The increasing prevalence of musculoskeletal disorders in the workplace has been identified as one of the most costly health concerns faced by industrialized nations. Epidemiologic studies suggest that both physical and psychosocial factors play a critical role in the development of work-related neck pain, yet interactions among these risk factors remain poorly understood. The underlying cause of chronic neck pain remains undiagnosed for the majority of cases, likely resulting in suboptimal treatment for many individual patients. The overall goal of this project is to assess the validity of a new screening protocol to identify stress-evoked muscle activity that may either cause or exacerbate neck pain in susceptible individuals.
Aim 1 will use a case- control study design to assess the discriminant and concurrent validity of a standardized screening protocol to detect elevated psychomotor responses to stress in subjects with and without chronic neck pain.
Aim 2 will use a prospective study design to determine the predictive validity of this screening protocol by assessing the risk of developing chronic neck pain in asymptomatic office workers during the first year of employment in a high-risk occupation.
This aim will also determine the diagnostic cutoff score for stress-evoked muscle activity that best predicts the future development of chronic neck pain. Findings from this project will inform the design of future clinical trials by providing a validated tool to identify subgroups of individuals that are most likely to benefit from stress-management interventions to prevent or treat chronic neck pain, which will ultimately improve clinical decision-making for practitioners who treat this disorder. This project will also provide new information on modifiable physical and psychosocial risk factors for chronic neck pain, consistent with research priorities outlined by a multidisciplinary task force of experts in the field.

Public Health Relevance

The Bone and Joint Decade Task Force on Neck Pain recently recognized a need for studies to identify clinical subgroups of patients that are most likely to respond to specific types of treatment. This Task Force further emphasized the need to better understand how psychosocial and physical exposures at work interact with each other to cause neck pain, and to identify modifiable risk factors to prevent the development of neck pain. This project will develop and test a new clinical tool to screen for elevated muscle activity in response to stress. This information will be used in future clinical trials to determine whether stress-management interventions can be used to reduce excessive muscle activity that either causes or exacerbates neck pain in susceptible individuals.

Agency
National Institute of Health (NIH)
Institute
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Type
Research Project (R01)
Project #
5R01AR056704-02
Application #
8103820
Study Section
Musculoskeletal Rehabilitation Sciences Study Section (MRS)
Program Officer
Tonkins, William P
Project Start
2010-07-01
Project End
2014-06-30
Budget Start
2011-07-01
Budget End
2012-06-30
Support Year
2
Fiscal Year
2011
Total Cost
$303,936
Indirect Cost
Name
University of Colorado Denver
Department
Physical Medicine & Rehab
Type
Schools of Medicine
DUNS #
041096314
City
Aurora
State
CO
Country
United States
Zip Code
80045
Gaffney, Brecca M; Maluf, Katrina S; Davidson, Bradley S (2016) Evaluation of Novel EMG Biofeedback for Postural Correction During Computer Use. Appl Psychophysiol Biofeedback 41:181-9
Marker, Ryan J; Balter, Jaclyn E; Nofsinger, Micaela L et al. (2016) Upper trapezius muscle activity in healthy office workers: reliability and sensitivity of occupational exposure measures to differences in sex and hand dominance. Ergonomics 59:1205-14
Shahidi, Bahar; Curran-Everett, Douglas; Maluf, Katrina S (2015) Psychosocial, Physical, and Neurophysiological Risk Factors for Chronic Neck Pain: A Prospective Inception Cohort Study. J Pain 16:1288-1299
Shahidi, Bahar; Sannes, Timothy; Laudenslager, Mark et al. (2015) Cardiovascular responses to an acute psychological stressor are associated with the cortisol awakening response in individuals with chronic neck pain. Physiol Behav 150:93-8
Kittelson, Andrew J; George, Steven Z; Maluf, Katrina S et al. (2014) Future directions in painful knee osteoarthritis: harnessing complexity in a heterogeneous population. Phys Ther 94:422-32
Marker, Ryan J; Stephenson, Jennifer L; Kluger, Benzi M et al. (2014) Modulation of intracortical inhibition in response to acute psychosocial stress is impaired among individuals with chronic neck pain. J Psychosom Res 76:249-56
Gaffney, Brecca M; Maluf, Katrina S; Curran-Everett, Douglas et al. (2014) Associations between cervical and scapular posture and the spatial distribution of trapezius muscle activity. J Electromyogr Kinesiol 24:542-9
Marker, Ryan J; Maluf, Katrina S (2014) Effects of electrocardiography contamination and comparison of ECG removal methods on upper trapezius electromyography recordings. J Electromyogr Kinesiol 24:902-9
Shahidi, Bahar; Haight, Ashley; Maluf, Katrina (2013) Differential effects of mental concentration and acute psychosocial stress on cervical muscle activity and posture. J Electromyogr Kinesiol 23:1082-9
Balter, Jaclyn E; Molner, Jennifer L; Kohrt, Wendy M et al. (2013) Mechanical pain sensitivity and the severity of chronic neck pain and disability are not modulated across the menstrual cycle. J Pain 14:1450-9

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