Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Spain.
VALTRADOFI Research Group, Department of Physiotherapy, Faculty of Health, Camilo Jose Cela University, Villanueva de la Cañada, Spain.
Pain Med. 2023 Jul 5;24(7):881-889. doi: 10.1093/pm/pnac206.
OBJECTIVE: Given that identification of groups of patients can help to better understand risk factors related to each group and to improve personalized therapeutic strategies, this study aimed to identify subgroups (clusters) of women with fibromyalgia syndrome (FMS) according to pain, pain-related disability, neurophysiological, cognitive, health, psychological, or physical features. METHODS: Demographic, pain, sensory, pain-related disability, psychological, health, cognitive, and physical variables were collected in 113 women with FMS. Widespread pressure pain thresholds were also assessed. K-means clustering was used to identify groups of women without any previous assumption. RESULTS: Two clusters exhibiting similar widespread sensitivity to pressure pain (pressure pain thresholds) but differing in the remaining variables were identified. Overall, women in one cluster exhibited higher pain intensity and pain-related disability; more sensitization-associated and neuropathic pain symptoms; higher kinesiophobia, hypervigilance, and catastrophism levels; worse sleep quality; higher anxiety/depressive levels; lower health-related function; and worse physical function than women in the other cluster. CONCLUSIONS: Cluster analysis identified one group of women with FMS exhibiting worse sensory, psychological, cognitive, and health-related features. Widespread sensitivity to pressure pain seems to be a common feature of FMS. The present results suggest that this group of women with FMS might need to be treated differently.
目的:鉴于识别患者群体有助于更好地了解与每个群体相关的风险因素,并改进个性化治疗策略,本研究旨在根据疼痛、与疼痛相关的残疾、神经生理、认知、健康、心理或身体特征,识别纤维肌痛综合征(FMS)女性的亚组(聚类)。
方法:在 113 名 FMS 女性中收集了人口统计学、疼痛、感觉、与疼痛相关的残疾、心理、健康、认知和身体变量。还评估了广泛的压痛阈值。使用 K-均值聚类来识别没有任何先验假设的女性群体。
结果:确定了两个表现出相似的广泛压痛敏感性(压痛阈值)但在其余变量上存在差异的聚类。总体而言,一个聚类中的女性疼痛强度和与疼痛相关的残疾更高;更多的感觉过敏相关和神经病理性疼痛症状;更高的运动恐惧、警觉性和灾难化水平;睡眠质量更差;焦虑/抑郁水平更高;健康相关功能更差;身体功能更差。
结论:聚类分析确定了一个具有更差感觉、心理、认知和健康相关特征的 FMS 女性群体。广泛的压痛敏感性似乎是 FMS 的共同特征。本研究结果表明,这组 FMS 女性可能需要采用不同的治疗方法。
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