Resilience Factors, Pain, and Physical Activity in Adolescent Chronic Musculoskeletal Pain

青少年慢性肌肉骨骼疼痛的弹性因素、疼痛和体力活动

• 批准号: 10984668
• 负责人: William Robert Black
• 金额: $ 15.82万
• 依托单位: RESEARCH INST NATIONWIDE CHILDREN'S HOSP
• 依托单位国家: 美国
• 财政年份: 2024
• 资助国家: 美国
• 起止时间: 2024-01-17 至 2026-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10984668
• 关键词: Resilience; Factors; Pain; Physical; Activity

PROJECT SUMMARY AND ABSTRACT: Chronic musculoskeletal pain (CMSKP) is common in adolescents. Participation in regular physical activity (PA) is effective in reducing CMSKP but PA participation is still below recommended levels. There is a need to better understand ways to better promote PA in adolescent CMSKP (e.g., decreasing sedentary activity vs. increasing moderate to vigorous PA), factors that affect PA (e.g., resilience, pain modulation, stress dysregulation), and the mechanistic underpinnings of how these factors affect PA and pain. This knowledge may lead to the development of improved interventions for CMSKP. Psychological resilience factors that build on positive attributes, such as self-efficacy, motivation, and psychological flexibility may help adolescents to engage in PA. While resilience factors are important for overall pain coping, they only recently are being considered as predictors for PA. The overall goal of this proposal is to develop and pilot a feasibility study of an intervention that increases resilience for PA in adolescents with CMSKP. This is significant because the development of such an intervention may lead to improved PA and subsequently improved chronic pain for adolescents with CMSKP. This study first evaluates pathways of resilience factors on PA and pain in adolescents with CMSKP (Aim 1), and the modulation of pain and stress. 60 adolescents with CMSKP will complete self-report measures of resilience and vulnerability factors, and objectively measured PA, pain (Quantitative Sensory Testing), and stress (Cortisol Awaking Response). We will evaluate whether endogenous pain modulation and stress regulation mediate the relationships between resilience and PA. This study also will consider resilience factors that are significant in predicting less sedentary PA as intervention targets, and it will develop, refine (Aim 2) and (Aim 3) conduct a pilot feasibility and acceptability study of a resilience-focused chronic pain intervention for youth (Pain REsilience Promotion for Youth [PREP-Y]). The manual will be developed based on an established treatment program for adolescent CMSKP in adolescents (i.e., FIT Teens) and modified to target resilience mechanisms and sedentary activity. This will be done with integrated feedback from content experts in pediatric pain and CMSKP patients. The intervention will then be provided to 30 patients in groups of 4 to 6. This project will be implemented as part of a strong career development plan consisting coursework, experiential training, and intensive mentorship from a team of experts in pediatric behavioral intervention development and evaluation, psychological factors of pediatric pain, physical activity intervention, and pain physiology and assessment. Completion of this study will occur across two academic medical centers with a joint department of pediatrics, a well-establish pain treatment service, and research institutes to promote the growth and development of research faculty. This study and career development plan will promote the establishment of independent, extramurally funded clinical-research program focused on improving clinically meaningful outcomes for adolescents CMSKP.

项目概要和摘要： 慢性肌肉骨骼疼痛（CMSKP）在青少年中很常见。参加定期体育活动 (PA) 可以有效减少CMSKP，但PA 参与仍低于推荐水平。有必要更好 了解更好地促进青少年 CMSKP 中 PA 的方法（例如，减少久坐活动与增加 中度至剧烈 PA）、影响 PA 的因素（例如弹性、疼痛调节、压力失调）以及 这些因素如何影响 PA 和疼痛的机制基础。这些知识可能会导致发展 改进 CMSKP 干预措施。建立在积极属性之上的心理弹性因素，例如 自我效能、动机和心理灵活性可能有助于青少年参与 PA。韧性的同时 这些因素对于整体疼痛应对很重要，但直到最近才被认为是 PA 的预测因素。这 该提案的总体目标是制定并试点一项增强复原力的干预措施的可行性研究 用于 CMSKP 青少年的 PA。这很重要，因为这种干预措施的发展可能 导致患有 CMSKP 的青少年 PA 改善，并随后改善慢性疼痛。本研究首先 评估患有 CMSKP 的青少年 PA 和疼痛的弹性因素的途径（目标 1），以及调节 的痛苦和压力。 60 名患有 CMSKP 的青少年将完成自我报告的复原力和脆弱性测量 因素，并客观测量 PA、疼痛（定量感官测试）和压力（皮质醇觉醒） 回复）。我们将评估内源性疼痛调节和压力调节是否介导 弹性与 PA 之间的关系。这项研究还将考虑在以下方面发挥重要作用的弹性因素： 预测较少久坐的 PA 作为干预目标，并将制定、完善（目标 2）和（目标 3） 针对青少年的以复原力为重点的慢性疼痛干预的试点可行性和可接受性研究（Pain REsilience 青年促销[PREP-Y]）。该手册将根据既定的治疗方案制定 针对青少年（即 FIT 青少年）的青少年 CMSKP 并进行修改以针对弹性机制和久坐 活动。这将通过儿科疼痛和 CMSKP 患者内容专家的综合反馈来完成。 然后将向 30 名患者提供 4 至 6 人一组的干预措施。该项目将作为 强大的职业发展计划，包括课程作业、体验式培训和强化指导 儿科行为干预开发和评估、儿童心理因素的专家团队 儿科疼痛、身体活动干预以及疼痛生理学和评估。完成本研究将 发生在两个学术医疗中心，并设有儿科联合部门，这是一种成熟的疼痛治疗方法 服务和研究机构，促进研究人员的成长和发展。这项研究和 职业发展计划将促进建立独立的、外部资助的临床研究 计划的重点是改善青少年 CMSKP 的临床有意义的结果。