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基于家庭的治疗性运动对纤维肌痛成人的有效性:系统评价和荟萃分析。

The effectiveness of home-based therapeutic exercises on adults with fibromyalgia: a systematic review and meta-analysis.

机构信息

Department of Rehabilitation Sciences, Faculty of Applied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan.

出版信息

Int J Rehabil Res. 2023 Dec 1;46(4):359-368. doi: 10.1097/MRR.0000000000000606. Epub 2023 Oct 31.

Abstract

The objective of this systematic review and meta-analysis is to evaluate the effectiveness of home-based exercises (HBE) in alleviating pain, fatigue, depression, and anxiety and enhancing the quality of life (QOL) among adults with fibromyalgia. A comprehensive search was conducted across four databases PubMed, Cochrane, CINAHL (EBSCO), and PEDro to identify eligible randomized controlled trials (RCTs). Standardized mean differences (SMDs) at a 95% confidence interval (CI) were computed. Ten RCTs met the inclusion criteria, involving 601 participants, with a good-to-fair quality according to the PEDro scale. Of the 10 included studies, 3 compared HBE to no exercise, while 7 compared HBE to center-based exercises (CBE). HBE showed significant pain reduction (SMD = 0.775, P = 0.003) and improved QOL as measured by the fibromyalgia impact questionnaire (FIQ) (SMD = 0.621, P = 0.001) compared with no exercise, but there were no significant differences in depression and QOL as measured by SF-36 compared with CBE. In contrast, CBE demonstrated greater pain reduction (SMD = -1.325, P < 0.001) and improved FIQ scores (SMD = -0.843, P = 0.017) compared with HBE. In conclusion, HBE exhibit effectiveness in alleviating pain, and depression and enhancing QOL among fibromyalgia patients in comparison to no exercise. However, CBE are more effective in reducing pain and enhancing QOL than HBE, although HBE can be valuable for maintaining activity levels in fibromyalgia patients between treatment cycles.

摘要

本系统评价和荟萃分析的目的是评估家庭锻炼(HBE)在缓解疼痛、疲劳、抑郁和焦虑以及提高纤维肌痛患者生活质量(QOL)方面的有效性。通过对四个数据库(PubMed、Cochrane、CINAHL(EBSCO)和 PEDro)进行全面检索,确定了符合纳入标准的随机对照试验(RCT)。使用 95%置信区间(CI)计算标准化均数差(SMD)。10 项 RCT 符合纳入标准,涉及 601 名参与者,PEDro 量表评分为良好至中等。在纳入的 10 项研究中,有 3 项比较了 HBE 与无运动,而 7 项比较了 HBE 与中心基础运动(CBE)。与无运动相比,HBE 显示出显著的疼痛减轻(SMD=0.775,P=0.003)和改善的生活质量(用纤维肌痛影响问卷(FIQ)测量,SMD=0.621,P=0.001),但与 CBE 相比,抑郁和生活质量(用 SF-36 测量)没有显著差异。相比之下,CBE 显示出更大的疼痛减轻(SMD=-1.325,P<0.001)和 FIQ 评分的改善(SMD=-0.843,P=0.017),与 HBE 相比。总之,与无运动相比,HBE 在缓解疼痛、抑郁和提高纤维肌痛患者的生活质量方面具有疗效。然而,与 HBE 相比,CBE 在减轻疼痛和提高生活质量方面更有效,尽管 HBE 在治疗周期之间维持纤维肌痛患者的活动水平方面可能具有价值。

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