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身体感知干预对纤维肌痛和慢性疲劳综合征的有效性:一项系统评价和荟萃分析。

Effectiveness of body awareness interventions in fibromyalgia and chronic fatigue syndrome: a systematic review and meta-analysis.

作者信息

Courtois Imke, Cools Filip, Calsius Joeri

机构信息

Reval Research Center, University Hasselt, Faculty Medicine and Life Science, Belgium.

Belgian Center for Evidence-Based Medicine, Belgian Branch of the Dutch Cochrane Center (CEBAM), Belgium.

出版信息

J Bodyw Mov Ther. 2015 Jan;19(1):35-56. doi: 10.1016/j.jbmt.2014.04.003. Epub 2014 Apr 18.

Abstract

OBJECTIVES

Patients with long-lasting pain problems often complain of lack of confidence and trust in their body. Through physical experiences and reflections they can develop a more positive body- and self-experience. Body awareness has been suggested as an approach for treating patients with chronic pain and other psychosomatic conditions. The aim of this systematic review is to assess the effectiveness of body awareness interventions (BAI) in fibromyalgia (FM) and chronic fatigue syndrome (CFS).

METHODS

Two independent readers conducted a search on Medline, Cochrane Central, PsycINFO, Web of knowledge, PEDro and Cinahl for randomized controlled trials.

RESULTS

We identified and screened 7.107 records of which 29 articles met the inclusion criteria. Overall, there is evidence that BAI has positive effects on the Fibromyalgia Impact Questionnaire (FIQ) (MD -5.55; CI -8.71 to -2.40), pain (SMD -0.39, CI -0.75 to -0.02), depression (SMD -0.23, CI -0.39 to -0.06), anxiety (SMD -0.23, CI -0.44 to -0.02) and Health Related Quality of Life (HRQoL) (SMD 0.62, CI 0.35-0.90) when compared with control conditions. The overall heterogeneity is very strong for FIQ (I(2) 92%) and pain (I(2) 97%), which cannot be explained by differences in control condition or type of BAI (hands-on/hands-off). The overall heterogeneity for anxiety, depression and HRQoL ranges from low to moderate (I(2) 0%-37%).

CONCLUSIONS

Body awareness seems to play an important role in anxiety, depression and HRQoL. Still, interpretations have to be done carefully since the lack of high quality studies.

摘要

目的

长期存在疼痛问题的患者常常抱怨对自己的身体缺乏信心和信任。通过身体体验和反思,他们可以形成更积极的身体和自我体验。身体意识已被提议作为治疗慢性疼痛和其他身心疾病患者的一种方法。本系统评价的目的是评估身体意识干预(BAI)对纤维肌痛(FM)和慢性疲劳综合征(CFS)的有效性。

方法

两名独立的研究者在Medline、Cochrane Central、PsycINFO、Web of knowledge、PEDro和Cinahl数据库中检索随机对照试验。

结果

我们识别并筛选了7107条记录,其中29篇文章符合纳入标准。总体而言,有证据表明,与对照条件相比,BAI对纤维肌痛影响问卷(FIQ)(MD -5.55;CI -8.71至-2.40)、疼痛(SMD -0.39,CI -0.75至-0.02)、抑郁(SMD -0.23,CI -0.39至-0.06)、焦虑(SMD -0.23,CI -0.44至-0.02)和健康相关生活质量(HRQoL)(SMD 0.62,CI 0.35-0.90)有积极影响。FIQ(I² 92%)和疼痛(I² 97%)的总体异质性非常强,无法用对照条件或BAI类型(动手/不动手)的差异来解释。焦虑、抑郁和HRQoL的总体异质性范围从低到中度(I² 0%-37%)。

结论

身体意识似乎在焦虑、抑郁和HRQoL中发挥重要作用。然而,由于缺乏高质量的研究,解释仍需谨慎。

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