Redondo Javier Rivera, Justo Carmen Moratalla, Moraleda Francisca Valdepeñas, Velayos Yolanda García, Puche José Juan Osés, Zubero Julio Ruiz, Hernández Teresa González, Ortells Loreto Carmona, Pareja Miguel Angel Vallejo
Instituto Provincial de Rehabilitación, Hospital Universitario Gregorio Marañón, Madrid, Spain.
Arthritis Rheum. 2004 Apr 15;51(2):184-92. doi: 10.1002/art.20252.
To analyze the long-term efficacy of 2 interventions for female fibromyalgia (FM) patients: 1) cognitive-behavioral therapy (CBT), and 2) a physical exercise (PE)-based strategy.
We conducted a prospective, long-term, randomized, parallel clinical trial. The outcome variables are physical activity, aerobic capacity, and results of the Fibromyalgia Impact Questionnaire (FIQ), Short Form 36, Beck Anxiety and Depression Inventory, Chronic Pain Self-Efficacy Scale, and Chronic Pain Coping Inventory. All were measured at baseline, posttreatment, 6 months, and 1 year. The duration of both treatments was 8 weeks.
Some items of the FIQ and some strategies to cope with pain improved significantly in both groups after treatment. All variables measuring functional capacity improved significantly in the PE group, whereas only physical activity of the vertebral column improved in the CBT group. There were no differences in anxiety, depression, and self efficacy after treatment in either group. After 1 year of followup, most of the parameters had returned to baseline values in both groups. However, in the PE group, functional capacity remained significantly better.
PE and CBT improve clinical manifestations in FM patients only for short periods of time. Improvement in self efficacy and physical fitness are not associated with improvement in clinical manifestations.
分析两种干预措施对女性纤维肌痛（FM）患者的长期疗效：1）认知行为疗法（CBT），以及2）基于体育锻炼（PE）的策略。
我们进行了一项前瞻性、长期、随机、平行临床试验。结局变量包括身体活动、有氧运动能力，以及纤维肌痛影响问卷（FIQ）、简明健康调查问卷36项（Short Form 36）、贝克焦虑抑郁量表、慢性疼痛自我效能量表和慢性疼痛应对量表的结果。所有这些均在基线、治疗后、6个月和1年时进行测量。两种治疗的持续时间均为8周。
治疗后两组的FIQ部分项目及一些疼痛应对策略均有显著改善。PE组中所有测量功能能力的变量均有显著改善，而CBT组仅脊柱的身体活动有所改善。两组治疗后焦虑、抑郁和自我效能方面均无差异。随访1年后，两组的大多数参数均恢复至基线值。然而，PE组的功能能力仍显著更好。
PE和CBT仅在短时间内改善FM患者的临床表现。自我效能和身体素质的改善与临床表现的改善无关。
