Projects
The main focus of research projects in the Kashikar-Zuck lab are to develop safe and effective non-pharmacologic treatments for complex chronic pain conditions in children, examine the physical, psychological and social contributors to pain and disability, understand the long-term impact of pain on children and their families, and collaborate with translational researchers to examine the underlying causes for pediatric chronic pain.
Fibromyalgia Integrative Training Program for Teens (FIT Teens) – Multi-center Randomized Controlled Trial
This large NIH-funded multi-site clinical trial (R01 AR070474) aims to evaluate the efficacy of a specially designed training program (FIT Teens) for the treatment of juvenile fibromyalgia (JFM). The FIT Teens program combines cognitive-behavioral therapy (CBT) with specialized neuromuscular exercise developed in collaboration with sports medicine experts. The goal is to evaluate whether FIT Teens is more effective than CBT alone, or graded aerobic exercise alone, for the treatment of disability and pain in adolescents with JFM. The trial is being conducted across 6 pediatric hospitals in the US, with Cincinnati Children’s as the primary site.
Several ancillary and related studies on JFM and other types of musculoskeletal (MSK) pain are being conducted in the Kashikar-Zuck lab and include:
- Adaptation of the FIT Teens intervention to other pain conditions and rheumatic diseases
- relationship between psychological coping, pain catastrophizing and fear of movement on subjective and objective measures of functioning
- biomechanical assessments of gait, posture, balance and strength
- daily diary monitoring of pain, sleep, physical activity and fatigue
- actigraphy monitoring of physical activity
- impact of COVID 19 on mood symptoms in adolescents with JFM
- executive functioning in children with chronic MSK pain
- psychological factors in post-surgical pain and return to sport/long-term outcomes
The JOY-CR (Juvenile Onset FibromYalgia Contact Registry) and Longitudinal Follow-Up of Adolescents with Juvenile Fibromyalgia into Young Adulthood
The Kashikar-Zuck lab is developing the largest registry of clinically well-characterized patients diagnosed with Juvenile Fibromyalgia (JFM) and/or Chronic Widespread Musculoskeletal Pain (CWP). The registry will serve as a resource for conducting research studies about mechanisms of JFM and chronic pain, including surveys, assessments of physical functioning or biomarker studies – and clinical trials. One key objective of the registry is to conduct longitudinal follow-up studies to assess long-term physical and psychosocial health of teenagers with juvenile fibromyalgia as they enter young adulthood. The goal is to determine the long-term prognosis of chronic musculoskeletal pain in children, impact of chronic pain on important developmental milestones and quality of life, as well as identify targeted outcomes for prevention and early intervention.
Collaborative Projects
Validation of the American College of Rheumatology Fibromyalgia Diagnostic Criteria in a Pediatric Population with Juvenile Fibromyalgia
The aim of this project in collaboration with pediatric rheumatologists from the Childhood Arthritis and Rheumatology Research Alliance (CARRA) is to validate a questionnaire/screening tool that could help with the proper identification of fibromyalgia in children and adolescents. The purpose of this research study is to see if the American College of Rheumatology (ACR 2010) criteria for adult fibromyalgia can be applied to children and adolescents.
Identifying Neural Pathophysiology in Juvenile Fibromyalgia
This project is an NIH-funded study (R01 AR074795) in collaboration with Robert Coghill, PhD (principal investigator) and Marina López-Solà, PhD (University of Barcelona, Spain). The goal of this project is to identify fMRI-based multivariate patterns of brain activity during core symptom-provocation tasks that are sensitive and specific for JFM (compared to healthy adolescents), and to study mechanisms of altered sensory perception and self-referential processing in JFM.
Biofeedback-based Virtual Reality for Postoperative Pain Management in Children and Adolescents
The goal of this NIH-funded study (R34AT011218) in collaboration with Vanessa Olbrecht, MD, Nationwide Children’s Hospital, is to refine a treatment protocol for the perioperative application of biofeedback-based virtual reality and to conduct a clinical trial using this treatment protocol compared to active control in children and adolescents undergoing surgery to verify feasibility and acceptability of the intervention.
Risk factors for Opioid Use and Misuse in Women with and without a History of Childhood Maltreatment
This study in collaboration with investigators Sarah Beal, PhD and Christopher King, PhD examines cognitive and affective function, stress, pain processing, and opioid use and misuse data from young adult women who have and have not experienced childhood maltreatment, and determine the strength of the association between opioid use/misuse, maltreatment status, and pain experiences.
