Relationships Between Pain-Related Psychological Factors, Gait Quality, and Attention in Chronic Low Back Pain

慢性腰痛中疼痛相关心理因素、步态质量和注意力之间的关系

• 批准号: 10679189
• 负责人: Anna H Bailes
• 金额: $ 4.96万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-06-01 至 2025-11-12
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10679189
• 关键词: Accelerometer; Address; Adoption; Adult; Anxiety; Attention; Back; Behavior; Belief; Biomedical Engineering; Biometry; Black race; Chronic low back pain; Clinical; Cognition; Cognitive; Country; Data Set; Development; Doctor of Philosophy; Evaluation; Failure; Fellowship; Fright; Funding; Gait; Goals; Grant; Health; Helping to End Addiction Long-term; Human; Impairment; Individual; Infrastructure; Intervention; Knowledge; Literature; Low Back Pain; Measures; Mentorship; Mission; Movement; Musculoskeletal Equilibrium; Outcome; Pain; Participant; Patients; Pattern; Persistent pain; Physical therapy; Population; Populations at Risk; Psychological Factors; Psychology; Public Health; Questionnaires; Research; Research Methodology; Research Training; Risk; Role; Sample Size; Sampling; Scientist; Solid; System; Testing; Therapeutic Intervention; Thinking; Training; Translational Research; Treatment outcome; United States National Institutes of Health; Universities; Vulnerable Populations; Walking; Work; career; chronic pain management; clinical predictive model; clinical training; cognitive change; cognitive function; design; disability; disability risk; experience; functional decline; gait symmetry; high risk population; improved; improved outcome; novel; pain catastrophizing; programs; recruit

Project Summary/Abstract Poor gait quality in chronic low back pain (cLBP) contributes to decreased mobility and functional decline. Those with cLBP and pain-related psychological factors (e.g., fear-avoidance, pain catastrophizing) are at elevated risk for these poor clinical outcomes. However, the relationships between fear-avoidance/pain catastrophizing and gait quality in cLBP remain unknown, largely due to use of inconsistent gait quality metrics in small samples. To improve clinical outcomes in this at-risk population, there is a critical need to 1) examine relationships between fear-avoidance/pain catastrophizing and gait quality using rigorous metrics, and 2) conduct a mechanistic exploration of contributors to gait quality impairments. As a first step toward the long-term goal of improving physical therapy interventions for cLBP, the overall objective of this proposal is to 1) determine the relationship between fear-avoidance/pain catastrophizing and gait quality, and 2) test the contribution of attention on gait quality in those with heightened fear-avoidance/pain catastrophizing. The rationale is that establishing the ways in which fear-avoidance/pain catastrophizing are related to gait quality may lead to new treatment interventions (e.g., cognitive reframing surrounding movement, attention-shifting strategies) to improve clinical outcomes in this high-risk population. The central hypothesis is that 1) fear-avoidance/pain catastrophizing is associated with worse gait quality, and 2) reduced attention capacity associated with fear/catastrophizing contributes to poor gait quality. Aim 1 is to determine the relationship between fear-avoidance/pain catastrophizing and gait quality in cLBP. Aim 2 is to determine the role of attention in the relationship between fear-avoidance/pain catastrophizing and gait quality. Under Aim 1, accelerometry-based gait quality metrics will be derived from a large, existing raw data set (n=500) collected as part of an ongoing grant (1U19AR076725-01). For Aim 2, 50 participants will be recruited to perform a dual-task assessing the impact of attention on gait quality. The proposed project is significant because it uses rigorous, accelerometry-based metrics to examine relationships between fear- avoidance/pain catastrophizing and gait quality, and it is the first and necessary step toward identification of novel treatment targets (i.e., fear, attention-related deficits) that when prioritized in physical therapy, may improve outcomes in this population. Under this fellowship, the applicant will gain unique opportunities for integration of top-tier research and clinical training through University of Pittsburgh’s DPT/PhD in Bioengineering program. The proposed project will be completed within the University of Pittsburgh NIH-funded BACPAC Consortium Mechanistic Research Center, where the trainee will have unrivaled access to experts across the country, recruitment and biostatistical support, and novel infrastructure to advance her toward a career as an independent clinician-scientist. A mentorship team consisting of experts in chronic low back pain, gait, attention, translational research, and pain psychology will support the applicant’s training goals in research methods/design, gait accelerometry, human movement, professional development, and mentorship.

项目摘要/摘要 慢性下腰痛（CLBP）的收集质量差会导致移动性下降和功能下降。那些 与CLBP和与疼痛有关的心理因素（例如，避免恐惧，疼痛灾难性）的风险升高 对于这些不良的临床结果。但是，避免恐惧/疼痛灾难性与 CLBP中的步态质量仍然未知，这主要是由于小样本中使用不一致的步态质量指标。到 改善这种高危人群中的临床结果，至关重要1）检查 避免恐惧/疼痛灾难性灾难性和使用严格的指标收集质量，2）进行机械 探索步态质量障碍的贡献者。作为朝着改善长期目标的第一步 CLBP的物理治疗干预措施，该提案的总体目的是1）确定关系 在避免恐惧/疼痛的灾难性和步态质量之间，以及2）测试关注对步态的贡献 避免恐惧/疼痛的人的质量。理由是建立方式 避免恐惧/疼痛灾难性与收集质量有关的可能导致新的治疗干预措施 （例如，围绕运动的认知反映，注意力转移策略），以改善临床结果 这个高风险的人口。中心假设是1）避免恐惧/疼痛灾难性与 步态质量较差，以及2）降低与恐惧/灾难性相关的注意力能力有助于步态不良 质量。目标1是确定避免恐惧/疼痛灾难性的关系并收集质量 CLBP。目标2是确定注意力在避免恐惧/疼痛之间的关系中的作用 和步态质量。在AIM 1下，基于加速度计的步态质量指标将源自一个大的现有原始 数据集（n = 500）作为正在进行的赠款（1U19AR076725-01）的一部分收集。对于目标2，将有50名参与者 招募以执行双重任务评估注意力对步态质量的影响。拟议的项目是 意义重大，因为它使用严格的，基于加速度计的指标来检查恐惧之间的关系 避免/痛苦灾难性并收集质量，这是识别的第一步 新颖的治疗靶标（即恐惧，与注意力相关的缺陷）在物理治疗中优先考虑，可以改善 这个人群的结果。在此奖学金下，申请人将获得独特的整合机会 通过匹兹堡大学的DPT/PHD生物工程计划进行的顶级研究和临床培训。 拟议的项目将在匹兹堡大学NIH资助的BACPAC财团内完成 机械研究中心，学员将在那里无法与全国专家无与伦比的访问权限 招聘和生物统计学支持以及新颖的基础设施，以使她成为独立的职业 临床医生科学家。一个心态团队，由慢性腰痛，战斗，注意力，翻译专家组成 研究和疼痛心理学将支持申请人在研究方法/设计方面的培训目标 加速度计，人类运动，专业发展和心态。