腰背疼痛的疼痛弹性。 (Resilience)
多模式疼痛弹性方法对慢性下背部疼痛的功效
慢性疼痛影响美国约20%的成年人,并可能导致严重的个人,社会和经济挑战。 它通常接受包括阿片类药物在内的药物治疗,这些药物会带来依赖风险。 虽然疼痛教育(PE)有助于人们更好地理解疼痛并可能减轻症状,但单独使用时通常只有适度的影响。
这项研究的目的是探索将疼痛教育与其他疗法相结合,例如物理疗法,认知行为技术和健康的生活方式策略,以多模式的弹性方法可以带来更大的好处。 该研究旨在回答以下问题:
与仅疼痛教育相比,联合,全人的方法可以更有效地改善慢性疼痛的人的预后吗?
研究概览
详细说明
慢性疼痛是疼痛,持续超出典型的愈合持续时间,通常定义为持续至少3-6个月。 大约20%的美国人口经历了慢性疼痛。 患有慢性疼痛的风险因素多种。 女性,年龄较大,生活在贫困中,患有慢性健康状况或残疾和退伍军人是慢性疼痛的危险因素之一。 慢性疼痛会影响生活质量以及工人的生产力。 慢性疼痛为旷工超出了旷工,损失工资,损失了3000亿美元的医疗保健系统的经济负担,包括用于疼痛管理,手术和残疾补偿的一系列服务。 此外,慢性疼痛的阿片类药物处方是阿片类药物使用障碍的主要驱动力。 教那些患有慢性疼痛的人如何有效地管理疼痛可以改善生活质量,并减少对阿片类药物的依赖的风险。
慢性疼痛的非药物和非侵入性治疗包括物理疗法,认知行为技术以及促进健康生活方式的策略。 疼痛教育(PE)已被提倡作为减轻慢性疼痛的方法。 体育教导说,疼痛不仅是组织损伤的结果。 相反,体育的基础是教育可能导致情感,信念和过去经验等痛苦的因素。4 但是,PE是产生小效果的单一模态。 多模式弹性方法模型可能会产生更大的影响。
研究类型
注册 (实际的)
阶段
- 不适用
联系人和位置
学习地点
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New York
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New York、New York、美国、10011
- Integrative Pain Science Institute
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参与标准
资格标准
适合学习的年龄
- 成人
- 年长者
接受健康志愿者
描述
纳入标准
- 在至少6个月的时间里,患有慢性疼痛的成年人。
- 能够阅读和理解英语。
排除标准
- 经历急性疼痛与最近的损伤或疼痛有关,持续不到6个月。
- 无法阅读或理解英语。
学习计划
研究是如何设计的?
设计细节
- 主要用途:治疗
- 分配:随机化
- 介入模型:并行分配
- 屏蔽:双倍的
武器和干预
参与者组/臂 |
干预/治疗 |
|---|---|
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有源比较器:恐惧小组
该干预措施解决了负面价系统,以减少恐惧和威胁。
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健康素养方法
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有源比较器:优势群体
该小组解决了奖励学习的正价系统
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基于优势的疼痛恢复方法
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研究衡量的是什么?
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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Pain intensity
大体时间:At baseline (pre-intervention) and at 90-day follow-up.
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Pain intensity will be measured by the Defense of Veterans Pain Rating Scale. This is a numerical scale with descriptors 0 = No pain
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At baseline (pre-intervention) and at 90-day follow-up.
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次要结果测量
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
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Pain Resilience Scale
大体时间:At baseline (pre-intervention) and at 90-day follow-up.
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The Pain Resilience Scale (PRS), is a questionnaire measuring your ability to maintain positive functioning (emotions, thoughts, actions) despite intense or chronic pain, focusing on Behavioral Perseverance (pushing through) and Cognitive/Affective Positivity (staying positive).
It's a 14-item tool where you rate how much certain statements describe you (0-4 scale), predicting better coping, less catastrophizing, and improved quality of life compared to general resilience measures.
The PRS was developed as a pain-specific measure of resilience, and its validity within the chronic pain population is superior to general resilience scales.
It has high internal consistency (Cronbach's α = .94)
and high test-retest reliability (r = .79).47
The PRS provides a total score, along with two distinct subscales for cognitive/affective positivity and behavioral perseverance.
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At baseline (pre-intervention) and at 90-day follow-up.
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The Defense and Veterans Pain Rating Scale (DVPRS 2.0)
大体时间:At baseline (pre-intervention) and at 90-day follow-up.
|
The Defense and Veterans Pain Rating Scale (DVPRS 2.0) is a pain assessment tool that utilizes a numerical rating scale (0-10) enhanced by functional word descriptors, color coding, and pictorial facial expressions matched to pain levels.
The Defense and Veterans Pain Rating Scale (DVPRS 2.0) was used to measure pain intensity and pain interference with activity, sleep, mood, and stress.
The DVPRS is a reliable (Cronbach's α = 0.871) and valid instrument that provides standard language and metrics to communicate pain and related outcomes.
Lower scores indicate less pain intensity and pain interference.
It has been recommended for veteran as well as civilian populations.
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At baseline (pre-intervention) and at 90-day follow-up.
|
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Patient-Reported Outcomes Measurement Information System (PROMIS®) Pain Interference
大体时间:At baseline (pre-intervention) and at 90-day follow-up.
|
Patient-Reported Outcomes Measurement Information System (PROMIS®) Pain Interference Short Form 6b was also used to measure pain interference.
The PROMIS® is a reliable (Cronbach's α = 0.88 to 0.97) self-report measure of the consequences of pain on relevant aspects of a person's life and how pain hinders social, cognitive, emotional, physical, and recreational engagement.
The Minimal Clinically Important Difference (MCID) for the PROMIS® is estimated to be 3.0 T-score points for pain samples representing the smallest meaningful improvement for this population.
Lower scores indicate less pain interference.
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At baseline (pre-intervention) and at 90-day follow-up.
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Optimal Screening for Prediction of Referral and Outcome-Yellow Flag (OSPRO-YF)
大体时间:At baseline (pre-intervention) and at 90-day follow-up.
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The Optimal Screening for Prediction of Referral and Outcome-Yellow Flag (OSPRO-YF) is an assessment tool designed to help orthopedic physical therapy clinicians screen patients and clients for psychosocial distress.
Test items assess depression, anxiety, kinesiophobia, anger, fear-avoidance beliefs, catastrophizing, self-efficacy, and pain acceptance.
As OSPRO-YF summarizes 11 psychological questionnaires, it is not scored like a conventional screening tool.
Quartile scores are used instead of cutoff scores for consistency and assessment.
Scores that are in the top quartile (top 25%) for negative psychological questionnaires (Negative Mood and Fear Avoidance questionnaires) Scores that are in the bottom quartile (bottom 25%) for positive psychological questionnaires (Positive Affect/Coping questionnaires).
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At baseline (pre-intervention) and at 90-day follow-up.
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合作者和调查者
调查人员
- 研究主任:Kerstin Palombero, PhD、Widener University
出版物和有用的链接
一般刊物
- Tatta, J., Pignataro, R., Bezner, J., & Rothschild, C. (2024). Internet-Delivered Pain Resilience Therapy: A Multi-Subject Case Series. Journal of Physiotherapy in Mental Health, 1(1), 55-79. https://doi.org/10.70205/jptmh.v1i1.9277
- Tatta J, Pignataro RM, Bezner JR, George SZ, Rothschild CE. PRISM-Pain Recovery and Integrative Systems Model: A Process-Based Cognitive-Behavioral Approach for Physical Therapy. Phys Ther. 2023 Oct 3;103(10):pzad077. doi: 10.1093/ptj/pzad077.
研究记录日期
研究主要日期
学习开始 (实际的)
初级完成 (实际的)
研究完成 (实际的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (实际的)
研究记录更新
最后更新发布 (实际的)
上次提交的符合 QC 标准的更新
最后验证
更多信息
与本研究相关的术语
计划个人参与者数据 (IPD)
计划共享个人参与者数据 (IPD)?
IPD 计划说明
IPD 共享时间框架
IPD 共享访问标准
IPD 共享支持信息类型
- 研究方案
药物和器械信息、研究文件
研究美国 FDA 监管的药品
研究美国 FDA 监管的设备产品
在美国制造并从美国出口的产品
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