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The HAPPINESS Trial: cHAnging the Perceived Pain INtensity in divErSe Populations With Spinal Cord Injury

Not Applicable
Recruiting
Conditions
Spinal Cord Injuries
Interventions
Behavioral: Daily 2 min pain management survey
Behavioral: Qigong
Registration Number
NCT06140355
Lead Sponsor
University of Minnesota
Brief Summary

Chronic neuropathic pain affects 69% of adults with spinal cord injury (SCI). Current treatment options are limited (primarily pain medications) with insufficient benefits and significant risks for addiction and adverse effects. Of the available mind and body approaches, Qigong is the most accessible for adults with SCI with evidence for effectiveness in reducing pain, but there is insufficient evidence to make recommendations for adults with SCI. Thus, the feasibility of Qigong in SCI needs to be established.

To support our feasibility study, we investigated a 12-week remote Qigong program in adults with SCI and neuropathic pain. We recruited 23 adults with SCI, 18 completed the study, and 12 completed the 1-year follow-up. They practiced Qigong 138% of the required intensity (which was, at least 3x/week with Qigong video through the internet). Their pain was reduced by 44% after 12 weeks of Qigong practice and was still reduced at the 6-week and 1-year follow-up. However, three key elements need to be addressed before performing a larger effectiveness study: (1) feasibility/acceptability of Qigong from adults with SCI of diverse backgrounds; (2) feasibility of the study design with control group); and (3) objective outcome measures.

This R34 feasibility study, the HAPPINESS trial (cHAnging the Perceived Pain INtensity in divErSe populations with Spinal cord injury), will expand on our prior study to consolidate feasibility with a rigorous protocol. We will address the following aims: AIM 1. Identify the facilitators/barriers to participating in a Qigong study through focus groups/interviews with stakeholders from diverse backgrounds, defined as Hispanics, veterans, and adults living in rural, underserved areas. AIM 2. Establish the feasibility of study design/methods of the HAPPINESS trial in adults with SCI (at least 50% of diverse backgrounds) through pre-specified targets for recruitment/enrollment, feasibility, and acceptability of design and outcomes. Using a Phase I randomized controlled trial design, 40 adults with SCI-related neuropathic pain will be randomized to 12-week remote Qigong intervention OR a short daily pain management survey that can be completed on phone/iPad/computer + 6-month follow-up. The study results will facilitate a rigorous structure to design larger effectiveness studies and facilitate a clear pathway for researchers to investigate Qigong and other mind-body approaches for whole-person health in diverse groups of adults with chronic/neurological disorders.

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
All
Target Recruitment
40
Inclusion Criteria
  • 18+ years old
  • medically stable
  • with neuropathic pain above 0 on the Neuropathic Pain Questionnaire (NPQ) scale
  • willing to participate in a remote Qigong intervention (from any location with internet connection)
  • fluent in English or Spanish
  • access to the internet and a computer/iPad or smartphone
Exclusion Criteria
  • uncontrolled seizure disorder
  • cognitive impairment and/or communicative disability (e.g., due to brain injury) preventing them from following directions or from learning
  • ventilator dependency
  • major medical complications
  • pressure ulcers hindering prolonged sitting or lying down
  • (planning to become) pregnant or planning a major surgery during the study (given study duration, regular Qigong practice, and frequent check-ins)
  • regular Tai Chi or Qigong practice in the past 6 months (3x/week or more)
  • currently engaged in other rehabilitation programs that would influence outcomes

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Active comparison groupDaily 2 min pain management surveyadults with SCI-related neuropathic pain with at least 50% from diverse groups randomized to active comparator group
Experimental groupQigongadults with SCI-related neuropathic pain with at least 50% from diverse groups randomized to experimental group
Primary Outcome Measures
NameTimeMethod
recruitment rates6 months post-intervention

The proportion of potential participants contacted who agreed to participate

the recruitment rate for complete and incomplete SCI6 months post-intervention

Ratio of complete/incomplete SCI.

Attrition rates in Qigong and Manage My Pain app group.6 months post-intervention

Proportion of people withdrawing from the study in either group. Drop-out due to unrelated reasons will count as part of the general attrition.

intervention adherence6 months post-intervention

the website log times will indicate the date and duration that the video is accessed. From this information, we will collect the number of minutes that they practice.

This information will be checked with the self-report during the weekly calls, in which they will report the number of minutes per week they have practiced.

the frequency of use of the Manage My Pain app (recommended daily check in)6 months post-intervention

Weekly/ monthly check-ins (reporting min/week of practice) to identify facilitators and barriers to practicing Qigong. The website logs time and duration of video access. A Qigong certified instructor will do 1:1 Qigong session with each participant via zoom monthly for quality control/to give guidance.

Feasibility of adhering to the collection of quantitative measure 16 months post-intervention

% Adherence in completing all assessments during the study and in the monthly follow-up phase

Feasibility of adhering to the collection of quantitative measure 26 months post-intervention

% Adherence to wearing Fitbit Charge 6 and sending the data through their phone App

Secondary Outcome Measures
NameTimeMethod

Trial Locations

Locations (3)

University of Miami

🇺🇸

Miami, Florida, United States

University of Texas - Rio Grande Valley

🇺🇸

Harlingen, Texas, United States

University of Minnesota

🇺🇸

Minneapolis, Minnesota, United States

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