Development and feasibility of a mind-body intervention to improve physical activity for patients with chronic hip pain

改善慢性髋部疼痛患者身体活动的身心干预措施的开发和可行性

• 批准号: 10591772
• 负责人: Kate Jochimsen
• 金额: $ 4.7万
• 依托单位: WEST VIRGINIA UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-02-15 至 2023-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10591772
• 关键词: Accounting; Adherence; Adoption; Adult; Affect; Benchmarking; Biomechanics; Caring; Chronic; Clinic; Clinical; Clinical Management; Clinical Trials; Complement; Data Collection; Development; Disease; Economically Deprived Population; Education; Eligibility Determination; Enrollment; Feasibility Studies; First Generation College Students; Fright; Functional disorder; Funding; Future; Goals; Health; Hip Pain; Hip region structure; Hybrids; Individual; Injury; Internet; Intervention; Interview; Joints; Kentucky; Learning Skill; Mentored Patient-Oriented Research Career Development Award; Mentors; Methods; Mind-Body Intervention; Mindfulness Training; Modality; Modeling; National Center for Complementary and Integrative Health; Operative Surgical Procedures; Orthopedics; Outcome; Pain; Pathology; Patient Care; Patient Participation; Patients; Persistent pain; Personal Satisfaction; Persons; Physical Function; Physical Rehabilitation; Physical activity; Physical therapy; Positioning Attribute; Procedures; Provider; Psychosocial Factor; Randomized, Controlled Trials; Recovery; Rehabilitation therapy; Research; Research Design; Research Methodology; Research Personnel; Risk; Rural; Rural Population; Scientist; Self Efficacy; Site; Symptoms; Telephone; Time; Training; Treatment outcome; Trust; United States National Institutes of Health; Universities; West Virginia; Wisconsin; academic standard; acceptability and feasibility; career development; chronic musculoskeletal pain; chronic pain; clinical practice; disability; effective therapy; feasibility testing; geographic barrier; improved; intervention delivery; middle age; mind/body; mindfulness; multimodality; novel; pain catastrophizing; pain reduction; physical therapist; preference; psychologic; psychosocial; randomized, clinical trials; recruit; satisfaction; screening; sedentary; sedentary activity; skills; socioeconomic disadvantage; therapy development

PROJECT SUMMARY Chronic hip pain affects 18.2 million adults annually, with hip-related pain (intra-articular non-arthritic hip pathologies) accounting for 60% of chronic hip pain cases in young- to middle-aged adults. Surgery and non-operative treatments for hip-related pain fail to provide ubiquitous benefit as pain and dysfunction persist for a majority of patients. Individuals with persistent pain often reduce their activity to minimize symptoms despite strong evidence that regular physical activity reduces chronic musculoskeletal pain. Poor psychosocial health (i.e., low self-efficacy, high pain catastrophizing, and kinesiophobia) is common among individuals with chronic musculoskeletal pain and further reinforces low participation in physical activity. Mind-body interventions improve psychosocial health, yet to date, have not been implemented to provide comprehensive, psychologically informed care for patients with hip-related pain. I will fill this gap through the development (Aims 1 and 2) and feasibility testing (Aim 3) of Helping Improve PSychosocial Health (HIPS), a novel, multimodal mindbody intervention to improve physical activity for sedentary individuals with hip-related pain and poor psychosocial health. Following the Fear Avoidance Model (FAM) of chronic pain, the multimodal HIPS mind-body intervention will incorporate pain education, mindfulness training, and goal-setting to improve psychosocial health and facilitate focused engagement in rehabilitation. I hypothesize that the HIPS mind-body intervention will improve physical activity among sedentary individuals with hip-related pain and poor psychosocial health. Increased physical activity will improve pain, function and overall well-being. The HIPS mind-body intervention will be delivered by physical therapists in a hybrid in-persontelephone format to reduce geographic barriers and enable the participation of patients without broadband internet access. The incorporation of mind-body interventions into psychologically informed clinical practice has demonstrated preliminary efficacy; however, evidence is lacking to support its’ broad adoption. Findings from this project will directly inform a multisite feasibility study (3-year NCCIH R01) of the HIPS mind-body intervention. Rigorous evidence of the feasibility (this K23 and future multisite feasibility RCT) and efficacy (future R01) of mind-body interventions such as HIPS, and the subsequent embedding of mind-body interventions into physical therapy clinics will provide support for the broad adoption of psychologically informed rehabilitation. The candidate’s long-term goal is to become an independent, NIH-funded scientist advancing psychologically informed rehabilitation by developing and implementing effective mind-body and rehabilitative interventions to optimize clinical outcomes and improve well-being for patients with chronic hip pain. This K23 will support this goal by providing protected time to complete critical training in mindfulness and mind-body intervention development and clinical trials to complement her expertise in physical rehabilitation and biomechanics.

项目摘要 慢性髋关节疼痛每年会影响1,820万成年人，并患有髋关节疼痛（关节内非关节炎髋关节病理） 在年轻至中年成年人中，占慢性髋关节疼痛病例的60％。手术和非手术治疗 与大多数患者的疼痛和功能障碍持续存在，与髋关节相关的疼痛无法提供无处不在的益处。有个人 持续性疼痛通常会减少其活动，以最大程度地减少符号目的地的有力证据表明定期体育锻炼 减轻慢性肌肉骨骼疼痛。不良的社会心理健康（即，自我有效，高疼痛灾难性低下， 运动恐惧症）在患有慢性肌肉骨骼疼痛的个体中很常见，进一步增强了参与 体育锻炼。尚未实施思维体干预改善心理健康的健康 全面的，心理知情的护理，适用于髋关节疼痛的患者。我将通过开发填补这一空白 （目标1和2）以及可行性测试（AIM 3）帮助改善社会心理健康（臀部），这是一种新颖的多模式身心身体干预，可改善与髋关节疼痛和心理社会心理健康不良的久坐的人的体育锻炼。 遵循慢性疼痛的恐惧避免模型（FAM），多模式的臀部心理干预将纳入 疼痛教育，正念训练和目标设定，以改善社会心理健康并促进参与 康复。我假设臀部的心身干预将改善久坐的体育锻炼 患有髋关节疼痛和心理健康不良的人。体育锻炼增加将改善疼痛，功能和 整体福祉。物理治疗师将以混合面对面的电话格式进行臀部的心身干预措施，以减少地理障碍，并使没有宽带互联网访问的患者参与。 心理干预措施中的心理知情临床实践的保险已经证明了初步 效率;但是，缺乏证据支持其广泛采用。该项目的发现将直接告知 臀部心身干预的多站点可行性研究（3年NCCIH R01）。可行性的严格证据 （此K23和未来的多站点可行性RCT）以及诸如臀部等心身干预措施的效率（未来R01），以及 随后将心身干预措施嵌入物理疗法诊所将为广泛采用提供支持 心理知情的康复。候选人的长期目标是成为一名独立的NIH资助 科学家通过开发和实施有效的思维体和 康复干预措施以优化临床结果并改善慢性髋关节疼痛患者的福祉。这 K23将通过提供受保护的时间来完成正念和心身的批判性培训，以支持这一目标 干预开发和临床试验，以补充她在身体康复和生物力学方面的专业知识。