Research | Kratz Lab

We begin our research by considering how symptoms affect people’s daily lives. Current measurements, such as neuropsychological exams administered during a health visit, may not fully capture the momentary fluctuation of someone's condition. Many patients describe their symptoms—such as pain, cognitive function, or fatigue—as constantly fluctuating, with “good days” and “bad days” and further variation within those days. Consequently, our research seeks to capture such day-to-day experiences with symptoms. In one of our ongoing studies, CogDetect-MS, we use a combination of in-person tests and ecological momentary assessments (or EMAs), which is a period of “home monitoring” where participants complete surveys and wear an activity watch for a number of weeks after their in-person visit. This methodology not only reveals real-life momentary fluctuation but also enables us to recommend short- and long-term symptom management strategies. 

While most research in this area focuses on finding treatments or cures, we recognize that people still live with pain and/or fatigue. Our research has found that behavioral changes can greatly improve the quality of life for people experiencing these symptoms. In one of our past studies, Pain Acceptance in SCI Study (PASS), we found that individuals who accepted their pain associated with spinal cord injury (or SCI) had lower use of pain medications and experienced less interference in their daily activities. By understanding and capturing the lived experiences of people with these symptoms, we can provide valuable information and practical tools to healthcare professionals and shape the direction of future research. These tools are also made accessible to people struggling with pain, fatigue, or cognitive dysfunction for immediate implementation (like our MyMSToolkit website available on our home page!)

Our research also involves clinical trials aimed at alleviating these symptoms. Many people with multiple sclerosis (MS) suffer from fatigue, and current options to mitigate fatigue are limited. However, these options may be more effective when used together rather than in isolation. Our previous study COMBO-MS considered this question and used cognitive-behavioral therapy (CBT), modafinil, or a combination of both to observe their effects on MS-associated fatigue. Currently, our lab is involved in another clinical trial—CANSLEEP-MS—that looks at the impact of cannabis (CBD and/or THC) on pain and sleep for people with MS.

By capturing momentary fluctuations, implementing behavioral changes, and conducting clinical trials, we create a comprehensive understanding of the impact current treatments can have on people’s daily symptoms. This insight is invaluable to impact research, inform healthcare providers, and ultimately enhance the well-being of those dealing with these symptoms.

What is it?

Our lab has a research registry for people interested in hearing about new studies in our lab.

What does it do?

The purpose of this registry is to keep the names and contact information of people who would like to hear about our future studies.

The potential benefit of joining this registry is having the opportunity to participate in studies that you may not otherwise learn about. 

The only risk involved in joining the registry is a very small chance of a loss of confidentiality. We will reduce this risk by storing your data in locked cabinets and on a password-protected, web-based database that is hosted by the University of Michigan. Only trained researchers and staff who are affiliated with the registry will be able to access your information. 

You will remain in the registry for as long as you wish, and you may withdraw at any time.

How do I join?

If you would like to join this registry or would like any additional information, you can contact the registry staff at 734-936-2844 or [email protected]. 

Currently recruiting!

Study Overview

Chronic pain affects more than 19 million adults in the U.S. and is linked to reductions in physical activity. Changes in physical activity due to chronic pain are often measured only through patient recall, which can be unreliable. Members of the Kratz Lab are working with colleagues at University of Michigan Health back pain clinics to test the Veraband, a new disposable activity monitor designed to help clinicians better understand their patients' movement patterns and improve care for chronic low back pain. 

What do I have to do?

• Patient participants are asked to wear a Veraband activity monitor on their non dominant wrist for up to 6 weeks, started 2 weeks before their treatment for chronic low back pain (injection, new medication, new physical therapy, etc). They will be asked to complete a baseline survey prior to wearing the band and a follow-up survey to conclude study activities.
  • Participants will receive $150 for full completion of the study, which is sent via check in the mail.
• Clinician participants are asked to do a demographic survey and then fill out surveys based on their patient’s data from the Veraband. They fill out 2 surveys per patient in the study.
  • Clinicians have the option of being published on the paper or $300 compensation.

Who is eligible?

• Patients of consented clinicians who experience chronic lower back pain for more than half the days in the past 6 months.
• Must also not have other conditions or system diseases that greatly affect their movement.

Contact

VERABAND Staff Contact: Jade Treder or Quynh Tran

Phone: (734) 936-2844

Email: [email protected]  

Study ID: HUM00270696  IRB: IRBMED  Date approved: 1/16/2026

Currently recruiting!

Study Overview

Pain is a common symptom for people living with knee osteoarthritis, and it can disrupt a person’s daily life. Exercise is a common treatment for knee osteoarthritis pain but has been shown to have varying and limited effects. This study is based on the idea that improving sleep may increase the pain-relieving benefits of exercise for knee osteoarthritis. 

What do I have to do?

Home monitoring sessions: You will first be asked to complete an online survey about your demographics and general health. You will then be asked to wear a PRO-Diary activity monitor (watch) for 1 week (24 hours per day). We will also ask you to answer some questions about your symptoms on the PRO-Diary 4 times each day you are wearing it.

Study participants will then be randomized to one of two groups:

1. Personalized exercise program: Participants will meet with an assigned health coach for 6 sessions over 8 weeks (once per week for the first 4 sessions, then every 2 weeks for the remaining sessions). The exercise program is an informational, supported, self-help program.
2. Move & Snooze: Participants in this group will receive the personalized exercise program treatment as detailed above but will be asked to concurrently complete an online course of cognitive behavioral therapy for insomnia (CBT-I) through a program called Sleepio. This course will be delivered across 6 weekly sessions that include cognitive and behavioral techniques to improve sleep and insomnia symptoms.

Participants will be asked to complete additional home monitoring sessions halfway through the treatment period (4 weeks), at the end of the treatment period (8 weeks), and at 6 and 12 months after the treatment period is over. 

Participants can receive up to $500 in compensation ($100 for each completed home monitoring period).

Who is eligible?

1. Must be at least 50 years old.
2. Must be diagnosed with knee osteoarthritis and experience persistent, moderate-intensity knee osteoarthritis-related pain.
3. Must have persistent insomnia symptoms.
4. Must not have previously had a knee replacement.
5. Must not meet or exceed 150 minutes of moderate-intensity or 75 minutes of vigorous exercise per week.

Contact

Move & Snooze study staff: Jade Treder, Haley Lazarus, Brooke Morrison, or Quynh Tran

Phone: (734) 936-2844

Email: [email protected]

Currently recruiting!

Study Overview

The majority of people with MS experience problems with sleep, pain, or both. Sleep problems affect more than half of people with MS. Sleep problems also have the potential to worsen chronic pain, which affects about half of people with MS. We hope to learn more about the pain-sleep connection.

What do I have to do?

If you participate in this study, you will start off with a 2-3 hour in-person visit, your first overnight sleep study, and your first 14-day “home monitoring” session with the PRO-Diary watch. We will ask you to provide about three teaspoons of blood at your initial visit and at the mid-treatment and final treatment timepoints.

After the 14-day home monitoring (PRO-Diary watch), you will be assigned 1 of 4 treatments as detailed below. Randomization and treatment delivery may be in person, or done virtually (without an in-person visit). If done virtually, study drug may be shipped directly to your home.

1. Prescription CBD (in the form of liquid Epidiolex) + a placebo (inactive) version of THC capsule
2. Prescription THC (in the form of dronabinol capsule) + a placebo (inactive) version of CBD liquid
3. A combination of both prescription CBD and THC (in the form of liquid Epidiolex and dronabinol capsule)
4. Placebo (inactive) versions of both CBD and THC (capsule + liquid with no active drug in either product).

Complete two online surveys at about 6 and 12 weeks after you begin treatment.
Begin a second 14-day session of “home monitoring” 10 weeks after treatment starts.
Complete a second overnight sleep study just before the end of your 12 weeks of treatment.

You will also complete several scheduled follow-up phone calls with the study team (lasting about 15 minutes each).

These activities will occur over a duration of about 14 weeks (with treatment lasting 12 weeks). Additional unscheduled in-person or phone assessments may occur. We will also do a final follow-up call about 30 days after your treatment ends.

Participants will receive up to $400 for full study completion.

Who is eligible?

• Must be between 18 and 65 years old
• Must have MS
• Must have chronic pain

Contact

CANSLEEP-MS Study Staff

David Johnson, Dan Farkas, or Brooke Morrison
Phone: (734) 936-2844
Email: [email protected] 

Study ID: HUM00190734 IRB: IRBMED Date Approved: 11/3/2020

*NOT currently recruiting*

Study Overview

Cognitive dysfunction is common in many different clinical conditions, including multiple Multiple Sclerosis (MS). Little is known about the impact of cognitive dysfunction where it matters most – in the everyday lives of people with these conditions. This study is designed to examine the cognitive function in real-world settings in people with MS.   We expect the knowledge gained in this study will lead us to new insights about how to measure cognitive functioning in daily life and better ways to improve the overall health-related quality of life of people with MS.

What do I have to do?

• Participants in this study will complete 3 in-person study visits and 3 “home-monitoring periods” over the course of 2 years. Each in-person study visit is followed by a 14-day home-monitoring period.
• During the home-monitoring period, participants will wear an activity monitor on their wrist and use a study-provided smartphone to complete brief surveys and thinking tests four times daily.
• At the end of the home monitoring period, participants will mail the devices back using pre-paid study-provided shipping boxes.

Participants will receive up to $600 for full study completion.

Who is eligible?

• Must be at least 18 years old.
• Must have MS.
• Must ambulate independently at least 50% of the time.

Contact

CogDetect-MS Study Staff: Keara Ginell or Josiah Goga
Phone: (734) 936-2844
Email: [email protected] 

Study ID: HUM00199732 IRB: IRBMED Date Approved: 04/26/2022

*NOT currently recruiting*

This study examined symptoms and functioning in the daily lives of people with multiple sclerosis (MS). Common MS symptoms such as fatigue, pain, and depression may be associated with day-to-day functioning. The goal of this study was to learn more about the day-to-day experience of adults with MS to help us learn more about how to treat and prevent common MS symptoms and functional problems.

Publications:

How Do Pain, Fatigue, Depressive, and Cognitive Symptoms Relate to Well-Being and Social and Physical Functioning in the Daily Lives of Individuals With Multiple Sclerosis?
Kratz, A. L., Braley, T. J., Foxen-Craft, E., Scott, E., Murphy, J. F., 3rd, & Murphy, S. L. (2017). Arch Phys Med Rehabil, 98(11), 2160-2166.

Ecological Momentary Assessment of Pain, Fatigue, Depressive, and Cognitive Symptoms Reveals Significant Daily Variability in Multiple Sclerosis.
Kratz, A. L., Murphy, S. L., & Braley, T. J. (2017a). Arch Phys Med Rehabil, 98(11), 2142-2150. doi:10.1016/j.apmr.2017.07.002

Pain, Fatigue, and Cognitive Symptoms Are Temporally Associated Within but Not Across Days in Multiple Sclerosis.
Kratz, A. L., Murphy, S. L., & Braley, T. J. (2017b). Arch Phys Med Rehabil, 98(11), 2151-2159. doi:10.1016/j.apmr.2017.07.003

Chronic pain is a very serious and common problem for people with spinal cord injury (SCI). Unfortunately, pain is not adequately treated in SCI. Therefore, the search is on for new treatments that can help those with SCI to cope more effectively with their pain. The goal of this study was to open a window onto the day-to-day experiences of pain in adult with SCI, to help us develop better and more individualized self-management therapies for those with SCI who are struggling to cope with chronic pain. The University of Michigan was the lead site, collaborating with Wayne State University and University of Washington, to examine pain and pain coping in the day-to-day lives of adults with spinal cord injury. The purpose of this study is gather new information that will let us know how pain affects well-being and participation in people with spinal cord injury, and what types of coping are related to optimal adjustment to pain.

Publications:

Medicate or Meditate? Greater Pain Acceptance is Related to Lower Pain Medication Use in Persons With Chronic Pain and Spinal Cord Injury. 
Kratz, A. L., F. Murphy J, r., Kalpakjian, C. Z., & Chen, P. (2018). Clin J Pain, 34(4), 357-365.

Pain Acceptance Decouples the Momentary Associations Between Pain, Pain Interference, and Physical Activity in the Daily Lives of People With Chronic Pain and Spinal Cord Injury.
Kratz, A. L., Ehde, D. M., Bombardier, C. H., Kalpakjian, C. Z., & Hanks, R. A. (2017). J Pain, 18(3), 319-331. doi:10.1016/j.jpain.2016.11.006

Are Intensive Data Collection Methods in Pain Research Feasible in Those With Physical Disability? A Study in Persons With Chronic Pain and Spinal Cord Injury.
Kratz, A. L., Kalpakjian, C. Z., & Hanks, R. A. (2017). Quality of Life Research, 26(3), 587-600.

Cognitive “fog” is characterized by problems with attention and memory and is reported in a number of different conditions, including fibromyalgia (“fibrofog”), cancer treated with chemotherapy (“chemofog”), depression, and multiple sclerosis.  The aim of this study was to examine subject and objective markers of cognitive dysfunction to determine whether there are similarities and/or differences in the nature of cognitive fog in these four clinical groups.

Many people with fibromyalgia report having problems with their thinking (cognition) during their daily lives; these thinking problems are commonly called “fibrofog”. However, little is known about the nature of fibrofog and how it is experienced in daily life. This study is designed to examine thinking in real-world settings in people with and without fibromyalgia. We expect the knowledge gained in this study to lead to new insights about the nature of fibrofog and better ways to help people with fibromyalgia effectively manage problems with fibrofog.

For many persons with MS, fatigue is the most debilitating symptom of the condition. This clinical trial, which was guided by feedback from persons with MS, MS providers, community organizations, and payers, compared the effectiveness of current options available: cognitive behavioral therapy alone, modafinil alone, or a combination of both. Results of this study will help patients, providers, and policy makers determine which patients with fatigue respond best to cognitive behavioral therapy or modafinil, and which persons with MS may benefit most from a combination of these treatments.

Individuals with spinal cord injury (SCI) frequently suffer from pain. Evidence suggests that patients themselves can have a significant and positive impact on their own quality of life by taking an active role in the self-management of their pain.

The purpose of this study was to improve management of pain through the use of a newly developed web-based program called My SCI Toolkit. The My SCI Toolkit provides education, guidance, and skill-building exercises that are specifically tailored for people with SCI and pain. Participants were randomized to one of 3 groups for use of the program: unguided, coached, and waitlist. (IRBMED: HUM00192610)

The purpose of this study was to learn more about the caregiving experiences, friendship patterns, and how these link to health and well-being among African American and European American MS caregivers. Caregivers participated in a focus group study lasting 60-90 minutes. Questions included their caregiving experiences, friendship patterns, and their implications for health and well-being. (IRBMED: HUM00237494)