Examining Interoceptive Awareness as a Mechanism of Change in Yoga for Chronic Low Back Pain

检查内感受意识作为瑜伽改变慢性腰痛的机制

• 批准号: 10606857
• 负责人: Katherine E Gnall
• 金额: $ 4.35万
• 依托单位: UNIVERSITY OF CONNECTICUT STORRS
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-06-01 至 2025-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10606857
• 关键词: Address; Adult; Aftercare; American; Anxiety; Area; Attention; Awareness; Behavioral Medicine; Biometry; Caring; Categories; Chronic low back pain; Clinical; Clinical Trials; Collaborations; Complex; Connecticut; Data; Development; Economics; Effectiveness; Emotional; Esthesia; Fellowship; Funding; Goals; Health; Healthcare; Individual; Institution; Interoception; Intervention; Link; Measures; Mediation; Medical; Mental Depression; Mental Health; Mentorship; Methodology; Mind-Body Intervention; Musculoskeletal Pain; National Center for Complementary and Integrative Health; Pain; Pain interference; Pain management; Participant; Patient Self-Report; Patients; Perception; Pharmacological Treatment; Physical activity; Process; Productivity; Property; Protocols documentation; Psychological Factors; Public Health; Quality of life; Randomized, Controlled Trials; Research; Research Priority; Research Project Grants; Research Support; Resources; Role; Sensory; Severities; Sleep disturbances; Testing; Training; United States; Universities; Yoga; abuse liability; biopsychosocial; bodily sensation; career; chronic pain; chronic pain management; chronic painful condition; cost; daily functioning; disability; economic cost; exercise intervention; experience; improved; mind/body; multimodality; pain outcome; pain patient; pain relief; pain sensitivity; pharmacologic; physical conditioning; pre-doctoral; programs; psychologic; response; social; societal costs; training project; trial comparing

PROJECT SUMMARY Chronic pain is a major public health concern and among the most common reasons adults seek medical care in the United States. Chronic pain is a complex biopsychosocial process modulated by psychological factors, including the perception, appraisal, and emotional processing of sensations. Chronic low back pain (CLBP) is increasingly common and is associated with poor physical and mental health. Pharmacological approaches are relatively ineffective for long term pain treatment and have high addictive and abuse potential. Given the myriad economic, psychological, and social costs associated with CLBP, mind-body therapies (MBTs) such as yoga have received growing attention and empirical support for its treatment. Still, less is known about how yoga improves pain outcomes for CLBP or how it compares to and whether it operates distinctly from other physical activity interventions commonly used to treat CLBP. One hypothesized mechanism of MBTs for improving chronic pain is through improvements in interoceptive awareness, or the awareness of one’s internal bodily sensations. To date research has not examined the mechanistic role of interoceptive awareness in MBTs for CLBP. Thus, building on an ongoing NCCIH-funded randomized controlled trial (RCT) comparing 12-week yoga and physical activity interventions for CLBP, the proposed predoctoral study aims to 1) test whether a yoga intervention results in greater changes in interoceptive awareness compared to physical activity; and 2) determine whether changes in interoceptive awareness account for the clinical benefit of yoga for individuals with CLBP as assessed by multiple measures of pain. This predoctoral study capitalizes on an ongoing clinical trial and adds a unique and important contribution by assessing participants’ interoceptive awareness at baseline, mid-treatment (6-weeks), and post-treatment (12-weeks). The proposed project will test the mechanistic role of interoceptive awareness on improvements in both self-report (i.e., pain severity and interference) and objective (i.e., pain sensitization) assessments of chronic pain. This research project will directly address three of NCCIH’s top research priorities by elucidating the mechanistic role of interoception in mind and body treatments for pain. If the mechanistic role of interoceptive awareness in yoga is supported, non-pharmacological mind-body pain therapies can be further optimized for enhanced effectiveness in relieving CLBP. The fellowship’s training aims align closely with the goals for the proposed research project. The individualized training plan will provide the applicant with specialized training in interoception, RCT methodology, MBTs, biostatistics, and professional development for a research career in behavioral medicine. The training plan will leverage existing resources available at the applicant’s primary institution, the University of Connecticut, with collaboration and mentorship from leading experts across the nation.

项目概要 慢性疼痛是一个主要的公共卫生问题，也是成年人寻求医疗护理的最常见原因之一 美国。慢性疼痛是一个受心理因素调节的复杂的生物心理社会过程，包括 慢性腰痛 (CLBP) 的感知、评估和情绪处理越来越常见。 与身体和心理健康状况不佳有关，从长远来看，药理学方法相对无效。 考虑到无数的经济、心理和社会成本，这种药物具有很高的成瘾性和滥用潜力。 与 CLBP 相关的瑜伽等身心疗法 (MBT) 受到越来越多的关注和实证支持 然而，对于瑜伽如何改善 CLBP 的疼痛效果，或者它与 CLBP 的比较，人们知之甚少。 它的作用是否与常用于治疗 CLBP 的其他身体活动干预措施不同。 MBT 改善慢性疼痛的机制是通过提高内感受意识，或意识 迄今为止，研究尚未检验内感受意识的机制作用。 因此，以 NCCIH 资助的一项正在进行的比较 12 周的随机对照试验 (RCT) 为基础。 瑜伽和身体活动干预对 CLBP 的影响，拟议的博士前研究旨在 1）测试瑜伽是否 与身体活动相比，干预会导致内感受意识发生更大的变化；2）确定 内感受意识的变化是否可以解释瑜伽对 CLBP 患者的临床益处： 这项博士前研究利用了一项正在进行的临床试验，通过多种疼痛指标进行评估，并增加了一项独特的研究。 通过评估参与者在基线、治疗中期（6周）的内感受意识，做出了重要贡献， 拟议的项目将测试内感受意识对治疗后（12 周）的作用。 自我报告（即疼痛严重程度和干扰）和客观（即疼痛敏化）评估的改进 该研究项目将通过阐明 NCCIH 的三个首要研究重点。 内感受在精神和身体疼痛治疗中的机械作用 如果内感受的机械作用。 支持瑜伽意识，可以进一步优化非药物身心疼痛疗法以增强 缓解 CLBP 的有效性 该奖学金的培训目标与拟议研究的目标紧密一致。 个性化培训计划将为申请人提供内感受、RCT方面的专门培训。 行为医学研究生涯的方法论、MBT、生物统计学和专业发展。 培训计划将利用申请人的主要机构，即大学的现有资源 康涅狄格州，得到全国领先专家的合作和指导。