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.

项目摘要和摘要： 慢性肌肉骨骼疼痛（CMSKP）在青少年中很常见。参加常规体育锻炼（PA） 有效地减少CMSKP，但PA的参与仍然低于建议的水平。有必要更好 了解在青少年CMSKP中更好地促进PA的方法（例如，久坐的活动与增加 中度至剧烈的PA），影响PA的因素（例如，弹性，疼痛调节，压力失调）和 这些因素如何影响PA和疼痛的机械基础。这些知识可能导致发展 CMSKP的改进干预措施。基于积极属性的心理弹性因素，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。同时弹性 因素对于总体疼痛应对很重要，直到最近才被视为PA的预测因子。这 该提案的总体目标是开发和试行一项可行性研究，以提高弹性的干预措施 在具有CMSKP的青少年中为PA。这很重要，因为这种干预的发展可能 导致PA的改善，随后改善了CMSKP青少年的慢性疼痛。这项研究首先 评估CMSKP（AIM 1）和调制的青少年的PA和疼痛的弹性因素的途径 疼痛和压力。 60个具有CMSKP的青少年将完成自我报告的韧性和脆弱性测量 因素和客观测量的PA，疼痛（定量感觉测试）和压力（皮质醇醒来 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。这项研究还将考虑具有重要意义的弹性因素 预测久坐的PA作为干预目标，它将发展，完善（AIM 2）和（AIM 3）进行 针对青少年的以弹性为中心的慢性疼痛干预的飞行员可行性和可接受性研究（疼痛弹性 促进青年[Prep-Y]）。该手册将根据已建立的治疗计划制定 青少年（即适合青少年）的青少年CMSKP，并修改为靶弹性机制和久坐 活动。这将通过儿科疼痛和CMSKP患者的内容专家的综合反馈来完成。 然后，将向30例4至6组的患者提供干预措施。该项目将作为一部分实施 一项强大的职业发展计划，包括课程工作，体验培训和深入的指导 小儿行为干预发展和评估专家团队 小儿疼痛，体育锻炼干预以及疼痛生理和评估。这项研究的完成将 在两个学术医疗中心与儿科联合部门发生，这是一种很好的疼痛治疗 服务和研究机构，以促进研究教师的成长和发展。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的临床意义成果。