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一种新型多组分疗法对纤维肌痛女性患者的疗效:一项随机临床试验。

Effectiveness of a novel multicomponent treatment in women with fibromyalgia: A randomized clinical trial.

作者信息

Araya-Quintanilla Felipe, Álvarez-Bueno Celia, Cavero-Redondo Iván, Ramírez-Vélez Robinson, Sepúlveda-Loyola Walter, Gutiérrez-Espinoza Héctor

机构信息

Escuela de Kinesiología, Facultad de Odontología y Ciencias de la Rehabilitación, Universidad San Sebastián, Santiago, Chile.

Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain.

出版信息

Br J Pain. 2024 Oct 18:20494637241293760. doi: 10.1177/20494637241293760.

Abstract

BACKGROUND

Multicomponent treatment is commonly used. However, there are no studies that included graded motor imagery and therapeutic neuroscience education to multicomponent treatment for patients with fibromyalgia This study aims to compare the short-term effects (at 12 weeks) of a multicomponent treatment combined with graded motor imagery and therapeutic neuroscience education versus standard treatment in patients with FM.

METHODS

The study was a single-blinded randomized controlled trial. Sixty-five women with a clinical diagnosis of FM were randomly allocated (1:1) into two groups. The experimental group ( = 33) received a novel multicomponent treatment combined with graded motor imagery and neuroscience education. The control group ( = 32) received a standard treatment including pharmacotherapy and standard physician education. The primary outcome was pain intensity assessed with the Numeric Pain Rating Scale (NPRS). The secondary outcomes were changes in the Fibromyalgia Impact Questionnaire (FIQ), the Pain Catastrophizing Scale (PCS), the Tampa Scale of Kinesiophobia (TSK-17), and the Pittsburgh Sleep Quality Index (PSQI) scores. All outcomes were assessed at baseline and 12 weeks.

RESULTS

All of the participants completed the trial. The between-group mean differences at 12 weeks were: NPRS-1.18 points (95% confidence interval [CI] -0.4 to -1.8; η = 0.47; < .001); FIQ-16.21 points (95% CI -10.9 to -22.1; η = 0.58; < .001); PCS total domain -12.5 points (95% CI -7.2 to -17.8; η = 0.61; < .001); TSK-17-6.15 points (95% CI -3.5 to -8.7; η = 0.52; < .001); and PSQI-2.74 points (95% CI -1.4 to 4.0; η = 0.54; < .001). All differences were statistically significant in favor of the novel multicomponent treatment group and had a large effect size.

CONCLUSIONS

In the short term, a novel multicomponent treatment, including graded motor imagery and neuroscience education, was an effective therapeutic intervention for improving clinical outcomes compared with standard treatment in women with FM. Additional studies are needed to support long-term clinical effectiveness in these patients.

摘要

背景

多组分治疗常用。然而,尚无研究将分级运动想象和治疗性神经科学教育纳入纤维肌痛患者的多组分治疗中。本研究旨在比较多组分治疗联合分级运动想象和治疗性神经科学教育与标准治疗对纤维肌痛患者的短期(12周时)效果。

方法

本研究为单盲随机对照试验。65名临床诊断为纤维肌痛的女性被随机(1:1)分为两组。实验组(n = 33)接受一种新的多组分治疗,联合分级运动想象和神经科学教育。对照组(n = 32)接受包括药物治疗和标准医生教育的标准治疗。主要结局是用数字疼痛评分量表(NPRS)评估的疼痛强度。次要结局是纤维肌痛影响问卷(FIQ)、疼痛灾难化量表(PCS)、坦帕运动恐惧量表(TSK - 17)和匹兹堡睡眠质量指数(PSQI)评分的变化。所有结局均在基线和12周时进行评估。

结果

所有参与者均完成试验。12周时组间平均差异为:NPRS - 1.18分(95%置信区间[CI] - 0.4至 - 1.8;η = 0.47;P <.001);FIQ - 16.21分(95%CI - 10.9至 - 22.1;η = 0.58;P <.001);PCS总分域 - 12.5分(95%CI - 7.2至 - 17.8;η = 0.61;P <.001);TSK - 17 - 6.15分(95%CI - 3.5至 - 8.7;η = 0.52;P <.001);PSQI - 2.74分(95%CI - 1.4至4.0;η = 0.54;P <.001)。所有差异均有统计学意义,有利于新的多组分治疗组,且效应量较大。

结论

短期内,一种新的多组分治疗,包括分级运动想象和神经科学教育,与标准治疗相比,是改善纤维肌痛女性临床结局的有效治疗干预措施。需要更多研究来支持这些患者的长期临床有效性。

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