Clarke-Jenssen Anne-Cathrine, Mengshoel Anne Marit, Strumse Yndis Staalesen, Forseth Karin Oien
Department of Orthopedics, Oslo University Hospital, Rikshospitalet, NO Oslo, Norway. Department of Orthopedics, Oslo University Hospital, Rikshospitalet, NO Oslo, Norway.
J Rehabil Med. 2014 Jul;46(7):676-83. doi: 10.2340/16501977-1819.
To study the long-term effects on symptoms and physical function of a 4-week rehabilitation programme for patients with fibromyalgia, and to determine whether there are any differences if this programme is applied in a warm or cold climate.
A total of 132 patients with fibromyalgia were randomized to a rehabilitation programme in a warm or cold climate, or to a control group without intervention. Assessments were performed before and after intervention, and after 3 and 12 months. The main outcome measures were pain, measured by tender point count (TPC), and physical function, measured with the 6-min walk test (6MWT).
There was no difference in any outcome variables at baseline. Persistent reduction in pain measured by TPC occurred only in the warm climatic setting. Mean difference (95% confidence interval (CI)) in TPC between warm and cold climate groups 1 year after the intervention was -1.7 (-2.9 to -0.5) and between the warm climate and the control group -2.2 (-3.3 to -1.0). Three months after the intervention the mean difference between the warm and cold climate groups in pain distribution (McGill mannequin) was -12 (-20 to -5) and between the warm climate and the control group -11 (-18 to -3). There were comparable improvements in physical function (6MWT) between the 2 intervention groups and the control group. The mean difference (95% CI) in 6MWT 1 year after the intervention between the warm climate and the control group was 33 (7-59) m. The corresponding value between the cold climate and the control group was 29 (3-55) m. Grip Strength (95% CI) was increased by 4.6 kg (2.3-6.4) in the warm climate and by 3.2 kg (0.9-5.5) in the cold climate compared with the control group 1 year after the intervention.
A rehabilitation programme for fibromyalgia may have a long-term effect on pain, as measured by TPC and pain distribution, when applied in a warm climatic setting, and may improve physical function regardless of the climatic setting.
研究为期4周的纤维肌痛患者康复计划对症状和身体功能的长期影响，并确定该计划在温暖或寒冷气候下实施是否存在差异。
总共132名纤维肌痛患者被随机分为在温暖或寒冷气候下接受康复计划组，或不接受干预的对照组。在干预前后、3个月和12个月后进行评估。主要结局指标为通过压痛点计数（TPC）测量的疼痛，以及通过6分钟步行试验（6MWT）测量的身体功能。
基线时任何结局变量均无差异。仅在温暖气候环境下，通过TPC测量的疼痛持续减轻。干预1年后，温暖气候组与寒冷气候组之间TPC的平均差异（95%置信区间（CI））为-1.7（-2.9至-0.5），温暖气候组与对照组之间为-2.2（-3.3至-1.0）。干预3个月后，温暖气候组与寒冷气候组之间疼痛分布（麦吉尔人体模型）的平均差异为-12（-20至-5），温暖气候组与对照组之间为-11（-18至-3）。两个干预组与对照组在身体功能（6MWT）方面有类似改善。干预1年后，温暖气候组与对照组之间6MWT的平均差异（95%CI）为33（7-59）米。寒冷气候组与对照组之间的相应值为29（3-55）米。与对照组相比，干预1年后温暖气候组握力（95%CI）增加4.6千克（2.3-6.4），寒冷气候组增加3.2千克（0.9-5.5）。
纤维肌痛康复计划在温暖气候环境下实施时，对通过TPC和疼痛分布测量的疼痛可能有长期影响，且无论气候环境如何，均可改善身体功能。
