Generalized joint hypermobility and chronic neck pain: associations with dynamic cervical spine instability

全身关节过度活动和慢性颈部疼痛：与动态颈椎不稳定性的关联

• 批准号: 10605837
• 负责人: Rebecca Abbott
• 金额: $ 7.61万
• 依托单位: UNIVERSITY OF MINNESOTA
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-08-28 至 2026-08-27
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10605837
• 关键词: 3-Dimensional; Affect; Age; Arthralgia; Articular Range of Motion; Biological Markers; Biomechanics; Biometry; Cervical; Cervical spine; Chronic; Chronic neck pain; Classification; Clinical; Connective Tissue; Data; Data Collection; Development; Diagnostic; Economic Burden; Environment; Etiology; Extensor; Fellowship; Flexor; General Population; Goals; Grant; Health; Human Subject Research; Image; Imaging Techniques; Individual; Injury; Institution; Intervention; Isometric Exercise; Joint Instability; Joint Laxity; Joints; Knowledge; Longevity; Manuscripts; Measurement; Measures; Mechanics; Mediating; Mentorship; Methods; Minnesota; Mission; Motion; Movement; Neck; Neck Pain; Optics; Outcome; Pain; Participant; Patient Self-Report; Persons; Phase; Physical Examination; Population; Preparation; Prevalence; Questionnaires; Rehabilitation therapy; Research; Research Design; Research Personnel; Role; Rotation; Sampling; Source; Surveys; Techniques; Training; Trauma; Treatment outcome; United States; United States National Institutes of Health; Universities; Variant; biomarker identification; career development; chronic painful condition; clinical imaging; debilitating pain; disability; effective therapy; high risk; imaging modality; improved; improved outcome; in vivo; kinematics; medical schools; opioid epidemic; pain-related disability; research facility; sex; socioeconomics; targeted treatment; therapy development; treatment strategy

Project Summary/Abstract Chronic neck pain is a significant socioeconomic burden and a leading cause of disability in the United States. Static imaging and physical examination often fail to identify a specific source of pain, hindering the development of targeted interventions and contributing to poor outcomes. Evidence suggests that individuals with generalized joint hypermobility (GJH), an excessive range of motion across multiple joints affecting approximately 20% of the population, are more likely to develop chronic neck pain. The long-term objective of this research is to develop effective and targeted interventions to improve outcomes in chronic neck pain. As a step towards this goal, the objective of the proposed study is to identify clinical features and biomechanical mechanisms of chronic neck pain in GJH. Aim 1 will determine the prevalence and clinical features of chronic neck pain in GJH. Data collection for this first phase of the study will take place at a research facility at the Minnesota State Fair, providing a large, diverse sample of the general public across the lifespan. Aim 2 will determine the extent to which dynamic intersegmental instability is associated with chronic neck pain, and mediated by neck strength and endurance, in individuals with GJH. Study groups will include GJH with chronic neck pain, asymptomatic GJH, and age- and sex- matched healthy controls. The measurement of dynamic intersegmental instability requires in vivo cervical spine kinematics. We will utilize an advanced imaging technique, biplane videoradiography, to capture dynamic intervertebral motion during active movement. The results will elucidate the roles of dynamic intersegmental instability and neck strength and endurance in chronic neck pain and GJH. Identification of biomarkers will provide a mechanistic basis for development of targeted therapies for chronic neck pain. This proposal provides training from an outstanding mentorship team in a research-rich environment within the Medical School at the University of Minnesota. Included in the training plan are training in the techniques of biplane videoradiography and optical motion capture, didactic courses and mentorship in biostatistics and human subjects research design, and engagement in career development activities including manuscript and grant preparation. The research in this proposal aligns closely with the missions of the NIH and participating institutions, identifying mechanisms in neck pain for the development of treatment strategies to improve outcomes in a chronic, disabling condition. The proposed study will provide foundational knowledge and exceptional fellowship training as the trainee transitions to an independent investigator role.

项目概要/摘要 在美国，慢性颈部疼痛是一项重大的社会经济负担，也是导致残疾的主要原因。 静态成像和体格检查常常无法确定疼痛的具体来源，从而阻碍了疼痛的治疗。 制定有针对性的干预措施并导致不良结果。有证据表明，个人 患有全身性关节过度活动（GJH），多个关节的运动范围过大，影响 大约 20% 的人口更有可能患上慢性颈部疼痛。长期目标 这项研究旨在制定有效且有针对性的干预措施，以改善慢性颈部疼痛的结果。作为一个 为了实现这一目标，拟议研究的目标是确定临床特征和生物力学 GJH 慢性颈部疼痛的机制。目标 1 将确定慢性病的患病率和临床特征 GJH 的颈部疼痛。第一阶段研究的数据收集将在位于 明尼苏达州博览会，为公众提供了整个生命周期的大量、多样化的样本。目标2将 确定动态节段间不稳定性与慢性颈部疼痛相关的程度，以及 GJH 患者的颈部力量和耐力介导。研究小组将包括患有慢性疾病的 GJH 颈部疼痛、无症状 GJH 以及年龄和性别匹配的健康对照。动态测量 节间不稳定性需要体内颈椎运动学。我们将利用先进的成像技术 双平面视频放射摄影技术，捕捉主动运动过程中的动态椎间运动。这 结果将阐明动态节段间不稳定性以及颈部力量和耐力在慢性疾病中的作用 颈部疼痛和 GJH。生物标志物的鉴定将为靶向药物的开发提供机制基础 慢性颈部疼痛的治疗方法。 该提案在研究丰富的环境中提供了优秀导师团队的培训 明尼苏达大学医学院。培训计划中包括以下技术培训： 双平面视频放射摄影和光学动作捕捉、生物统计学和生物统计学方面的教学课程和指导 人类受试者研究设计，以及参与职业发展活动，包括手稿和 拨款准备。本提案中的研究与 NIH 和参与项目的使命密切相关 机构，确定颈部疼痛的机制，以制定治疗策略以改善 慢性、致残状态的结果。拟议的研究将提供基础知识和 当受训者过渡到独立调查员角色时，将进行特殊的研究金培训。