Examining Interoceptive Awareness as a Mechanism of Change in Yoga for Chronic Low Back Pain

检查内感受意识作为瑜伽改变慢性腰痛的机制

• 批准号: 10606857
• 负责人: Katherine E Gnall
• 金额: $ 4.35万
• 依托单位: UNIVERSITY OF CONNECTICUT STORRS
• 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 2025-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10606857
• 关键词: Address; Adult; Aftercare; American; Anxiety; Area; Attention; Awareness; Behavioral Medicine; Biometry; Caring; Categories; Chronic low back pain; Clinical; Clinical Trials; Collaborations; Complex; Connecticut; Data; Development; Economics; Effectiveness; Emotional; Esthesia; Fellowship; Funding; Goals; Health; Healthcare; Individual; Institution; Interoception; Intervention; Link; Measures; Mediation; Medical; Mental Depression; Mental Health; Mentorship; Methodology; Mind-Body Intervention; Musculoskeletal Pain; National Center for Complementary and Integrative Health; Pain; Pain interference; Pain management; Participant; Patient Self-Report; Patients; Perception; Pharmacological Treatment; Physical activity; Process; Productivity; Property; Protocols documentation; Psychological Factors; Public Health; Quality of life; Randomized, Controlled Trials; Research; Research Priority; Research Project Grants; Research Support; Resources; Role; Sensory; Severities; Sleep disturbances; Testing; Training; United States; Universities; Yoga; abuse liability; biopsychosocial; bodily sensation; career; chronic pain; chronic pain management; chronic painful condition; cost; daily functioning; disability; economic cost; exercise intervention; experience; improved; mind/body; multimodality; pain outcome; pain patient; pain relief; pain sensitivity; pharmacologic; physical conditioning; pre-doctoral; programs; psychologic; response; social; societal costs; training project; trial comparing

PROJECT SUMMARY Chronic pain is a major public health concern and among the most common reasons adults seek medical care in the United States. Chronic pain is a complex biopsychosocial process modulated by psychological factors, including the perception, appraisal, and emotional processing of sensations. Chronic low back pain (CLBP) is increasingly common and is associated with poor physical and mental health. Pharmacological approaches are relatively ineffective for long term pain treatment and have high addictive and abuse potential. Given the myriad economic, psychological, and social costs associated with CLBP, mind-body therapies (MBTs) such as yoga have received growing attention and empirical support for its treatment. Still, less is known about how yoga improves pain outcomes for CLBP or how it compares to and whether it operates distinctly from other physical activity interventions commonly used to treat CLBP. One hypothesized mechanism of MBTs for improving chronic pain is through improvements in interoceptive awareness, or the awareness of one’s internal bodily sensations. To date research has not examined the mechanistic role of interoceptive awareness in MBTs for CLBP. Thus, building on an ongoing NCCIH-funded randomized controlled trial (RCT) comparing 12-week yoga and physical activity interventions for CLBP, the proposed predoctoral study aims to 1) test whether a yoga intervention results in greater changes in interoceptive awareness compared to physical activity; and 2) determine whether changes in interoceptive awareness account for the clinical benefit of yoga for individuals with CLBP as assessed by multiple measures of pain. This predoctoral study capitalizes on an ongoing clinical trial and adds a unique and important contribution by assessing participants’ interoceptive awareness at baseline, mid-treatment (6-weeks), and post-treatment (12-weeks). The proposed project will test the mechanistic role of interoceptive awareness on improvements in both self-report (i.e., pain severity and interference) and objective (i.e., pain sensitization) assessments of chronic pain. This research project will directly address three of NCCIH’s top research priorities by elucidating the mechanistic role of interoception in mind and body treatments for pain. If the mechanistic role of interoceptive awareness in yoga is supported, non-pharmacological mind-body pain therapies can be further optimized for enhanced effectiveness in relieving CLBP. The fellowship’s training aims align closely with the goals for the proposed research project. The individualized training plan will provide the applicant with specialized training in interoception, RCT methodology, MBTs, biostatistics, and professional development for a research career in behavioral medicine. The training plan will leverage existing resources available at the applicant’s primary institution, the University of Connecticut, with collaboration and mentorship from leading experts across the nation.

项目摘要 慢性疼痛是一个主要的公共卫生问题，其中最常见的原因是成年人在 美国。慢性疼痛是一个复杂的生物心理社会过程，该过程由心理因素调节，包括 感知的感知，评估和情感处理。慢性腰痛（CLBP）越来越普遍，并且 与身体和心理健康不良有关。长期的药理学方法相对无效 疼痛治疗，具有较高的添加剂和滥用潜力。考虑到无数的经济，心理和社会成本 与CLBP相关，思维体疗法（MBT）（例如瑜伽）已得到越来越关注和经验支持 治疗。尽管如此，关于瑜伽如何改善CLBP的疼痛结果或与之比较的疼痛结果的了解较少。 它是否与通常用于治疗CLBP的其他体育活动干预措施明显。一个假设 MBT改善慢性疼痛的机制是通过改善感受性意识或意识来提高 一个人的身体感觉。迄今为止，研究尚未检查感知意识的机械作用 在MBT中用于CLBP。这是基于正在进行的NCCIH资助的随机对照试验（RCT）进行比较12周的 瑜伽和CLBP的体育锻炼干预措施，拟议的术前研究旨在1）测试瑜伽是否是否 与体育活动相比，干预会导致感受性意识的变化更大。 2）确定 感知性意识的变化是否占CLBP患者瑜伽的临床益处的临床益处是否解释 通过多种疼痛度量进行评估。这项主要研究大利用了正在进行的临床试验，并添加了独特的 以及通过评估参与者在基线，中期（6周）中评估参与者的感知性意识来做出的重要贡献 和治疗后（12周）。拟议的项目将测试感知性意识的机理作用 自我报告（即疼痛严重程度和干扰）和客观（即疼痛敏化）评估的改善 慢性疼痛。该研究项目将通过阐明NCCIH的三个主要研究优先事项。 互感在思维和身体治疗中的机械作用。如果互感的机械作用 支持瑜伽的意识，可以进一步优化非药物心理疼痛疗法以增强 减轻CLBP的有效性。奖学金的培训与拟议研究的目标紧密相符 项目。个性化的培训计划将为申请人提供互认为专门的培训，RCT 行为医学研究职业的方法论，MBT，生物统计学和专业发展。 培训计划将利用申请人小学机构可用的现有资源 康涅狄格州，全国领先的专家的合作和心态。