Vincent Ann, Whipple Mary O, Oh Terry H, Guderian Janet A, Barton Debra L, Luedtke Connie A
Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota.
Fibromyalgia and Chronic Fatigue Clinic, Mayo Clinic, Rochester, Minnesota.
Pain Manag Nurs. 2013 Dec;14(4):228-235. doi: 10.1016/j.pmn.2011.05.001. Epub 2011 Jul 2.
Fibromyalgia is a complex heterogeneous disorder for which a multidisciplinary individualized approach is currently advocated. We executed a 1-week multidisciplinary fibromyalgia clinical program with seven patients, based on our experience with our existing 1.5-day multidisciplinary fibromyalgia program that has demonstrated both short- and long-term benefits. The current expanded program was not designed as a clinical study, but rather as a clinical feasibility assessment, and it was multidisciplinary in nature, with cognitive behavioral therapy, activity pacing, and graded exercise therapy as major components. We assessed changes in individual patients at 1 week and 3 months after the program with the use of validated self-report measures of pain, fatigue, and self-efficacy. All patients indicated at least small improvements in pain and physical symptoms at both 1 week and 3 months, and all but one patient showed improvement in self-efficacy at 1 week and 3 months. Similar trends were observed for fatigue. Based on our early clinical experience, we conclude that the 1-week multidisciplinary fibromyalgia program is logistically feasible and has potential for clinical efficacy. Further research is needed and is planned to test the clinical efficacy of this program and compare it with other interventions.
纤维肌痛是一种复杂的异质性疾病,目前提倡采用多学科个体化方法进行治疗。基于我们现有的为期1.5天的多学科纤维肌痛项目所展示的短期和长期益处的经验,我们对7名患者实施了为期1周的多学科纤维肌痛临床项目。当前扩展后的项目并非设计为一项临床研究,而是作为一项临床可行性评估,其本质上是多学科的,主要组成部分包括认知行为疗法、活动节奏控制和分级运动疗法。我们使用经过验证的疼痛、疲劳和自我效能感的自我报告测量方法,评估了项目结束后1周和3个月时个体患者的变化情况。所有患者均表示在1周和3个月时疼痛和身体症状至少有小幅改善,除1名患者外,所有患者在1周和3个月时自我效能感均有改善。疲劳方面也观察到了类似趋势。基于我们早期的临床经验,我们得出结论,为期1周的多学科纤维肌痛项目在后勤保障上是可行的,并且具有临床疗效潜力。需要并计划进行进一步研究,以测试该项目的临床疗效并将其与其他干预措施进行比较。