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.

项目概要 慢性髋部疼痛每年影响 1820 万成年人，伴有髋部相关疼痛（关节内非关节炎髋部病变） 占青壮年慢性髋痛病例的 60%，手术和非手术治疗。 由于大多数患者持续存在疼痛和功能障碍，因此与髋部相关的疼痛无法提供普遍的益处。 尽管有强有力的证据表明定期进行体力活动，但持续的疼痛常常会减少他们的活动以尽量减少症状 减轻慢性肌肉骨骼疼痛。社会心理健康状况不佳（即自我效能感低、灾难性疼痛严重，以及 运动恐惧症）在患有慢性肌肉骨骼疼痛的个体中很常见，并进一步加剧了运动参与度的低下 身体活动可以改善心理社会健康，但迄今为止尚未实施。 我将通过开发来填补这一空白。 帮助改善心理社会健康 (HIPS)（目标 1 和 2）和可行性测试（目标 3），这是一种新颖的多模式身心干预措施，旨在改善患有髋部相关疼痛和心理社会健康状况不佳的久坐个体的身体活动。 遵循慢性疼痛的恐惧避免模型 (FAM)，多模式 HIPS 身心干预将纳入 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集中参与 我率先提出 HIPS 身心干预将改善久坐的身体活动。 患有髋部相关疼痛和心理健康状况不佳的人，增加身体活动将改善疼痛、功能和健康状况。 HIPS 身心干预将由物理治疗师以混合面对面电话形式进行，以减少地理障碍，并使没有宽带互联网接入的患者也能参与。 将身心干预纳入心理知情的临床实践已初步证明 功效；然而，缺乏证据支持其广泛采用。该项目的调查结果将直接告知。 HIPS 身心干预的多地点可行性研究（3 年 NCCIH R01） 可行性的严格证据。 （本 K23 和未来的多中心可行性 RCT）和身心干预措施（如 HIPS）的功效（未来 R01）以及 随后将身心干预融入物理治疗诊所将为广泛采用提供支持 候选人的长期目标是成为一个独立的、由 NIH 资助的人。 科学家通过开发和实施有效的身心康复来推进心理康复 康复干预措施可优化慢性髋部疼痛患者的临床结果并改善其健康状况。 K23 将通过提供受保护的时间来完成正念和身心的关键训练来支持这一目标 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。