
10426235 - 财政年份:2016
- 资助金额:
-- - 项目类别:
Post exertion malaise in GWI_Brain autonomic and behavioral interactions
GWI_Brain 自主神经和行为相互作用中的劳累后不适
- 批准号:
10291815 - 财政年份:2016
- 资助金额:
-- - 项目类别:
Post exertion malaise in GWI_Brain autonomic and behavioral interactions
GWI_Brain 自主神经和行为相互作用中的劳累后不适
- 批准号:
9210549 - 财政年份:2016
- 资助金额:
-- - 项目类别:
Post exertion malaise in GWI_Brain autonomic and behavioral interactions
GWI_Brain 自主神经和行为相互作用中的劳累后不适
- 批准号:
10683715 - 财政年份:2016
- 资助金额:
-- - 项目类别:
Impact of exercise training on pain and brain function in Gulf War Veterans
运动训练对海湾战争退伍军人疼痛和大脑功能的影响
- 批准号:
8277785 - 财政年份:2011
- 资助金额:
-- - 项目类别:
Impact of exercise training on pain and brain function in Gulf War Veterans
运动训练对海湾战争退伍军人疼痛和大脑功能的影响
- 批准号:
8793726 - 财政年份:2011
- 资助金额:
-- - 项目类别:
Impact of exercise training on pain and brain function in Gulf War Veterans
运动训练对海湾战争退伍军人疼痛和大脑功能的影响
- 批准号:
8003196 - 财政年份:2011
- 资助金额:
-- - 项目类别:
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