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

• 批准号: 10615985
• 负责人: Constance Margaret Johnson
• 金额: $ 46.27万
• 依托单位: UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-08-01 至 2024-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10615985
• 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; Body mass index; Calcitonin Gene-Related Peptide; Caring; Centers for Disease Control and Prevention (U.S.); Chinese; 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; 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 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; prescription pain reliever; primary endpoint; primary outcome; psychologic; reduce symptoms; relating to nervous system; satisfaction; secondary outcome; side effect; smartphone Application; social factors; treatment effect; usability

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.

慢性下腰痛（CLBP）是65岁以上患者诊断出的最常见疼痛状况 美国。在开发新的干预措施时，它们的成本通常更高，需要额外的诊断 测试并增加对医疗保健提供者（HCP）的访问。老年人通常还有其他医疗保健问题 并需要更多的帮助才能访问HCP，这延迟了治疗并进一步提高成本。镇痛药是 通常是处方的，但是它们可能会昂贵，并且在这个已经脆弱的情况下会特别麻烦 人口。耳尖端穴位点（APA）将针灸样刺激应用于没有耳塞 使用针（即，将种子粘在穴位上）来治疗疾病/症状。 APA特别适合 对于未满足CLBP管理的当前挑战。我们提出了一项随机对照试验，以确定 APA在缓解CLBP方面的功效和（2）检查APA对CLBP的生理机制。 我们将确定4周APA治疗对65岁或CLBP的成年人的疗效。由 NIH疼痛联盟研究工作组，CLBP的标准化研究方法将用于 测量研究结果（即疼痛强度，疼痛干扰和身体功能）。我们还将衡量 可以适应或介导APA影响的心理，行为，个人和社会因素。我们也是 认为炎性细胞因子可能部分解释了APA缓解疼痛的作用机理并改善 背面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颖的管理方法 老年人的CLBP，这是一种创新，无创，低成本，可自我管理的，非药物 作为CLBP的辅助治疗方法，具有最小的副作用。如果成功，痛苦的范式 管理层将从传统的医学模型转变为更大的综合医学和自我管理 范式避免了长期残疾的不必要进化。

项目成果

Evaluating Auricular Point Acupressure for Chronic Low Back Pain Self-Management Using Technology: A Feasibility Study.

使用技术评估耳穴穴位按摩对慢性腰痛的自我管理：可行性研究。

• DOI: 10.1016/j.pmn.2021.11.007
• 发表时间: 2022
• 期刊: Pain management nursing : official journal of the American Society of Pain Management Nurses
• 作者: Yeh,ChaoHsing;Kawi,Jennifer;Ni,Aiguo;Christo,Paul
• 通讯作者: Christo,Paul

A prospective randomized controlled study of auricular point acupressure to manage chronic low back pain in older adults: study protocol.

一项耳穴穴位按摩治疗老年人慢性腰痛的前瞻性随机对照研究：研究方案。

• DOI: 10.1186/s13063-019-4016-x
• 发表时间: 2020
• 期刊: Trials
• 影响因子: 2.5
• 作者: Yeh,ChaoHsing;Li,Cuicui;Glick,Ronald;Schlenk,ElizabethA;Albers,Kathryn;Suen,LornaKwai-Ping;Lukkahatai,Nada;Salen,Nicole;Pandiri,Sonaali;Ma,Weixia;Perrin,Nancy;Morone,NataliaE;Christo,PaulJ
• 通讯作者: Christo,PaulJ

Auricular Point Acupressure Smartphone Application to Manage Chronic Musculoskeletal Pain: A Longitudinal, One-Group, Open Pilot Trial.

• DOI: 10.1177/2164956120987531
• 发表时间: 2021
• 期刊: Global advances in health and medicine
• 作者: Kawi J;Yeh CH;Li M;Caswell Bs K;Mazraani Md M;Lukkahatai PhD Rn N;Mensah Rn S;Taylor J;Budhathoki C;Christo P
• 通讯作者: Christo P

Biological Correlates of the Effects of Auricular Point Acupressure on Pain.

耳穴穴位按压对疼痛影响的生物相关性。

• DOI: 10.1016/j.pmn.2022.11.004
• 发表时间: 2023
• 期刊: Pain management nursing : official journal of the American Society of Pain Management Nurses
• 作者: Yeh,ChaoHsing;Lukkahatai,Nada;Huang,Xinran;Wu,Hulin;Wang,Hongyu;Zhang,Jingyu;Sun,Xinyi;Smith,ThomasJ
• 通讯作者: Smith,ThomasJ