VCOM Pain Free Research Collaborative

Официальное название

MERCI Chronic Pain Research Clinic (Medical Education and Research in Compassionate Integration/Intervention)

Обзор

Studies estimate that 30% of people worldwide experience chronic pain. The mechanisms causing this pain can vary: a neuropathic offender, such as nerve compression; a structural offender, such as long-term effects of soft tissue damage and repair; or nociplastic, dysfunctional offenders, such as fibromyalgia. The type of pain experienced influences diagnostic and treatment choice. In theory, there's a significant blending of these pain types within individuals and across patients, leading many specialists to view pain classification as a spectrum. Multidisciplinary pain management (MPM) is a standard model for addressing and treating different mechanisms of chronic pain using multiple interventions from different disciplines. Although many clinics employing these strategies have resulted in positive and clinically effective outcomes, the creation and implementation of such facilities have not been widespread. With increasing focus on psychosocial factors that impact pain in conjunction with structural and biomechanical offenders, a need for a whole-person, integrated approach to chronic pain management is needed. We propose an observational study to gather data that will inform the design, implementation, and operation of such a chronic pain research clinic.

Вмешательства

• Поведенческое Behavior Change Coaching
  Done by Dr. Hollingsworth or students via consultations with participants. Participant's health behavior aspirations or target outcomes will be clarified, informed by the participant's interactions with other MERCI providers. Behaviors that move the participant towards their aspirations/outcomes will be explored to find target behaviors that the participant is motivated and able to do. Target behaviors and supporting habits will be designed into the participant's existing routine. The Fogg Behav
• Поведенческое Nutrition
  Nutrition: The nutrition intervention will be conducted as a 12-week protocol with assessment points at baseline, 1 month, and 3 months. Following consent, eligible participants will work through a self-taught educational module detailing the anti-inflammatory dietary program. Once the module is completed, participants will be scheduled for one-on-one counseling sessions with a Registered Dietitian or a supervised Dietetic Intern or Medical Student on the research team to receive personalized gu
• Другое Autonomic Recalibration
  Participant will be outfitted with the Empatica wrist sensor. An initial history to rule out pathology and document a chief complaint relevant to pain is conducted. An initial head to toe assessment of withdrawal or startle reflex behavior in response to palpation is performed to identify trigger points and establish patterns of sympathetic dominance. The pattern of sympathetic dominance is addressed during treatment by Primal Reflex Release Technique Protocol to inhibit somatic afferent feedbac
• Процедура Dry Needling
  An initial history to document a chief complaint relevant to pain is conducted and to identify and potential contraindications (infection of overlying skin, patient on anticoagulation drugs, 1st trimester of pregnancy, etc.) A physical exam is performed to identify the trigger points causing pain. The subject is educated about the risks/benefits/indications and alternative treatments. The subject is also educated about dry needling aftercare. The skin over the trigger points is cleaned with 70%
• Другое Osteopathic Manipulative Treatment
  Osteopathic Manipulative Treatment: After inform and consent process, the subject will enter patient room and meet with Dr. Hayes, who will conduct a brief history of patient pain, injuries, and procedures. Subjects will be asked to wear, or change into, athletic shorts or a tank top or loose-fitting T-shirt to facilitate treatment. Subject will undergo a brief somatic dysfunction screen, which involves light tough and manipulation. Once Hayes has diagnosed potential dysfunctions, he will procee
• Поведенческое Counseling Psychology
  Psychoeducation Workshop and Counseling: The psychoeducational group intervention will be done according to the standardized Empowered Relief (Darnall et al., 2024) protocol. Empowered Relief is a single-session, 2-hour group workshop (online or in person) that teaches participants pain neuroscience education, mindfulness principles, and cognitive-behavioral skills. During the program, participants will complete a personalized plan to work toward pain relief. This program requires a certified in
• Другое Multiple Treatments
  Subjects receiving multiple treatment interventions over the same period of time. Example: A subject joins the Osteopathic Manipulative Treatment group and meets with Dr. Hayes for treatment visits. At the same time, they are meeting with Dr. Kirby in a separate visit (or at the same time, if scheduling allows) to discuss Nutrition. Any subjects who were in multiple/overlapping treatment groups will fit this description.

Первичные конечные точки

• Pain Intensity (NRS Pain Scale) [Срок оценки: Beginning of each Visit through study completion, an average (anticipated) of 6 months]
• PROMIS (Pain Interference, SF4a) [Срок оценки: Beginning of each Visit through study completion, an average (anticipated) of 6 months]
• Use of analgesics (QAQ-Quantitative Analgesic Questionnaire) [Срок оценки: Beginning of each Visit through study completion, an average (anticipated) of 6 months]
• Human Flourishing (Secure Flourishing Index) [Срок оценки: Beginning of each Visit through study completion, an average (anticipated) of 6 months]

Критерии участия

Критерии включения

• Those experiencing chronic pain, i.e., ongoing pain not relevant to an acute perturbation (e.g., recent injury).

Критерии исключения

• Those subjects seeking pharmaceutical intervention
• Those whose myofascial pain is deemed functional (normal response to acute injury or ongoing pathology

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Нет

Дизайн исследования

Распределение

Нерандомизированное

Модель

Перекрёстный дизайн

Маскирование

Открытое

Основная цель

Лечение

Центры проведения

США · 1 центр

• Edward Via College of Osteopathic Medicine-Auburn — Auburn

Публикации

• Kuntz JL, Young DR, Saelens BE, Frank LD, Meenan RT, Dickerson JF, Keast EM, Fortmann SP. Validity of the Exercise Vital Sign Tool to Assess Physical Activity. Am J Prev Med. 2021 Jun;60(6):866-872. doi: 10.1016/j.amepre.2021.01.012. Epub 2021 Mar 27. PMID 33781618
• Buysse DJ, Reynolds CF 3rd, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989 May;28(2):193-213. doi: 10.1016/0165-1781(89)90047-4. PMID 2748771
• Cohen S, Kamarck T, Mermelstein R. A global measure of perceived stress. J Health Soc Behav. 1983 Dec;24(4):385-96. No abstract available. PMID 6668417
• Barkham, Michael, Bewick, Bridgette, Mullin, Tracy, Gilbody, Simon, Connell, Janice, Cahill, Jane, Mellor-Clark, John, Richards, David, Unsworth, Gisela, Evans, Chris, (2013), The CORE-10: A short measure of psychological distress for routine use in the psychological therapies. Counselling and Psychotherapy Research, 13 doi: 10.1080/14733145.2012.729069.
• Sullivan, M. J. L., Bishop, S. R., & Pivik, J. (1995). The Pain Catastrophizing Scale: Development and validation. Psychological Assessment, 7(4), 524-532. https://doi.org/10.1037/1040-3590.7.4.524
• Hooper, L. M., Stockton, P., Krupnick, J., & Green, B. L. (2011). The development, use, and psychometric properties of the Trauma History Questionnaire. Journal of Loss and Trauma, 16, 258-283.
• Jensen, Mark P., Hypnosis for Chronic Pain Management: Therapist Guide, Treatments That Work (New York, 2011; online edn, Oxford Academic, 1 Apr. 2015), https://doi.org/10.1093/med:psych/9780199772377.001.0001, accessed 12 Mar. 2024.
• Robinson-Papp J, George MC, Wongmek A, Nmashie A, Merlin JS, Ali Y, Epstein L, Green M, Serban S, Sheth P, Simpson DM. The Quantitative Analgesic Questionnaire: A Tool to Capture Patient-Reported Chronic Pain Medication Use. J Pain Symptom Manage. 2015 Sep;50(3):381-6. doi: 10.1016/j.jpainsymman.2015.03.013. Epub 2015 Apr 23. PMID 25912277

Идентификаторы

NCT: NCT06533345 · 2024--061

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

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