Novel Interventions for Gulf War Veterans' Illnesses

针对海湾战争退伍军人疾病的新颖干预措施

• 批准号: 10683727
• 负责人: Deanna L. Mori
• 金额: --
• 依托单位: VA BOSTON HEALTH CARE SYSTEM
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-04-01 至 2024-09-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10683727
• 关键词: Aftercare; Chinese; Chronic; Cognition; Diffusion Magnetic Resonance Imaging; Drug Side Effects; Education; Educational process of instructing; Effectiveness; Exercise; Fatigue; Functional Magnetic Resonance Imaging; Goals; Gulf War; Gulf War veteran; Healthcare; Home; Individual; Intervention; Investigation; Length; MRI Scans; Measures; Mind-Body Intervention; Participant; Patients; Pharmacotherapy; Physical Function; Pilot Projects; Quality of life; Randomized; Reporting; Research; Research Design; Rest; Stretching; Symptoms; Tai Ji; Treatment Efficacy; Veterans; Well in self; Work; chronic pain management; cognitive function; comparison intervention; disabling symptom; effective therapy; experience; follow up assessment; follow-up; improved; intervention participants; meetings; neurobiological mechanism; novel; pain reduction; pain symptom; persistent symptom; physical conditioning; public health relevance; randomized trial; reduce symptoms; symptom treatment

 DESCRIPTION (provided by applicant): Over 40,000 Veterans who served in the 1991 Gulf War (GW) have a persistent form of chronic multisymptom illness that defines Gulf War Veterans Illness (GWVI). With no existing proven treatments to provide relief to these sufferers, it is critical to find efficacious and acceptable treatments for GWVI. Our long-term goal is to develop a safe, readily available, mind-body treatment to reduce pain and other chronic symptoms and enhance wellness in Veterans with GWVI. Tai Chi is a traditional Chinese mind-body therapy that has been practiced for centuries. In the last decade, we have demonstrated that Tai Chi can improve both physical health and psychological well-being in patients with a variety of chronic conditions. The proposed randomized trial will establish the effectiveness of a Tai Chi mind-body treatment in Veterans with GWVI. One hundred and twenty participants meeting criteria for GWVI will be randomly assigned to either a Tai Chi exercise or a stretching and wellness education group for 12 weeks with a post-treatment assessment, and follow-up assessments. For an exploratory sub-study, 40 Veterans (approximately 20 from each condition) will undergo MRI scanning at each assessment point. We will accomplish the following Specific Aims: Specific Aim 1: Evaluate whether the Tai Chi intervention will reduce symptoms of pain in Veterans with GWVI more than the Wellness intervention. We hypothesize that participants randomized to the Tai Chi intervention will show a greater reduction in pain symptoms than those in the Wellness intervention and will maintain changes over a 9-month follow-up period. Specific Aim 2: Evaluate whether the Tai Chi intervention improves fatigue, cognition, quality of life, and physical functioning in GW Veterans with GWVI, as compared to the Wellness intervention. We hypothesize that participants randomized to the Tai Chi intervention will evidence more improvement in fatigue, cognitive functioning, quality of life, and physical functioning than those randomized to the Wellness intervention and will maintain changes over a 9-month follow-up period. Specific Aim 3: Explore a potential neurobiological mechanism by which Tai Chi can reduce pain and other symptoms and improve quality of life in Veterans with GWVI. We hypothesize differences in resting state fMRI and on diffusion tensor imaging (DTI) in participants randomized to the Tai Chi intervention compared with Wellness intervention participants and that these differences will maintain over the 9-month follow-up period. The proposed trial, informed by our prior investigations, with a robust study design and strong research team, will produce valuable results that can have a direct and immediate impact on healthcare practices for GWVI. If proven as an effective treatment for the symptoms of GWVI, this non-pharmaceutical treatment could easily be implemented in VA facilities, and Veterans could be taught how to continue to practice independently within their own homes. Providing GW Veterans even moderate relief from chronic and debilitating symptoms of GWVI could have a profound impact on improving their overall sense of well-being and quality of life, the ultimate measure of treatment efficacy.

 描述（由申请人提供）： 超过 40,000 名参加过 1991 年海湾战争 (GW) 的退伍军人患有一种持续存在的慢性多症状疾病，这种疾病被定义为海湾战争退伍军人病 (GWVI)。由于没有现有有效的治疗方法可以缓解这些患者的症状，因此找到有效且有效的治疗方法至关重要。我们的长期目标是开发一种安全、易于使用的身心治疗方法，以减轻退伍军人的疼痛和其他慢性症状并增强太极拳的健康。太极拳是一种传统的中国身心疗法，已经实践了几个世纪，我们已经证明太极拳可以改善各种慢性病患者的身体健康和心理健康。确定太极拳身心治疗对患有 GWVI 的退伍军人的有效性。符合 GWVI 标准的 120 名参与者将被随机分配到太极拳练习组或拉伸和健康教育组，并进行为期 12 周的治疗后治疗。评估和后续评估。在探索性子研究中，40 名退伍军人（每种情况约 20 名）将在每个评估点接受 MRI 扫描。我们将实现以下具体目标： 具体目标 1：评估太极干预是否会减轻患有 GWVI 的退伍军人的疼痛症状。我们追求的是，​​随机接受太极干预的参与者比接受健康干预的参与者表现出更大的疼痛症状减轻，并且将在 9 个月内保持变化。具体目标 2：与健康干预相比，评估太极干预是否可以改善患有 GWVI 的 GW 退伍军人的疲劳、认知、生活质量和身体机能。与那些相比，疲劳、认知功能、生活质量和身体机能有更多改善 随机接受健康干预，并将在 9 个月的随访期内保持变化。 具体目标 3：探索太极拳可以减轻 GWVI 差异的退伍军人的疼痛和其他症状并改善生活质量的潜在神经生物学机制。根据我们之前的调查，随机接受太极干预的参与者与健康干预参与者进行静息状态 fMRI 和弥散张量成像 (DTI) 比较，这些差异将在 9 个月的随访期内保持不变。凭借稳健的研究设计和强大的研究团队，将产生有价值的结果，对 GWVI 的医疗保健实践产生直接和立即的影响，如果被证明是治疗 GWVI 症状的有效方法，这种非药物治疗可以很容易地在中国实施。退伍军人管理局和退伍军人可以学习如何继续在自己的家中独立练习，甚至为 GWVI 的慢性和衰弱症状提供适度缓解可能会对改善他们的整体幸福感和生活质量产生深远的影响。 ， 这治疗效果的最终衡量标准。