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Pathak A, Rai J, Rai NK, Singh R, Bhatt GC. Effectiveness of rehabilitation strategies in primary fibromyalgia syndrome: A systematic review and meta-analysis. Br J Pain 2023; 17:375-399. [PMID: 37538942 PMCID: PMC10395393 DOI: 10.1177/20494637231168021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/05/2023] Open
Abstract
Objectives The aim of this review was to (1) summarize evidence on the effectiveness of rehabilitation strategies in fibromyalgia syndrome (FMS) and (2) determine the most effective rehabilitation strategy for reducing pain and depression in people with FMS. Data Sources PubMed, Ovid (Sp), and Cochrane search engines were used for identifying relevant studies done up to 1st of July 2022. Study Selection Randomized control trials (RCTs) that have a passive control group and an active control group were included in this review for primary and secondary aim, respectively. The primary outcome measures were pain and depression. Secondary outcome was one from the sleep or fatigue or healthy related quality of life (HRQOL). Data Extraction Two researchers independently selected the studies and extracted the key information. Data Synthesis A total of 25 RCTs were included. Studies with passive control group showed moderate to large positive effects on pain (standard mean difference -0.65, 95% confidence interval -0.93 to -0.38; I2 = 72%) and HRQOL (MD -5.40, 95% CI -10.17 to -0.62; I2 = 74%) but were not statistically significant for sleep, fatigue, and depression. Furthermore, on subgroup analysis studies with a short term protocol showed significant effects on pain only, whereas studies with long term protocols showed positive effects on pain and HRQOL only, but no statistical significance at the time of post-trial follow-up. Studies with active control groups gave non-significant results except where there was mixed exercises, which showed a positive effect (mean difference -4.78, 95% CI -7.98 to -1.57; I2 = 0%) for HRQOL. Conclusion All rehabilitation strategies were effective for pain and HRQOL, and had a marginal effect on depression, sleep, and fatigue but efficacy was not maintained at the time of post-trial follow-up. However, in this review, we could not differentiate any rehabilitation strategies for the best among those used in the included studies.
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Affiliation(s)
- Akash Pathak
- Department of Physiology, All India Institute of Medical Sciences, Bhopal, India
| | - Jyotsana Rai
- Department of Physiology, All India Institute of Medical Sciences, Bhopal, India
| | - Nirendra K. Rai
- Department of Neurology, All India Institute of Medical Sciences, Bhopal, India
| | - Ruchi Singh
- Department of Physiology, All India Institute of Medical Sciences, Bhopal, India
| | - Girish C. Bhatt
- Department of Pediatrics, All India Institute of Medical Sciences, Bhopal, India
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Amigos de Fibro (Fibro Friends): development of an educational program for the health promotion of fibromyalgia patients. Prim Health Care Res Dev 2022; 23:e44. [PMID: 35924710 PMCID: PMC9381164 DOI: 10.1017/s1463423621000773] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Educational practices are indicated to promote the health of people with fibromyalgia in primary health care. We aimed to develop an educative interdisciplinary program intended at the health promotion of individuals with fibromyalgia. METHODS It is a study protocol that was developed following three phases in the city of São Paulo city, Brazil. Qualitative research was carried out, through a focal group, with 12 individuals with fibromyalgia and 10 health professionals. A thematic content analysis was made according to the content proposed by Bardin. RESULTS Fibro Friends is an interdisciplinary program with educational approaches that must be performed in 15 meetings, once a week for 1 h and 20 min. Participants were the following professionals: a Physiotherapist, a Doctor, a Psychologist, a Nutritionist, a Nurse, a Pharmacist/Druggist, a Speech Therapist, an Occupational Therapist, a Naturopath, and a Social Worker. A physical exercise program will also be carried out. The professionals must discuss in a lecture, conversation hearing, and/or group dynamic, about strategies to promote health and pain control in fibromyalgia. CONCLUSION Fibro Friends is a program presenting educational interdisciplinary information to individuals with fibromyalgia, being considered a trend to future care. Fibro Friends is a practical guide, logical, and efficient to patients with fibromyalgia at the basic attention to health.
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Yepez D, Grandes XA, Talanki Manjunatha R, Habib S, Sangaraju SL. Fibromyalgia and Depression: A Literature Review of Their Shared Aspects. Cureus 2022; 14:e24909. [PMID: 35698706 PMCID: PMC9187156 DOI: 10.7759/cureus.24909] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/11/2022] [Indexed: 12/12/2022] Open
Abstract
Fibromyalgia (FM) is a chronic pain syndrome characterized by widespread, persistent pain that lasts more than three months without an evident organic lesion. FM has been considered controversial throughout history due to its validity as a diagnosis being constantly in question. Most patients diagnosed with FM are females. FM has been associated with multiple conditions, including irritable bowel and psychiatric disorders. Among all associated conditions, depression has been frequently found in patients with FM. Studies suggest that depression negatively affects the outcome of patients with FM. Moreover, a bidirectional relation between FM and depression has been depicted: depression increases the risk of FM being diagnosed later in life, as well as FM increases the risk of developing depression. In this article, we discussed aspects that FM and depression share and that might link both diseases, such as certain elements they seem to share in their pathophysiology: predisposing and triggering factors, central sensitization and kindling, areas of the brain implicated in both pain modulation and mood regulation, and hypothalamic-pituitary-adrenal axis (HPA axis) alterations. In addition, we highlighted the prevalence of depression in patients with FM, overlapping symptoms between FM and depression and how to assess them, and treatment strategies that have shown effective management of both conditions when concomitant. Due to the improvement of many aspects of FM when depression is appropriately targeted, screening for depression in patients with FM, despite its difficulty, has been encouraged.
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Affiliation(s)
- Daniela Yepez
- Faculty of Medicine, Universidad Catolica de Santiago de Guayaquil, Guayaquil, ECU
| | - Xavier A Grandes
- Research, Universidad Catolica de Santiago de Guayaquil, Guayaquil, ECU
| | | | - Salma Habib
- Medicine and Surgery, Institute of Applied Health Sciences (IAHS), Chittagong, BGD
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Shen B, Li Y, Du X, Chen H, Xu Y, Li H, Xu GY. Effects of cognitive behavioral therapy for patients with rheumatoid arthritis: a systematic review and meta-analysis. PSYCHOL HEALTH MED 2020; 25:1179-1191. [PMID: 32129673 DOI: 10.1080/13548506.2020.1736312] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
This study aimed to assess the effects of cognitive behavioral therapy on the psychological and physiological health of rheumatoid arthritis patients. An extensive literature search was conducted, using the PubMed, Web of Science, Cochrane Library, Embase, CNKI Scholar, WanFang, and VIP databases, from inception to December2018. The quality of the studies was evaluated by 2 independent authors, according to the basic criteria provided by the Cochrane Handbook for evaluating randomized trials. Meta-analysis was performed with Review Manager 5.3. Six randomized controlled trials met the inclusion criteria of the current study. Using standard mean differences (SMD) and 95% confidence intervals (CI), our results showed that cognitive behavioral therapy could significantly reduce levels of anxiety (SMD = -0.30, 95% CI [-0.52, -0.09], P= 0.005) and depression (SMD = -0.48, 95% CI [-0.70, -0.27], P< 0.00001), and relieve fatigue symptoms (SMD = -0.35, 95% CI [-0.60, -0.10], P= 0.006) in rheumatoid arthritis patients.This is the first known assessment of the efficacy of cognitive behavioral therapy on rheumatoid arthritis patients using meta-analysis. Large-scale randomized controlled trials need to be implemented to further explore this issue.
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Affiliation(s)
- Biyu Shen
- Center for Translational Pain Medicine, Institute of Neuroscience, Soochow University , Suzhou, China.,Nursing School of Soochow University, Soochow University , Suzhou, China.,Department of Nursing, The Second Affiliated Hospital of Nantong University , Nantong, China
| | - Yongchang Li
- Center for Translational Pain Medicine, Institute of Neuroscience, Soochow University , Suzhou, China
| | - Xian Du
- Nursing School of Nantong University, Nantong University , Nantong, China
| | - Haoyang Chen
- Nursing School of Nantong University, Nantong University , Nantong, China
| | - Yucheng Xu
- Center for Translational Pain Medicine, Institute of Neuroscience, Soochow University , Suzhou, China
| | - Huiling Li
- Nursing School of Soochow University, Soochow University , Suzhou, China
| | - Guang-Yin Xu
- Center for Translational Pain Medicine, Institute of Neuroscience, Soochow University , Suzhou, China
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Evcik D, Ketenci A, Sindel D. The Turkish Society of Physical Medicine and Rehabilitation (TSPMR) guideline recommendations for the management of fibromyalgia syndrome. Turk J Phys Med Rehabil 2019; 65:111-123. [PMID: 31453551 PMCID: PMC6706830 DOI: 10.5606/tftrd.2019.4815] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Accepted: 05/23/2019] [Indexed: 11/21/2022] Open
Abstract
In the present study, we aimed to establish a national guideline including recommendations of the Turkish Society of Physical Medicine and Rehabilitation (TSPMR) for the management of Fibromyalgia (FM) syndrome. This guideline was built mainly in accordance with the 2017 revised European League Against Rheumatism (EULAR) guideline recommendations for the management of FM. A total of 46 physical medicine and rehabilitation specialists were included. A systematic literature search was carried out in PubMed, Scopus, Cochrane, and Turkish Medical Index between 2000 and 2018. Evidence levels of the publications were evaluated, and the levels of recommendation were graded on the basis of relevant levels of evidence, The Assessment of Level of Agreement with opinions by task force members was established using the electronic Delphi technique. Recommendations were assessed by two Delphi rounds and 7 of 10 points were deemed necessary for agreement. The treatment recommendations were classified as non-pharmacological therapies (6 main items), pharmacological treatments (10 items), and complementary therapies (5 items). These were recommended in the light of evidence, depending on the clinical and general condition of each patient. This is the first national TSPMR guideline recommendations for the management of FM in Turkey. We believe our effort would be helpful for the physicians who are interested in the treatment of FM.
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Affiliation(s)
- Deniz Evcik
- Department of Physical Medicine and Rehabilitation, Guven Hospital, Ankara, Turkey
| | - Ayşegül Ketenci
- Department of Physical Medicine and Rehabilitation, Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Dilşad Sindel
- Department of Physical Medicine and Rehabilitation, Istanbul University Istanbul Faculty of Medicine, Istanbul, Turkey
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Köllner V, Bernardy K, Greiner W, Krumbein L, Lucius H, Offenbächer M, Sarholz M, Settan M, Häuser W. Psychotherapie und psychologische Verfahren beim Fibromyalgiesyndrom. Schmerz 2017; 31:266-273. [DOI: 10.1007/s00482-017-0204-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Vas J, Santos-Rey K, Navarro-Pablo R, Modesto M, Aguilar I, Campos MÁ, Aguilar-Velasco JF, Romero M, Párraga P, Hervás V, Santamaría O, Márquez-Zurita C, Rivas-Ruiz F. Acupuncture for fibromyalgia in primary care: a randomised controlled trial. Acupunct Med 2016; 34:257-66. [PMID: 26879181 DOI: 10.1136/acupmed-2015-010950] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/23/2015] [Indexed: 12/18/2022]
Abstract
OBJECTIVES To evaluate the efficacy of an individualised acupuncture protocol for patients with fibromyalgia. METHODS Randomised controlled multicentre trial, blinded to participants and to data analysts. Conducted in three primary care centres in southern Spain. A total of 164 participants aged over 17 years and diagnosed with fibromyalgia were enrolled in this trial; 153 participants completed the study. Participants were randomly assigned to either the real intervention (individualised acupuncture, IA) or the sham intervention (sham acupuncture, SA). In both the IA and SA groups, one session per week (lasting 20 min) was provided, in addition to usual pharmacological treatment. The primary outcome was change in pain intensity at 10 weeks. RESULTS Intention-to-treat analysis revealed that the decrease in pain intensity at 10 weeks was greater (p=0.001) in the IA group (-41.0%, 95% CI -47.2% to -34.8%) than in the SA group (-27.1%, 95% CI -33.2% to -20.9%). During the follow-up period, significant differences (p<0.01) in favour of the IA group persisted at 12 months (IA: -19.9%, 95% CI -24.6% to -15.1%; vs SA: -6.2%, 95% CI -11.2% to -1.2%). CONCLUSIONS Individualised acupuncture treatment in primary care in patients with fibromyalgia proved efficacious in terms of pain relief, compared with placebo treatment. The effect persisted at 1 year, and its side effects were mild and infrequent. Therefore, the use of individualised acupuncture in patients with fibromyalgia is recommended. TRIAL REGISTRATION NUMBER ISRCTN60217348.
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Affiliation(s)
- Jorge Vas
- Pain Treatment Unit, Doña Mercedes Primary Health Centre, Dos Hermanas, Spain Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Andalucía, Spain
| | - Koldo Santos-Rey
- Pain Treatment Unit, Doña Mercedes Primary Health Centre, Dos Hermanas, Spain
| | | | - Manuela Modesto
- Pain Treatment Unit, Doña Mercedes Primary Health Centre, Dos Hermanas, Spain
| | - Inmaculada Aguilar
- Pain Treatment Unit, Doña Mercedes Primary Health Centre, Dos Hermanas, Spain
| | - M Ángeles Campos
- Primary Health Centre Las Cabezas de San Juan, Las Cabezas de San Juan, Spain
| | | | - Milagrosa Romero
- Primary Health Centre Las Cabezas de San Juan, Las Cabezas de San Juan, Spain
| | | | - Vanesa Hervás
- Mental Health Services, Virgen de Valme University Hospital, Sevilla, Spain
| | - Olalla Santamaría
- Mental Health Services, Virgen de Valme University Hospital, Sevilla, Spain
| | | | - Francisco Rivas-Ruiz
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Andalucía, Spain Research Unit, Agencia Sanitaria Costa del Sol, Marbella, Spain
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