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Principal Investigator: Radha Korupolu
Organization: UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON
Fiscal Year: 2024
Award: $225,005
Funding agency: National Center for Complementary and Integrative Health
Project Summary:
The prevalence of debilitating chronic pain in people with spinal cord injury (SCI) ranges from 65-85%. Chronic
pain after SCI contributes to anxiety, depression and diminishes the health-related quality of life (QOL).
Pharmacological agents such as opioids are the primary therapeutic options to manage chronic pain after SCI,
but are ineffective in relieving pain and associated with significant side effects. Mindfulness meditation training
(MM) has been shown to improve mental and physical symptoms, including pain-related interference, in many
studies of people without SCI who have chronic pain. However, these interventions are typically lengthy,
expensive, and require in-person visits with a therapist, making them inaccessible to many people with SCI.
Mounting evidence suggests that mobile apps may provide an effective and low-cost way to provide MM.
Indeed, one recent study found that internet-based MM training led to reduced pain interference and improved
mental health in people with SCI and chronic pain, suggesting app-based MM interventions may have promise
in this population. However, this study used an intervention created by the researchers which is not currently
available to the public for free, limiting large-scale dissemination. Additionally, the feasibility found in that study
may not necessarily translate to that of an existing, publicly available app-based MM intervention among
persons with SCI. Similarly, the feasibility of other app-based MM interventions for non-SCI populations may
not translate to persons with SCI due to the specific physiological limitations experienced by person with SCI.
Our multidisciplinary, interinstitutional team of investigators proposes to randomize 60 SCI patients
experiencing chronic pain to practice audio-guided MM for ≥ 10 minutes daily for 6 weeks using the free app
“Mindfulness Coach” developed by the Department of Veteran Affairs, or to view TED talks for ≥ 10 minutes
daily for 6 weeks on the free TED app (active control). Primary outcomes are the feasibility and
acceptability of proposed interventions in people with SCI and chronic pain. Secondary outcomes include the
feasibility of collecting patient-reported outcomes of pain, anxiety, depression, mindfulness, and quality of life.
Given the great need for remotely delivered, low-cost chronic pain management and unique physiological
limitations among person with SCI, it is essential to determine the feasibility and acceptability of a free,
publicly available app-based MM intervention prior to conducting a larger efficacy study. With the emerging use
of telemedicine in this COVID-19 era, therapy-focused apps and remote data collection are becoming
increasingly popular making this line of inquiry both timely and innovative. Furthermore, the app-guided MM
intervention has the potential to facilitate self-management of pain by persons with SCI, as the MM exercises
can be practiced at the individual’s preferred time and place. The long-term goal of this study is to improve pain
management and QOL of people with SCI living with chronic pain by identifying affordable and accessible app-
guided interventions which can be used as an adjuvant tool after SCI in conjunction with other treatments.
Terms: <Active Follow-up><Adherence><Adjuvant><Adjuvant Therapy><Affect><Anti-epileptic><Anxiety><Award><COVID crisis><COVID epidemic><COVID pandemic><COVID-19 crisis><COVID-19 epidemic><COVID-19 era><COVID-19 global health crisis><COVID-19 global pandemic><COVID-19 health crisis><COVID-19 pandemic><COVID-19 period><COVID-19 public health crisis><COVID-19 years><Categories><Clinical><Clinical Trials><Cognitive Disturbance><Cognitive Impairment><Cognitive decline><Cognitive function abnormal><Consent><Constipation><Data><Data Collection><Diagnosis><Disturbance in cognition><Drugs><Education for Intervention><Educational Intervention><Eligibility><Eligibility Determination><Exercise><Feedback><Funding><Goals><Grant><Health Care Systems><Healthcare Systems><Home><Impaired cognition><Individual><Instruction Intervention><International><Internet><Intervention><Intervention Strategies><Investigators><Life><Measures><Medication><Medicine><Meditation><Mental Depression><Mental Health><Mental Hygiene><Non-pharmacologic Therapy><Nonpharmacologic Intervention><Nonpharmacologic Therapy><Nonpharmacologic approach><Nonpharmacologic treatment><Opiates><Opioid><Outcome><Pain><Pain Control><Pain Therapy><Pain interference><Pain management><Pain quality><Painful><Participant><Patient Outcomes Assessments><Patient Reported Measures><Patient Reported Outcomes><Persistent pain><Persons><Pharmaceutical Preparations><Physiatrics><Physiatry><Physical Medicine><Physiologic><Physiological><Pilot Projects><Population><Prevalence><Procedures><Proliferating><Protocol><Protocol Screening><Protocols documentation><Psyche structure><Psychological Health><Public Health><QOL><Quality of life><Randomized><Recommendation><Rehabilitation Medicine><Remote management><Reporting><Research><Research Assistant><Research Personnel><Researchers><Risk><Running><SARS-CoV-2 epidemic><SARS-CoV-2 global health crisis><SARS-CoV-2 global pandemic><SARS-CoV-2 pandemic><SARS-coronavirus-2 epidemic><SARS-coronavirus-2 pandemic><SCI Patients><Sedation procedure><Self Care><Severe Acute Respiratory Syndrome CoV 2 epidemic><Severe Acute Respiratory Syndrome CoV 2 pandemic><Severe acute respiratory syndrome coronavirus 2 epidemic><Severe acute respiratory syndrome coronavirus 2 pandemic><Spinal Cord Trauma><Spinal Trauma><Spinal cord injured><Spinal cord injury><Spinal cord injury patients><Survey Instrument><Surveys><Telemedicine><Therapeutic><Time><Training><Training Intervention><Translating><Traumatic Myelopathy><United States Department of Veterans Affairs><United States Veterans Administration><Veterans Administration><Veterans Affairs><Visit><WWW><Withdrawal><Work><acceptability and feasibility><access to health care><access to healthcare><accessibility of health care><accessibility to health care><accessibility to healthcare><active control><active followup><addiction><addictive disorder><adherence rate><adjuvant treatment><anti-depressant agent><anti-depressant drugs><anti-depressants><anti-depressive agents><anti-epileptic agents><anti-epileptic drugs><chronic pain><chronic pain control><chronic pain intervention><chronic pain management><chronic pain therapy><chronic pain treatment><cognitive dysfunction><cognitive loss><college><collegiate><community advisory board><community advisory committee><community advisory panel><compare intervention><comparison intervention><constant pain><coping><coronavirus disease 2019 crisis><coronavirus disease 2019 epidemic><coronavirus disease 2019 global health crisis><coronavirus disease 2019 global pandemic><coronavirus disease 2019 health crisis><coronavirus disease 2019 pandemic><coronavirus disease 2019 public health crisis><coronavirus disease crisis><coronavirus disease epidemic><coronavirus disease pandemic><coronavirus disease-19 global pandemic><coronavirus disease-19 pandemic><cost><delivered on-line><delivered online><delivered remotely><depression><design><designing><determine efficacy><drug/agent><efficacy analysis><efficacy assessment><efficacy determination><efficacy evaluation><efficacy examination><efficacy study><efficacy trial><evaluate efficacy><examine efficacy><experience><follow up><follow up assessment><follow-up><followed up><followup><followup assessment><handheld mobile device><health care access><health care availability><health care service access><health care service availability><health related quality of life><healthcare access><healthcare accessibility><healthcare availability><healthcare service access><healthcare service availability><homes><improved><innovate><innovation><innovative><instructional intervention><inter-institutional><interventional strategy><lasting pain><mental><mindfulness><mindfulness meditation><mobile app><mobile application><mobile device><mobile device application><multidisciplinary><non-drug therapy><non-drug treatment><nondrug therapy><nondrug treatment><on-going pain><on-line delivery><ongoing pain><online delivery><pain outcome><pain reduction><pain relief><pain self-management><pain treatment><pain-related outcome><personal care><pharmacologic><physical symptom><pilot study><post intervention><primary outcome><randomisation><randomization><randomly assigned><recruit><reduce pain><relieve pain><remote delivery><response><retention rate><retention strategy><satisfaction><secondary outcome><sedation><severe acute respiratory syndrome coronavirus 2 global health crisis><severe acute respiratory syndrome coronavirus 2 global pandemic><side effect><tool><treat chronic pain><web><web based delivery><world wide web>