Department of Medicine and Surgery, University of Parma, Italy.
Department of Psychology Renzo Canestrari, Alma Mater Studiorum, University of Bologna, Italy.
Clin Exp Rheumatol. 2023 Jun;41(6):1332-1341. doi: 10.55563/clinexprheumatol/7hvaya. Epub 2023 Jun 28.
A two-arm parallel randomised controlled trial was conducted to evaluate the efficacy of a group acceptance-based treatment (ABT) in improving pain acceptance, pain catastrophising, kinesiophobia, pain intensity and physical functioning compared to treatment as usual in patients with fibromyalgia (FM) and comorbid obesity.
Female individuals diagnosed with FM and obesity (n = 180) were randomly assigned to either a three-weekly group acceptance-based treatment plus treatment as usual (ABT+TAU) or only TAU. The variables of interest were assessed at baseline (T0) and after the interventions (T1). The treatment protocol for the ABT+TAU condition, designed for an inpatient rehabilitation context, is based on acceptance and commitment therapy but focuses specifically on pain acceptance, a crucial factor in fostering a more functional adaptation to chronic pain.
Participants in the ABT+TAU group showed significant improvements in pain acceptance (i.e. the primary outcome), but also in pain catastrophising, kinesiophobia, and performance-based physical functioning (i.e. the secondary outcomes) compared to those in the TAU group. However, there were no significant differences in pain intensity between the two groups.
These findings indicate that a brief group-based ABT intervention is effective in enhancing pain acceptance, reducing pain catastrophising and kinesiophobia, and improving performance-based physical functioning. Furthermore, the observed improvements in kinesiophobia and physical functioning may have particular relevance for individuals with comorbid obesity, as they can facilitate greater adherence to physical activity and promote weight loss.
本研究采用双臂平行随机对照试验,评估了一种基于接纳的团体治疗(ABT)在改善纤维肌痛(FM)合并肥胖患者的疼痛接纳、疼痛灾难化、运动恐惧、疼痛强度和身体功能方面的疗效,与常规治疗(TAU)相比。
将诊断为 FM 和肥胖的女性个体(n=180)随机分配至为期 3 周的基于接纳的团体治疗加 TAU(ABT+TAU)组或仅 TAU 组。在基线(T0)和干预后(T1)评估感兴趣的变量。ABT+TAU 组的治疗方案基于接纳与承诺疗法,但特别侧重于疼痛接纳,这是促进对慢性疼痛更具功能性适应的关键因素。
与 TAU 组相比,ABT+TAU 组在疼痛接纳(即主要结局)以及疼痛灾难化、运动恐惧和基于表现的身体功能(即次要结局)方面均有显著改善。然而,两组之间的疼痛强度没有显著差异。
这些发现表明,短暂的基于团体的 ABT 干预措施有效增强了疼痛接纳,减轻了疼痛灾难化和运动恐惧,改善了基于表现的身体功能。此外,观察到的运动恐惧和身体功能的改善对于合并肥胖的个体可能具有特殊意义,因为它们可以促进对身体活动的更高依从性,并促进体重减轻。