Management of Chronic Low Back Pain in Older Adults Using Auricular Point Acupressure

使用耳穴按摩治疗老年人慢性腰痛

基本信息

批准号：
9918218
负责人：
Chao Hsing Yeh
金额：
$ 62.7万
依托单位：
JOHNS HOPKINS UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-08-01 至 2023-04-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9918218
关键词：
Acupressure Acupuncture Points Acupuncture Therapy Address Adherence Adult Advisory Committees Affect Age Age-Years Analgesics Anti-Inflammatory Agents Anxiety Back Behavioral Belief Biological Biological Markers Blood Calcitonin Gene-Related Peptide Caring Centers for Disease Control and Prevention (U.S.)Chinese People Chinese Traditional Medicine Chronic low back pain Clinical Data Diagnosis Diagnostic tests Ear Ear Acupuncture Ecological momentary assessment Elderly Electric Stimulation Ethnic Origin Evolution Fibrinogen Fright Gender Goals Guidelines Health Personnel Healthcare Home environment Immune signaling Improve Access Individual Inflammatory Institute of Medicine (U.S.)Institutes Insurance Coverage Integrative Medicine Interleukin-1 beta Interleukin-4 Intervention Marital Status Massage Measures Mediating Mediator of activation protein Medical Mental Depression Mission Modeling Monitor Motivation National Institute on Aging Needles Office Visits Opioid Outcome Outcome Study Pain Pain intensity Pain interference Pain management Participant Patients Persons Pharmaceutical Preparations Pharmacology Physical Function Physiological Placebo Effect Protocols documentation Provider Psychological Factors Quality of life Randomized Controlled Trials Relaxation Reporting Research Seeds Self Management Signal Transduction Sleep Smoking Societies Specificity Spinal Manipulation Standardization Surgeon Symptoms System Testing Time United States United States National Institutes of Health Visit Vulnerable Populations chronic pain chronic pain management clinical practice comorbidity comparison group cost cytokine design disability evidence based guidelines expectation experience follow-up functional improvement health care availability improved improved functioning innovation novel strategies opioid epidemic pain outcome pain relief prescription opioid primary endpoint primary outcome psychologic reduce symptoms relating to nervous system satisfaction secondary outcome side effect smartphone Application social factors treatment effect usability

项目摘要

Chronic low back pain (cLBP) is the most common pain condition diagnosed in patients 65 years or older in the United States. While new interventions are being developed, they often cost more, require additional diagnostic tests, and increase visits to health care providers (HCP). Older adults often have additional health care issues and need more assistance to access HCP, which delays treatment and further increases cost. Analgesics are often prescribed, yet they can be costly and have particularly troublesome side effects in this already vulnerable population. Auricular point acupressure (APA) applies an acupuncture-like stimulation to ear acupoints without using a needle (i.e., seeds are taped to the acupoints) to treat illness/symptoms. APA is particularly well-suited for current challenges of unmet cLBP management. We propose a randomized controlled trial to (1) determine the efficacy of APA in relieving cLBP and (2) examine the physiologic mechanisms of the APA effect on cLBP. We will determine the efficacy of a 4-week APA therapy for adults 65 years or older with cLBP. Guided by the NIH Pain Consortium Research Task Force, the standardized research approach on cLBP will be used to measure the study outcomes (i.e., pain intensity, pain interference and physical function). We will also measure psychological, behavioral, personal and social factors that may moderate or mediate the effects of APA. We also believe inflammatory cytokines may partially explain the mechanism of action of APA for pain relief and improved back-specific physical function and plan to measure these. This study will identify a novel approach to manage cLBP in older adults, which is an innovative, non-invasive, low-cost, self-manageable, non-pharmacological approach as an adjunctive therapy for cLBP, with minimal side effects. If successful, the paradigm of pain management will shift from a traditional medical model to a larger integrative medicine and self-management paradigm to avoid unnecessary evolution towards prolonged disability.

慢性腰痛 (cLBP) 是 65 岁或以上患者中最常见的疼痛病症。美国。虽然正在开发新的干预措施，但它们往往成本更高，需要额外的诊断测试，并增加对医疗保健提供者 (HCP) 的就诊。老年人经常有额外的医疗保健问题并需要更多援助才能获得 HCP，这会延误治疗并进一步增加费用。镇痛药是经常开处方，但它们可能成本高昂，并且在这个本来就脆弱的地区会产生特别麻烦的副作用人口。耳穴按摩 (APA) 对耳穴施加类似针灸的刺激，而无需使用针（即将种子贴在穴位上）来治疗疾病/症状。 APA 特别适合针对当前未满足的 cLBP 管理挑战。我们提出一项随机对照试验来 (1) 确定 APA 在缓解 cLBP 方面的功效；(2) 检查 APA 对 cLBP 影响的生理机制。我们将确定 4 周 APA 治疗对 65 岁或以上患有 cLBP 的成人的疗效。指导下 NIH 疼痛联盟研究工作组，cLBP 的标准化研究方法将用于衡量研究结果（即疼痛强度、疼痛干扰和身体功能）。我们也会测量心理、行为、个人和社会因素可能会调节或调节 APA 的影响。我们也相信炎症细胞因子可以部分解释 APA 缓解疼痛和改善疼痛的作用机制背部特定的身体功能并计划测量这些功能。这项研究将确定一种新的管理方法针对老年人的 cLBP，是一种创新、非侵入性、低成本、可自我管理、非药物的方法该方法作为 cLBP 的辅助治疗，副作用最小。如果成功的话，痛苦的范例管理将从传统的医疗模式转向更大的综合医疗和自我管理避免不必要的长期残疾演变的范例。