The interaction between analgesic medication and exercise-induced musclehypertrophy in patients with low back pain

腰痛患者镇痛药物与运动引起的肌肉肥大之间的相互作用

• 批准号: 10458668
• 负责人: Bahar Shahidi
• 金额: $ 38.71万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-01 至 2025-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10458668
• 关键词: Activities of Daily Living; Address; Affect; Analgesics; Animals; Atrophic; Back; Belief; Benzodiazepines; Blood; Chronic; Chronic low back pain; Clinical; Clinical Practice Guideline; Complex; Diagnosis; Dose; Drug Addiction; Drug Prescriptions; Exercise; Exercise Tolerance; Exposure to; Fright; General Population; Goals; Human; Hypertrophy; Impairment; Incidence; Individual; Infiltration; Knowledge; Literature; Low Back Pain; Measures; Medication Management; Metabolism; Mitochondria; Modality; Muscle; Muscle Cells; Muscle Proteins; Muscle relaxants; Muscle satellite cell; Musculoskeletal; Myalgia; Neuraxis; Non-Steroidal Anti-Inflammatory Agents; Operative Surgical Procedures; Opioid; Outcome; Pain; Participant; Pathologic; Patients; Pattern; Performance; Pharmaceutical Preparations; Population; Prevention; Prognosis; Protein Biosynthesis; Psychosocial Factor; Recommendation; Recovery; Recurrence; Rehabilitation therapy; Reporting; Resolution; Risk; Spinal; Symptoms; Time; Torque; Training Programs; United States; Vertebral column; Work; base; cost; disability; exercise program; exercise training; experience; health management; improved; inhibitor; innovation; insight; muscle hypertrophy; neurophysiology; pain reduction; pain relief; persistent symptom; precision medicine; programs; psychosocial; rehabilitation management; resistance exercise; response; standard of care; stem cell function; strength training; treatment strategy

Low back pain (LBP) is a complex condition that affects 65-85% of the population, and is the leading musculoskeletal condition contributing to disability in the United States. Seventy-five percent of individuals undergoing treatment for this condition experience suboptimal or poor outcomes in the form of disability and deficits in functional capacity, including strength and endurance of the lumbar musculature. The most common initial treatments for individuals with chronic LBP are exercise-based rehabilitation, and pharmacological management in the form of analgesic medications. Although these two conservative treatment modalities are often concurrently prescribed, the influence of analgesic medications on the capacity of muscle to adapt in response to exercise is unknown. Importantly, in healthy individuals, some of these medications have been shown to inhibit muscle protein synthesis, metabolism, and stem cell function. The influence of medications may explain the variability in muscle- specific and clinical outcomes associated with exercise-based rehabilitation in this population. To address these current gaps in the literature, we propose to define medication usage patterns and clinical outcomes across individuals with chronic low back pain who are participating an exercise-based rehabilitation program. Specific Aim 1 will investigate the influence of symptom interference, psychosocial factors, and diagnosis on analgesic medication use relative to exercise in individuals with LBP. Specific Aim 2 will evaluate the influence of medication type, dose, and timing on exercise performance. Finally, Specific Aim 3 will determine if medication type, dose, and timing influences the magnitude of muscle hypertrophy and clinical outcomes after completion of a 12-week resistance exercise program. Determining the impact of common analgesic medications on muscle hypertrophy, exercise performance, and clinical outcomes is an important step in optimizing conservative management in individuals with low back pain. This information will also be applicable to a variety of musculoskeletal conditions for which similar treatment strategies are employed. This contribution is significant because it is the first step in a precision medicine approach aimed at establishing appropriate and targeted exercise and analgesic medication prescriptions for reversing muscle impairments that obstruct patient recovery. This proposal is innovative because it aims to fill a large gap in knowledge regarding the influence of analgesic medication on muscle adaptation in individuals with pain and pathological muscle.

腰痛 (LBP) 是一种复杂的疾病，影响着 65-85% 的人口，并且是主要的疾病 在美国，肌肉骨骼疾病导致残疾。百分之七十五 接受这种疾病治疗的个体会经历以下形式的次优或不良结果： 功能障碍和缺陷，包括腰部肌肉组织的力量和耐力。 慢性腰痛患者最常见的初始治疗是基于运动的康复， 以及以镇痛药物形式进行的药物管理。虽然这两个 保守治疗方式通常同时进行，镇痛药的影响 药物对肌肉适应运动的能力的影响尚不清楚。重要的是，在 健康个体，其中一些药物已被证明可以抑制肌肉蛋白质合成， 代谢和干细胞功能。药物的影响可以解释肌肉的变异性 与该人群基于运动的康复相关的具体和临床结果。到 为了解决目前文献中的这些空白，我们建议定义药物使用模式和临床 参加基于运动的慢性腰痛患者的结果 康复计划。具体目标 1 将调查症状干扰的影响， 心理社会因素以及与运动相关的个体镇痛药物使用的诊断 腰痛。具体目标 2 将评估药物类型、剂量和时间对运动的影响 表现。最后，具体目标 3 将确定药物类型、剂量和时间是否影响 完成 12 周阻力后肌肉肥大的程度和临床结果 锻炼计划。确定常见镇痛药物对肌肉肥大的影响， 运动表现和临床结果是优化保守治疗的重要一步 腰痛患者的管理。此信息也适用于各种 采用类似治疗策略的肌肉骨骼疾病。这个贡献是 意义重大，因为这是精准医学方法的第一步，旨在建立适当的 以及用于逆转肌肉损伤的有针对性的运动和镇痛药物处方 阻碍患者康复。该提案具有创新性，因为它旨在填补知识方面的巨大空白 关于镇痛药物对患有疼痛和疼痛的个体肌肉适应的影响 病理性肌肉。